Microbiologists warned on the day that Gordon Brown, the prime minister, announced the “deep clean” policy that such routine annual cleans would be ineffective and the medical journal The Lancet has since said they will not affect the risk of infection.

Challenged by MPs on the Commons’ health committee that the policy was really “more a publicity exercise than evidence based”, Mr Johnson said that would be “a fair point to make if the only thing we were announcing was deep clean”.

From:
http://www.ft.com/cms/s/0/2836088a-9ee7-11dc-b4e4-0000779fd2ac.html

Brown’s claim to competence is already finished – kaput. He sold our gold reserves at giveaway prices, vandalised our pension schemes with the sledgehammer of tax, opened the doors to unchecked immigration (ministers have no idea how many foreign workers are here), demanded unconscionable sacrifices from our Armed Forces (for which they pay in blood), and managed the nation’s money so ineptly that, despite a long period of economic growth, the United Kingdom is on course this year for a £40 billion shortfall in public finances, £6 billion more than Brown predicted in his last Budget.

On July 24, 2006 Health Direct posted NHS targets blamed as crowded wards increase risk of superbugs when we noted that there is a scientific correlation between high bed occupancy rates with high MRSA superbug ineffections, and deaths.

Government targets to cut NHS hospital waiting times are putting patients at increased risk of infection with the superbug MRSA, an official report has revealed. An internal policy review conducted by the Department of Health, leaked to The Independent, has for the first time shown that there is a direct link between the number of patients in hospital – measured by bed occupancy – and MRSA rates. Ministers have denied there is a link.

The most crowded hospitals, with occupancy rates over 90 per cent, have MRSA rates that are over 42 per cent higher than average, according to the report. Those with occupancy rates above 85 per cent have MRSA rates 16 per cent above average.

The findings of the review are considered so sensitive that two attempts by The Independent to obtain the report under the Freedom of Information Act were rejected. Reducing bed occupancy in all NHS trusts to a maximum of 85 per cent would save 1,000 cases of MRSA a year, it says.

The latest figures for 2004-05 show that 88 NHS trusts in England, one fifth of the total, had occupancy rates over 90 per cent and almost half (45 per cent) had occupancy rates over 85 per cent.

Researchers from the University of York experts say more should be spent on monitoring “adverse incidents”.

The labour government has encouraged trusts in recent years to spend more effort looking at complications and mistakes involving their patients.

Managers are supposed to report even “near misses” in which patients suffered no harm, so that lessons can be learned.

However, other studies have suggested that the reporting rate is poor. The University of York study focused on a single major acute hospital in England, and pored over the notes of 1,006 people admitted into it.

Possible under-estimate

While 87 people had definitely suffered at least one “adverse event”, the researchers said it was likely that even more had suffered harm.

Alongside more than 40 infections, there were 27 complications during or following operations, 19 drug complications, and 12 cases of bedsores. Between 30% and 55% of these could have been prevented by clinical staff or managers.

Examples of preventable incidents included a mistake in an operation which led to the death of the patient, another which caused lifelong damage, and a case in which a patient became addicted to opioid drugs after being given a high dose during and after a hospital stay.

Professor Trevor Sheldon, who led the research, said that “finger-pointing” was not the answer – although the scale of the problem meant that more resources should be spent tackling it.

“The rates we found do not show that the NHS is faring worse – this is an international issue, and other countries have similar or worse rates.

“The question we have to ask is whether the NHS is currently doing enough to help people find the time to reflect on these cases and learn lessons from them.

“Our research does confirm though that hospitals are not completely safe places, and that people should try to steer clear of them unless absolutely necessary.”

A spokesman for the NPSA welcomed the study, and said it was working with the NHS to improve safety.

“Around 13 million people are admitted to acute hospitals each year in England and Wales. Most people are cared for safely, however regrettably sometimes things can and do go wrong.”

From:
http://news.bbc.co.uk/1/hi/health/7116711.stm

On March 08, 2005 Health Direct posted: 25,000 die from preventable VTE
as each year over 25,000 people in England die from venous thromboembolism (VTE) contracted in hospital.

This is more than the combined total of deaths from breast cancer, AIDS and traffic accidents, and more than twenty five times the number who die from MRSA. The figures are alarmingly high.

“It’s frustrating that in 2006 we do not have a clearer idea of how many people die or are harmed when this could have been avoided” Sir Ian Kennedy, of the Healthcare Commission. To illustrate his point, he said the National Audit Office could only estimate the number of deaths as a result of patient safety incidents ranged from 840 to 34,000.

Health Direct suggests that being treated in a UK hospital is now three times as dangerous as it was only three years ago.

Some areas do not have dedicated cleaning staff and ambulance crews are left to give the vehicles a “quick mop out”, the health union said.

The government said it expected trusts to follow national guidance on ambulance cleaning.

Unison called for cleanliness standards to be properly applied and monitored across trusts to improve standards.

Ambulance crews questioned by the union said targets, time and money were all to blame for different cleaning practices between trusts. In the worst example, ambulance crews in the North West have no dedicated cleaning staff or cleaning time.

Paramedics report that they do not get time to even check the vehicles, which are never deep cleaned.

The only precaution is that if staff know a patient is infected, for example with Clostridium difficile, the ambulance will be mopped out.

At the other end of the scale London Ambulance Service has introduced on-site cleaners who work throughout the night to routinely deep clean the fleet.

They also restock ambulances with fresh kit, freeing up paramedics for seeing patients. Effectively, crews bring in a dirty vehicle and leave with a cleaned one, Unison said.

In the South West, funding problems are causing delays to plans to employ staff to carry out deep cleaning, staff said.

And paramedics in Wales agreed not enough was being done although the service is looking at a similar deep clean system to that used in London. Sam Oestreicher, Unison national officer for ambulance staff said: “The government recently announced extra money for deep cleaning hospitals, but ambulances seem to have been forgotten.

“They are part of the patient care package and no one should have to travel or work in a dirty ambulance.

He added: “In many trusts, ambulance crews are responsible for cleaning their own vehicles and this is a waste of their time and training.

“They should be out there saving lives not mopping out the back of a dirty ambulance.”

He said existing voluntary guidelines should become mandatory standards. But stressed that extra funding would be needed if or resources would be cut elsewhere.

“The Ambulance Service Association has issued guidance and we expect trusts to follow this. “Trusts should also take cleaning time into account when managing their supply of ambulances to attend emergency calls.”

From:
http://news.bbc.co.uk/1/hi/health/7109769.stm

Before the arrival of the first treatment centres, private hospitals frequently charged 30 to 50 per cent above the NHS price.

The treatment centres helped to drive that cost down and the growing number of private hospitals on the so-called “extended choice network” treat patients at the NHS price, so long as they can control the workflow.

However, hospitals and primary care trusts in which patients are in danger of breaching waiting-time targets have reverted to “spot purchasing” – buying operations at the last minute, say Richard Jones, commercial director of Spire Healthcare (formerly Bupa Hospitals), and David Mobbs, chief executive of Nuffield Hospitals.

“We are not bound by the tariff [the NHS price] when we are called in as a distress purchase caused by the need to treat patients urgently so that they do not breach waiting times,” Mr Jones said.

“It costs us more because we cannot plan our spare capacity in the way we can when patients choose to use us, or the primary care trust has a longer-standing contract.

“It would be better value for money for the NHS if we were able to treat patients in a planned way or through patients choosing to come to us, as they are entitled to.”

Neil Bentley, director of public services with the CBI employers’ group, said the re-emergence of spot purchasing “shows why it does not make sense to cut back on the second wave of independent treatment centres”, as ministers are expected to do this week.

“Does the government really want to go back to a regime where it will cost the NHS more to get patients treated?”

From:
http://www.ft.com/cms/s/0/bddd10a8-9308-11dc-ad39-0000779fd2ac.html

The total surplus will be almost 2 per cent of the NHS budget. It is understood to be causing embarrassment at the Department of Health amid concerns that it will be accused of presiding over a ‘bust and boom’ health economy, coming just two years after the NHS was more than £500m in the red.

Part of the massive surplus is made up of £729m ‘topsliced’ from primary care trust allocations by strategic health authorities, according to figures placed in the House of Commons library.
“A £1.8bn projected underspend for this financial year would be more than three times the £510m underspend for 2006-07″

An inspection of board documents shows that, by September this year, the SHAs were forecasting an annual underspend of £1.5bn in total.

But since then SHAs are thought to have identified a further £300m in surpluses.

An underspend of this size at this time is particularly difficult for the DoH as it recently told the NHS pay review body that staff should get pay rises next year of no more than 2 per cent.

A senior source close to the DoH said ‘It doesn’t look good. The £1.8bn net surplus is a conservative estimate. There will be a lot of pressure on SHAs over the next few weeks to manage the situation closely and to bring the underspend down.’

NHS Confederation policy director Nigel Edwards said: ‘There’s a lot of anxiety that these overspends will now be clawed back. In some cases PCTs have run up surpluses to fulfil strategic plans but there are now a number of rumours that the Treasury will claw these back.’

A £1.8bn projected underspend for this financial year would be more than three times the £510m underspend for 2006-07. That followed a £547m overspend in 2005-06. King’s Fund chief economist John Appleby said: ‘An underspend by that amount will be seen as just as bad as an overspend.

Parliament does not approve of large NHS underspends as it commits those resources for health spending, not to just sit there.’

Speaking at the King’s Fund last week – before the size of the underspend was revealed – NHS chief executive David Nicholson said it was important that NHS organisations made a surplus in order to support financial planning and service development.

However, he added: ‘We don’t want to go from bust to boom or for people to use the surplus to avoid making difficult decisions.’

A senior source at one SHA told HSJ it had experienced problems persuading PCTs to spend more money. ‘PCTs have been in turnaround mode for two years. We keep telling them there must be more things they can spend their money on but they are being too careful.’

He said it was particularly frustrating as PCTs had more work to do to reach the 18-week target, yet were hesitant to commit more funds to achieve it.

http://www.hsj.co.uk/news/nhs_underspends_by_18bn.html;jsessionid=B8A4866B8FD4B1
A19AA07A40F0519E3B?tmcsTrackingInfo=$bwXIN5QVzbX-mAJfyanFI5by4WRgd0ar4zKp
LsisaNXWUsjCN5y1kupJw-tDw7kXdRuUDHrfbhT$

Health Direct thinks that it is an absolute disgrace that we have had trusts making large numbers of staff and nurses redundant to achieve financial targets, whilst we witness obscene amounts of public monies paid out in redundancy payoffs!

The new Strategic HA’s are growing at a rapid rate (and cost) and will soon be a mirror image of what they replaced – yet they still remain in denial over the real NHS funding issues. Cautious PCT’s are not the underlying reason for the surplus – it is the freeze on recruitment.

The latter contributing to over-stressed and over worked staff – and subsequently a demoralised NHS workforce.

The Norfolk and Norwich University Hospital is on “black alert” and has declared a major incident in order to discharge non-urgent patients.

In a statement, the hospital said 10 ambulances were waiting to admit patients with paramedics treating them.

It said all other general hospitals in the east were on the same alert level.

The statement added: “All the hospitals in the region are currently on black alert and the Norfolk and Norwich University Hospital is also experiencing very high emergency demand. The hospital is currently full and our emergency areas are at full capacity.”

‘Extreme pressure’

The hospital said it was working with social services and other organisations to help move patients with less-severe medical conditions.

“As a result of the extreme pressure we are under, we have declared a major incident in order that all the agencies can take appropriate action to discharge patients and free-up beds,” the statement added.

“We currently have 10 ambulances waiting to admit patients and ambulance crews are looking after those patients.”

The Norfolk and Norwich University Hospital NHS Trust said while it was under extreme pressure, the hospital was not turning patients away.

The statement continued: “The hospital is not closed, but we would also urge members of the public who have minor health problems not to attend A&E; as staff are being kept extremely busy dealing with 999 patients with more serious health problems.”

From:
http://news.bbc.co.uk/1/hi/england/norfolk/7106402.stm

These had to be “pursued”, he told the Commons home affairs committee. The plan to put 50 million patients’ records on the database is part of a £12bn NHS IT overhaul.

The scheme has raised concerns over cost and the security of information.

A poll for the Guardian suggests that 59% of GPs in England are unwilling to upload any record onto the database without the patient’s specific consent.

Three quarters of more than 1,000 doctors questioned believed medical details would become less secure when they are put on a database that will eventually be used by the NHS and social services.

‘Misuse’

Mr Jeavons, who was appointed in May, said the Department of Health did not itself hold many people’s personal records but added that it provided guidance to NHS trusts on how to handle data.

At a committee hearing, Labour MP Margaret Moran said to him: “Even if we get the technology right, the problem is abuse by people or misuse of data. How confident are you that there won’t be problems over data and privacy?”

Mr Jeavons replied: “You cannot stop the wicked doing wicked things with information and patient data…

“Of course, we have examples where staff do abuse their privileges and have to be pursued through disciplinary procedures.”

He added that the government had to “make sure” that people who abused the system knew they were “going to get caught”.

The NHS scheme is intended to “modernise” the service.

By 2014, 30,000 GPs in England are supposed to be linked up to nearly 300 hospitals giving the NHS a “21st century” computer network.

It involves an online booking system, Choose and Book, a centralised medical records system, e-prescriptions and fast computer network links between NHS organisations.

It is said to be the most ambitious computer project in the world and represents the largest single investment in IT in the UK.

‘Surveillance’

Opponents say it is too expensive and will compromise the confidentiality of records.

The home affairs committee is looking at whether the UK has become a “surveillance society”.

In its hearing, it senior civil servants working in the education, transport and justice fields were also questioned.

The MPs were told different departments could not share information without legal guidelines being followed and rights of access clarified.

Clare Moriarty, constitution director at the Ministry of Justice, said efforts to make data protection as “robust” as possible were essential.

Questioned as to whether information had sometimes gone between departments unofficially, she replied: “I’m not aware of any department sharing data by stealth.”

‘Foolhardy’

Government chief information officer John Suffolk told the MPs that setting up a nationwide database going across Whitehall departments and other government agencies would create more problems.

He said: “When you work at a national scale, to continue to put more eggs in a single basket is a foolhardy approach.”

Mr Suffolk added: “The more and more you put it into a large database, with more and more people having access, it becomes more complex…

“If we can avoid setting up large-scale citizens’ databases, that would be a wise thing to do.”

The Information commissioner last year warned the UK risked “sleep-walking into a surveillance society”.

The committee’s inquiry will include the impact of identity cards, the expansion of the DNA database and the rise in the use of CCTV cameras.

From:
http://news.bbc.co.uk/1/hi/uk_politics/7103667.stm

The sensitive personal details of 25 million Britons could have fallen into the hands of identity fraudsters after a government agency lost the entire child benefit database in the post.

A major police investigation is being conducted after Alistair Darling, the Chancellor, admitted yesterday that names, addresses, birth dates, national insurance numbers and bank account details of every child benefit claimant in the country had gone missing.

The confidential material is on two CDs that were placed in the post by a junior employee at the HM Revenue & Customs office in Tyne & Wear more than a month ago and have not been seen since.

The Chancellor and the Prime Minister have known about the loss since November 10 but there were concerns last night that the police were not told for a further five days and the banking industry was not alerted until last Friday.

The catastrophic breach of personal security led to the resignation of Paul Gray, the chairman of HMRC, and called into question the Government’s competence, especially its ability to manage an ID card system in the future.

No evidence of criminal activity has been detected but Scotland Yard has appointed an expert in organised crime to head the investigation. Acting Assistant Commissioner Janet Williams is heading a team of 12 officers who are combing Government offices for the lost data.

The Serious Organised Crime Agency is also advising on the potential criminal abuses of information about the identities and finances of 7.25 million British households.

Equipped with such detail, identity thieves could plunder bank accounts, obtain credit cards and take out fraudulent loans.

The banking industry has upgraded its fraud detection systems to keep a constant watch on all accounts into which child benefit is paid.

Bankers reacted angrily to a suggestion by Mr Darling that he had delayed his announcement because the financial sector was “adamant” it needed time to prepare.

A senior City source said: “By 9.30 on Monday we were ready to run. It is hard to fathom why any suggestion was made that any delay was down to us.”

Mr Darling told the Commons that the information should never have left the HMRC offices and its transfer in unregistered mail was against all procedures.He said the missing data was not enough in itelf for someone to access an account for fraudulent purposes because passwords and pin numbers were required.

But he apologised to the country for what he described as an “extremely serious failure on the part of HMRC to protect sensitive personal data entrusted to it.”

Richard Thomas, the Information Commissioner, said: “This is an extremely serious security breach.”

Health Direct points out that it’s clear breach of the Data Protection Act by the HM Revenue & Customs (Principle 7 – keeping subject data safe). The Revenue have acted illegally.

Opposition MPs should press for a full enquiry by the Information Commissioner’s Office.

From:
http://timesonline.co.uk/tol/news/uk/article2910705.ece

David Rosin, a former vice-president of the Royal College of Surgeons, says female and ethnic minority consultants are being given preferential treatment to meet artificial quotas.

Rosin, also a former president of the Association for Cancer Surgery, failed to get the top “platinum award” award 10 years in a row despite being backed in his application by the royal college and his NHS trust.

He said: “When I asked a previous president [of the Royal College of Surgeons] why I had been unsuccessful, the answer came back immediately: ‘What do you expect? You are not black, you are not female and you have all four limbs.’ ”

Rosin’s comments are likely to provoke a row about whether policies to promote equal opportunities in the NHS have led to positive discrimination.

Figures show a dramatic increase in the number of women and ethnic minorities winning merit awards over the past five years. They can add up to £73,000 to a consultant’s annual salary of about £112,000.

Ministers and NHS chiefs have been encouraging more women and ethnic minorities to apply. Supporters say that in the past the vast majority of the extra payments went to an “old boys’ network” of sometimes “mediocre” white male consultants.

However, Rosin, who retired from his NHS post as a senior consultant surgeon at St Mary’s NHS Trust hospital, London, in June, believes it has now tipped into positive discrimination.

“It is time that someone spoke up concerning the reverse discrimination with respect to merit awards,” he wrote in a letter to the magazine Hospital Doctor. “In the politically correct environment in which we live, there is now definitely reverse discrimination.”

He was incredulous at his failure to get a platinum award, despite being editor of an international medical journal, editing 16 textbooks and publishing more than 100 peer-reviewed medical papers.

He said he was also on call for the NHS every second night for his first 14 years as a consultant and helped to introduce a new form of cancer surgery clinic and many new minimal access surgical techniques.

Rosin was supported by a council member of one of the royal medical colleges, who, asking to remain anonymous, said: “As in any situation where people are trying to correct what is perceived as a wrong in the past, an element of bias will be introduced.

The feedback one hears from these committees is that, where there is a fine balance between two candidates, then there will be a willingness to recognise the merits of someone who has been previously disadvantaged.”

About half of Britain’s 33,000 consultants receive an award at some level, ranging from £2,850 to £73,158. The scheme costs the NHS at least £250m a year.

Aneez Esmail, professor of general practice at Manchester University, whose research in 1998 showed how few women and ethnic minority consultants got the awards, denied that standards had been compromised.

“More women and ethnic minorities are successful but the actual standards are not compromised,” he said. “Previously, mediocre white candidates were getting awards and you really had to be quite exceptional as a woman or ethnic minority to get an award. With more transparency and clear criteria there is greater competition and more women and ethnic minorities are successful. People like Mr Rosin may lose out.”

His 1998 research, published in the British Medical Journal, showed that white consultants were given 95% of bonuses despite making up just 74% of the eligible consultant workforce. Nonwhite consultants earned just 5% of bonuses despite making up 14% of the eligible consultant workforce.

A follow-up paper in 2000-2001 found that white consultants received 37% more bonuses than nonwhite consultants and men gained 25% more bonuses than women. However, this year’s data, released by the health department, show that the percentage of women applicants succeeding in getting bronze awards, worth about £34,000 on top of their annual salary, is now equal to that of men.

Doctors would not be expected to apply for the four top awards until they had been consultants for a decade. Women taking breaks to have children have therefore been less likely to apply.

As many British Indian consultants as white British consultants are also now being awarded the first level of bonus, worth £2,850.

Professor Hamid Ghodse, medical director of the committee which decides on who gets awards, acknowledged that it had actively been trying to get more women and ethnic minority consultants to apply for bonuses – and would continue to do so.

Health Direct reproduces some more posted comments:

Why call it reverse discrimination? It is racial and gender discrimination, plain and simple, and there is a law against it but our political elite think they are above the law.

R Mason, London, UK

This is not about money but a perception of an unfairness which is currently rife in our society as well as the natural desire of any hard working , exceptionally productive professional to receive an acknowledgement from his peers of his achievemnets and worth.

C J Hathaway, Billericay, UK

The system of merit awards for consultants should be scrapped. It is unfair, unjust and, as all consultants that I know will agee, misused. Like the jealousy generated by private practice it is a force for distrust and anger which divides the consultant body. and this can only be bad for the profession and patients alike.

Dr. Patrick J. Salt, Walsall, West Midlands

From:
http://timesonline.co.uk/tol/news/uk/health/article2890947.ece

A patient who is feeling better can readily – and wrongly – believe it is not worth finishing the course of medicine, especially if it tastes nasty.

In the same way, it is a mistake to think that the role of the private sector in improving the National Health Service can be cut back now that some benefits are already evident. Yet Alan Johnson, health secretary, is on the brink of slashing plans to extend private sector involvement in treatment centres and diagnostic services. This would be an unwelcome retreat.

Private sector companies had been expecting the award of business worth £700m a year from this second wave of big central contracts. Instead, it looks as though the schemes going ahead will be worth less than half that, and may total as little as £200m.

The adverse effects of this reduction go well beyond the compensation that the government will have to pay for cancelling so late.

The argument is not really about the details of each contract up for decision. It is about the broader impact on public healthcare of such a significant scaling back of private sector work.

In the years when Tony Blair was pursuing market-like reforms for the health service, he had a dual purpose in involving the private sector. He wanted to increase capacity and also to challenge NHS hospitals so they would perform more strongly.

This meant the drive to include the private sector had to come from Whitehall and was often resented at local level because it caused disruption.

The success to date in both aims should not disguise the animosity that has accompanied it. As a result, if ministers do not push the role of the private sector in the NHS, there is little chance that anyone will call on private companies.

This matters, because it is too soon to be sure that public sector healthcare will hold on to the benefits already gained if competition from the private sector fades away.

Shrinking the scale of private sector NHS contracts also makes businesses warier about engaging in this activity. The first wave of contracts was also smaller than initially expected. So private sector contractors are surely pricing into their bids the prospect that the health service will be an unreliable customer.

Even more worrying for the government, they may decide that their time and money is better spent elsewhere entirely. This would mean that there was not a flourishing private sector to act as a force for change at primary care level. For a lasting benefit to the NHS, the dose of competition needs to be stepped up, not scaled down.

From:
http://www.ft.com/cms/s/0/729db8cc-9236-11dc-8981-0000779fd2ac.html

The health secretary announced that three small contracts for scans and renal dialysis, worth £40m a year, would go ahead. But six more surgical treatment centre contracts have been scrapped, taking to 15 the total abandoned since the procurement was launched in 2004. Only one out of nine original contracts for diagnostic services now survives.

Procurement will continue on seven more treatment centre deals, most of which have already shrunk considerably in size. But while the intention is to take final decisions by March, a health department spokesman said there was “no guarantee” they would go ahead.

Even if they did, the total value of the contracts looks unlikely to top £2.5bn on industry estimates, against the £6bn that the private sector was originally promised. Without them the total will be nearer £2bn.

Announcing his decisions, Mr Johnson insisted that the reduction in the size of the procurement “does not represent a change in policy”.

But Chris Ham, former head of the strategy unit at the health department, said: “That is not a credible statement. The contribution of the private sector will be much smaller than planned, and the potential for innovation reduced.

This is the strongest signal yet that the prime minister is distancing his government from the policies of his predecessor.”

Mr Johnson insisted the independent sector had “an important and increasing role in the NHS” despite the cutbacks, which included firing Care UK, an independent provider, from an already operational diagnostic contract in the West Midlands on the grounds that only 5 per cent of its capacity was being used.

A “significant increase in productivity” in the local NHS had removed the need for the contract, Mr Johnson said, as he also cited improved NHS performance for the scrapping of six more treatment centre deals.

Mr Johnson said his approach to the independent sector “is pragmatic, not ideological”. Where it offered good value for money “we will bring them in”.

However, both Nuffield and Spire Hospitals, two of the biggest private groups, say the majority of primary care trusts are “hiding” the right to choose by not putting the independent providers on the front screen of the “choose and book” system that family doctors use to help patients decide where to go.

Because the private hospitals are hidden on the back screen, they say, only well-informed patients get through.

That was producing “a postcode lottery” in access to care, said Richard Jones, chairman of the NHS Partners Network, which represents the private providers.

David Mobbs, chief executive of Nuffield Hospitals, said ministers should make clear that such “attempts to thwart choice unfairly and to distort markets will not be tolerated”.

In an attempt to appease the private sector, Mr Johnson promised a campaign to raise the awareness of patients’ right to choose, and a new advisory forum of private providers.

In public, the private operators reacted with restraint at the cutbacks. In private, they were furious.

Neil Bentley, the CBI’s public services director, said the decisions were “a Christmas present for opponents of reform” and that “patients are the losers”.

Karen Jennings, head of health at the trade union Unison, welcomed the government’s “change of emphasis” on private sector involvement, as the Conservatives accused ministers of “incompetence” after spending tens of millions of pounds on the failed bids.

From:
http://www.ft.com/cms/s/0/ca759530-93ab-11dc-acd0-0000779fd2ac.html

The thwarting of private services should come as surprise to readers of Health Direct. On
July 26, 2007 we posted: Alan Johnson blocks new wave of private health clinics when the health secretary, Alan Johnson, yesterday vetoed plans for a third wave of independent sector treatment centres to compete with NHS hospitals.

In a break with Tony Bliar’s drive to expose the health service to the challenge of market forces, Mr Johnson said local NHS commissioners should adopt a more pragmatic approach to treating patients on the waiting list for tests and operations in England.

He will allow them to buy extra capacity from the private sector if they need it to meet targets on waiting times, and can show it provides value for the taxpayer. But he told the Commons health committee: “There will be no need for another national independent-sector procurement … There will not be a third wave.”

Mr Johnson was presented with plans for a third wave when he became health secretary last month, but he refused to endorse them.

As for the right to choose on October 31, 2007 Health Direct posted: Only 44pc recall hospital choice watchdog finds

Further evidence that the Labour’s “choice” policy is struggling as a means of driving reform in the National Health Service has come from the latest survey of how far it is being offered to patients.

A mere 44 per cent of patients could recall being offered a choice of hospital for their first outpatient appointment in May – down from 48 per cent in March – with provisional results for July showing a further decline to 43 per cent.

The Conservatives accused ministers of “robbing junior doctors of a roof over their heads” just months after mishandling their recruitment to speciality training places under the Modernising Medical Careers (MMC) system.

Just under 4,000 UK trained junior doctors have so far not got a training post.

Under the system in place before the introduction of MMC this year, employers were required to offer Pre-Registration House Officers accommodation on site for their first year’s training.

But changes introduced without parliamentary debate mean that the trainees are no longer automatically entitled to rooms.

The change came into force in August, but hospitals were asked to delay it until 2008, as jobs had already been advertised with accommodation.

The Conservatives said that the Department of Health had “added insult to injury” by making free or subsidised accommodation offered to junior doctors after August 2008 taxable as a benefit in kind.

Stephen O’Brien, the Tory health spokesman, said the change would cause problems for many junior doctors, who have to move between hospitals as many as four times in their first year, making it difficult to secure private rented accommodation.

From:
http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2007/11/15/ndoctors115.xml

On Sept 13, 2007 Health Direct posted A terrible way to treat our doctors- Financial Times Comment

Modernising Medical Careers (MMC) is a suitably Orwellian name for a Stalinist new system for training doctors in the National Health Service. The phrase is a perfect example of newspeak. To oppose a “modern” system is to be a conservative, if not a reactionary.

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.

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.

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?

And now Labour is suggesting that after shunting doctors off to all points of the compass they have to struggle to find their own accommodation. The disaster that is labour’s incompetent stewardship of the NHS continues to lurch to new levels of incredulity.

A minority of about 27 organisations – including hospital and primary care trusts – are in such difficulty that according to Steve Bundred, the commission’s chief executive, “there appears little hope that they can get out of trouble by themselves”.

The commission’s report also provides the first firm figures on the cost of redundancies from the government’s decision to slash the number of strategic health authorities and primary care trusts – revealing that the average payout has exceeded £300,000.

The finding that the best performers in the NHS are opening up an ever-wider gap with those at the bottom mirrors the conclusion of last week’s “state of the nation” report from the Healthcare Commission on the NHS.

“There is a worrying gap between the top performers and those still failing to meet their duty to balance their books,” Mr Bundred said, in spite of the NHS’s surplus of £515m last year and forecast surplus of £983m this year. Foundation trusts are also sitting on cash balances of more than £1.3bn.

Its measures of quality showed high performance at the top end, a disappointing number of NHS organisations providing a merely adequate service, and big problems at the bottom end.

The worst performers on service quality were in general also the worst performers financially.

Mr Bundred said the NHS “needs to focus urgently on the management of this small group of NHS bodies that are failing across the board”.

Alan Johnson, the health secretary, has said the poorest performing hospitals faced being taken over by organisations that performed better. This has happened in Birmingham, where the Heart of England foundation trust took over the Good Hope hospital.

Meanwhile, the Commission reported that the bill for redundancies arising from health service reorganisation had so far amounted to £192m, with much more to come in this year’s accounts.

The average payout stands at more than £308,000. Some payments to individuals had been “significant”, the commission said, with some costing more than £500,000.

Savings from reducing the number of organisations amounted to only £90m of the £250m that the government had said the changes would generate, the commission said. It would be monitoring closely whether the savings were made, it added.

The health department has said the cost of job losses will amount to at least £320m. The Audit Commission noted that someone made redundant might be re- employed by the NHS after only four weeks. But it said it had not been possible to find out in how many cases this had occurred.

From:
http://www.ft.com/cms/s/0/b36e7de8-80f5-11dc-9f14-0000779fd2ac.html

Health Direct suggest that the Audit Commission is behind the curve in their calculations. On July 20, 2007 Health Direct posted: NHS manager’s payout is nearly £1m

An NHS manager has been given a redundancy package worth almost £1 million in what was described as “a lottery win rather than a payout”. David Johnson, the former head of a regional strategic health authority, was one of about 70 staff who left the organisation when it was abolished as part of a restructuring programme.

The 50-year-old received a package worth £899,810 including salary and pension arrangements. The reorganisation was supposed to save £250 million a year in administration costs. However, the NHS is thought to have spent at least £320 million on redundancy packages to those who have lost their jobs.

The decisio – will not only mark another retreat from the use of the private sector in healthcare but will also see the health department forced to pay out millions of pounds in compensation.

Although Alan Johnson, health secretary, is to announce that a number of contracts will go ahead, including ones for extra imaging and renal services, about six contracts will be canned, on top of a number that were scrapped earlier this year.

The treatment centres that remain in the programme are, in most cases, smaller than the deals originally envisaged.

The move means that the original £700m a year’s worth of business will turn out to be worth less than half of that – possibly as little as £200m.

People in the industry say that the late cancellations mean that the government will have to pay out up to £20m in bid costs to contractors, which include Netcare, Clinicenta and Alliance Medical. This is on top of £5m already paid out for scrapped schemes.

Stephen O’Brien, the Conservative health spokesman, said yesterday that he will be asking the National Audit Office to investigate the programme. “The health department has spent a phenomenal amount of money to achieve very little,” he said.

Aside from the private sector’s costs, the health department had by March this year already spent £72m on the procurement, according to official figures.

The department admitted last month that just eight of the 190 staff in the health department’s commercial directorate were civil servants. The remainder were external hirings costing a total of between £88,000 and £120,000 a day – or the equivalent of between £20m and £30m a year.

The dramatic scaling back of the second wave of big central contracts will delight Unison and other opponents of the drive to involve the private sector in the delivery of NHS care.

However, it has left much of the private sector fuming, although ministers will argue that big opportunities remain as the government’s focus for the private sector switches from hospital services to primary care and proposed “polyclinics”.

But one senior executive said companies were now very wary. “There is a trust issue here,” he said. “We have been led up the garden path. We are not sure we want to go up it again”.

From:
http://www.ft.com/cms/s/0/1073a3fc-918f-11dc-9590-0000779fd2ac.html

Health Direct is puzzled that labour’s centralist edicts do not cover smoking. Does labour think that having burnt £500 million on their nanny state anti smoking campaigns that nobody smokes any more? If so how wrong are their health wazzocks!

On October 22, Health Direct posted: Nanny state burns £500m on failed anti smoking campaigns

The National Health Service has spent almost £500m on services to stop people smoking but with no discernible impact on either the proportion of the adult population that smokes or the numbers smoking.

People with a Body Mass Index (BMI), a calculation which takes into account height and weight, of between 18.5 and 25, are deemed to be within a “healthy” weight range.

But the study says their risk increases as they head towards the 25 mark, and that everyone should try to be as close to the lower end as possible.

There is no new research involved in this document: the panel examined 7,000 existing studies over five years.

The result, they say, is the most comprehensive investigation ever into the risks of certain lifestyle choices.

Labour wants you to stop now:

RECOMMENDATIONS INCLUDE:
Little red meat
No alcohol
Avoid bacon, ham, and other processed meats
No sugary drinks
No fruit juice
No weight gain after 21 (Presumably your age rather than IQ)
Exercise every day
Breastfeed children
Do not take dietary supplements to cut cancer

The nannies see body fat as a key factor in the development of cancer, estimating its significance to be much higher than previously thought.

The report’s authors say they have produced a list of recommendations, not “commandments”.

“But if people are interested in reducing their cancer risk, then following the recommendations is the way to do it,” said Professor Martin Wiseman.

“Cancer is not a fate, it is a matter of risk, and you can adjust those risks by how you behave. It is very important that people feel that they are in control of what they do.”

However, two-thirds of cancer cases are not thought to be related to lifestyle, and there is little people can do to prevent the disease in these circumstances.

Nevertheless, more than three million of the 10 million cases of cancer which are diagnosed across the world each year could be prevented if the recommendations were followed, Professor Wiseman indicated.

In the UK alone, there are 200,000 new cases of cancer each year.

Cancers of the colon and breast are some of the most common forms of the disease, and the report says the evidence is “convincing” that body fat plays a key role in the development of these tumours.

The report also links the kind of food consumed to cancers, especially colorectal ones.

In particular, researchers say people should stop eating processed meats, such as ham, bacon and salami, and limit the consumption of red meat to 500g a week – although this still means you could eat, for instance, five hamburgers each week.

” Alcohol, red meat and bacon in moderation will do us no harm, and to suggest it will is wrong”,
Karol Sikora a Cancer specialist

From a cancer perspective, all alcohol should be avoided, although researchers accepted drinking small amounts could have protective benefits for other diseases.

The recommendation is therefore no more than two drinks a day for a man, and no more than one for a woman, slightly less than current UK government guidelines.

Sugary drinks meanwhile should be avoided, as these make you fat, and fruit juice consumption should also be reduced.

The report is also the first to urge breastfeeding as a means to protect against cancer, arguing that it may reduce breast cancer in the mother and prevent obesity in the child – although this has not been proven.

Cancer specialist Professor Karol Sikora said: “The educational message for the public should be that there are healthy diets and unhealthy diets but we should keep everything in perspective and not suggest rigid avoidance.

Antonia Dean, a specialist at Breast Cancer Care, said: “it is notoriously difficult to examine the potential role of diets or other lifestyle factors on breast cancer, as it is hard to isolate specific influences or establish how they might interact with each other.

“It is important that women keep the report findings in perspective – after gender, the highest known risk factor in relation to breast cancer is age, with 80 per cent of cases occurring in women over the age of 50.”

From:
http://news.bbc.co.uk/1/hi/health/7069914.stm

The shift was needed to make allowance for people who chose to wait longer, did not turn up for their appointments or who had clinical reasons why their treatment should wait, said Ben Bradshaw, the health minister, yesterday.

One option under consideration was to set the target so that 90 per cent of patients who needed hospital admission were treated within 18 weeks. For those treated as outpatients or in the community the target would be 95 per cent.

The shift is likely to be seen by some as an attempt to soften a demanding target that the National Health Service is required to hit by the end of next year. But Mr Bradshaw said the change was aimed at recognising the reality of what happened, without burdening hospitals with the bureaucracy of having routinely to provide reasons for every patient who appeared to breach the 18-week promise.

The parallel was with the four-hour wait for treatment in accident and emergency departments where the target was 98 per cent in recognition that some patients needed to wait longer for clinical observation.

Norman Lamb, the Liberal Democrat health spokesman, said ministers would struggle to convince the public “that this change isn’t merely providing political cover because of fears they will fail to achieve their -target”.

Bradshaw’s moving goalpsots were made as the health department published its latest, but still incomplete, data on 18-week waits, which show continued progress towards the target but with large variations.

Fifty-six per cent of patients admitted to hospital were seen within 18 weeks in August, up from 48 per cent in March, along with three-quarters whose treatment did not require admission.

Nonetheless, large numbers are still waiting more than a year.

From:
http://www.ft.com/cms/s/0/83212d74-8e66-11dc-8591-0000779fd2ac.html

Less than two months ago Health Direct posted: Ben Bradshaw is confident of achieving 18 week target when Ben Bradshaw was forced to defend the incompetence of his Department of Health this week after a detailed analysis by the Financial Times found that fully a quarter of the population would have to wait longer than the basic 18 weeks between referral by a GP and treatment which labour promised.

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.

Bradshaw was responding to news that Health Direct posted on September 10, 2007
NHS to miss 18 week treatment wait targets

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 suggest.

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.

Former miner, trade union activist and Labour Party member Tom Kilcourse never thought he’d hear himself say the ideal of the NHS has had its day. But his experience of healthcare provision in France, where he retired with his wife Rita, has convinced him that a radical re-think is needed.

In April 1993, a year after moving to the Normandy town of Jumierge, Mr Kilcourse was examined at the Bichat hospital in Paris, and told that he needed a heart transplant. Mrs Kilcourse, 75, could not face travelling to Paris, so she checked the information that by law is published on every hospital and found nearby Rouen University Hospital the second best for that procedure. Within weeks the operation had been done.

Mr Kilcourse says France’s system is insurance-based with doctors and consultants in competition for patients. He added: “If the British knew how badly they are being served there would be a revolution.”

Ultrasound in India

Growing up in India, Sudhanshu Sarangi regarded the NHS as the pinnacle of health-care. But he has since changed his views.

A senior officer in the Indian Police Service, Mr Sarangi, 40, recently came to Britain to complete a PhD at Liverpool University.

Shortly before travelling, Mr Sarangi had an operation on his gall bladder. He developed an infection, but when he visited his GP in Liverpool Mr Sarangi was told he would have to wait six weeks for an ultrasound examination by a specialist.

Instead he went back to India for treatment. “I flew to Hyderabad and received the tests on the day I arrived,” he said. The tests cost £50; if he had gone private in the UK he would have paid £1,200.

On his return to Liverpool Mr Sarangi was referred to a consultant for specialist treatment prescribed in India. But after six weeks the appointment was cancelled at five days’ notice and he now faces a further six-week wait. “I’ll go to Hyderabad,” he said.

Kidney transplant in US

It is down to the bravery of his niece, rather than the NHS, that John Blackley is well today.

Carol Kennedy donated a kidney to her uncle, saving him months of waiting on dialysis for a donor. For the transplant to take place, however, the 38-year-old had to travel to Austin, Texas, because of the time it would have taken to happen in Britain.

Mr Blackley, 55, left Scotland in the 1980s to work in America. When he was diagnosed with kidney failure it was found Ms Kennedy, back in Glasgow, was a perfect match. She wanted the operation in Scotland.

Before the transplant could go ahead she had to have a routine psychiatric assessment, but the shortage of psychiatrists in Strathclyde meant a delay of at least seven months. Also, the operation would have to wait another six to eight months, due to a shortage of surgeons.

Ms Kennedy flew to Texas and after 10 days, during which she and her uncle had psychiatric tests, health evaluation and counselling, a successful transplant took place.

Dental work in Cyprus

It was not waiting lists nor the fear of superbugs that drove Bob Richard-son to have his root canal treatment carried out in Cyprus. It was the prospect of saving himself £350.

A retired NHS health professional, he is critical of the cost charged for what should be routine treatment.

“I was quoted £500 for the treatment in the UK and £150 by the specialist in Cyprus, where I have my second home.

“I had no qualms about getting the work done in the UK, but my dentist said he wasn’t specialised to carry out the treatment so I had to look for a specialist. But the price difference between here and Cyprus was astounding,” said Mr Richardson, 60, from Welwyn, Hertfordshire.

He said only by improving clinical productivity and introducing genuine competition into the NHS can any problems be solved.

“If enough folk travelled abroad for procedures it would bring the cost of private care down in this country,” he said.

From:
http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2007/11/04/nhs204.xml

The Tory plans present a political challenge to Gordon Brown’s government to spell out how it plans to achieve improvements to the service, commentators say.

Under the Tory proposals a separate NHS board, which would still be subject to ministerial direction, would allocate resources, issue commissioning guidance and performance manage health authorities and primary care trusts, with family doctors being given real budgets to buy NHS care.

Monitor, the foundation trust regulator, would become a full economic regulator for healthcare. It would have a duty to promote competition, set the prices for NHS care and oversee market entry and exit for independent as well as NHS-run providers of care.

Healthwatch, a new patient and public involvement body, would work alongside the existing NHS inspectorate.

Andrew Lansley, the Conservative health spokesman, said the package would “give greater freedom to the NHS” and “get politicians and the Department of Health out of the day to day management of the NHS”.

It also allowed for competition and choice to drive improvements, with polls showing that most of the public did “not care who provides the service” as long as it remained free at the point of use and of good quality.

The Conservatives, he said, would use opposition time or a private member’s bill to put the proposed legislation before parliament.

He said that last year Mr Brown, when chancellor, appeared to be in favour of a more independent NHS, “but he seems to have reneged on that view”.

Chris Ham, the former head of the Department of Health’s strategy unit and professor of health service management at Birmingham University, said that while the details differed considerably, the thrust of the Conservatives’ bill would have produced similar results as Blairite reforms.

“It begins to establish some clear blue water between Tory and Labour health reforms. It throws down the gauntlet to Gordon Brown and his health ministers to be much clearer about the mechanisms they want to use to drive further improvements in the NHS.

“Are they going to push through Blair’s market-based reforms, or are they going to come up with an alternative Brownite version that is different both from where the Blairites were going and where the Tories are?”

Professor Ham said he was sceptical about how far politicians would in practice be willing or able to live with the effects of market-based reform in the NHS.

“But this sounds like a more coherent version of NHS independence combined with market-based reforms than the present government has been able to articulate.”

From:
http://www.ft.com/cms/s/0/49ccf188-89b2-11dc-8dff-0000779fd2ac.html

Despite the huge amounts invested in the health service by the Government in recent years, fears over its future continue to grow among patients. The survey’s findings show high levels of concern across the entire health service.

Nearly half of those questioned by the Patients Association said they wanted to see further cuts in waiting times for treatment, an urgent reduction in infections such as MRSA and Clostridium difficile (C. diff) and an increase in the number of doctors, nurses and other healthcare staff.

Leading Patient Association trustee Ann Alexander, a solicitor who specialises in health cases, said: “We have to make sure that the health service has adequate numbers of healthcare professionals capable of providing treatment within a reasonable amount of time in a safe environment.

“We don’t want people put off by the fear of catching serious infections in hospital to the extent they feel they have to go abroad for treatment.”

The survey comes as new figures reveal that last year about 70,000 Britons spent more than £315 million paying for treatment in overseas hospitals and clinics to escape long NHS waiting lists and high rates of infection.

The amount is expected to grow substantially over the coming years. The numbers of patients seeking treatment abroad is forecast to rise to almost 200,000 by the end of the decade, as revealed last week by Health Direct last week ; Record numbers go abroad for health treatments

That could mean as much as £886 million being spent by Britons on foreign treatment.

Keith Pollard, of the information website Treatment Abroad, who carried out the study, said: “Despite huge investment in the NHS over the past 17 years, patients from the UK are voting with their feet and travelling abroad.”

A fifth of those questioned by the Patients Association identified a reduction in waiting times as their main priority. Fifteen per cent said cuts in hospital infections would make the greatest difference to them and 14 per cent wanted to see more staff on duty.

The findings follow the publication of official figures which show the labour Government is failing to meet its target for reducing the spread of hospital infections.

Cases of C. diff increased by seven per cent in hospital patients over the age of 65. Cases of MRSA fell by 10 per cent from a high of 7,096, but this was not enough to meet the Government’s pledge to halve the rate by next year.

However, despite grave concerns over the NHS, the Patients Association survey found a clear majority rejects any move towards creating an insurance-based health care system on US or French lines.

More than 40 per cent support the current method of funding the NHS through national taxation. Twenty four per cent of those who took part, however, back a tax deductible insurance policy as a way of paying for treatment.

The survey, shows an overwhelming majority want an end to Britain’s healthcare “postcode lottery” where availability of drugs and treatments depends on location.

The Patients Association is still collecting responses to its survey at www.patientsassociation.org.uk.

From:
http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2007/11/04/nhs104.xml

In recent years it has been brought lower and lower by kiss -and-tell betrayals, by “reality” TV, by shockumentaries and by liars, fantasists, hucksters and geeks of every kind, crowing and denouncing and emoting in a hideous new version of Bunyan’s Vanity Fair.

Outstanding among these is Michael Moore, the American documentary maker. He specialises in searing indictments, such as Fahrenheit 9/11 and Bowling for Columbine, and has, without a doubt, a genius for it.

Although his films are crude, manipulative and one-sided, he is idolised by millions of Americans and Europeans, widely seen as some sort of redneck Mr Valiant-for-truth.

Nothing could be further from the truth. His latest documentary, Sicko, was recently released in cinemas. Millions of people will see it and all too many of them will be misled.

Sicko, like all Moore’s films, is about an important and emotive subject – healthcare. He contrasts the harsh and exclusive system in the US with the European ideal of universal socialised medicine, equal and free for all, and tries to demonstrate that one is wrong and the other is right.

So far, so good; there are cases to be made.

Unfortunately Sicko is a dishonest film. That is not only my opinion. It is the opinion of Professor Lord Robert Winston, the consultant and advocate of the NHS. When asked on BBC Radio 4 whether he recognised the NHS as portrayed in this film, Winston replied: “No, I didn’t. Most of it was filmed at my hospital [the Hammersmith in west London], which is a very good hospital but doesn’t represent what the NHS is like.”

I didn’t recognise it either, from years of visiting NHS hospitals. Moore painted a rose-tinted vision of spotless wards, impeccable treatment, happy patients who laugh away any suggestion of waiting in casualty, and a glamorous young GP who combines his devotion to his patients with a salary of £100,000, a house worth £1m and two cars. All this, and for free.

This, along with an even rosier portrait of the French welfare system, is what Moore says the state can and should provide. You would never guess from Sicko that the NHS is in deep trouble, mired in scandal and incompetence, despite the injection of billions of pounds of taxpayers’ money.

While there are good doctors and nurses and treatments in the NHS, there is so much that is inadequate or bad that it is dishonest to represent it as the envy of the world and a perfect blueprint for national healthcare. It isn’t.

GPs’ salaries – used by Moore as evidence that a state-run system does not necessarily mean low wages – is highly controversial; their huge pay rise has coincided with a loss of home visits, a serious problem in getting GP appointments and continuing very low pay for nurses and cleaners.

At least 20 NHS trusts have even worse problems with the hospital-acquired infection clostridium difficile, not least the trust in Kent where 90 people died of C diff in a scandal reported recently.

Many hospitals are in crisis. Money shortages, bad management, excesses of bureaucrats and deadly Whitehall micromanagement mean they have to skimp on what matters most.

Overfilling the beds is dangerous to patients, in hygiene and in recovery times, but it goes on widely. Millions are wasted on expensive agency nurses because NHS nurses are abandoning the profession in droves. Only days ago, the 2007 nurse of the year publicly resigned in despair at the health service.

There is a dangerous shortage of midwives since so many have left, and giving birth on the NHS can be a shocking experience.

Meanwhile thousands of young hospital doctors, under a daft new employment scheme, were sent randomly around the country, pretty much regardless of their qualifications or wishes. As foreign doctors are recruited from Third World countries, hundreds of the best-qualified British doctors have been left unemployed. Several have emigrated.

As for consultants, the men in Whitehall didn’t believe what they said about the hours they worked, beyond their duties, and issued new contracts forcing them to work less. You could hardly make it up.

None of these problems mean we should abandon the idea of a universal shared system of healthcare. It’s clear we would not want the American model, even if it isn’t quite as bad as portrayed by Moore. It’s clear our British private medical insurance provision is a rip-off. I believe we should as a society share burdens of ill health and its treatment.

The only question is how best to do that and it seems to me the state-run, micromanaged NHS has failed to answer it.

By ignoring these problems, and similar ones in France’s even more generous and expensive health service, Moore is lying about the answer to that question. I wonder whether the grotesquely fat film-maker is aware of the delicious irony that in our state-run system, the government and the NHS have been having serious public discussion about the necessity of refusing to treat people who are extremely obese.

One can only wonder why Sicko is so dishonestly biased. It must be partly down to Moore’s personal vainglory; he has cast himself as a high priest of righteous indignation, the people’s prophet, and he has an almost religious following.

He’s a sort of docu-evangelist, dressed like a parody of the American man of the people, with jutting jaw, infantile questions and aggressively aligned baseball cap.

However, behind the pleasures of righteous indignation for him and his audience, there is something more sinister. There’s money in indignation, big money.

It is just one of the many extreme sensations that are lucrative for journalists to whip up, along with prurience, disgust and envy. Michael Moore is not Mr Valiant-for-truth. He is Mr Worldly-wiseman, laughing behind his hand at all the gawping suckers in Vanity Fair. Don’t go to his show.

From:
http://www.timesonline.co.uk/tol/comment/columnists/minette_marrin/article2753620.ece

The figures, released yesterday by the Health Protection Agency, cast doubt on whether targets set by the Government to reduce C diff cases by 30 per cent in the next four years can be met.

It comes after at least 90 patients died from C diff at Maidstone and Tunbridge Wells Hospital trust and contributed to the deaths of around 200 others in Britain’s worst superbug outbreak.

Alan Johnson, the Health Secretary, said yesterday that the hospital’s board may have acted illegally when trying to pay off Rose Gibb, the trust’s chief executive, with £250,000 days before a damning report into the outbreak was published.

Signalling a clampdown on the “gravy train” managers who take large payoffs, Mr Johnson blocked the massive severance package.

Managers often receive pension benefits and large lump sums to leave failing trusts, only to re-appear in another hospital within months.

David Nicholson, the NHS chief executive, has today written to all hospital trusts warning them when severance deals are not acceptable.

The Health Protection Agency data showed cases of MRSA fell by 10 per cent last year, with 6,381 reported between April 2006 and March 2007, compared with 7,096 the previous year – but even that is not enough to meet the Government promise to halve the rate by 2008.

In January, a leaked Department of Health memo suggested that the target would never be met and rates of MRSA would only be reduced by a third and not half. Please see the posting by Health Direct below.

Richard James, Professor Of Microbiology at Nottingham University, said: “The target rate for MRSA reduction was over-ambitious and a lot of people suspected it would not be achieved. The Government have given themselves a longer period with C diff, but it remains to be seen if that will be hit.”

Mr Johnson insisted he was confident of hitting the target.

“These figures today are very encouraging,” he told BBC Radio 4.

Georgia Duckworth, from the HPA Centre For Infections, said the rise in C diff was slowing down and “going into the plateau” as results for April to June 2007 show a 13 per cent drop compared with the same period last year, with 13,660 cases, down from 15,639.

She said the drop in MRSA was impressive and constituted a “major achievement”.

However, a spokesman for the Patients Association said the alarming rate of infection in Britain’s hospitals — which sees 8.2 per cent of patients pick up a bug each year — was a “disgrace”.

Figures for glycopeptide-resistant enterococcal (GRE bacteria), which causes wound infections and blood poisoning, also show an increase in infection rates with 903 cases reported in 2005/06 compared to 758 in the previous year.

From:
http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2007/11/02/nhos102.xml

On 11 Jan 07 Health Direct posted NHS hospitals may never achieve MRSA superbug targets

The NHS is not on track to meet its MRSA target and perhaps never will, a leaked government memo says. In November 2004, then health secretary John Reid pledged MRSA rates would be halved by April 2008.

But the memo, sent to ministers by a Department of Health official, said it would only be cut by a third by then. It also reportedly recommended ways to handle the news in the media. Dr Mark Enright, from Imperial College, said the target was “unrealistic”.

On the one hand Health Direct is pleased that Alan Johnson is waking up to the disgrace that is thousands of preventable deaths, on the other hand the figures for summer are usually lower than those for winter- so worse may be expected.

She found bed linen, gowns and tables were a more common source of the superbug than floors, the Lancet Infectious Diseases study said.

The most common MRSA superbugs sites are:
Bed linen – 41% of sites contaminated
Patient gown – 40.5%
Overbed table – 40%
Floor – 34.5%
Furniture, bed-rails, side-rails – 27%

Dr Dancer, from Glasgow’s South General Hospital, said the problem was that hospital cleaning tended to concentrate on areas of visible dirt such as floors.

But she said they would be much more effective if they targeted hotspots that hands came into contact with regularly.

She added that without such strategies, campaigns to get people to wash their hands were not effective.

Bed linen, patient gowns and overbed tables were the most common sources with over 40% of these sites contaminated. Door handles, bed-rails, furniture and taps were also common sources, she said.

Dr Dancer also claimed that the cleaning did not even need to be done with state-of-the-art cleaning agents.

“Hot soapy water is enough,” she said.

“Governments across the UK need to reconsider their approaches. We are just trying to remove visible dirt from areas such as floors when this is not the best approach,” she added.

She also criticised the Department of Health in England for the plans for a deep clean of hospitals. “It is like using a sledgehammer to crack a nut. And anyway it will only have an impact in the first week and then hospitals will be dirty again.”

Chief Nursing Officer Christine Beasley said the government was using a range of measures, including enforcing hygiene rules with the threat of fines.

But she defend deep cleaning as an “important tool”.

She added: “Infection control is a complex problem that needs a range of solutions and the fact is there is no single remedy.”

From:
http://news.bbc.co.uk/1/hi/health/7069897.stm

Health Direct notes that most of the experts’ suggestions for solving the MRSA superbugs crisis are sadly lacking from Stalinist Brown’s centralist dictat:

On Sept 26, 2007 Health Direct posted: Gordon Stalinist Brown pledge on NHS funding and MRSA

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.