Instead of “pandering to populism” politicians should listen to the evidence, the editorial said.

The government said the plans were part of a wide range of preventive measures.

Prime Minister Gordon Stalinist Brown announced plans to “deep clean” hospitals ward by ward over the next year to return hospitals to the state they were in when they were built.

His comments followed proposals from Health Secretary Alan Johnson for a new dress code for NHS staff which would advise against long-sleeved coats and ties for doctors as they can become contaminated.

But The Lancet said a government working group had found no conclusive evidence that uniforms or other work clothes posed a significant hazard in terms of spreading infection.

Instead the focus should be on disinfection of high touch surfaces rather than deep-cleaning wards to get rid of visible dirt, the journal said.

The editorial said: “Brown also plans to double the number of hospital matrons, to check on ward cleaning, and accost doctors wearing long sleeves.

“They would be better employed making sure doctors, nurses and visitors wash their hands properly, the proven way to stop hospital acquired infections,” the editorial stated.

Professor Richard James, director of the Centre for Healthcare Associated Infections at the University of Nottingham agreed the evidence on transmission of infection from clothing such as long sleeves was not clear but short sleeves may encourage staff to wash their hands properly.

He added: “The main route of transmission of MRSA is person-to-person contact and this will be affected little by deep cleaning.

“In contrast, Clostridium difficile is transmitted by contact with faecal contamination so it may be more effective here.”

He said in addition to hand washing, other useful strategies would be screening patients for MRSA on admission, regular use of hydrogen peroxide vapour generators to kill bugs in the hospital environment and educating patients and visitors on ways they can reduce risk.

Chief Nursing Officer, Professor Christine Beasley said there was no single solution and the new proposals were part of a wider set of measures to reduce hospital-acquired infections.

She agreed that there was no evidence that uniforms themselves pose a significant risk of transmitting infections but said long sleeves and watches “get in the way of washing and decontaminating the hands, wrists and forearms”.

“Clean and tidy hospitals and staff are very important to patients,” she said. “We make no apology for asking hospitals to take every reasonable measure to reduce infection and increase patient confidence that this is an issue the NHS is taking seriously.”

Dr Mark Enright, an expert in molecular epidemiology at Imperial College, London said deep cleaning would be a waste of resources and an inconvenience to patients and staff.

“MRSA is a major problem in the UK because it is present, mostly unknowingly, in patients and staff.

“Interrupting the chain of transmission from these people to new hosts should be the main focus of infection control, not attempts at the sterilisation of floors and windows.”

From:
http://news.bbc.co.uk/1/hi/health/7016425.stm

On Sept 26, 2007 Health Direct posted: Gordon Stalinist Brown pledge on NHS funding and MRSA as hospitals are to use new deep clean techniques in which wards are stripped and subjected to steam cleaning and high strength disinfectant in an attempt to reduce outbreaks of MRSA and C difficle superbugs.

Earlier this year (11 Jan 07) Health Direct also posted 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 labour government memo said.

The cross-party group of peers said the UK was lagging behind western Europe. It also called for advice to pregnant women and young children not to eat peanuts to be withdrawn. The labour government said the findings would be considered.

It comes after the Commons Health Committee criticised the lack of services in 2004.

The number of people suffering allergic reactions has trebled in the last 20 years with a third of the population estimated to suffer at some point in their lives.

Each year over 6,000 people in England are admitted to hospital – a quarter of these with anaphylaxis which is a severe and potentially life- threatening reaction involving breathing difficulties.

Allergic reactions are caused by substances in the environment known as allergens, of which the most common are pollen from trees and grasses, house dust mites, wasps, bees and food such as milk and eggs.

The Lords report called for specialist allergy centres to be set up in each region similar to the models operating in Denmark and Germany.

At the moment there are over 90 clinics, but only six are led by allergy consultants that can treat and diagnose the full range of conditions.

The report said GPs and other health professionals had poor knowledge of allergies and recommended allergy training becomes a more important component of medical training.

The committee also heard evidence that abstaining from eating peanuts in pregnancy and in the early years may be increasing the risk of allergies developing and as a result called for a change to government guidance.

The peers said food warnings – which commonly involve the catch-all term “may contain nuts” – need to be clearer with details of the specific amounts of allergen contained within the product.

The report also called for better training for school staff to deal with allergies.

The government currently advises pregnant women and young children not to eat peanuts because of the risk of allergic reactions. But the House of Lords committee said this should be withdrawn after hearing evidence from experts that abstaining may increase the risk of developing an allergy.

The Department of Health says the guidance is based on expert advice, but it will look at it after hearing form a Food Standards Agency allergen review

Committee chairman Baroness Finlay said: “We have a severe shortage of expert medical provision to deal with allergies. “The government must now take steps to deal with this problem.”

Jules Payne from the British Allergy Foundation agreed with the findings. She said: “The problem is clearly at epidemic levels, which the House of Lords report has recognised.

“It also recognises that there’s an appalling lack of allergy services within the NHS in the UK. Now at the moment we’ve got people who wait for months, if not years, for a referral to see an allergy specialist, so that really does need addressing.”

Muriel Simmons, of the Allergy UK support group, welcomed the report, saying allergy services needed improving.

But she added: “Similar recommendations were made in 2004, but there has been nothing in the last three years to suggest that the government is taking serious steps to ease the burden of allergy sufferers.”

A Royal College of Physicians spokeswoman said: “A post code lottery prevails.”

From:
http://news.bbc.co.uk/1/hi/health/7012794.stm

Health Direct observes that one of the limitations of centralist state control over any industry is that events constantly arise that don’t meet the pre proscribed targets regime.

With Stalinist Brown’s current supposed focus on MRSA superbugs, cancer and 18 week waiting times, the dramatic rise of allergy sufferers has missed his radar. Accordingly their plight will continue to worsen until he comes up with some more dictats.

The move comes as Gordon Brown seeks to make the state of the National Health Service a top priority and will be funded with £50 million from strategic health authority budgets.

Deep cleaning will be used to target the superbug Clostridium difficile, which has proved more difficult to reduce than MRSA.

Hospitals are expected to begin the programme from December, although health professionals said that basic hygiene, such as handwashing and other cleanliness, was the key to eradicating hospital-acquired infections.

Mr Brown announced the move in a column in a Sunday newspaper, writing: “A ward at a time, walls, ceilings, fittings and ventilation shafts will be disinfected and scrubbed clean.”

Mike Penning, a Conservative health spokesman, said: “Thousands of relatives who have lost loved ones to hospital diseases each year will be asking, ‘What has Gordon Brown been doing for the past ten years?’”

From:
http://www.timesonline.co.uk/tol/news/politics/article2518134.ece

As for the prospective of an imminent general election- don’t hold you breath as Brown like any bully is running scared. He hasn’t got the funds nor the candidates in place

Sir Bob Worcester, of Mori, is unconvinced. “The polls are being so misread that I almost weep reading some of this nonsense,” he said. “There is absolutely no way this guy is going to call an election.”

Health Direct notes that the Stalinist’s trite idea of deep cleaning hospitals over Christmas is as fatuous as John Not Fit For Purpose Reid’s broken promise of halving the number of MRSA cases. The government hasn’t a clue how many people have MRSA now- up until last month they only counted cases in the over 65 year olds.

Also Brown cynically doesn’t promise clean wards. All he mentions is cleaner hospitals. Until he develops a zero tolerance towards dirty hospitals we are all going to suffer.

Earlier this year (11 Jan 07) Health Direct also posted 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 labour government memo says.

On 2 May 07 Health Direct posted that Deadly NHS superbugs continue rising with C difficile again up when more hospital patients in England are getting the deadly Clostridium difficile bug, figures show.

Health Protection Agency (HPA) data showed 55,681 cases were reported among over 65s in 2006 – up 8% in a year. MRSA cases continued their downward trend, but they are not falling quickly enough to meet Labour’s target next year.

Much of the money is concentrated in a minority of the 67 foundation trusts, and some of it appears to reflect prepayment for work not yet done.

The surplus exceeds the £1bn being forecast for the rest of the NHS. Foundation trusts account for only about a third of acute and mental health spending.

Some of the cash is simply working capital but a significant part of it could be invested in new or improved services.

Reporting the first quarter results, Monitor, the foundation trust regulator, said their financial strength put foundation trusts “in a good position to invest in reshaping services for the benefit of their communities”.

But they were reluctant to do so yet because it was not clear what primary care trusts – the chief commissioners of care for patients – wanted to buy.

“There is an increasingly urgent need for clear indications from commissioners about their healthcare purchasing intentions,” said Bill Moyes, Monitor’s chairman. Without certainty about long-term requirements, trust boards were reluctant to invest.

The lack of clarity, he said, is “having an impact on the timing of significant investment decisions”.

But while Monitor says the lack of investment is not all the fault of foundation trusts, it also takes them to task for not using some of the money to invest in better environments for patients and ensuring they hit healthcare targets.

Twenty-two of the 67 are behind targets for the reduction of hospital-acquired infections, and some are behind on other government targets. A significant number are failing to make progress, having forecast in their annual plans that they would.

With the judgement of foundation trusts’ performance relying on a degree of self-certification, Mr Moyes warned that Monitor would put independent review teams into hospitals where boards appeared to make overly optimistic progress predictions.

The Foundation Trust Network – the body that represents foundation trusts – said it would be “concerned” if that “marked a move away from its role as a risk-based regulator towards direct performance management”.

From:
http://www.ft.com/cms/s/0/e351a596-68a2-11dc-b475-0000779fd2ac.html

The revelation from Monitor that fudged financial fiddling is still rife in the NHS reminds Health Direct of our posting on Patricia Hewitt’s distorted financial observation.

On June 07, 2007 Health Direct posted: NHS figures show 510m Pound annual surplus as the NHS apparently made a small surplus in 2006/07, figures unveiled by Health Secretary Patricia Hewitt showed.

The NHS recorded a surplus of £510 million, the data showed. However, 22% of NHS organisations are still in debt and unable to balance their books. The gross deficit of the NHS stood at £911 million, down from £1.3 billion in 2005/06.

To offset the deficit and create the surplus, regional health bosses have been building up cash reserves.

They took millions of pounds from primary care trust (PCT) budgets and held back £450 million from training and public health budgets.

Dr Jonathan Fielden, chairman of the British Medical Association’s Consultants’ Committee, said: “While the NHS may be in credit today, the journey to balance the books has wreaked havoc on the NHS and is a return to boom and bust health economics.

Professor Janet Finch, chair of the Universities UK health and social care policy committee, said: “On the face of it, today’s announcement is good news. But take a closer look at the Strategic Health Authorities’ ‘strategic reserves’ and they seem to consist of funds from the education and training budgets. If things continue in this way, it will be a disaster for patient care and health service morale. “

The huge sum is detailed in confidential data from the NHS Litigation Authority, which handles most of the legal claims for medical negligence against the health service in England.

It shows that the organisation has been fighting a barrage of legal cases in which the compensation being sought by families amounted to a total of £4.49bn. Three-quarters of that, £3.3bn, relates to incidents in which a child has developed cerebral palsy, brain damage which is often caused by being starved of oxygen during birth, and been left disabled. A further £739m involves claims over what the NHSLA calls ‘other brain damage’.

The disclosure that such large amounts of NHS cash could potentially have to be spent settling such claims has reopened the debate about the quality and safety of Britain’s maternity services.

Professor Sabaratnam Arulkumaran, the incoming president of the Royal College of Obstetricians and Gynaecologists, last night accused hospitals of putting babies and pregnant women at unnecessary risk by not employing enough senior staff on labour wards.

The number of consultants and midwives at up to half of hospitals ‘aren’t adequate’ and women using those hospitals are at greater risk of a problem arising, Arulkumaran said.

‘The staffing numbers for consultants aren’t adequate at 40 to 50 per cent of hospitals in the UK, though I’m sure that will apply to midwives too. The risk incidence must be greater at those hospitals,’ he said. ‘There’s a direct connection between staffing levels and the risk for patients. We know that the main cause of risk incidence is inadequate personnel.’

In a speech on 3 October Arulkumaran will say that, despite improvements, much more needs to be done. The number of consultants needs to increase immediately from 1,600 to at least 2,100 and ideally 2,500, in order to give women the best possible maternity care, he said. Money used for litigation would be better spent hiring more senior staff.

Next month the royal college, which represents Britain’s 5,500 specialist maternity doctors, and other specialists involved in maternity care will demand that the NHS significantly improves staffing levels.

A hard-hitting joint report, Safer Childbirth, will argue that the more babies a hospital delivers, the higher the level of cover it should provide. Any hospital which has at least 6,000 births a year should have a consultant obstetrician on duty around the clock, and until 10pm daily at those which deliver at least 5,000 babies, rather than just during the day as happens in most places at the moment, said Arulkumaran.

In his speech the royal college president will cite data showing that more than one in 100 births in England, Wales and Northern Ireland ends with the baby’s death in the womb, at delivery or within seven days of birth.

He will also highlight National Patient Safety Agency findings that the largest number of babies who die do so between midnight and 8am, a period when few hospitals have a consultant on duty.

The Department of Health defended the maternity services in England. Litigation costs could be high because lifetime care was expensive, it said. Gwyneth Lewis, its chief adviser on maternity care, said: ‘Due to the skill and expertise of our midwives and doctors, England is one of the safest places to have a baby.

There is no hard evidence to suggest that up to half of all maternity units are unsafe.’ He added that the government had overseen ‘a major expansion in the number of consultants’.

But Karlene Davis, general secretary of the Royal College of Midwives, said: ‘The service is at breaking point.’

From:
http://observer.guardian.co.uk/uk_news/story/0,,2175218,00.html

The plight of the midwifery profession will not be news to Health Direct readers: 5,000 extra midwives are needed to cope with the increase in birthrate RCM find On 3 Sept 2007- Health Direct posted- Nearly 5,000 more midwives will be needed by 2012 if the labour Government is to meet its target for maternity services, the Royal College of Midwives said.

The college has increased its target from 3,000 because of a rising birthrate, which has exceeded government estimates, and a reassessment of present shortages.

Ben Page, public affairs managing director, said that the public’s expectations about the economy and whether public services would improve had returned to the level they stood at when Tony Blair left office.

The polling company’s quarterly “delivery index” has long been used in Downing Street to track the public’s views on public service reform.

In May, as Gordon Brown prepared to take over as prime minister, fractionally more of those interviewed believed the government’s policy would improve the state of the economy in the long term.

By this month the net score between those who believe things will get better and those who believe they will get worse was minus seven.

On public services generally, those who believe things will get worse outnumber those who believe they will get better by 22 percentage points, against 13 in May.

That is chiefly due to expectations over the future performance of the National Health Service declining from a net score of minus 14 to minus 19.

That is nothing like as bad as in September last year, when the proportion who believed services would get worse outnumbered those who believed they would get better by 32 points.

“The NHS remains a key concern for the government,” Ipsos Mori said. But “crime, immigration and pensions are [also] key challenges for the Brown government – most of the public are currently pessimistic about these”.

A mere 20 per cent are confident that the government will manage immigration well, 23 per cent that they will do the right thing on pensions and 23 per cent that crime will reduce over the next few years.

From:
http://www.ft.com/cms/s/0/de5492aa-657e-11dc-bf89-0000779fd2ac.html

The dip in Stalinst Brown’s fortunes were highlighted in Health Direct’s post on 18 Sep 2007-
Labour lead halved as voters feel pinch when Gordon Stalinist Brown’s opinion poll lead has halved in the space of a month, making an early election much less likely, according to the latest Sunday Times-YouGov poll of more than 1,800 people.

The Government is considering at what age girls should be vaccinated against human papillomavirus (HPV) amid concern that immunising pre-teens would encourage under-age sex.

Research by the Health Protection Agency found that, from the age of 14, the risk of HPV infection rises sharply. Up to 14, less than five per cent are infected with HPV.

The report said the findings are likely to be an underestimate of infection rates because of problems with the test and the figures should be considered conservative.

There are almost 3,000 new cases of cervical cancer in the UK each year and another study by the agency found that vaccination could prevent 70 per cent of them.

But the vaccines must be administered before infection with HPV and so it is recommended to introduce an immunisation programme for girls from the age of 12.

The agency investigated 1,483 girls from the age of 10 to 29 and results were presented at its conference in Warwick yesterday.

Professor Pat Troop, chief executive of the agency, said: “This study is a valuable addition to our understanding of HPV infection.”

From:
http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2007/09/20/nvirus120.xml

It says that it is committed to buying £1.4 billion of services from independent surgical treatment centres (ISTC), including hip replacements, cataract surgery and diagnostics, during the initial phase of this programme.

However, according to the Department of Health, the scheme is running at 16 per cent below capacity in value terms, meaning that only £1.18 billion of services are provided by private hospitals for NHS patients.

The remaining £222 million of public money is being paid regardless because most of the hospitals’ operators have negotiated “take or pay” clauses in their contracts with the NHS. It means that they are paid the same sum regardless of whether the NHS sends enough patients.

A spokesman for the Department of Health agreed: “The whole programme utilisation of the wave-one ISTC programme is currently 84 per cent.”

The department declined to comment on capacity at individual centres, saying only that “specific details about individual schemes and their contracts are commercially sensitive”.

However, The Times has learnt of several individual ISTCs that have been operating well below capacity.

Mercury Health’s St Mary’s NHS Treatment Centre in Portsmouth is running at just 80 per cent of capacity, according to its owner, Care UK. It was contracted originally to perform 435,000 individual procedures for the NHS over five years. On current trends, it is expected to perform tens of thousands fewer than this.

Another ISTC, Capio Healthcare’s centre in Reading, was also undershooting significantly, although it has increased patient numbers recently and in July was operating at 90 per cent of capacity.

Graham Kendall, spokesman for the NHS Partners Network, the organisation representing independent healthcare providers, said that take-or-pay clauses were common and were crucial at the programme’s outset to justify the initial investment of building and equipping the centres.

Some insiders concede that they have damaged the industry’s reputation and in the new contracts under discussion for the second phase of the programme, due to begin in 2010, the clauses will be dropped, Mr Kendall said.

Privately, independent hospital operators blame poor estimates of numbers of patients when contracts were signed, as well as vested interests in the NHS that have made some trusts reluctant to refer patients to private hospitals. Institutional opposition from unions and other elements within the NHS hierarchy have proved another stumbling block, they say.

From:
http://business.timesonline.co.uk/tol/business/industry_sectors/health/article2485086.ece

Health Direct has witnessed many NHS cockups by the Department of Health, but these no work but pay clauses seem farcical in the extreme.

Labour rewards failure as NHS pays private companies for failed PFI bids On 8 May 07 Health Direct posted: Private companies that fail to win hospital building contracts are set to pocket millions of pounds in “compensation” from the NHS.

Hospitals negotiating private finance initiative (PFI) schemes could be forced to pay almost 2 per cent of the total contract costs to short-listed private companies which fail to secure deals, under proposals being discussed by the Department of Health (DoH).

On Aug 26, 2005 Health Direct also posted: Nearly 70,000 paid for diagnostic scans go unused
as the NHS is failing to use thousands of extra diagnostic scans bought by the Department of Health from the private sector last year.

More than half of the MRI (magnetic resonance imaging) scans – almost 70,000 – that the DoH bought on behalf of the NHS from Alliance Medical last year have yet to be used.

While Labour enjoys a five-point lead over the Conservatives, it has slipped three points from 42% to 39% while the Tories have climbed from 32% to 34%. The Liberal Democrats, on the eve of their party conference, have edged up from 14% to 15% but remain well down on their 23% share of the vote in the May 2005 general election.

One threat for Brown is over the crisis in the financial markets, which led to the Bank of England’s rescue of Northern Rock last week. YouGov asked about the outlook for people’s finances over the next 12 months.

Only just over a quarter, 26%, said their finances would remain healthy, compared with 50% who said they would be under some pressure and 21% who predicted that they would be under a lot of pressure.

Even before the crisis, families were being squeezed by the five interest rate rises since August last year, higher energy costs and increases in food prices. Earnings have risen at a slower rate than prices.

According to the poll, 46% of people say they will spend less on non essential items over the next 12 months, against 12% who expect to spend more. Further increases in mortgage rates could add to the pressure, the poll suggests, with 16% expecting to face serious problems.

Another potential problem for Brown is over the new European Union reform treaty, which the government is expected to accept in the coming months. He has rejected a referendum on the treaty claiming it differs from the original EU constitution rejected by French and Dutch voters.

But, with some Labour MPs, the trade unions and the Tories backing calls for a referendum, the prime minister appears to be setting his face against public opinion. By 60% to 16%, voters think there should be a referendum on the treaty. Worryingly for Brown, this is also the strong view among Labour supporters, who back a vote by 47% to 28%.

Because Labour promised a referendum on the original constitution, voters believe, by 61% to 12%, that Labour would be breaking its pledge if it refuses to hold one on the treaty. As for how people would vote in such a referendum, more than a third don’t know, but of those who declared a view, 41% would reject it, with 17% in favour.

The poll also examined attitudes to the National Health Service, following Sir Derek Wanless’s report last week, which said that the NHS had not improved enough in return for the 50% real increase in spending poured in since 2002.

Only 6% think the NHS has got “much” better in recent years, while 21% say it is slightly better. In contrast, 22% say it is slightly worse and 19% much worse. By 68% to 18% they say taxpayers have not got good value for the extra money.

From:
http://www.timesonline.co.uk/tol/news/politics/article2461294.ece

Staff will also be ordered to ditch their ties, wrist watches and jewellery amid fears that they prevent doctors and nurses from washing their hands properly.

The new “bare below the elbows” dress code, which hospitals in England will have to enforce by next January, will be one of a series of measures announced by Mr Johnson to cut the rate of hospital-acquired infections such as MRSA.

They come only weeks after a report found that British hospitals were among the worst in Europe for superbugs, trailing behind countries including Slovakia, Hungary, Poland and the Czech Republic.

The Health Secretary will also announce that matrons will be given new powers to help the Government to meet the target it set three years ago of cutting MRSA rates by half by next year.

They will report directly to their hospital boards four times a year to ensure that their views are heard by senior management.

The measures follow a warning from doctors last month that the Government would not meet its MRSA target because of poor hospital management practices. Please see also the Health Direct posting below.

An editorial in The Lancet in August blamed hospital managers for failing to train staff in antibacterial prescribing, and providing inadequate hand-washing and isolation facilities.

Patient groups welcomed the initiatives but said they were concerned that they would not improve hygiene conditions in hospitals sufficiently.

“At the moment, about 60 per cent of doctors don’t wash their hands between patients,” said Derek Butler, the chairman of MRSA Action UK.

“We applaud Mr Johnson for his commitment to cutting infection rates but we think the biggest challenge is getting hospital staff to improve their standards of hygiene. If the Government can’t do that, they are going to struggle to cut MRSA rates.”

Hospitals will also be issued with new guidance about isolating patients who become infected with C. difficile or MRSA.

This will mean more single rooms being used and more “cohort nursing” – where patients suffering from the same infection are nursed together.

In addition, hospital chief executives will have to report all MRSA and C. difficile infections to the HPA, or face a fine.

Dame Karlene Davis, the general secretary of the Royal College of Midwives, welcomed the Government’s commitment to cutting infection rates.

“One of the biggest killers of child-bearing women was puerperal sepsis. This has improved significantly with the recognition of the need for hand hygiene to reduce cross-infection,” she said.

“This situation remains as relevant today as it did many decades ago and the RCM wholly supports any measure which seeks to avoid infection.”

From:
http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2007/09/17/nhealth117.xml

Health Direct applauds these moves.There has to be a zero tolerance approach to tackling MRSA superbugs. It is shocking that, after countless government initiatives, the number of hospitals failing to protect patients from these infections has quadrupled.

It’s a shame though that these measures will not take effect until January next year. Based on current statistics it will mean another 12,000 contracting these killer diseases unnecessarily.

Hospitals losing fight to defeat MRSA, C Difficile superbugs- health watchdog warns was posted by Health Direct on Tue 19 Jun 07- One in four NHS trusts is failing the latest labour government targets on cleanliness and tackling superbug infections.

Figures released by the Healthcare Commission show that six out of ten trusts in England have reported failing one or more of the twenty four “core standards” on all aspects of care, on which they are assessed by the NHS watchdog.

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.

In a letter to the Financial Times editor (but to their credit buried by the FT in it’s website) was published:

From Ben Bradshaw MP.

Sir, Contrary to your report “NHS to miss treatment wait targets” (September 10), we are confident of achieving the historic milestone of a maximum

18-week wait from GP to treatment by next year. Indeed, in some parts of the country this is already happening.

Nor has the government gone cool on the contribution made by the independent sector in helping reduce waiting and extend choice.

We recently approved another independent provider to boost services in Lancashire and Cumbria and expect to make further such approvals in the months to come.

Ben Bradshaw,
Health Minister

http://www.ft.com/cms/s/0/8afc0168-5f36-11dc-837c-0000779fd2ac.html

Health Direct can not believe the stupidity of Ben Bradshaw’s statement which he had to write to counter the Financial Times’s damming research:
“Confident of achieving 18-week wait promise”- not by a quarter of the population,
“in some parts of the country this is already happening”- even the Financial Time article states teh blooming obvious that half the country is covered
“recently approved another independent provider”- splendid, but what aboout the rest of the country?

Health Direct covered the research NHS to miss 18 week treatment waiting times targets- by the proverbial country mile on Mon 10 Sept 2007- The National Health Service is set to fall well short of its target of ensuring that no one waits more than 18 weeks from seeing a family doctor to completion of treatment, latest official figures predict.

But while the figures point to waits for diagnostic tests being a key contributor to delays in treatment, private sector contracts originally designed to deliver 1.5m extra tests a year are still being held up by an ever lengthening review in the Department of Health of whether they should go ahead.

in January, when the figures were first collected, 47 per cent of patients completed their treatment within 18 weeks. By June that figure had risen to 54 per cent – a 7 percentage-point improvement in six months.

But with only 18 months to go, progress at the same rate would still leave 25 per cent of patients waiting more than 18 weeks. In June, 25,000 of the patients treated had waited more than a year, and almost 75,000 more than six months.

Anthony Harrison, an academic at the King’s Fund think-tank who is following the 18-week target, said: “With previous targets to cut waits for surgery there has always been an acceleration towards the end, with the figures improving faster as the deadline nears.”

“But this target is different. It cannot be achieved just by doing more of the same – more operations or more outpatient appointments. It requires changes to the way services are provided so that, for example, scans and tests can be performed and a decision made on treatment on the same day. That is organisationally much more difficult to achieve.”

As an example of practical realities, Alan Johnson has just confirmed that as more data is being compiled, in the actual rate of treatment in Gloucestershire has gone DOWN from 51% in March 2007 to 48% in June 2007. Courtesy of:
http://www.theyworkforyou.com/wrans/?id=2007-09-12a.155305.h

For more information on the Barking Ben Bradshaw Health Direct provides details from Wikipedia and They Work for You:

Ben Bradshaw MP

Benjamin Peter James Bradshaw (born 30 August 1960 in London) is a British politician and the Labour Member of Parliament for Exeter

The Minister of State in the Department of Health and Minister for the South West was one of the first openly gay MPs.

In Parliament Bradshaw introduced the Pesticides Act in 1998 [1], which gave more powers to inspectors. He became a Parliamentary Private

Secretary to the Minister of State at the Department of Health John Denham in 2000. After the 2001 General Election Bradshaw entered Tony Blair’s government as the Parliamentary Under Secretary of State at the Foreign and Commonwealth Office. Only days after being appointed to the Foreign Office he had to answer questions following the terrorist attacks of 11 September 2001.

Bradshaw became the Deputy to the Leader of the House of Commons Robin Cook in 2002, and was an Under Secretary of State at the Department of Environment, Food and Rural Affairs from 2003 until 2006, when he was made a Minister of State at the same department.

On 28 June 2007 he was moved to become a Minister of State in the Department of Health and was also given the responsibility of being Minister for the South West.

His support for the Iraq War proved unpopular amongst many in a seat with a high student population.

When first elected in 1997, Ben Bradshaw was one of the first gay MPs to be out at the time he was initially elected, along with Stephen Twigg.

He lives with his partner, Neal Dalgleish, who is a BBC producer on 24 June 2006, Bradshaw and his partner undertook a civil partnership ceremony, the first MP to do so . He does not own a car; instead he frequently cycles. His brother is Jonathan Bradshaw, CBE, Professor of Social Policy at the University of York.

http://en.wikipedia.org/wiki/Ben_Bradshaw

How Ben Bradshaw has voted on key issues since 2001:

* Has never voted on a transparent Parliament.
* Voted moderately for introducing a smoking ban.
* Voted strongly for introducing ID cards.
* Voted very strongly for introducing foundation hospitals.
* Voted strongly for introducing student top-up fees.
* Voted very strongly for Labour’s anti-terrorism laws.
* Voted very strongly for the Iraq war.
* Voted very strongly against investigating the Iraq war.
* Voted very strongly for replacing Trident.
* Voted moderately for the fox hunting ban.
* Voted strongly for equal gay rights.

http://www.theyworkforyou.com/mp/ben_bradshaw/exeter

Yet, like all systems of centralised planning, this one has proved inefficient, inflexible and inhumane. It is an object lesson in the dangers of the ever-growing capture of hitherto autonomous professions and institutions by the state.

Like most outsiders (and many insiders), I find it impossible to understand precisely what has happened, but having a daughter-in-law at the sharp end has helped. The outlines at least are clear. They also offer a classic example of how a government-run monopoly behaves.

What, then, lay behind the fiasco that Modernising Medical Careers has become? There appear to be three causes.

First, the department resolved on seizing control over medical training from the professional colleges and consultants, who happen to know what doctors can (and should be able to) do.

Second, the bureaucrats made a mess of manpower planning: in England, for example, 29,200 doctors have been competing for the 15,600 training places they arbitrarily decided to create.

Third, they chose this moment of upheaval to introduce an inflexible and characteristically defective computerised system (the Medical Training and Application System) to allocate doctors across the country.

As always, reasons existed for the shift to central planning: critics complained that the traditional apprentice system was riddled with favouritism; and the European Union’s working time directive sharply cut hours for junior doctors, which not only necessitated a greater number of them, but also reduced the experience each would gain from a given period of training.

Some reform was presumably necessary. But this one is an object lesson in what happens when the government introduces a “big bang” shift to a centralised, computer-driven system. A bureaucratic monster replaced what had been a moderately flexible, albeit imperfect, system.

In the old system hospitals hired senior house officers; now they are sent them like a parcel of slaves. In the old system, if doctors did not get a job first time they could keep on applying; in the new system, they were to be given just one chance a year.

In the old system, if they made a wrong choice it was relatively easy to change; in the new system, doctors must decide early and are then stuck with the consequences. In the old system, hospitals could change the mix of junior doctors relatively easily; in the new system, nobody knows what flexibility will exist.

Allocations to training posts are within huge geographical areas. But doctors are dispatched, like so much meat, to one hospital. Do they live hours away? That is tough luck. Do they have a partner, or even children? That is just tougher luck. Do they wish to switch hospital or sub-speciality? They must be joking. Do they wish to know the terms and conditions of their employment before arriving? They must reallybe joking.

To put the point bluntly, these highly trained professionals, on whom you may depend for your lives or those of your loved ones, are being treated with contempt. Do you want to be looked after by someone so treated?

To make the computerisation manageable, the doctors were allowed only very limited choices – far too few to eliminate random factors. As the chaos mounted, people were offered just one interview each.

The result was that those most likely to fail to get a job were the best, because they made the most desirable options their first choice. To make the computerised system “fair”, much of the detail of people’s careers and the detailed knowledge of those they worked for were also eliminated.

Centrally planned systems always eliminate latent knowledge, ignore human motivation and destroy flexibility. It was predictable that this Gosplan for the training of doctors would end up just as it has. It could not do anything else. This is a superb example of how the combination of centralisation of power with a belief in rationalistic planning works in the real world.

No less predictable is the fact that those who made these blunders are still in place. One might have expected resignations, starting with Sir Liam Donaldson, chief medical officer.

But bureaucrats are far too grand to be held accountable. It is doctors whose lives are disposable. Who cares that they have devoted up to a decade to the acquisition of knowledge and experience? Who cares that patients will be worse served? What matters is that the Department of Health is firmly in charge.

So is the NHS suffering from an excess of free market zeal, as many on the left believe? Hardly. Where it matters, the planners are in charge. As always, they are making a big mess and, as almost always, they look likely to get away with it unscathed.

By Martin Wolf
http://www.ft.com/cms/s/0/bb574538-5cda-11dc-9cc9-0000779fd2ac.html

Health Direct notes that the Financial Times then printed a torrent of letters in response to this considered review. Two are included below:

Bureaucratic machine that cares little for best medical practice

From Dr Angus McNair.

Sir, I would like to congratulate Martin Wolf for such an accurate summary of the feelings of junior doctors at the present (“A terrible way to treat our doctors”, September 7, 2007). I have been struggling to explain to people outside the profession exactly how bad this process has been and he has described it very eloquently.

Like the majority of doctors, I entered this profession with the main aim of looking after patients. I realised that this would involve sacrifices to many aspects of my life, but I accepted these sacrifices with this aim in mind.

When a patient you are responsible for is sick you need to be with them and have the knowledge and skills required to treat them. This is what motivates doctors to work as hard as they do, not the financial reward or apparent “social status”, but the knowledge that you make a difference when it counts.

Therefore it seems farcical that our employers would do anything but create a supportive and flexible environment for us to practise.

This process has only succeeded in making us feel undervalued and is demotivating the whole workforce.

It becomes very difficult to make these great personal sacrifices when they are in the name not of patient care but of a bureaucratic machine that seems to care little for your welfare or best medical practice.

Angus McNair,
Bristol BS8 4BG

http://www.ft.com/cms/s/0/b4b6eed2-6008-11dc-b0fe-0000779fd2ac.html

Ministers were warned but insisted on the ‘big bang’ approach to change

From Dr Andrew Rowland.

Sir, Martin Wolf is absolutely right that the implementation of the Modernising Medical Careers applications process has left us with an inflexible system that threatens professional standards in the NHS.

Thousands of junior doctors are now in posts for which they are massively overqualified, in areas where they do not want to be or specialities they would not have not chosen. Many are being underpaid by their new employers, who claim that they have had insufficient time to identify the hours their new trainees are working.

But, as Mr Wolf quite rightly points out, ultimate responsibility for this whole mess lies not with NHS trusts but with the ministers and civil servants who insisted on a “big bang” approach to change.

There was little engagement with the medical profession, which repeatedly warned that disaster was looming. Even when 10,000 doctors took part in a public protest calling for the plans to be delayed, the government ploughed ahead.

Doctors are understandably concerned that their professionalism is being undermined and that standards of care could be eroded. A recent survey of British Medical Association members showed that nine in 10 believe MMC, in combination with working time reductions, represents a threat to the “gold standard” of consultant training for which the NHS used to be famous.

Those who call for trainee doctors to show more flexibility should be aware that they are at the mercy of a monopoly employer, and that within such a rigid appointments system it is verging on the impossible to change posts. Insofar as it is possible for the government to address the bitterness of junior doctors, a relaxation of the rules on job transfers would be a step in the right direction.

Andrew Rowland,

Vice-Chairman,
Junior Doctors Committee,
British Medical Association

http://www.ft.com/cms/s/0/7a2aee9a-6007-11dc-b0fe-0000779fd2ac.html

The UK’s ageing population, and the ever-rising cost of new treatments, means NHS spending never actually falls year-on-year – despite politicians endlessly accusing each other of “cuts”.

Instead, the NHS spend grows at different rates at different times. And, by this measure, the extent to which New Labour has spent on our health service becomes extremely clear.

Under the Thatcher and Major Tory administrations, real spending – after inflation – grew by between 2 and 4 per cent a year. But Labour’s increases cranked up that average to almost 5 per cent after 1997, and more than 7 per cent after 2001.

As Chancellor, Gordon Brown drove through all that new money. Now, as Prime Minister, his chance of winning an election depends in part on the public’s perception of how those extra billions have been spent.

It must be galling for Brown, then, that a recent Guardian poll suggested 44 per cent of the public thought the NHS would deteriorate under Labour, but only 35 per cent under the Tories.

Labour is used to “leading” on health. The creation of the NHS after the Second World War is, perhaps, the party’s proudest achievement.

More seriously for Brown, NHS resources are set to tighten considerably over the next few years. A new financial settlement, to be announced next month, will reduce spending growth, perhaps by half, but certainly to no more than 5 per cent.

At that point, voters will start asking if Brown’s NHS spending splurge has been squandered. The UK now spends around 9 per cent of our national income on health when private care is included – equal to the European average. Yet the NHS lurches from crisis to crisis.

The Labour government’s reputation on health took a bad knock after 2005 when big deficits appeared across the service. Earlier this year, almost half of all NHS trusts were in the red – with the total cash shortfall of £1.3bn.

Ministers clamped down, imposed “minimum waiting times” on at least two-fifths of the NHS’s acute hospital. The British Medical Association said this was “crazy”. Operations and other treatments were being delayed for months, it said, even though staff and equipment were available, “just to make the accountants’ numbers add up”.

Since then, the NHS has swung back into surplus. But, over the summer, evidence has continued to emerge suggesting “health” may not be the sure-fire electoral asset which Labour has long assumed.

One of Britain’s leading trauma surgeons broke cover to expose a national shortage of emergency beds – meaning thousands of serious injury victims are left in agony. And there were more signs that, despite now spending more per head than France and Germany on cancer, our survival rates remain poor.

The NHS continues to lag behind Europe when it comes to diagnostic cancer scans, time to first treatment and access to radiotherapy and cancer drugs.

Then, later in the summer, the head of NHS information technology – the UK’s highest paid civil servant – suddenly resigned. While the Government’s ambitious plans to harness IT to improve health care are bearing some fruit, parts of the project remain years behind schedule and total costs are heading for £20bn – £7bn over budget.

No one ever said running the NHS is easy. And even number-crunchers like me would be foolish not to recognise the expertise and dedication of countless NHS staff. But, as the political season restarts, and with health set to take centre-stage, it’s worth wondering if the tens of billions of pounds we’ve just thrown at the NHS could have been better spent. I think it could.

By Liam Halligan, Economics Editor, Sunday Telegraph
http://www.telegraph.co.uk/money/main.jhtml?xml=/money/2007/09/09/ccliam109.xml

This voter distrust of labour’s NHS funding has been going on for a while. On Tue 28 Nov 06 Health Direct posted: Labour continues to pay the price for it’s NHS cutbacks and closures with the voters as the public remains deeply sceptical over the government’s ability to improve public services and the economy, according to the latest findings from Ipsos Mori’s public delivery index.

A mere 19 per cent of adults believe the National Health Service is getting better, against 46 per cent who believe it is worsening. Just one person in 100 believes the NHS will get better over the next few years, against 13 who believe it will get much worse. (Which proves the adage that you can fool some of the people some of the time- but eventually people will see through the spin and lies.)

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

It was published yesterday, five years after his review for the Treasury paved the way for the extra £43.2 billion that the Government has since spent on the NHS.

Sir Derek, a former chief executive of NatWest bank, sees some improvements in the service, but also identifies a range of failings, including mismanaged structural changes; generous pay deals that failed to produce an obvious return; and a neglect of public health.

He said at the publication of his report that the extra resources had undoubtedly improved patient care over the past five years. “But what is equally clear from this review is that we are not on course to deliver the sustainable and world-class healthcare system, and ultimately the healthier nation, that we all desire,” he said.

Sir Derek would have liked the Government to have commissioned the review, but it showed no enthusiasm for doing so. The King’s Fund stepped in, enabling him to produce this report.

He states that more money will be needed over the next two decades unless steps are taken to deal with pressing concerns. That could undermine the current widespread political support for the NHS “and raise questions about its long-term future”, he says.

Of the more than £43 billion extra that has been spent, pay and price inflation have accounted for £18.9 billion, he concludes. New contracts for consultants, GPs and other staff have been introduced, but “there is very little robust evidence so far to demonstrate significant benefits arising from the new pay deals”.

Staff numbers have risen far above the targets set in the NHS Plan of 2000, with targets for consultants exceeded by 16 per cent, for GPs by 166 per cent, for nurses by 272 per cent, and for therapists by 102 per cent.

The biggest increase in NHS activity has been in accident and emergency departments, where attendances have grown by more than a third since 2002-03. This is hard to explain, but is probably caused by changes in behaviour, shorter waiting times and changes in GPs’ out-of-hours arrangements, the report says.

Public health budgets, aimed at tackling issues such as obesity and smoking, had been raided to bridge financial problems in the NHS, he said. It was impossible to track trends in public health spending or health promotion in the past five years because no official figures were kept.

Sir Derek said: “It is also indicative of the relatively low priority given to public health that, while non public health medical staff numbers have increased by nearly 60 per cent since 1997, the number of public health consultants and registrars has gone down overall.”

Sir Derek said at the publication of the report that there were “lots of positives” in his study. These included reduced waiting times, the use of less expensive statins and extra staff. He said that the framework introduced by the Government should remain in place for the next few years to minimise further disruption.

He said in his report, however, that the restructuring had been expensive and had taken managers’ eyes off the priority of running the service.

Norman Lamb, the Liberal Democrat health spokesman, said: “This report is a damning critique of the Government’s failure to get value for money out of all the extra investment in the NHS. Ministers cannot ignore these recommendations as they did with last year’s report by Sir Derek into social care.”

Andrew Lansley, the Shadow Health Secretary, said: “Even Gordon Brown’s own adviser thinks he has mismanaged the NHS. Labour have invested lots and achieved too little. Gordon Brown is obsessed with pursuing top-down reorganisation instead of delivering genuine reform, which gives power to professionals and better healthcare to patients.”

He added: “Public health budgets have been robbed to pay off huge deficits despite warnings about the strain that spiralling obesity levels will have on the NHS. Labour’s ignorance belies their arrogance.”

From:
http://www.timesonline.co.uk/tol/news/uk/health/article2433049.ece

But while the figures point to waits for diagnostic tests being a key contributor to delays in treatment, private sector contracts originally designed to deliver 1.5m extra tests a year are still being held up by an ever lengthening review in the Department of Health of whether they should go ahead.

Negotiations on the contracts, initially worth about £200m a year, began more than two and a half years ago. Just two are operational. A review of the six remaining schemes – which would not start operation for some months, even if they were approved today – was meant to be completed by the end of August. But a health department spokesman said at the weekend that they were still under review.

Senior health department sources insist some of the remaining deals will be approved. But private sector suppliers are doubtful that many of them will be.

Waning enthusiasm for using the contracts to boost capacity and stimulate competition come as the latest “referral-to-treatment” figures show that the NHS is running behind schedule to hit a target of no patient waiting more than 18 weeks for treatment by the end of 2008.

The figures need treating with caution as the service can currently only count the total waiting time for about 80 per cent of patients. But in January, when the figures were first collected, 47 per cent of patients completed their treatment within 18 weeks. By June that figure had risen to 54 per cent – a 7 percentage-point improvement in six months.

But with only 18 months to go, progress at the same rate would still leave 25 per cent of patients waiting more than 18 weeks. In June, 25,000 of the patients treated had waited more than a year, and almost 75,000 more than six months.

Anthony Harrison, an academic at the King’s Fund think-tank who is following the 18-week target, said: “With previous targets to cut waits for surgery there has always been an acceleration towards the end, with the figures improving faster as the deadline nears.”

“But this target is different. It cannot be achieved just by doing more of the same – more operations or more outpatient appointments. It requires changes to the way services are provided so that, for example, scans and tests can be performed and a decision made on treatment on the same day. That is organisationally much more difficult to achieve.”

From:
http://www.ft.com/cms/s/0/fda8e0b0-5f35-11dc-837c-0000779fd2ac.html

Over eighteen months ago- on January 06, 2006 Health Direct posted the following: Labour ministers promises on ambitious 18 week maximum wait for surgery when the labour government’s goal to get the maximum wait for a non-emergency operation on the National Health Service down to 18 weeks by 2008 is ambitious.

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.

On the health department’s own planning assumptions, to achieve a maximum wait of 18 weeks – from the first GP visit to an operation – the average wait will need to be about nine weeks.

That implies something like an average two week wait from GP to the outpatient visit, three weeks for diagnostic tests, which may include scans and investigative pathology, and then no more than a four week wait once a decision is made to operate.

At the moment, no data exists to measure how long that total wait is – chiefly because there are no national data on how long patients wait for diagnostics. In some parts of the country, however, patients can wait 26 weeks or longer for a scan- which would blow the 18 week promise clearly off course.

But published figures show that the average wait for an outpatient appointment is currently almost 7 weeks – more than three times longer than the two weeks that it will need to be by 2008.

That figure has been falling, down from 7.7 weeks in 2000. But it is falling so slowly that on current trends it will take 35 years to get down to an average two week wait.

“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”.

To hit it will require “an unprecedented increase in productivity”, he said, when, on most measures, NHS productivity has been falling as large parts of the extra spending have gone into pay.

As these Sept 07 figures show- a quarter of the population are going to have to wait at least 18 weeks for treatment by 2009.

The Cresswell story shows how far the NHS and Department of Health have blindly followed the prevailing New Labour ideology that the only way to improve public services is by using market mechanisms and introducing competition.

There is no good evidence for this belief, and as David Craig and Richard Brooks show clearly in their recent book Plundering the Public Sector, civil servants have swallowed the advice of expensive management consultants, wasting billions of taxpayers’ money and then applying pressure to newly formed, inexperienced primary care trusts to make them toe the party line.

So far, Gordon Brown has not shown any signs of tackling this scandalous situation.

The Liberal Democrat and Green parties have good clear policies, and David Cameron needs to produce a definitive plan to stop this waste of public money.

The NHS is not a business, it is a service, and its staff welcome the extra finance, but not the way in which it is being wasted on setting up a market that is quite inappropriate for healthcare, as the costly and inefficient US system demonstrates clearly.

Wendy Savage,

Chair,
Keep Our NHS Public steering group,
London N1 8HN

From:
http://www.ft.com/cms/s/0/800e7e22-5da4-11dc-8d22-0000779fd2ac.html

He is representing a Rugby man who pays thousands for cancer drugs because his primary care trust has refused, saying their effectiveness is limited. Warwickshire PCT said the decision was not made on the basis of cost.

The life-extending drugs are funded by PCTs elsewhere in the country.

Mr Heaton-Harris, who represents the East Midlands, has asked the European Commission to investigate the case of Russ Jones, a constituent who is dying from a rare form of abdominal cancer.

Mr Jones pays £3,500 a month for his daily tablets of Sutent, a drug he says will allow him to live longer. In other parts of the country the drug is available on the NHS.

Mr Jones told BBC News 24: “I know there’s not much else for me, and this is the only chance that is available. Without it I will die sooner than I would.”

Mr Heaton-Harris said: “If you’re being withheld treatment because of where you live, it could be as similar as being denied treatment because of your religion or colour.”

In a statement, a spokesman for Warwickshire PCT said: “Warwickshire Primary Care Trust have a duty for ensuring all its resident population are in receipt of health care services.

“The main focus for the Individual Cases Panel was to consider the outcome for Mr Jones, and was not concerned with creating a precedent for the PCT that would be unaffordable.

“These decisions are never made without a lot of thought and consideration, and each case is considered on an individual basis.”

The Department of Health said that not only was it unacceptable for trusts to refuse treatment that has already been licensed elsewhere, but they should not refuse to pay because a drug is too expensive.

The postcode lottery in drug funding has seen patients being treated alongside each other in the same hospital, but with different levels of NHS funding.

From:
http://news.bbc.co.uk/1/hi/health/6974681.stm

The University of Dundee-led study reported in the British Dental Journal found 18% of final-year students planned to stick to private work.

In contrast, of the 141 students questioned, just 3% planned to work solely for the NHS after graduating.

Some 79% of students planned to split their career between the NHS and the private sector, according to the survey.

A similar poll of first-year dental students carried out two years ago also found levels of interest in an NHS-only career were very low.

However, the proportion of respondants who planned to work exclusively in the private sector was just 7.5%.

Retirement plans

The latest poll, of students at the universities of Dundee and Manchester, found about 60% planned to retire or cut down on their workload before the age of 60.

More than half said they would take time out of the profession once they started their families.

Lead researcher Dr Fiona Stewart said: “If these career intentions are followed through it could impact significantly on the future clinical commitment available to the NHS, and in our view these intentions should be taken into account for future dental workforce planning.”

Peter Ward, chief executive of the British Dental Association, said: “This research confirms what we already know; that the great majority of young dentists aspire to work in the NHS.

“Whether the NHS will be able to provide them with jobs is another matter. The reality is that the new dental contract in England and Wales has restricted the amount of dentistry that primary care trusts and local health boards are able to commission.

“According to the labour government’s own estimate, approximately two million people who wish to access NHS dentistry are unable to do so. It would be regrettable if young dentists were denied the opportunity to provide that care.”

Labour MP Kevin Barron, of the Commons health committee, has said dentists have a “moral obligation” to give the NHS more as it costs £175,000 to train them.

Figures from the NHS Information Centre show NHS dentists on average now earn about 52% of their income from private patients – the first time private work has accounted for a greater share.

The labour government introduced a new NHS contract for dentists in April 2006 giving them the same money for treating fewer patients in a bid to get away from the “drill and fill” culture and attract more dentists to the NHS.

From:
http://news.bbc.co.uk/1/hi/health/6983060.stm

CAB said the fear of being struck off a surgery’s patient list can often deter rural residents from filing a grievance through the NHS complaints system.

The scheme, which will be rolled out nationally next week, was welcomed by the Scottish Public Services Ombudsman.

John Montgomery, who manages the service in four CAB offices in the Borders, said the service was currently dealing with eight cases.

Patients can highlight problems with any aspect of the health service, including dentists, GPs, hospitals, NHS24 and the Ambulance Service.

‘Cause problems’

Mr Montgomery told the BBC Scotland news website: “There is a perception, particularly in rural areas, that complaining about services like local GPs could jeopardise access to the local doctor in the future.

“Many people have to complain in the first instance directly to the surgery and it could be the GP’s wife who is the surgery manager.

“So that can create a perception that complaining may cause problems for the patient.

“We can advice patients of their rights, write letters on their behalf and liaise with the NHS.”

Previously, patients were guided through the NHS complaints process by Health Councils, but they were abolished in 2005. At the time, the Scottish Public Services Ombudsman (SPSO), said that this gap in support was “a cause for concern”.

The CAB scheme is the first complaints advice service for patients since 2005.

The SPSO said that intense support was needed for anyone making a complaint about treatment they receive.

From:
http://news.bbc.co.uk/1/hi/scotland/south_of_scotland/6981684.stm

The call came on the same day that a baby was born in the back of an ambulance after her mother was unable to give birth at her nearest hospital because there were not enough midwives on duty.

In April the labour Government published its blueprint for maternity services, promising women a choice of where to have their babies. The RCM said at the time that the proposals could not be delivered without at least another 3,000 midwives. But it has now revised the figure upwards, arguing that many trends threaten to upset the Government’s plans.

There has been a 12.5 per cent increase in the birthrate since 2001, but midwife numbers have risen by only 4.5 per cent since 1997. The RCM said that fewer midwives were being trained, and even those who did qualify found it hard to get jobs because of the cuts made to bring the NHS back into financial balance.

Nearly half of all midwives are due to retire in the next decade, the RCM said, but demand for their services is greater because births are becoming more complex.

Louise Silverton, deputy general secretary of the RCM, said: “We have real concerns about the Government’s ability to deliver because there are simply not enough midwives.”

Scarborough and North East Yorkshire NHS Trust, which ran a £7.2 million deficit last year but is planning to break even this year, provoked a row by announcing plans to cut 600 jobs, a third of its workforce. It also plans to cut all deliveries at maternity wards in Malton, Whitby and Bridlington in favour of a unit in Scarborough.

A lack of midwives at Malton Hospital forced Sally West, 36, to take a 26-mile trip to Scarborough. Malton is only three miles from her home and she had expected to give birth to her daughter there. Instead Phoebe was delivered in an ambulance in the car park of Scarborough Hospital.

Clive Milson, Phoebe’s father, accused hospital bosses of “gambling with people’s lives” and urged them to keep the units open. “We were fortunate there were no complications.”

From:
http://www.timesonline.co.uk/tol/life_and_style/health/article2358440.ece

Labour’s labour crisis is nothing new to Health Direct’s readers. On March 27, 2007 we posted NHS crisis is forcing cuts to maternity care, charity warns

Support for pregnant women is being cut because of the NHS’s financial troubles, a healthcare charity has warned. The National Childbirth Trust (NCT) says it is receiving “increasing reports” that NHS antenatal classes, breastfeeding services and postnatal visits are being cancelled.

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