The figures from the Office for National Statistics suggest efforts by the labour government to improve public confidence have had little effect.

The survey places even more pressure on the government to restore trust, following an equally biting analysis from the Statistics Commission. As reported in the Financial Times, the watchdog has published on its website a harsh valedictory note attacking departments for spinning statistics.

Britons’ lack of trust in official figures- barely one third believe them to be generally accurate – is unchanged since the last survey two years ago.

This is in spite of ONS measures designed to boost confidence, including the launch of a personal inflation calculator, data reviews, and improved information on macroeconomic revisions.

People were more sceptical about how the figures were used than about how they were produced.

In this sense, the public’s assessment echoes the views of the Commission. Its farewell report did not attack the compiling of the statistics, but rather the way in which they were presented by some government departments.

Only 16 per cent agreed that “the government uses figures honestly when talking about its policies”. But there was a small increase in the number of people who felt figures were compiled without interference – from 17 per cent in 2005, when the survey was last conducted, to 20 per cent in 2007.

Two years ago a survey of opinion formers by the Commission showed they believed the quality of statistics was among the best in the world. However, the same experts complained that “growing emphasis on performance indicators and targets had meant that official statistics were perceived as sometimes being pushed too far, beyond what they were capable of measuring”.

Their proposed solution was a “greater distance between the producers of statistics and government”.

The ONS reports to the chancellor but from April 1 control will pass to the new Statistics Authority, which answers directly to parliament and has a remit to improve public trust.

For the ONS survey, the public was asked about trust in six sets of data. The most trusted were road accident statistics and the least trusted were hospital waiting lists. No datasets had become more trusted since 2005. There was a fall in the numbers believing population figures to be accurate.

Lord Lipsey, of the newly formed Campaign for Real Statistics, which wants to reduce data misuse, said: “The abuse of statistics is reaching epidemic proportions.”

Problems of presentation

NHS inpatient and outpatient waiting times, Department of Health “Only online tables are produced, there is no commentary and definitions are aimed at suppliers of the information rather than users”

Armed forces quarterly press release, Defence Analytical Services Agency “A confusing title (the topic is the number of serving personnel and planned requirement over the last 12 months), inadequate commentary and notes and no indication of sources or methods, and defined as a press release and not a statistics release”

House building, communities and local government department “The commentary compares two statistics that should not be compared (they don’t cover the same time period), it does not mention the PSA [public service agreement] target for new buildings completed, and the charts are not included in the text” Source: Statistics Commission

http://www.ft.com/cms/s/0/13ba248a-f48d-11dc-aaad-0000779fd2ac.html

Health Direct is reminded of two adages- you can fool some of the people some of the time- and he who lives by the sword dies by the sword.

James Purnell, the Work and Pensions Secretary, said that all 2.6 million benefit claimants will be forced to undergo tests from 2010 to prove that they are unfit. The Conservatives said that money allocated in the Budget for the tests was insufficient.

Mr Purnell gave warning that for people who did not play by the rules there would be “clear consequences” for their behaviour.

“For those who play by the rules we will provide extra support so they can realise their ambitions,” he said in the Commons.

Chris Grayling, his Conservative shadow, said that only £10 million extra had been put aside to pay for assessments – not even enough to cover reassessments for 16-24 year olds announced last November.

“That will leave 94 per cent of current claimants – some 2.5 million people – outside the Government’s plans. There is no money set aside to pay for them to have assessments, and no money to pay for expanded back-to-work programmes of the kind in use in countries like the United States.”

Describing the announcement as “the worst kind of political fraud”, Mr Grayling added: “When you read the small print, it is simply not true. The money being set aside amounts to less than £4 per claimant – enough to pay for their bus fares to the local job centre and nothing more.

“It will cause considerable disquiet among incapacity benefit claimants, without giving them any promise of extra support to get back into work. It is designed to create headlines, without the Government actually having to deliver the kind of radical welfare reform that this country needs.”

Officials insisted that the total allocated for testing in 2010 was £30million, with a further £20million coming from departmental savings. In addition there was already money in the system for reassessing of claimants.

They added that it would take three years for all the claimants to undergo the tests, and that there was sufficient money for that to happen.

Meanwhile, charities voiced worries. Paul Treloar, the director of policy and services at the Disability Alliance, said that his charity supported efforts to help disabled people into work, but said it was “dishonest” to use a more stringent test simply to reduce the number of claimants.

Moving the bar higher to claim incapacity benefit was not a solution.

“When people have been on incapacity benefit for significant periods of time, simply moving them to the job-seekers’ allowance is not going to help them back into work.”

He said that, in his experience, “it does cause concern when people think there are intentions simply to throw them off benefits”.

Kevin Doherty, the director of services at Disability Action, added that the “overall ethos” of the vast majority of those claiming incapacity benefit was the desire to work.

He called for “creative programmes and initiatives to be introduced to the overall working environment”.

Vince Cable, the Liberal Democrats’ Treasury spokesman, accused Labour and the Tories of “dishonesty and naivety” in “imagining people who want to work are being barred from doing it because of the benefits system”.

Many of those claiming incapacity benefit were mentally ill and were unable to seek employment.

From:
http://business.timesonline.co.uk/tol/business/economics/budget_2008/article3549631.ece

Health Direct notes this is a ‘con’ because Labour has no intention of putting MOST of these IB claimants back to work. That’s because most of them are people who can’t get work because of discrimination and Labour’s not happy about that fact coming out.

A report published shows that attempts to narrow the gaps have largely failed. In infant mortality and life expectancy, two important measures, the gap is wider now than it was then.

David Sinclair, head of policy at Help the Aged, said that the figures made a mockery of labour’s attempts to tackle rising inequality and represented a staggering failure.

“The starkest demonstration of the gap between rich and poor can be seen in the gulf in life expectancy between different social groups. Despite the Government’s commitment that no-one should be disadvantaged by where they live, the reality is that people who are poor, or who live in poor communities die earlier” he said.

In 1995-97, the baseline for the life expectancy comparison, the average man had a life expectancy at birth of 75.1, while for those in the poorest areas it was 72.7 – a gap of 1.9 years. By 2004-06, life expectancy had risen on average to 77.3, but for the poor areas it was 75.3 – a gap of two years.

For women, the gap grew even more quickly. It was 1.4 years in 1995-97, but had risen to 1.6 years by 2004-06, an 11 per cent increase.

For child mortality, the gap has also widened, the report admits. In 1997-99, the baseline for this target, the average rate was 5.6 per 1,000 live births, while that for the poorest groups was 6.3, a gap of 14 per cent. By 2004-06, the average had fallen to 4.8, while the poorest group had reached 5.6, a gap of 17 per cent.

Cancer deaths showed no significant change in the gaps between rich and poor, but in heart deaths there was a widening in relative terms.

Other targets, such as under-18 conceptions, deaths in road traffic accidents, the number of GPs per 100,000 people, smoking prevalence and smoking in pregnancy, also show no change or widening gaps.

The sole exception among the health targets came in flu vaccinations, where the gap narrowed.

In her introduction to the report Dawn Primarolo, the Health Minister, claims to see “some signs of progress” but Sir Michael Marmot, chair of the scientific reference group on health inequalities, is more frank.

In his preface, he writes: “We are of the firm belief that there should be two central aims for health policy: improve overall health and reduce inequalities. The evidence shows success in the first but, as yet, not in the second, despite the welcome improvement in the health of the worst-off.

“It is simply too early to say if too little has been done or the right actions were not taken” he concludes.

Norman Lamb, the Liberal Democrat Shadow Health Secretary, said: “Widening health inequalities have been Labour’s most shameful NHS failure. For the past decade, this Government has delivered little more than broken promises on reducing health inequality.

“Too much vital investment has been wasted on organisational upheaval and top-down bureaucracy.

“The terrible truth is that people from poor backgrounds and those unable to act as strong advocates for their own health continue to die younger and have a worse quality of life than the population as a whole.”

Dr Michael Dixon, chairman of the NHS Alliance, said that better primary care was the key to reducing inequalities. “Health Minister Lord Darzi’s coming review of the NHS needs to focus on how primary care can lead the health service” he said.

“In particular, it must support strengthened practice-based commissioning, where local clinicians who know their patients make decisions about the services they need. That is the best way for the NHS to play its role in tackling health inequalities.”

Mr Sinclair said: “It’s vital that targetted initiatives are developed to tackle rising health inequality – action is urgently needed to ensure better and more equitable access to GPs and preventative health care services.

“All too often, poorly served communities are poorer communities – leading to a cycle of disadvantage and poor health. Gaps in NHS provision have a direct impact on health inequalities.

“Without action to tackle health inequalities the Government’s entire ageing strategy will be in jeopardy.”

From:
http://www.timesonline.co.uk/tol/news/uk/health/article3552767.ece

Health Direct is saddened but not surprised by the waste that labour’s decade of death has brought to the NHS. If you have a vote next month, please use it and remember the false lies about labour’s 24 hours to save the NHS.

GPs retiring between 2004 and 2006 had their pensions capped after earnings from the new contract rocketed and ministers argued they had to cap pensions to protect the taxpayer.

However, Lord Justice Mitting yesterday ruled that ministers had no power to impose the limit, which was an attempt “to renegotiate an arrangement that had already been determined”.

Dr Hamish Meldrum, chairman of the British Medical Association’s council, said: “We are delighted that the BMA has been vindicated in its decision to challenge the government.”

Doctors looked to the government to honour the deal, he said. The BMA said the cap had so far affected about 3,000 retiring GPs who had lost around £3,000 a year in pension. But the health department said the estimated long-term saving from the cap was £600m.

Mr Justice Mitting awarded the BMA its costs but gave Alan Johnson, the current health secretary, leave to appeal.

Lawyers for the health department argued the scale of the increases risked diverting resources from patients and were “indefensible”.

Ministers acted after GPs performed far better than expected under a new performance-related contract, with average earnings comfortably clearing £100,000. Ministers were also angered GPs took more of their practice earnings as profit in the early years of the contract.

However, Dr Meldrum said there was “a very important principle at stake, which is that when the government makes agreements it should stick to them”.

From:
http://www.ft.com/cms/s/0/45ac7808-f168-11dc-a91a-0000779fd2ac.html

Health Direct points out that labour’s attempt to claw back funds from doctors is a direct result of their incompetent renegotiation of GPs contracts in 2006.

Officials said a prudent estimate from data from a fifth of NHS trusts showed it was on course to save £1.14bn. They said the figures were positive but acknowledged it could have been more.

The Tories said the savings were peanuts compared to the scale of the project – it is the biggest civilian IT scheme in the world.

Central parts of the 10-year programme – aimed at linking more than 30,000 GPs to nearly 300 hospitals by 2014 – have been running up to two years behind schedule.

Electronic medical records and “choose and book” – an online appointments system for GPs – have been the worst-hit.

Despite the problems, labour said £208m had been saved by March 2007, mainly because of the broadband network installed across the NHS and the progress made with the digital imaging and scanning.

And it predicted that by the end, the savings would top £1bn.

The figures were revealed in the government’s benefits statement for the National Programme for IT.

Ministers were told to publish the accounts by the House of Commons’ Public Accounts Committee in a report last year criticising the progress being made.

The document shows that the project has under-spent by over 40% so far.

This indicates the scale of the delays as suppliers are only paid when they deliver, although officials warned this could not be interpreted as exactly over 40% of project falling behind schedule.

Richard Jeavons, a senior IT official at the Department of Health, said: “We can be positive about the evidence emerging. Of course, if we had not had delays we would be further ahead.”

But shadow health minister Stephen O’Brien criticised the fact only £208m had been saved so far, calling it “peanuts” compared to the cost of the programme.

“It is certainly nothing the government should be crowing about as it is the very least they should be doing to recover their incompetence on a grand scale.”

From:
http://news.bbc.co.uk/1/hi/health/7295116.stm

Health Direct points out that labour’s meddling, incompetence is beginning to come home to roost.

On March 20, 2006 Health Direct posted: NPfIT NHS plan is evolving but one-size-fits-all is a fundamental flaw, says hospital chief when Sir Jonathan Michael, a top NHS executive, who spoke at a healthcare symposium at London’s City University pointed to a fundamental flaw in the NHS’s IT-driven modernisation.

The flaw Michael sees in the National Programme for IT (NPfIT) is its centralised, standardised approach at a time when the health service is decentralising. The chief executive of Guy’s and St Thomas’ NHS Foundation Trust, Michael wants IT support for the specific ways people work in particular parts of his organisation, such as the accident and emergency department.

“The idea that the requirements for all hospitals are the same is, I think, simplistic. Flexibility is designed out of solutions and out of the implementation process. So standardisation of IT systems effectively dictates the standardisation of the business model,” he said.

Michael’s speech about the NPfIT commanded the rapt attention of his audience not simply because he is running one of the largest NHS trusts in the UK but because it is rare for any senior health service executive, especially one of Michael’s standing, to criticise openly the NPfIT.

Caring for some cancer patients, for example, requires joint decisions being made increasingly in multi-disciplinary teams. Video conferencing is key to that, said Michael, but the original plans for the NPfIT did not set aside money for video conferencing.

Telling leading dementia specialists of his determination to find a cure, he said: “I intend to scream and harangue while there is time.”

There are 15,000 people in the UK with early-onset dementia, which strikes under the age of 65 years.

Mr Pratchett has a rare form of the disease called posterior cortical atrophy, in which areas at the back of the brain begin to shrink and shrivel.

He says he is starting to notice its effect on him.

“I’ve given up my driving licence because I didn’t feel confident driving. And if I’ve got something inside out, it’s a little bit puzzling getting it the right way round again.”

He added: “The curious thing is that writing goes on, although the typing doesn’t.”

Mr Pratchett is paying for the Alzheimer’s drug Aricept because the NHS says he is too young to get it for free.

The author told the conference he is prepared to go to extreme lengths in order to beat the disease.

He said: “Personally, I’d eat the arse out of a dead mole if it offered a fighting chance.

“I am, along with many others, scrabbling to stay ahead long enough to be there when the cure comes along. Say it will be soon – there’s nearly as many of us as there are cancer sufferers, and it looks as if the number of people with dementia will double within a generation.

“In most cases, alongside the sufferer you will find a spouse suffering as much. It is a shock to find out that funding for Alzheimer’s research is just 3% of that to find cancer cures.”

In total, an estimated 700,000 people in the UK have Alzheimer’s disease.

However, the Alzheimer’s Research Trust estimates that just £11 per patient is spent annually on research into the disease – compared with £289 for each cancer patient.

Rebecca Wood, chief executive of the Alzheimer’s Research Trust, said the trust currently had to turn down two out of every three research projects due to lack of funds.

She said: “Whilst we were deeply saddened to learn of Mr Pratchett’s diagnosis, we are delighted that he has chosen to speak out about his experiences with Alzheimer’s disease, to raise awareness about its impact and the desperate need for more research.

“Research is the only way to beat this disease and help people like Terry – to prevent them losing their thinking skills and keep them doing the things they love.”

From:
http://news.bbc.co.uk/1/hi/health/7291315.stm

Health Direct notes that once again labour’s NHS funding system is again rightly attracting criticism for it’s double standards and postcode lottery.

The “residual value obligations” are part of the deal for the £1.5bn programme to provide extra operations for NHS patients, and were needed, along with guarantees of patient volumes, to attract new entrants into the NHS market, according to the department.

The first round of negotiations on whether the contracts will be renewed are likely to start next year.

Private operators will have the choice of agreeing a new contract, staying in the NHS market as an independent operator, switching their business to a mix of public and private patients, or selling the centres on if they can realise more for them than the residual value that the NHS is obliged to pay.

The health department said that if the NHS did acquire the property, it would have the choice of selling it, leasing it to private providers or using it directly for NHS patients.

The scale of payment – and indeed whether any residual value will have to be paid – varies between the centres, reflecting the individual deals struck with different providers.

Meanwhile, family doctors have voted overwhelmingly, if reluctantly, for a deal that will see part of the money in their existing contracts go towards paying for extended opening hours in some GP practices.

Faced with an option the government was offering, and one it said it would impose, the British Medical Association said that more than 90 per cent of GPs who voted had chosen the government’s initial offer.

GPs were also questioned about their attitude to the government bringing private sector operators in to general practice, with 93 per cent opposed, declaring the move will be bad for patients and the service as a whole.

Dr Laurence Buckman, the GPs’ chairman, said family doctors believe “they are being railroaded into an unrealistic vision of extended hours”, but it was time to draw a line under the dispute.

From:
http://www.ft.com/cms/s/0/8e1408e6-ebd1-11dc-9493-0000779fd2ac.html

The scale of the problem emerged as it was disclosed that the NHS has paid out almost £50 million in negligence claims related to cancer since 1995.

In total 502 cases of cancer were missed in 2006-7, an increase of almost 20 per cent on the previous year’s 433.

The number of mistakes made in treating patients who had been correctly diagnosed also rose.

Errors in chemotherapy treatment increased by 1.3 per cent to 6,344.

There were 1,854 mistakes in radiotherapy treatment, a rise of 2.6 per cent on the previous 12 months.

Since the mid 1990s there have been 1,179 clinical cancer negligence cases against the NHS.

The labour Government has paid £47 million in compensation but there is another £50 million outstanding.

A Department of Health spokesman said: “It is right that NHS patients should be able to obtain correct and full compensation. An increase in reported patient safety incidents is not a sign that the NHS is less safe for patients – quite the reverse.

From:
http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2008/03/11/nmeds511.xml

Details announced by the Department of Health reveal that some health authorities are expected to generate more than £200 million, 25 per cent of their income.

The department played down the £1.8 billion figure last night as a mere 2.3 per cent of turnover, but patient representatives said that it was astonishing that the NHS could be underspending by more than a billion pounds while patients were still being denied vital treatments.

Michael Summers, of the Patients’ Association, said: “When wards are closing and hospitals are cutting back on cleaning and nursing staff up and down the country, it is quite astonishing that they are generating such a huge surplus.”

Last month a former Second World War airman, Jack Tagg, was told by his local primary care trust in Torbay, Devon, that he could not be given drug treatment for age-related macular degeneration because it was too expensive. The trust, which later relented but only on a technicality, is heading for a £7.8 million surplus, 3.5 per cent of turnover, this year.

The figures were released on the same day that the labour Government said that it would not match moves by the Welsh Assembly to abolish parking charges in NHS car parks. Doctors and patients’ groups say that hospital car parking charges are a “tax on the sick” if they are used to subsidise services already funded by the taxpayer. From 2011 patients, staff and visitors will be able to park free at almost every NHS hospital in Wales.

The biggest surpluses have been made by the strategic health authorities: North East SHA, for example, expects to generate a surplus of more than £100 million on a £346 million turnover; North West SHA a £230 million surplus on a turnover of £877 million and Yorkshire and the Humber SHA £267 million on a £784 million turnover. The total surplus is equivalent to almost 1p off income tax.

The Department of Health said that all the surpluses would remain within the NHS. This has been possible since 1999, when Gordon Brown, then Chancellor of the Exchequer, relaxed the rules on carrying forward surpluses from one year to the next.

Last month the National Audit Office gave warning that some departments were losing confidence in the Treasury continuing to allow them to do this as public spending slows. By last April departments were sitting on £10 billion of unspent capital spending and £12 billion in unspent revenue.

The NHS has been told that it is expected to make at least as large a surplus in 2008-09 as it looks like making in 2007-08. Two years ago the NHS returned a deficit of £547 million, which was turned into a £515 million surplus in 2006-07. The steps taken to turn the service round have proved so effective that the surplus has risen to unprecedented levels in 2007-08.

David Nicholson, chief executive of the NHS, said: “Today’s report not only shows that the NHS now has a strong and sustainable financial position, but also, importantly, it shows that we remain on course to deliver against our key pledges.”

Karen Jennings, head of health for Unison, the public service union, said: “The £1.8 billion surplus shows the NHS is now in a much stronger financial position. Patients have the right to expect that this money is spent wisely and ploughed back into patient care.

“It must be remembered that the stronger financial position has been achieved on the backs of NHS staff. They have contributed through greater efficiency but there have also been job losses and below-inflation pay awards. With finance available it is time to give staff a decent pay settlement instead of holding them to a 2 per cent pay limit.”

Stephen O’Brien, the Conservative health spokesman, said: “The Government cannot have it both ways. They are boasting about a £1.8 billion surplus in the NHS but then claim that hospitals cannot improve patient care without revenue from car parking fees. This does not add up.”

From:
http://www.timesonline.co.uk/tol/news/politics/article3479152.ece

Health Direct notes that the management of the NHS is shambolic. At the local trust levels there is a dearth of management with any recognisable qualifications and at national level the whole thing is so big as to be unmanageable.

Meanwhile, website waiting times are up under Labour, patient deaths as a result of infections contracted in hospital are up and the shortage of doctors, nurses and technicians is up.

The Prostate Cancer Charter for Action found death rates from the cancer were twice as high in the London borough of Lewisham than in nearby Southwark.

The group said patients needed more encouragement to seek help earlier.

About 35,000 men are diagnosed with prostate cancer each year in the UK, and 10,000 die from the disease.

“Prostate cancer sufferers report worse care, lower awareness and poorer outcomes than other patients. More than any other cancer, the story of prostate cancer remains a story of inequalities.” Frank Chinegwundoh, of Prostate Cancer Charter for Action

One of the key problems is that men are often diagnosed late.

The group said there was much the labour government could do to tackle this and eradicate the postcode lottery.

The report said men should be provided with better information about the disease, including how to recognise the symptoms, in a bid to encourage them to seek a medical opinion at an earlier stage.

The lack of awareness about the cancer was illustrated in a separate report by the Prostate Cancer Charity.

The poll of 1,000 men over the age of 45 found one in three thought it was normal to get out of bed many times a night to go to the toilet – one of the key symptoms of prostate cancer.

Staffing levels

But Prostate Cancer Charter for Action also called for an increase in the numbers of specialist nurses for the disease as staffing levels vary widely across the country.

The figures, obtained from the Office for National Statistics, highlighted particularly stark contrasts in parts of London.

Deaths from the disease in North Southwark and Bermondsey stood at 15 per 100,000 compared with 38 per 100,000 in Lewisham West.

From:
http://news.bbc.co.uk/1/hi/health/7288088.stm

Health Direct highlights the plight of prostate cancer sufferers as being both the result of labour’s postcode lottery, but also the result of sexism whereby breast cancer sufferers are regarded as being a higher priority.

Please also read Health Direct’s post on Dec 18, 2007- Prostate Cancer- a health disservice

However, NHS data reveals in 1997-98 median average waits stood at 41 days, but by last year had risen to 49 days.

The labour government said it was the price paid for the end of really long waits, but doctors said longer waits included some patients with serious conditions.

Jonathan Fielden, chairman of the British Medical Association’s consultants committee, said: “All that has happened is that the government has put an end to the really long waits and the really short waits.

“Doctors have been stopped from using their clinical judgement and pushing people through the system when they need to be.

“Of course, it is good that the really long waits have gone, but it is wrong to say that all patient care has improved because of shorter waits.”

Labour has concentrated on reducing waiting times by introducing a succession of targets.

When the party came to power in 1997 waits of over 18 months were not uncommon.

Even by 2000, when the 10-year NHS Plan was published, there were still 125,000 people waiting over nine months.

However, the push has had the opposite – albeit fairly small – impact on average waiting.

The figures obtained by the BBC News website, from the NHS Information Centre, show that for some cancers average waiting has increased slightly, while big falls have been seen in more minor conditions such as cataract operations and treatment for dermatitis and eczema.

Katherine Murphy, of the Patients Association, said: “These figures make us really question whether patients are getting a better deal.

“What concerns me is that patients with serious conditions may be waiting longer than they used to be. That is wrong.”

Shadow health secretary Andrew Lansley said: “This shows how the bigger picture gets neglected in order to meet the government’s top-down targets.

“In meeting one target, another patient misses out. It is simply unfair.”

And Lib Dem health spokesman Norman Lamb added: “These figures massively undermine Labour’s claims to have made a substantial difference to NHS waiting times.”

http://news.bbc.co.uk/1/hi/health/7271772.stm

Health Direct warns that hard of hearing and dental patients still wait years for treatments, so there is stil considerable work to done to meet yet another labour promise.

The proportion of their income that dentists under 35 earn from NHS work has halved in the past five years.

Young dentists earned 64.7 per cent of their salary from the health service in 2001 but by 2005/06 that had fallen to just 36 per cent. Although the drop was most marked among dentists less than 15 years out of university, it was still substantial in the incomes of their older colleagues.

Dentists aged 55 years made 58 per cent of their overall salary from the NHS in 2000/01, but by 2005/06 that had fallen to 47.4 per cent. Those in the 45 to 54 age group saw their NHS related income fall from 54.6 per cent to 44 per cent.

The figures are included in an official report, Dental Earnings And Expenses Great Britain 2005/06, released by the NHS Information centre.

The British Dental Association said that older dentists may feel more loyalty to the NHS than their younger colleagues. Peter Ward, chief executive of the BDA, said: “What the figures do show is a dental workforce looking to a future in which they feel less and less able to rely on the NHS and patients demanding increasing amounts of care that the NHS does not provide.”

He predicted that the situation would only worsen as the effects of the new dental contract introduced in England and Wales two years ago become apparent. “The new contract … actually limits the amount of NHS dentistry that primary care trusts can commission.

“The result is that some dentists who want to provide NHS care are unable to do so and that millions of people who wish to access NHS care cannot.”

More than 1,000 dentists have left the NHS since the new system, which can enforce financial penalties if dentists fail to meet centrally imposed targets, was introduced. Dentists also complain that the new contract pays them the same amount for vastly different amounts of work, for example fitting one filling or 10.

Dr Anthony Halperin, chairman of the Patients Association and a practising dentist, described the numbers of young dentists forgoing NHS work as “worrying”. He said: “My fear is that we will lose more and more dentist time to the private sector and this will mean NHS care will be reduced to little more than a basic core service.”

Barry Cockcroft, chief dental officer for England, said that increasing access to NHS dentists was a “top priority” for the Government and that younger dentists were choosing to concentrate on more cosmetic work, not essential to the NHS.

From:
http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2008/03/05/ndentist205.xml

The labour government must continue to monitor the impact of 24 hour licensing on public health, doctors’ leaders have said in the wake of a review of licensing law.

Commenting on the results of today’s (Tuesday 4 March 2008) review of licensing laws in England and Wales, the BMA’s Head of Science and Ethics, Dr Vivienne Nathanson, says:

“It is essential that the government continues to review 24-hour licensing, not only for its effect on crime but also its impact on public health. Research has already indicated a possible link between 24-hour licensing and increases in alcohol-related cases in A&E; units. If this is confirmed in larger studies, the government must act.

“We are pleased that the government is proposing tough action on alcohol sales to under-18s. But tough talk alone is not enough – penalties must be enforced. There needs to be a change in perception – if retailers knew they couldn’t get away with selling alcohol to under-18s they probably wouldn’t do it.

“On a wider issue, the government needs to look at the whole area of alcohol misuse and licensing hours are just one aspect of this issue. The BMA recently launched its report on tackling alcohol misuse, and we want the government to also focus on taxation and access to alcohol. We are also calling for increased funding for treatment centres for people with alcohol problems.”

From:
http://www.bma.org.uk/pressrel.nsf/wlu/STRE-7CEK5C?OpenDocument&vw;=wfmms

Some £30bn of PFI projects, chiefly in health and local government, are off balance sheet and do not count towards the government’s rule that borrowing should not exceed 40 per cent of gross domestic product. Were they to come back on, the sums are large enough to break the rule, potentially altering the government’s assessment of the public finances.

The impending switch to international financial reporting standards from this April is widely expected to have that effect. A meeting of FRAB, the financial reporting board that advises the government, is understood to have backed that shift at a meeting last week.

However, there are signs that the Office for National Statistics, the guardian of the national accounts, will not replicate that change. This would allow the Treasury to continue to ignore a large proportion of PFI debt.

The differing approaches would lead to conflicting incentives. The Treasury would have a strong motive to continue to favour PFI schemes, while departments would no longer care whether a project was privately or publicly financed as both could come on to their books and be subject to government capital charges.

Most Treasury officials originally assumed that new accounting standards would see schemes count as public sector net debt. But the latest ONS view is that this was premature. The ONS is required to follow European accounting methodology which sees many PFI schemes in other European countries sit off the government’s books.

The outcome is likely to be that ONS will have to evaluate every PFI project separately against European national accounts conventions.

http://www.ft.com/cms/s/0/131f686a-e8ac-11dc-913a-0000779fd2ac,dwp_uuid=f0d249de-e821-11db-b2c3-000b5df10621.html

A private finance initiative project to build a new hospital for Maidstone and Tunbridge Wells NHS Trust in Kent has been forced to abandon its plans to issue insured bonds to fund the project, the Financial Times has learnt. It will instead turn to banks to provide the £225m ($446m) needed.

The U-turn is an example of how uncertainty over the future of bond insurers is changing the face of the PFI market, removing the cheapest funding option for big projects and potentially pushing up costs to the tax payer.

In recent years, bond insurers such as Ambac and MBIA have “wrapped” almost all PFI bonds by lending them their top-notch credit ratings, making them safer and so cheaper to issue.

For larger private finance deals of more than £100m, bond insurers undercut traditional competition, offering cheaper funding than bank loans.

An example of the scale of bond insurers’ involvement in PFI projects is Ambac UK, which has insured £5.7bn of PFI deals, including £1.7bn of PFI hospitals. Specific deals include:
£200m Northern batch PFI hospitals project closed last September.
£498mRoyal London and Barts PFI hospitals project – the largest PFI hospital project to date.
£730m Allenby & Connaught PFI military housing project – largest PFI accommodation project.

But as bond insurers, also known as monolines, have run into trouble over their involvement with US subprime debt, the situation has reversed dramatically. Investors’ confidence in “wraps” collapsed as rating agencies downgraded some bond insurers and put others on negative watch.

Tunbridge’s new hospital was to be funded with wrapped bonds, until the bond insurer was downgraded. David Hardy, director of John Laing Investments Limited, which leads the consortium running the project, said this ruled out the bond option.

“As a sponsor you have to ask three questions. First: will they be able to continue supporting the paper with their downgrades? Even if they could, would we be able to get sufficient investors interested in it? And if we could get people interested, at what cost?”

Under pressure to close the deal before delays caused mounting costs, the consortium and the NHS trust decided bank loans would provide the best value for money.

This is a pattern being repeated across the PFI market for big projects. Last month the UK’s largest PFI – to provide the RAF with a fleet of refuelling tankers – also switched from wrapped bonds to bank debt.

The £1bn scheme to provide a military flying training system for the British army may also be facing Tunbridge Wells’ dilemma. The Ministry of Defence said it was still working on a financial arrangement.

Market participants say other projects are going the same way, resulting in potentially higher funding costs for big PFI deals.

This could also be exacerbated by banks’ unwillingness to lend as cheaply as before in a time of tightening credit conditions.

“The bank markets have had a choppy period since the credit crunch, and for the more challenging or bigger deals obviously there’s a pricing consequence,” said Bruce B. White, head of Linklaters’ PFI team, who advises on bringing PFI deals to financial close.

Mike Chappell, who heads Lloyds TSB’s PFI team, said banks’ own exposure to the bond insurers as well as general tough credit conditions were affecting their appetite to buy syndicated debt – small parcels of PFI debt.

This may leave some bigger PFI deals stymied, unable to find sufficiently cheap financing to go ahead.

From:
http://www.ft.com/cms/s/0/15bc5a92-e8ac-11dc-913a-0000779fd2ac.html

The 24 hour service, which was started in 1998, was designed to dispense simple medical information and help prevent patients clogging up GPs’ surgeries, saving money.

However, there has been criticism over its running costs and the level of service that patients receive.

More than a third of patients treated by the organisation’s nurse advisers are referred to their GP or hospital accident and emergency unit.

Despite restructuring and a hiring freeze, documents presented to the board of NHS Direct show that so far this year the “total cost per call answered” has been £16.54.

Although the figure is predicted to fall by the end of the financial year to £15.91, that is still almost £2 per call more than the budget allows. The “total cost” is calculated by dividing NHS Direct’s complete expenditure, including publicity, web management and consultants, by the number of calls it answers, which is expected to hit almost six million by the end of the year.

The British Medical Association estimates that it costs the NHS between £20 and £25 every time a patient sees a GP, a figure that has risen as doctors salaries have increased because of a new contract. In 2000, ministers promised an investigation into the cost per call of NHS Direct after it was disclosed that the figure was £8.

Mike Penning, a shadow health minister, said he would be seeking a meeting with the head of NHS Direct to discuss the costs.

He said: “Frankly it is hugely disappointing that promises were made and yet we are still in the same position. Huge amounts of taxpayers money has been ploughed into NHS Direct and there is a real worry about whether it represents value for money.”

Norman Lamb, the Liberal Democrat health spokesman, said: “Broken labour Government pledges on the NHS are nothing new, so no one will be surprised at the cost of each call to NHS Direct.

“Ministers should ensure that each different service available to patients represents value for money.”

Matthew Elliott, of the TaxPayers’ Alliance, said: “NHS Direct has been going for 10 years now, and there is still no sign of it offering value for money. Millions that could be spent on frontline staff or sorely needed drugs currently denied to people are lavished on a service that often advises people to visit their GP anyway.

“Its continuing ineffectiveness raises serious questions about the Government’s capacity to effectively manage the NHS.”

A spokesman for NHS Direct said the total cost per call had fallen since 2002, when it was almost £18.

From:
http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2008/03/01/nhsdirect101.xml

Those hospitals whose parking is run by private companies will also have to reduce costs until their contracts expire.

The changes, the first in the UK, have been welcomed by patient groups but trusts say that they may come at a cost to patient care. Nearly £5.4 million was collected by NHS trusts in Wales from hospital parking charges in 2006-07, but the reforms will mean that by the end of the current assembly term in 2011, only four hospital sites of 130 should still have parking charges in place.

The British Medical Association (BMA) last week demanded that hospital car park charges be scrapped, claiming that they are “a tax on the sick”.

The Welsh NHS Confederation, which brings together all Welsh NHS organisations, said the reforms would “inevitably” add to the pressures on trusts.

The announcement will fulfil the Assembly’s commitment to reform charges for hospital parking, which was set out in the One Wales document outlining the agenda of the Labour and Plaid Cymru coalition.

It also adds to the disparities in NHS policy between the four home nations. All patients in Wales get free prescriptions; the English pay an average of £6.85 an item. Scotland spends more on NHS care — £1,610 per head of population last year — than anywhere else, with Northern Ireland spending the least (£1,550 a head).

Free prescriptions are already available for vulnerable older people in Scotland, and the SNP is planning to extend this to all patients. Certain drugs are also available on the NHS in Scotland but not in England and Wales, where different calculations are made about cost-effectiveness.

Despite these differences, the King’s Fund think-tank says it was almost impossible to compare health outcomes in the four countries because they collect data differently.

In an address to the Welsh Assembly this afternoon, Edwina Hart, the Health Minister, will say: “Car parking charges fall heavily on people frequently attending NHS hospitals, whether they are patients, staff or visitors.

“They are at best an inconvenience and at worst an unfair expense. Over time all NHS patients, visitors and those who care for them will not have the expense or inconvenience of charges. By the end of the current Assembly term, the vast majority of NHS sites will have free parking for all.”

Cath Lindley, general manager for Macmillan Cancer Support in Wales, said: “Cancer patients have long been calling for parking costs to be scrapped.

“On average, cancer patients make 60 trips to hospital from diagnosis to treatment to follow up and, as a result, they are hit particularly hard, both financially and emotionally, by travelling costs and unfair parking charges. These reforms would go some way towards reducing the financial burden that can come with a diagnosis of cancer.”

It is expected that the additional costs to the NHS in Wales will be met from within annual NHS funding allocations.

It is also understood that trusts will be required to submit plans on how they will deal with additional costs, potential increases in demand, promotion of green transport modes and the potential use of spaces by commuters and shoppers.

Mike Ponton, director of the Welsh NHS Confederation, said: “It costs a lot of money to run car parks and the dilemma now is how to meet these costs without impacting on patient care.

“It will inevitably add to the pressures placed on trusts to provide services and balance the books. It will be even more important now to find new ways of controlling car parks to avoid misuse, particularly where hospitals are near town centres.”

http://www.timesonline.co.uk/tol/news/uk/article3474721.ece

Health Direct applauds the Welsh decision. Car parking charges are a stealth tax on the sick

This is yet another ludicrous anomaly which shows clearly that there is no longer a National Health Service but an extremely unfair regional set up. The labour Government needs to examine clearly why these inequitable arrangements- different prescription charges, postcode lottery treatment, and cancer drugs availability are allowed.

Orthodontists have warned that in many cases the children suffer from much more serious problems by the time they are finally given treatment.

This weekend specialists claimed that in many parts of England the NHS had in effect ceased to provide corrective surgery for children.

They also warned that the labour government’s introduction of an 18 week waiting time target for orthodontics at the end of the year would be so difficult to meet that patients would not be referred at all and treatment would be rationed further.

Evidence of the collapse in orthodontics in parts of the country is revealed in research by the British Orthodontic Society. It found that in at least seven hospital catchment areas in England, children with serious conditions were waiting more than four years for hospital treatment.

In one area of the northeast children are waiting for seven years while in another the delay is 5½ years.

James Spencer, consultant orthodontist at Pindersfield hospital in West Yorkshire, said: “This is totally unsatisfactory. If we are not able to get on with the treatment conditions such as impacted teeth may cause damage to other teeth. The children may also suffer psychological damage or sleeping problems.”

Once children reach 18 they are no longer routinely entitled to NHS treatment. Orthodontists report that some children turn 18 while waiting to be assessed for care and thus lose their chance of surgery on the NHS.

From:
http://www.timesonline.co.uk/tol/news/uk/article3466774.ece

Health Direct cites this as yet is another disgusting legacy of this Labour Government.

The large increase comes after the Government ordered doctors to note healthcare acquired infections on death certificates whether it is the underlying cause of death or not.

This figures from the Office of National Statistics show the 6,480 death certificates in 2006 mentioned the bug, which takes hold in vulnerable patients often after a course of antibiotics. The previous year just 3,757 certificates mentioned it.

Data from the Health Protection Agency, which collects the total number of reported cases of infection from hospitals, shows there were 51,892 cases in patients over the age of 65 in 2005, rising to 55,636 in 2006.

Meanwhile, the number of death certificates mentioning MRSA levelled off at 1,652 in 2006. In one in three of these cases the infection was the main cause of death.

Figures from the HPA show the total number of cases of MRSA blood stream infection is dropping from 7,233 in 2004/5 to 7,096 in 2005/6 and down to 6,383 in 2006/7.

In 2005, the Government’s Chief Medical Officer Sir Liam Donaldson issued guidelines saying where a patient dies with an infection it should be put on the death certificate.

The proportion of patients where the death certificate shows C.diff was the cause of death has remained stabled at around 55 per cent of all certificates mentioning the bug.

Murray Devine, head of safety at Healthcare Comission said: “The sharp increase in reported deaths from C difficile is disturbing – but not surprising because it shows that previous deaths rates were probably seriously under-reported.”

She added: “Recent steps taken to combat the spread of C. difficile and MRSA won’t yet be fully reflected in these figures.”

The rise in the number of death certificates mentioning C.diff is due to better reporting and overall infection rates are dropping, Prof Brian Duerden, the Government’s Chief Microbiologist said.

He said: “The Chief Medical Officer wrote to the NHS in July 2005 to make clear that we wanted infections such as MRSA and C. difficile to be reported more accurately on death certificates. These statistics from 2006 show that this move has worked and our figures are now in line with other developed countries.

“Since 2006 we have taken significant steps to tackle infections. These include stringent hand-washing guidance for the NHS, a bare below the elbows dress code, putting matrons back in charge of cleanliness on their wards and an ongoing deep clean of every ward.

http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2008/02/28/nsuperbug228.xml