The U-turn comes after more than a decade of Government promises, made at the 1997 election and repeated in 2001, to bring an end to male and female patients sharing facilities in NHS hospitals.

Figures reveal that 31 pc of NHS trusts admit to having fully mixed wards – without any form of partition

Patients’ charities have argued for years that mixed-sex wards are undignified, degrading and put women at risk of attack from male patients.

A number of female patients in recent years have been the victims of assault from men in mixed-sex wards.

Figures obtained by the Conservatives under Freedom of Information laws showed that nearly a third of hospitals are still treating men and women in the same wards.

This is almost double the amount stated in a report released in May by the Chief Nursing Officer.

Following inquiries by The Daily Telegraph, the Department of Health disclosed that eliminating mixed-sex wards is no longer an aim.

A DoH spokesman said: “We have to get away from this idea of single-sex wards. That is not what it is all about.

“Now we are in a situation where we are moving away from a set target on single-sex accommodation and moving towards the NHS locally taking privacy and dignity much more seriously.

“It is possible to envisage patient privacy and dignity with patients of different sexes on the same wards but with proper segregation.

“There are different ways of ensuring that. It’s not about targets. Now it’s much more about what the patient feels.”

The spokesman said a mixed ward divided into bays by fixed partitions – not necessarily fixed to the ceiling, but high enough that patients perceive they are in a separate room – counted as single-sex accommodation.

Patient groups and the Tories said the comments meant the Government was “walking away” from its manifesto commitment.

Andrew Lansley, the shadow health secretary, said: “After 10 years of failing to deliver, Labour now appear willing to betray the interests of patients by dropping their manifesto commitment to abolish mixed-sex wards as patients understand them.

“As recently as last May, Patricia Hewitt made it clear that what she meant by single-sex accommodation excluded partitioned bays.

“Now it seems the department are accepting the proposition that patients should be in mixed-sex accommodation with nothing but flimsy partitions between them.

“Tony Blair said it couldn’t be beyond the wit of Government to sort it out, but it is clearly beyond the competence of Labour.”

Catherine Murphy, of The Patients Association, said: “What patients, especially female patients, want is pretty simple. It is to be nursed and cared for on a ward where only patients of their sex are present.

“Even with bays, you still have a situation where you will have a member of the opposite sex around. Women, especially, feel very intimidated.

“We should not be in a situation in 2007 where we are having men and women sharing the same facilities. It’s another target the labour Government is trying to walk away from and drop.”

In May, Patricia Hewitt, the then Health Secretary, vowed there was more to be done to “meet our commitment to eliminate mixed-sex wards”.

Miss Hewitt stated two years ago that partitioned bays were “not good enough”.

Mervyn Kohler, of Help the Aged, said: “Going into hospital can be a fraught enough experience as it is, especially for older, more vulnerable patients, without being burdened with the worry and utter humiliation of undressing and bathing on a mixed sex ward.”

The Patients Association has taken increasing numbers of calls from patients and relatives who relate frightening stories of lack of privacy.

It heard from one woman who complained that a confused elderly man had tried repeatedly to get into bed with her.

In another case, the screen dividing a woman’s bed from male patients was a “simple partition that did not even reach the ceiling and finished with flimsy net curtains”.

Janet Street-Porter, the writer and broadcaster, spoke movingly last year of how her sister suffered the “hell” of a mixed-sex ward during her final days.

Patricia Balsom, 57, who died eight months after being diagnosed with lung and brain cancer, left a diary chronicling the failing of the NHS over the last three weeks of her life.

She said she was twice woken by a patient who was standing naked by his bed.

The figures obtained by the Conservatives showed 31 per cent of the trusts admitted still having fully mixed wards – without any form of partition and excluding intensive care, emergency and children’s wards.

Some 26 per cent of trusts reported washing facilities were not segregated on all wards, while 29 per cent said lavatories were not fully segregated.

From:http://www.telegraph.co.uk/news/main.jhtml;jsessionid=SJAOTGWCN3CPXQFIQMFSFFWAVCBQ0IV0?xml=/news/2007/12/22/nwards122.xml

The director of one of India’s biggest private hospital chains said he was receiving five job applications a week from NHS doctors and that half his 3,000 consultants were from Britain.

“There’s a feeling that India’s time has come and there’s a huge need for these people to come back,” Anupam Sibal, director of the Apollo hospital in Delhi, said yesterday.

Doctors say they are moving to India because of its economy, state of the art equipment, higher standards than the NHS and a better quality of life. In particular, they say hospitals in India, which many Britons still imagine to be impoverished and dirty, suffer less from hospital-acquired infections such as MRSA.

India has no equivalent of the NHS but there has been a boom in private hospitals that resemble luxury hotels, with marble foyers and corridors mopped by an army of liveried cleaners.

One of those who has made the transition is Mahesh Kul-karni, an orthopaedic surgeon, who left Bristol Royal Infirmary after 10 years in Britain. He is now a consultant at the Aditya Birla Memorial hospital in Pune.

“The hospitals are better than in Britain,” he said. “This hospital is spotless and clean compared with the old hospitals in the UK, some of which are more than 100 years old. I started in January this year and I have not seen MRSA here yet.

“It’s had a lot of investment, and things I couldn’t do in Britain I can do here. We have ‘clean air’ operating theatres [that remove dust from the air], and our intensive care unit here is fully equipped with special monitoring instruments.

“When I went to England 10 years ago, India was 10 years behind Britain. Now there’s hardly any difference.”

Bristol Royal Infirmary defended its record, saying there had been a 35% increase in spending on new equipment and that its latest inspection had found cleanliness was “acceptable”.

Ameet Kishore had worked as an ear, nose and throat consultant in Glasgow Royal Infirmary for 12 years when he moved to the Apollo hospital in Delhi two years ago. Although reluctant to criticise the NHS, which had taught him so much, he said that the new Indian hospitals were cleaner and better resourced.

He contrasted the number of cochlear implant operations that he could perform: at Crosshouse hospital, Kilmarnock, the main ENT centre for the west of Scotland, he was limited to 40 a year; in Delhi he had done 70 in the past six months.

Other doctors cite new European Union rules for their decision to move. Shailendra Magdum, a specialist registrar in neurosurgery at Radcliffe Infirmary in Oxford until he left for India in August last year, said that rules favouring EU doctors over Indians had played a part.

The EU’s working time directive had also lowered NHS standards, he added, by restricting the amount of time that young doctors could spend on the wards.

“For a neurosurgeon to be good you have to spend a lot of time on the wards, but in Britain the working time directive is running down training,” he said.

Although salaries are usually lower in India, doctors are finding that their standard of living is better. Kishore said he lived in a bigger house with a driver, cleaner, cook, nanny and watchman to look after him, his wife and two young children.

From:
http://www.timesonline.co.uk/tol/life_and_style/health/article3056942.ece

Health Direct laments the wasted cost of training overseas medical staff- only for the UK to let these talented people slip through our fingers.

The disclosure has led to renewed calls for more stringent rules to stop politicians from cashing in too quickly on their time in office.

Hewitt, who resigned in June, has been inundated with consultancy jobs since leaving the Department of Health. She is set to be the latest in a series of health ministers and senior officials to move into the private sector.

Lord Warner and Alan Milburn, both former health ministers, have also benefited, moving to healthcare jobs soon after leaving office. Liz Kendall, Hewitt’s former special adviser, is now a healthcare consultant to a number of organisations, including private sector companies.

Hewitt, who was health secretary from May 2005 but stood down when Gordon Brown took over as prime minister, is expected to take up her roles in the new year.

Warner’s jobs, revealed this month, include advisory roles for Xansa, a technology company in Reading, Berkshire, that has a partnership with the Department of Health to provide finance services to National Health Service bodies, and Byotrol, an antimicrobial company that sells products to the NHS.

Warner also has an advisory role with DLA Piper, which advised ministers on the NHS’s £12 billion IT programme. Warner was responsible for this while a health minister.

The move into consultancy will raise fresh questions about whether companies are gaining a strategic advantage by hiring ministers with recent experience of the highest levels of government.

Norman Lamb, the Liberal Democrat health spokesman, said: “There is a question about whether they could exploit their continuing links with the government. We need a far greater cordon sanitaire to prevent any suspicions.”

Hewitt confirmed that she had received a number of offers and was likely to decide which ones to take up after Christmas. She said: “I haven’t taken up any appointments and I will only do so after I have had the advice from the Advisory Committee [on Business Appointments].”

This committee vets private sector roles for former ministers to ensure there is no conflict of interest. It often imposes a cooling-off period before such job offers can be taken up.

From:
http://www.timesonline.co.uk/tol/news/politics/article3056703.ece

Considering Hewitt’s inept performance as a labour government minister, Health Direct is surprised to learn that any company would consider touching her with a ten foot pole.

Health Direct wonders if the companies that are offering Hewitt the chance of gravy are either stupid, given her demonstrable lack of any ability, or hope to gain some advantage from employing a labour politician-I wonder what it could be ?

Ms Hewitt does however confirm a diagnosis of complete cynicism and a sickness in the body politic which will take many years to heal.

Ministers have given their backing to an initiative in Birmingham that is seeking to sidestep the controversial GP contract by encouraging doctors effectively to reapply for their jobs.

The project has angered the British Medical Association for seeking to corral GPs working alone into multi-doctor health centre “franchises” that would have set standards, longer opening hours and offer services ranging from x-rays to mental health advice.

“The idea that you can franchise health care and put health service workers in a uniform franchise like McDonald’s sounds so ridiculous I cannot believe anyone would consider doing this,” said Laurence Buckman, chairman of the BMA’s GPs committee. “Working evenings and weekends . . . is the only thing that matters to Gordon Brown.”

The Heart of Birmingham Teaching Primary Care Trust’s corporate franchise strategy suggests the model could eventually allow private providers, such as “Virgin, Tesco or Asda”, to quote the document, enter the market for GP services.

Managers are unable to force GPs to give up their single-practice surgeries. But they believe making doctors sign up to franchise agreements – overlaid on their existing contracts – will make them extend opening hours and offer more services, which would be easier to achieve in a bigger surgery. Doctors who opt out would face intense competitive pressure from other surgeries, managers believe.

The initiative may give the labour government a way to meet its pledge to increase out-of-hours care without having fully to renegotiate controversial GP contracts that gave family doctors a sharp pay rise through incentives that tended to shorten opening hours.

Health officials are closely monitoring the Birmingham scheme to see whether it can be used as a nationwide model. Ben Bradshaw, health minister, said: “Improving the quality and flexibility of GP services is a priority for the public. I applaud initiatives such as Birmingham’s to respond to the views and needs of the local community.”

From:
http://www.ft.com/cms/s/0/13fa0aac-ac42-11dc-82f0-0000779fd2ac.html

Health Direct notes that this is the same Brown Mr Bean that negotiated away the need for doctors to work weekends in the first place.

On January 31, 2007 Health Direct posted BMA team ‘stunned by GP contract’ as a bit of a laugh

GPs were so stunned by the terms offered to them when negotiating their new contract in 2004 that they thought it was a “bit of a laugh”, a doctor has said.

Dr Simon Fradd, who was one of British Medical Association’s GP negotiators, said they were shocked by the approach taken by the labour government. They could not believe it when GPs were given the chance not to do evening and weekend work for only a 6% pay cut, he said.

Colette Mills, a former nurse, has been told that if she attempts to top up her treatment privately, she will have to foot the entire £10,000 bill for her drugs and care. The bizarre threat stems from the refusal by the government to let patients pay for additional drugs that are not prescribed on the NHS.

Ministers say it is unfair on patients who cannot afford such top-up drugs and that it will create a two-tier NHS. It is thought thousands of patients suffer as a result of the policy.

Mills, 58, is thought to be the first to take a public stand in challenging her NHS trust to allow her to pay for the drug as part of her NHS treatment.

She wants to top up her treatment with Avastin. “The policy of my local NHS trust is that I must be an NHS patient or a private patient,” she said.

“If I want to pay for Avastin, I must pay for everything. It’s immoral that the drugs are out there and freely available to certain people, yet they say I cannot have it.”

With many “wonder drugs” in the pipeline that the NHS is unlikely to fund, her predicament is likely to be shared by increasing numbers of patients who could afford additional life-extending drugs but not the cost of their entire care.

Mills, a mother of two, who lives near Stokesley in North Yorkshire, is being treated with the drug Taxol, which is available on the NHS, but believes that her chances of halting the cancer would be improved by also using Avastin.

She is prepared to pay South Tees Hospitals NHS Trust for the Avastin and the cost of its administration. This would amount to at least £4,000 a month. Mills does not want to pay for all of her NHS treatment, however.

“The costs would increase from £4,000 a month to about £10,000 to £15,000 for all my care. I would need to pay charges for seeing the consultant, for the nurses’ time, for blood tests and scans,” she said.

Some doctors support her case. Professor Karol Sikora, medical director of CancerPartners UK, a private cancer company, said: “This is unfair to taxpayers who are entitled to NHS care. If this patient wishes to pay for another drug, that should be her choice.

The patient should be invoiced by the NHS for the extra treatment, with a mark-up to cover the hospital’s costs.” The government is opposed to the so-called “co-payments” because they would lead to patients in the same NHS ward receiving different drugs based solely on their ability to pay.

But doctors say this already happens where private and NHS patients are treated at the same NHS unit.

Some patients have got access to the drugs by going fully private. Others have continued with their basic NHS care while receiving an additional drug from a private company at home. By contrast, Mills believes that it is her right for her local NHS trust to provide the drug if she is prepared to pay for it.

South Tees Hospitals NHS Trust said: “If a patient chooses to go private for certain drugs they elect to become a private patient for the course of their treatment for that condition. That is the trust policy.”

The Department of Health said: “Co-payments would risk creating a two-tier health service and be in direct contravention with the principles and values of the NHS.”

From:
http://timesonline.co.uk/tol/life_and_style/health/article3056691.ece

Health Direct points out that this postcode lottery is a very strange stance for the Trust to take – but then again, perhaps not. We are after all dealing with the petty bureaucracy of the NHS – when NHS dental practices, those which remain that is, are allowed to mix private and NHS care.

It would be interesting to hear the same views of the anonymous spokesperson (or a senior manager) if his/her life, or that of a close relative were on the line. I’ll bet you anything a way would be found round the rules. These are meant only for the hoi polloi who have the temerity to have saved up enough for additional care.

Although the annual death toll from prostate cancer is the equivalent to the crashing of a fully laden jumbo jet every fortnight, little is heard about this silent killer, and it is hard to see how the forthcoming guidance from the National Institute for Health and Clinical Excellence aka National Institute for Curbing Expenditure (NICE) will do much, or indeed anything, to reverse the situation.

Compared with breast and lung cancer the cancerous cells of the prostate are relatively slow growing, often doubling in number only every two years or so.

This slow growth rate provides a window of opportunity for cure, since prostate cancer can be reliably eradicated while it remains within the gland, but becomes incurable once it spreads to the lymph nodes or bones.

Indeed, every one of those men who have died of the disease this year could potentially have been cured, if only their disease had been recognised earlier.

Yet Nice pays scant attention to early detection of the disease, and the labour Government has just ruled out the introduction of a mass screening programme.

Current draft guidance from Nice suggests that as a one-off measurement, blood tests marker for prostate disease are not accurate enough.

In fact, if screening happens regularly enough, checks on the rise of Prostate Specific Antigen, rather than its absolute value, enable us to detect the cancer risk increasing.

Meanwhile, the body dismisses new methods of treatment that are so often employed abroad, preferring instead to endorse “watchful waiting” as the disease develops and eventually spreads.

Doctors working in the field want to eradicate the cancer while causing minimal “collatoral damage” to sexual and urinary functions.

We know from experience how central these are to a man’s quality of life. New technologies in robotics now permit the removal of a cancerous prostate through a tiny keyhole near the belly button with minimal blood loss, preserving the tiny nerves which protect erectile function.

High intensity focussed ultrasound (HIFU) permits a minimally invasive means of destroying cancer, while cryosurgery kills cancer cells by freezing them.

Nice has the luxury of time to hedge its bets and await the results of long term medical trials, which could take decades to provide results.

The problem for those of us sitting opposite a patient and his family in clinic is what to do here and now.

Nobody wants to die from prostate cancer – often a slow and painful demise – but of course no one wants unnecessary treatment, especially if impotence and incontinence are the result.

New treatment options take us nearer to the “Holy Grail” of effective treatment with minimal side-effects. What is needed is a health service which harnesses today’s scientific breakthroughs and focusses on the future.

Unless it does so, the death toll among Britain’s men will continue to rise needlessly.

Written by Prof Roger Kirby who is chair of the charity Prostate Cancer UK.

From:
http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2007/12/16/ncancer216.xml

The groundbreaking ultrasound therapy has been shown to kill nine out of 10 prostate tumours, and five years after treatment, 80 per cent of patients show no sign of the cancer recurring.

Compared with surgery or conventional radiotherapy treatment, it is not invasive and is far less likely to lead to devastating side effects such as impotence or incontinence.

Suitable for treatment in the early stages of the disease, when it is not known how quickly it will spread, the ultrasound therapy is regarded by doctors as a vital new weapon in the battle against prostate cancer.

The UK’s most prevalent cancer among men, prostate cancer kills 10,000 a year, with 35,000 more cases diagnosed annually. A third of men over 50 contract it.

Three years ago, the National Institute of Health and Clinical Excellence (Nice) said men across the country should be offered the treatment, called High Intensity Focused Ultrasound (Hifu), free on the NHS.

But The Sunday Telegraph has learnt that Nice has now decided to reverse that decision. In the New Year, the controversial rationing body will massively restrict the use of the HIFU treatment.

Instead of it being available to all prostate cancer sufferers, it will now be restricted only to those who have already failed to respond to conventional treatment and whose cancer has returned.

The decision, set to be made in February, means Hifu will not be available to the vast majority of prostate cancer sufferers.

Cancer charities and senior doctors last night attacked the move as a U-turn.

Mark Emberton, a consultant urologist at University College Hospital, London, said he was worried that patients would be forced into the private sector, “which would be a disaster”, if they wanted the treatment.

He also questioned the logic of only offering Hifu to men whose cancer had returned, while denying it to patients in the early stages of the disease.

Meanwhile, Stephen Brown, a consultant urologist at Stepping Hill hospital, Stockport, said: “We think Hifu is a really good option for patients who want a lesser procedure.”

Prof Roger Kirby, who chairs the Prostate UK charity, also decried the decision. He said: “Restricting the treatments available will have a massive impact on the patient.”

Since Nice made its original ruling, permitting the use of Hifu, just 300 men have been given the treatment on the NHS.

Primary care trusts have so far been slow to foot the bill for the treatment, which is one-off but costs about £13,000.

This amount compares with £3,000 for radiotherapy, which takes six weeks, and £5,000 for surgery.

It is understood that Nice, which has refused to comment on its new guidelines, will rule that there is insufficient evidence to prove that Hifu has long-term value.

The U-turn comes despite the research published last month in the European Journal of Urology which found that eight out of 10 men were healthy five years after being treated with Hifu.

From:
http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2007/12/16/ncancer116.xml

Confidential medical records should only ever be seen by doctors and nurses who are working with the patient concerned, with the government spending some £13bn to digitise the medical records of every patient in Britain.

By 2010, the NHS Care Records scheme aims to have an electronic NHS Care Record for all patients.

The record will detail the key treatments and care given to each of the NHS’s 50 million patients.

But in the last year there have been incidents in Gloucester and Cheltenham where staff have shared passwords, giving unauthorised people access to confidential records.

At Bath’s Royal United Hospital the same type of breach took place while breaches of security also took place in Swindon and Bristol.

The North Bristol NHS Trust has reported catching a member of staff looking at friends’ records, although they were just issued with a warning.

The NHS electronic patients’ record has an electronic audit trail built into the system that shows who has accessed what record, how and why, and for how long. Any pattern of unusual activity can be flagged-up and appropriate action taken.

Somerset GP Dr Harry Yoxall told of two instances he encountered where records were accessed by inappropriate people.

“On the first occasion an employer of a relatively small computer supplier to the NHS was looking up information about one of his relatives by getting access to a GP medical records system,” he said.

“Then an employee of a hospital trust was using his access to their medical system to look up information about one of his relatives.”

One campaigner from the pressure group NHS Confidential Opt Out is encouraging people to remove themselves from the database system.

Helen Wilkinson said: “My concerns are that they need to put more stringent safeguards in place and also that they need to consider, perhaps, smaller local databases that actually link up, but with explicit patient consent, so that would put the patient in control.”

Richard Caves of the South West Strategic Health Authority said: “I am confident that a trust – where it suspects an individual member of his own staff as having unauthorised access to a record – that trusts will be able to take measures to track that down.”

From:
http://news.bbc.co.uk/1/hi/england/bristol/7119075.stm

NHS database will weaken patient security MPs learn was posted by Health Direct on Thu 22 Nov 2007- The man in charge of setting up the NHS medical records database has admitted that “you cannot stop the wicked doing wicked things” with information. Richard Jeavons, director of IT implementation at the Department of Health, said there were instances where staff “abuse their privileges”.

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.

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.”

Health Direct asks if you are still 100% confident that labour will keep all of your medical data secure?

The National Institute for Healthcare and Clinical Excellence (Nice) aka National Institute for Curbing Expenditure, will today row back on its controversial draft advice in June that stated people must be allowed to go blind in one eye before they can have injections of Lucentis – a drug for wet age-related macular degeneration (AMD).

Nice had also said that only people with certain types of lesions caused by the disease should get the drug, which would limit availability to 20% of patients.

Nice took the stand because of the cost of Lucentis, which is about £760 an injection. A full course for one eye could have cost £18,300. But the outcry from doctors and patient groups – Nice received 13,000 letters of protest – has led to a rethink and the manufacturer, Novartis, has offered a compromise deal on the cost.

“We are delighted by the new Nice guidelines, which will have a wonderful outcome for about 26,000 new wet AMD patients a year,” said Tom Bremridge, the chief executive of the Macular Disease Society.

“The drug has a beneficial effect on 90% of patients. However the good news is tinged with bitterness that it has taken such an effort of persuasion by all the interested parties to shift Nice from a position that defied common sense.”

The Royal National Institute for the Blind was also pleased. “Nice has given thousands of people the best Christmas present they could wish for – hope that their sight might be saved,” said the head of campaigns, Steve Winyard.

Novartis has offered to cover the costs of patients who require more than 14 injections of Lucentis. Patients will normally have three and then will be assessed to see whether they need more.

“Fourteen injections should result in stable vision for most patients and improved vision for around a quarter of patients,” said Andrew Dillon, the chief executive of Nice.

The NHS is currently funding an unprecedented trial comparing Lucentis with a second drug, Avastin, which is similar but licensed only for bowel cancer. Split into tiny doses, it is a fraction of the cost. If Avastin proves to be equally beneficial, the NHS may look for ways to use Avastin instead of Lucentis.

Wet AMD occurs when abnormal blood vessels growing behind the retina leak blood and fluid, raising the macula from its normal place in the back of the eye.

From:
http://www.guardian.co.uk/society/2007/dec/14/nhs.healthandwellbeing

Health Direct applauds the National Institute for Curbing Expenditure’s U Turn on funding injections of Lucentis – a drug for wet age-related macular degeneration (AMD).

On Thu 14 Jun 07- Health Direct posted Cruel watchdog NICE condems 20,000 to blindness to save money

Twenty thousand people will be condemned to blindness each year following a “cruel” and “appalling” decision by the health watchdog NICE, campaigners said today. The National Institute for Health and Clinical Excellence (aka National Institute for Curbing Expenditure) has come under intense pressure to approve the drugs Lucentis (ranibizumab) and Macugen (pegaptanib) for use on the NHS.

Steve Winyard, of the Royal National Institute for the Blind, said: “This preliminary guidance is worse than we ever imagined it could be. It is simply unacceptable that Nice is recommending that only a small minority of patients within England and Wales will benefit from these ground-breaking treatments. Nice must reconsider.”

“The NHS is currently in surplus, yet England and Wales are now two of the only countries in Europe to deny its citizens sight saving treatments.”

Tom Bremridge, the chief executive of the Macular Disease Society, said: “We are appalled by the Nice consultation document. Limiting the treatment options to 20 per cent of patients who would benefit is unjustifiable and allowing one eye to go blind before treating the second eye is cruel and totally unacceptable.”

In its annual “state of healthcare” report, the Healthcare Commission said on Tuesday 5 per cent of independent sector providers failed five or more of the core standards, with 6 per cent of National Health Service trusts failing a similar test.

Last year, 5 per cent of private acute hospitals failed to meet core standards, half the proportion of the year before, but the failure rate for private and voluntary mental health services – 85 per cent of whose beds are funded by the NHS – was more than 13 per cent.

Mental health is the area in which the NHS relies most heavily on the private sector and has been contracting for longest with it. But Anna Walker, the commission’s chief executive, said primary care trusts had “some way to go in checking how well their purchasing of services is working in this area”.

More than one in 10 independent mental healthcare providers failed to monitor or ensure the quality of treatment. A similar proportion failed to ensure patients were treated in safe premises, while 17 per cent failed to ensure that patients were “appropriately and safely restrained”.

In the acute sector, private hospital groups did much better, with only BMI/General Healthcare of the four big providers failing to meet core standards in every case.

Ms Walker said NHS and private providers were not yet measured by precisely the same standards, but the failings in both sectors were similar.

In the NHS, key failures involved the management of patient records, mandatory staff training and compliance with hygiene standards. In the independent sector, most widely flouted were yardsticks aimed at ensuring that patients were treated by appropriately-trained staff, risk management and treating patients in safe and appropriate premises.

In spite of some dire performance, Sir Ian Kennedy, the commission’s chairman, said: “We are close to being able to offer all patients a minimum guarantee on standards in the NHS and in the private sector – but we are not there yet.” Safety “is being taken more seriously”, he said, but action was still needed to drive through improvements in healthcare-associated infections.

While there was “still some way to go before everyone gets world-class care”, it was “crystal clear” healthcare had improved, with “genuinely dramatic” reductions in waiting times, and the health service contributing to growing life expectancy.

Patients were, however, still waiting far too long for “talking therapies”, help with deafness and for physiotherapy, which was covered by formal waiting time targets, he said.

Concerns remained about dignity and privacy in some hospitals, and the failure to correct health inequalities.

From:
http://www.ft.com/cms/s/0/eb6d9636-a2bd-11dc-81c4-0000779fd2ac,dwp_uuid=f0d249de-e821-11db-b2c3-000b5df10621.html

NHS patients face humiliating treatment- whatever happened to Dignity? was psoted by Health Direct on Thu 6 Dec 2007- Hospitals are still failing to treat people with dignity and respect as complaints reveal patients left unwashed, in soiled bedding and in humiliating open-backed gowns, the Healthcare Commission has said.

The commercial advisory board – whose members included investment bankers, lawyers and a former regulator – quit in September, declaring it was “wasting its time” as the government moved to scrap much of the second wave of independent sector treatment centres (ISTCs) on which it was, in part, advising.

These centres provide an alternative source of surgery and some diagnostics.

The board’s resignation letter says that in spite of “positive assurances at various meetings” with ministers and senior civil servants over four years, “it has never been apparent to the board that any subsequent action was taken as a result of the advice that it gave, both orally and in writing”.

Sir William Wells, the board’s chairman and a former chairman of the NHS appointments commission, writes in the resignation letter that “certainly no feedback was ever received”.

He says: “[The board’s] greatest concern has been, and remains to this day, that despite a number of presentations to the board on the subject, no one has ever been able to explain satisfactorily how taxpayers’ money was spent in the NHS, and what checks and balances were in existence to ensure the delivery of effective value for taxpayers.”

His comments come as the department’s commercial directorate is being revamped. It will no longer be a semi-freestanding central purchasing authority, but will be reduced in size and regionalised – becoming a consultancy body to primary care trusts, which are to take over locally the purchasing of independent-sector care for NHS patients.

The ISTC programme has been dramatically scaled back in spite of the department preparing an unpublished glossy document singing its praises. Entitled ISTCs – The Story So Far, it uses data up to July last year to argue that the centres “force the NHS to become more productive”, that they will suppress “year-on-year” increases in the cost of waiting-list surgery, and that their productivity, on a range of measures, is better than in NHS-run units.

Prepared by the commercial directorate that procured the ISTC programme, the document accepts that the centres need to be better integrated into the NHS.

But it also argues that even if the whole second wave of ISTCs had gone ahead, there would have been only “localised pressure” on NHS providers. Without a sufficiently large private sector “there will be no competitive tension” to drive down cost, raise quality and improve accessibility, it says, and the market will not be large enough to be “self-sustaining”.

From:
http://www.ft.com/cms/s/0/7d350fc8-a1dc-11dc-a13b-0000779fd2ac.html

On July 27, 2006 Heath Direct posted: Independent treatment centres (ISTC)s savaged by Health Select Committtee

The House of Commons Health Select Committee has scathingly reported that the Independent Sector Treatment Centres (ISTC)s have produced only a tiny fraction of the NHS’s total capacity, ISTCs are not necessarily more efficient than NHS Treatment Centres, there is no proof about whether the ISTC programme represented value for money and accused Labour Ministers of muddled and “inconsistent thinking”.

At the end of 2002, the Government decided to commission a number of independent sector treatment centres (ISTCs) to treat NHS patients who required relatively straightforward elective or diagnostic procedures. Several objectives were ascribed to the ISTC programme, including:
* Increasing elective capacity available to the NHS in order to reduce waiting lists and times;
* Reducing the spot purchase price in the private sector;
* Increasing patient choice within the NHS;
* Encouraging best practice and innovation;
* Stimulating reform within the NHS through competition.

Health Direct were surprised that the Department made no attempt systematically to assess and quantify the effect of competition from ISTCs on the NHS. Given its importance, the Department should have ensured that this was done from the beginning of the ISTC programme in 2003.

The Department of Health and the Secretary of State have, over the course of our inquiry, given answers which have shifted in both fact and emphasis as time has gone by, and the statement of the current position by the Secretary of State leaves several important questions unanswered.

Almost 100 community staff, who care for 1,000 seriously ill patients, have been on strike since November 8 and say they will not return to work until Ms Reissmann is reinstated.

Unison held a solidarity day nationwide under the slogan Silent Nightingales – Don’t Silence NHS Staff This Christmas, Reinstate Karen.

Ms Reissmann’s appeal started on Monday and is expected to finish today.

Vall Midson, who works with Karen, said: “A lot of staff have thanked us for standing up for the NHS. We had quite a few members of the public bring us sandwiches and flasks of tea to the demos. It is good to know everyone has heard about the strike and why we are doing it.”

Unison again backed Ms Reissmann, saying they will defend members’ rights to speak out without fear of persecution.

From:
http://www.manchestereveningnews.co.uk/news/s/1027263_nurses_hold_silent_protest

Health Direct wonders if something is seriously amiss in the North West socialist republic. On
June 28, 2007 in Labour’s NHS reforms pushed hospital chief to suicide Health Direct posted that a hospital manager jumped 100 feet to her death, driven to suicide by the stress of NHS reforms. Morag Shedden Wilson, 32, stabbed herself with a kitchen knife and then jumped from a motorway bridge on the M60 into the Manchester Ship Canal.

An inquest heard that Miss Wilson, who was head of dietetics at Wythenshawe Hospital, was under pressure because of reforms introduced by the Agenda for Change, a labour Government review.

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

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

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

The charity says current access to insulin pumps in the UK is patchy, with just 2 per cent of people with type-1 diabetes using pumps.

Simon O’Neill, director of care, information and advocacy at Diabetes UK, said: ‘In the long term, it would benefit the NHS by reducing the cost of treating diabetic complications, which currently runs at £5bn a year.

Just over two per cent (6,000) of people with Type 1 diabetes in the UK are using pumps compared to 15 to 20 per cent in the USA and Germany. Diabetes UK estimates that a further 50,000 people are eligible for insulin pumps but are being denied access.

Diabetes UK wants primary care organisations to end this postcode lottery and for the National Institute of Health and Clinical Excellence (NICE) to review their restrictive guidance.
The study

Researchers in Barcelona studied 153 people with Type 1 diabetes, who previously treated their condition with traditional injections. After two years of insulin pump therapy average blood glucose levels went down from 7.9% to 7.3% (good blood glucose levels are between 6.5% and 7.5 %).

“This research is more evidence that insulin pumps could benefit many more people with diabetes,” said Simon O’Neill, Director of Care, Information and Advocacy at Diabetes UK.

“Although pumps are not recommended for all people who manage their diabetes with insulin, it would be beneficial for many, including those with Type 2 diabetes. PCTs must ensure that people have the option according to clinical need, personal choice and suitability.
Long-term savings

“The annual cost of a pump is more than insulin injections, £1,400 compared to around £500. However, in the long term it would benefit the NHS by reducing the cost of treating diabetic complications, which currently runs at £5 billion a year.

“Diabetes UK urges NICE to take account of this new research and enable those suitable for pump therapy to move towards achieving good blood glucose control when it publishes new guidance in 2008.”

From:
http://www.diabetes.org.uk/About_us/News_Landing_Page/50000-people-denied-insulin-pumps-in-the-UK/

Health Direct notes that once again NICE- the National Institute for Curbing Expenditure’s rulings are blighting tens of thousands of patients.

On 14 Jun 07- Health Direct posted Cruel watchdog NICE condems 20,000 to blindness to save money when twenty thousand people will be condemned to blindness each year following a “cruel” and “appalling” decision by the health watchdog NICE, campaigners said.

The National Institute for Health and Clinical Excellence (aka National Institute for Curbing Expenditure) has come under intense pressure to approve the drugs Lucentis (ranibizumab) and Macugen (pegaptanib) for use on the NHS.

A third of complaints about the NHS relate to dignity, respect and nutrition in hospitals, the commission’s 2007 “state of healthcare” report found.

Mixed-sex wards are still a major problem, despite Labour’s manifesto pledges in 1997 and 2001 to abolish them.

The report also said that one in five patients who wanted help with eating did not get it, and others complained that food or drink was placed out of reach.

Examples of complaints over dignity included a lack of regular baths or showers, gowns that failed to protect patients’ modesty and curtains being opened while a patient is receiving intimate care.

The 136-page report also called for improvements in care for children, action on hospital superbugs, better service planning and promotion of patient safety.

The report said one in 10 hospitals in England did not meet standards on patient privacy and confidentiality.

Half of patients in mental health wards and almost three in five with learning disabilities were treated in mixed-sex accommodation.

A third of patients admitted to hospital as an emergency were sleeping in mixed-sex areas and 30 per cent of in-patients had to share bathroom or shower areas with the opposite sex.

Patients were also frustrated that staff often did not have access to their notes, meaning they had to describe their condition repeatedly to different doctors.

A fifth of patients had been assaulted on mental health wards. There was variation in treatment for cancer patients and hidden waiting times in areas that are not subject to targets, such as two-year waits for psychological therapies and hearing aids.

Opposition MPs said the report provided a “damning indictment” of the NHS after more than a decade of Labour government, which has seen huge increases in investment.

Funding has increased from £55 billion in 2002-3 to almost £90 billion in 2007-8, and the workforce has increased by 29 per cent.

The commission warned private hospitals failing on standards that they could be banned from providing care in the future.

Eleven NHS hospitals were named as performing badly in patient satisfaction surveys for the second year.

The report, presented to Parliament, made recommendations to improve waiting times in areas not covered by targets, promote a culture of safety, raise standards of care for children and inform patients better.

Sir Ian Kennedy, the chairman of the commission, said: “Let’s be clear that health care has improved. But there is still some way to go before everyone gets world-class care.

“People are getting healthier, but there is serious disparity in both general health and in the care available to the haves and the have-nots.”

The Liberal Democrat health spokesman Norman Lamb said: “As an NHS report card, the conclusion is could and must do a lot better. It is a damning indictment that 10 years into a Labour government, health inequalities are still shockingly wide.”

From:
http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2007/12/05/nhs105.xml

Classic Labour tactic this. Ivan Lewis’s caring, sharing labour government announces a laudable new spin policy for caring for the elderly and frail. Brilliant

On June 22, 2006 Health Direct posted: Minister wants Dignity debate for caring for the elderly

New care services minister Ivan Lewis has said he wants to make dignity of older people one of his top priorities. Speaking at a session on the out of hospitals white paper, he said: ‘I want to make dignity an important theme in my time as a minister. ‘This is not a gimmick; just another initiative. It should be at the heart of what we are doing.

‘I want to stimulate a debate about dignity in older people and the disabled. It has to be integral to how we are seen to support people in the modern world.’

He called for more PCT funding on prevention – such as £25 on griprails in people’s homes which would help prevent falls.

He then lambasted everybody else for not delivering his policy- when it’s his own fault because the Labour govt has not put a single new penny of money into the pot to pay for the new Dignity initiative.

Where is the money to pay for the £25 griprails that you mention- let alone the extra nurses that you want to police your dignity policy, Mr Lewis?

Figures highlighted by the Stroke Association yesterday showed that patients in some parts of England were almost 60 per cent more likely to get a potentially life-saving brain scan diagnosis within 24 hours than those in other regions.

They also revealed that people suffering a stroke in the East Midlands were almost 30 per cent less likely than those in the North East to be treated in a hospital stroke unit with specialist equipment and staff.
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Alan Johnson, the Health Secretary, today set out the Government’s new 10-year strategy to accelerate the emergency response to strokes and improve prevention and access to the most effective treatment.

Mr Johnson said that patients suffering a full stroke should have a brain scan in the next available scanning slot during normal working hours, while outside these hours they will receive a scan within 60 minutes before being moved to a stroke unit.

Higher-risk people suffering a minor stroke should have an MRI (magnetic resonance imaging) scan within 24 hours, while patients considered “low-risk” will
have access to a scan within seven days.

Joe Korner, of the Stroke Association, said: “Stroke is the UK’s third biggest killer. Despite clear clinical evidence that access to immediate brain scanning and admission directly to a stroke unit saves lives and reduces disability, current access to these life saving facilities is down to luck and postcode.”

Strokes are either blood clots or bleeds in the brain, which can leave lasting damage including speech, mobility and sight problems. Approximately a third of the 150,000 people who have a stroke in the UK each year die of it.

A scan is the only way to determine what type of stroke the patient is having and the best way to decide on the most effective form of treatment.

Data collected by the Royal College of Physicians found only 42 per cent of patients in England receive a brain scan to confirm their diagnosis within 24 hours.

New treatments with clot-busting drugs – called thrombolysis – can result in a much better and quicker recovery.

However the drugs must be given shortly after the onset of symptoms to be effective, and can only be used after a brain scan.

An estimated one in 10 stroke patients would benefit from thrombolysis, yet just one in 10,000 receive it.

From:
http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2007/12/05/nhs305.xml

On 27 Aug 07 Health Direct posted UK stroke treatment is worst in Europe with hundreds needlessly dying every year- The UK has the worst outcome for strokes in western Europe despite spending the same amount or more on care as other countries, a leading article in the British Medical Journal warned.

And it is nearly two years since MPs in the National Audit Office pointed out that hundreds of UK citizens are dying needlessly and over a year since Health Direct posted on July 12, 2006- Stroke patients dying needlessly from Labour’s health failures

Since then new Prime minster- same lack of compassion and urgency.

Stroke patients are needlessly dying or suffering more serious disablement because not enough priority is given to stroke services, according to a report by the Commons Public Accounts committee.

The report found that stroke is not treated as a medical emergency, brain scans for patients are often delayed and a significant proportion of stroke patients are not treated on specialist units.

The labour Government came under fire yesterday after its wide-ranging report into cancer services revealed its woeful under-investment in tackling the problem compared to other Western countries.

In England, just £80 per head of population is spent on cancer compared to £121 per head in France and £143 per head in Germany. Just 5.6 per cent of the total health budget is spent on cancer compared to 7.7 per cent in France, 9.2 per cent in the United States and 9.6 per cent in Germany.

The Cancer Reform Strategy, published yesterday, showed the UK ranks 22nd out of 28 European countries for mortality rates among women with cancer, and is ninth for mortality among men.

The figures from 2006 show women in Estonia, Slovakia, Lithuania and Slovenia are all more likely to survive cancer than women in the UK.

For men in the UK, mortality rates are better than in eastern Europe but still lag behind Iceland, Sweden, Malta, Finland, Cyprus, Switzerland, Norway and Germany.

The Conservatives attacked the labour Government for reneging on its promise seven years ago to make England’s cancer services the best in Europe, and said cancer survival rates in the UK were still lagging far behind “nearly every other” European country.

Mark Simmonds, the shadow health minister, said: “Gordon Brown and Alan Johnson [the Health Secretary] have been forced to admit their failure to achieve the best cancer survival rates in Europe, despite the huge amount of money they’ve spent on trying.

“What is saddening is that if the UK achieved European best levels of cancer survival rates then 95 lives each day could be saved.”

Cancer programmes currently cost £4.35 billion a year and costs will increase by an extra £70 million a year under the strategy which was announced by Mr Johnson and Prof Mike Richards, the labour Government’s “cancer tsar”, yesterday.

Norman Lamb, the Liberal Democrat health spokesman, declared the strategy was at risk due to the Government’s “inability” to secure value for money in the NHS.

He said: “The sad truth is that too much investment has been wasted on organisation upheaval and top-down bureaucracy.”

Andrew Lansley, the shadow health secretary, said: “While the Government has spent so much of taxpayers’ money, the UK is still lagging behind the rest of Europe in cancer survival rates. Sadly, today’s updated cancer strategy fails to clearly set out how we will turn that round.”

Spending on cancer has increased by 27 per cent over the last three years, making it the third-highest funded disease behind mental health and circulatory disease – despite being the biggest killer.

There has also been considerable variation on spending among primary care trusts in England. Even after variations in the population are taken into account, the amount spent ranges from 3.6 per cent of the budget to 9.1 per cent, the report said.

According to the Conservatives, each cancer patient in Oxfordshire, where David Cameron has his constituency, receives just £5,182 per year, but cancer sufferers in Nottingham receive £17,028, which is more than three times as much.

From:
http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2007/12/04/ncancer204.xml

The Healthcare Commission said in its report that more than 4,000 adults with Down’s syndrome and other disabling conditions are living in hospitals, treatment centres and secure facilities in England. It found inadequately trained staff failed to provide stimulation or the opportunity to make simple, everyday choices.

Adults in care that is provided or commissioned by the NHS had few opportunities for friendships. Many never got a visit from family. Some were not even allowed to make themselves a cup of tea.

The commission said: “Even in the best services, the safety and quality of care were not up to the standard expected of modern services.” There were “significant institutional failings” that deprived people of human rights and dignity. Services operated “off the radar” of senior NHS managers, “with poor leadership, poor training and no framework to measure the performance of services”.

The government responded last night with plans to strip the NHS of responsibility for the sector. Ivan Lewis, the care services minister, said he would publish proposals tomorrow to put local authorities in charge of commissioning services. He added: “It is totally unacceptable for anyone with a learning disability to be treated in a way that compromises their human rights.”

The commission decided to undertake the first national audit of learning disability services after it discovered malpractice in Cornwall and Carshalton, south London, where residents were tied up for prolonged periods in a misguided attempt to stop them harming themselves.

Anna Walker, the commission’s chief executive, said the national audit did not find such flagrant abuses at the 72 NHS trusts and 17 independent organisations visited by inspectors, after giving 24 hours notice of arrival.

But it identified “serious and unacceptable” lapses in the London borough of Bromley, where the primary care trust asked the inspectors for help in sorting out its facilities.

They found one house with gates on the bedroom doors and straps to restrain residents in chairs. Living standards were poor, with worn furnishings and toilet doors that would not close. Three crates of confidential information were left unsecured.

The commission also looked into complaints about NHS services in North Lincolnshire, Sandwell and Coventry, and an independent unit run by Care Principles Ltd in Stafford.

Walker said: “The report paints a bleak picture. Services for people with learning difficulties are not generally unsafe, but they are poor.”

She called for a sustained effort to provide excellent care for this vulnerable group, giving them choices and independent advocates to speak up for their interests.

Jonathan Hurley, a man with Down’s syndrome who took part in the inspections, said: “I have a full life. People in these homes don’t. I have choice. They don’t.”

Dame Jo Williams, the chief executive of Mencap, the learning disability charity which exposed the Cornwall scandal, said: “Immediate action must be taken to make sure that poor care for people with a learning disability is stamped out.”

The Department of Health merely said it was already committed to closing all “NHS campus” facilities for people with learning disabilities by 2010.

From:
http://www.guardian.co.uk/society/2007/dec/03/learningdisability.humanrights