The contract has been heavily criticised for failing to deliver promised improvements in dental care.

In 1999 Tony Blair pledged that everyone would have access to NHS dentistry within two years.

Figures out show that around half of the people in England saw an NHS dentist in the last two years. It means there has been a 3.9 per cent drop in the number of people treated in the first two years of the new system compared to the last two years of the old contract.

The data from the NHS Information Centre shows a rise in the number of treatments involving tooth extractions and dentures and a fall in the more complex crowns and fillings.

Dentists have consistently warned that the payment methods did not cover the costs of carrying out complex treatments and it would mean the incentive would be to pull the tooth out rather than attempt to fix it.

An analysis revealed that in England the proportion of treatments involving dentures increased from 38 per cent to 48 per cent and tooth extractions increased from seven per cent to eight per cent of treatments carried out in 2007/8.

In Wales the proportion of treatments where a tooth was pulled out increased from almost eight per cent to over nine per cent although there was no significant change in dentures.

Meanwhile treatments including crowns dropped from 48 per cent to 35 per cent in England and in Wales dropped from 44 per cent to 35 per cent.

Fillings also reduced from 28 per cent of treatments to 26 per cent.

Other findings show the number of dentists carrying out NHS work has increased by 3.2 per cent , an extra 655 dentists, compared to 2006/7.

Patients also paid more towards their NHS treatment with an increase of £56m or almost 12 per cent in revenue from patient charges.

From:
Dentists-pulling-out-more-teeth-instead-of-fixing-them.html

Health Direct asks what is the difference between being made to pay for NHS dentistry services and being made to pay for cancer drugs?

Harry Singer, 54, took advantage of the labour Government’s smoking cessation programme which pays doctors, pharmacists and community groups £45 for every patient they convince to give up for four weeks.

Stop Smoking Counsellor Singer received £89,505 from the NHS for signing people up to programmes to kick the habit. But many of the ‘registrants’ details were taken from other surveys or were friends who either did not smoke at all or had no intention of giving up.

Jailing Singer for 18-months, judge John Hillen said the antismoking scheme was “amateurish” and “cavalier” and blamed the labour Government’s target-driven culture.

“To pay lay people, albeit briefly trained, as stop smoking counsellors for recruiting and spending a few sessions with smokers is an astonishing way to spend public money,” said the judge.

He criticised Kensington and Chelsea Primary Care Trust for operating the scheme without checks which he said was an “extraordinary derogation of responsibility.”

“This was all driven by the need to meet targets and it is a feature of the target-driven culture of the governments of this country that it can lead to the opportunity for fraud,” the judge added.

“Anyone else listening to this case would have been appalled at the cavalier way in which the taxpayers’ money was dealt with by the Kensington and Chelsea Primary Care Trust and the positively amateurish way in which the finance department failed to have any sufficient checks on the money it was paying out on the no smoking service.”

The Primary Care Trust did not suspect the fraud even though Singer was 27 times better than the next best adviser. In just six months he claimed to have convinced 2,017 people to stop smoking, shattering the local target and winning a 2006 nomination for the Stop Smoking Supporter Award.

He received payments in respect of 1,989 people.

But he was eventually caught out when NHS bosses contacted his clients to find out the secret of his success and realised most of the people had never heard of him.

Police described Singer as a “Water Mitty” figure who had recognised the lax regime as an opportunity to print money.

Judge Hillen added: “This was not a sophisticated fraud. I am not going to name names but the public will be very surprised if there have not been resignations over this matter.”

Singer was convicted of 18 specimen false accounting charges between March and October 2006, and one count of concealing criminal property.

Diana Middleditch, Chief Executive of Kensington and Chelsea PCT, said: “The actions of one individual should not detract from the excellent work of the majority of our community advisers, who have a genuine interest in working alongside the local NHS to improve the health of our communities.”

A Department of Health spokesman added: “This year £56m was allocated to the NHS for smoking cessation services. We know that NHS stop smoking services have been hugely effective in helping people quit.”

From:
Government-targets-fostered-90000-NHS-fraud.html

Health Direct laments the yet again waste of tax payers’ money to hit labour’s NHS targets. This case further undermines any statistics that labour spout for the “success” of this costly project.

A report from the Department of Health said diabetes care is improving rapidly thanks to new guidelines developed five years ago.

More people are being diagnosed and are receiving treatment, the report said.

But critics said there are still 100 amputations a week due to diabetes complications and one in 10 adult deaths can be attributed to the condition and more children are being attending A&E; due to complications, showing that the Department of Health report ‘paints too rosy a picture’.

Diabetes UK chief executive Douglas Smallwood, said: “In view of such outcomes and the fact that the number of people with diabetes is set to double to four million by 2020, this report paints too rosy a picture of the current standard of diabetes care.

“We have a huge mountain to climb to ensure that all people with, and those at risk of, diabetes have access to the information, education, support and high-quality care to enable them to manage their condition on a day-to-day basis, with the help of specialist diabetes teams.

“The rate of progress in diabetes care needs to be much greater in the next five years than we’ve achieved in the previous five years.”

Five years after the Diabetes National Service Framework was published, around 600,000 people have been diagnosed with the condition, the report said.

And vascular checks announced in April, but yet to begin, are expected to prevent around 4,000 people from developing diabetes each year, it said.

Liberal Democrat health spokesman Norman Lamb said: “This report shows the NHS has taken a step in the right direction, but there is still a long way to go before people with diabetes are getting the help they need to manage their condition.

“But what is most striking about the report is what it doesn’t say. Almost no mention is made of the big risk that, unless we effectively tackle obesity, the number of people suffering with diabetes will almost certainly increase.

“A diabetes strategy will not be worth the paper it’s written on if a greater focus is not put on obesity.”

Health Minister, Ann Keen, said: “Today’s report shows that the NHS is getting better and better at identifying people with diabetes and at supporting them to manage their condition.”

From:
NHS-diabetes-care-still-has-mountain-to-climb-experts-warn.html

The Department of Health announced that just over 57,000 operations had been cancelled. However, these figures only cover cancellations made in the 24 hours before an operation.

The number of cancelled operations is almost twice as high as previously admitted by the labour Government with thousands of patients suffering from multiple cancellations.

Ministers have previously said that cancelling operations is “unacceptable” yet have failed to act to prevent hospitals from cancelling procedures, often just hours before surgery is due to take place.

The figures have been obtained by the Conservatives who used Freedom of Information laws to request the data from NHS trusts.

Andrew Lansley, the Shadow Health Secretary, said: “Having an operation cancelled can cause huge distress for patients and their families. It’s simply unacceptable that these figures are so high.

“The labour Government are directly to blame for these problems. NHS staff are doing the best they can but how can they plan patients’ care properly when they are continually hampered by Labour’s top-down targets? Labour’s boom and bust approach to the NHS finances has made things even worse, with bed shortages and staffing shortages in far too many trusts.”

The Conservatives claim that Kingston Hospital, York Hospitals and Sussex University Hospitals are among the most prolific cancellers of operations. Only one trust, the Clatterbridge Centre for Oncology said it had not cancelled any operations.

In total, more than 7,000 patients had their operation cancelled more than once. A third of trusts cancelled an operation for the same patient at least three times.

The Conservatives’ analysis reveals that the most popular reason cited for cancelling an operation was “problems with theatre bookings”. Thousands of operations were also cancelled because of bed shortages, administrative problems and staffing shortages.

The figures show that the scale of the problem is far larger than previously disclosed by the Government. Last year, the Department of Health announced that just over 57,000 operations had been cancelled. However, these figures only cover cancellations made in the 24 hours before an operation is due to take place

When hospitals were asked to reveal all cancelled operations, the figures were almost twice as high prompting allegations from the Conservatives that ministers were “spinning the statistics”.

131 of the country’s 171 NHS trusts responded to the Tories’ request for information. The trusts which responded said they had cancelled a total of 77,302 operations which, if extrapolated to include all hospitals, means that about 105,000 operations were cancelled nationally last year.

Shortly before the last election, Tony Blair, the former Prime Minister, said that it was “unacceptable” for operations to be cancelled.

A spokeswoman for the Patients Association said: “Everyone understands that in an emergency, a patient may not have the operation they need because the clinical priorities of another must take priority. The examples in this survey, however, reveal a situation where patients and their families are subject to an increasingly cavalier standard of care in which the NHS is not putting patients first.

“Patients, and taxpayers, expect better management of their NHS than this. The NHS only gets away with it because ultimately its patients cannot go elsewhere. When you know your customer doesn’t have a choice, such standards prevail.”

A spokesman for the Department of Health defended the Government and said it only collected figures for late cancellations as these were of most concern to patients.

From:
NHS-cancels-more-than-100000-operations-in-a-year.html

Cancer patients in Britain will consequently be denied more effective drugs that are available to sufferers in other countries.

Roche, the Swiss pharmaceutical giant, has already refused to supply economic data on its drug Avastin for treatment of lung and breast cancer to the National Institute for Health and Clinical Excellence (Nice), the authority that evaluates the cost-effectiveness of medicines for the NHS. This means Avastin will not be available on the NHS for those diseases.

Avastin is said to double the time a breast cancer patient’s condition remains stable when compared with existing treatments. Studies have also shown improved survival rates for lung cancer victims.

Roche said last week it will consider withdrawing from other evaluations rather than submit products only for them to be rejected by Nice as too expensive.

The statement is the latest twist in the growing row over decisions by Nice. Earlier this month Nice caused an outcry in a preliminary decision when it rejected the use of Avastin (also known as bevacizumab), Sutent (sunitinib), Nexavar (sorafenib) and Torisel (temsirolimus) as too expensive to treat kidney cancer.

“The alternative to these drugs for many patients is death,” said Jonathan Waxman, professor of oncology at Imperial College, London. “Nice is making terrible mistakes.”

The survival rates for cancer in Britain are already among the lowest in Europe — on a par with Poland, Slovenia and the Czech Republic, according to data published last year.

However, cancer charities acknowledge there has been significant improvement in rates since the government made the issue a priority with its NHS Cancer Plan, first launched in 2000.

Some consultants argue, however, that Britain already spends less on cancer drugs than many other European countries and that it is “crazy” to reject drugs proven to prolong life.

Richard Barker, director- general of the Association of the British Pharmaceutical Industry, which represents the drug companies, said: “Nice does a tough and necessary job, but is making errors because of a very mechanistic approach.

It relies too much on arithmetic and not enough on clinical judgment.”

Nice was created in 1999 with the aim of ensuring that decisions on the best and most cost-effective drugs for the NHS were made at a national level, were transparent and could be challenged.

When the drug companies scrutinised the economic modelling used by Nice, they realised that the estimated costs of their drugs and effectiveness could vary widely.

Even more seriously, some of the calculations were wrong. There was an outcry in the medical community in February 2006 when Nice stated that Temodal (temozolomide) — declared as the biggest breakthrough in treating brain tumours for decades — did not offer value for money.

Temodal had won approval from the European regulator in 2004, but many British patients were denied treatment as Nice wrangled over costs.

Peter Davison, 48, a manager for Cambridge University Press, was among the few British patients who received the drug — because he was diagnosed with a brain tumour while working in Singapore.

“I was lucky to be abroad,” said Davison, who is now in remission. “Four months after I had the operation to remove the tumour, I was running and climbing mountains.”

When Schering-Plough — the pharmaceutical company which markets Temodal — prepared its appeal against the Nice decision, it identified an error in the modelling. Once corrected, the model showed the drug was cost-effective — and as a result it was ultimately approved for NHS use.

Not surprisingly, the drugs companies now want full access to the economic models, with the chance to check the accuracy of the calculations. In May, the High Court ruled that Pfizer and Esai, the companies which market the Alzheimer drug Aricept, should be given full access to these models.

“We believe this modelling might not be fit for purpose and we want to check it,” said a Pfizer spokesman last week. Nice said it was seeking leave to appeal to the House of Lords after the High Court decision.

Even where the models are correct, consultants and patients’ groups say Nice fails to give proper weight to the evidence from clinicians and patients’ groups.

The Sunday Times has highlighted the fact that NHS patients do not even have the option of paying for the drugs privately because of government ban on “co-payments”. The labour government has said it will review the issue.

Professor Sir Michael Rawlins, chairman of Nice, said the evaluation process was recognised internationally and Nice had been commended by the World Health Organisation for the quality of its work. He said: “We have a finite amount of money to spend on healthcare and we have to divide it up in as fair and as equitable a way as we can. We can’t say to yes to everything. It’s awkward, it’s difficult, it’s unpleasant.”

From:
http://www.timesonline.co.uk/tol/news/uk/health/article4538256.ece

Nearly two-thirds of those surveyed said patients should be permitted to top up their treatment. The government is reviewing the issue after a Sunday Times campaign.

According to the latest YouGov poll, 73% believe that if treatments exist they should be available on the NHS. Only 21% think there should be a limit on treatment. Nearly a third said they would be prepared to pay extra taxes so the more expensive treatments could be available on the NHS.

Alan Johnson, the health secretary, has asked Professor Mike Richards, the cancer czar, to consider whether so-called co-payments should be allowed again. The labour government has previously argued such a scheme would create a two-tier service and has warned patients that care may be withdrawn if they pay for drugs privately.

From:
http://www.timesonline.co.uk/tol/news/uk/health/article4538256.ece

Health Direct asks why if labour allows the NHS to pay for the removal of 177,00 tattoos why don’t they also fund cancer drugs?

The total paid in charges per year increased 22 per cent between 1997 and 2007, according to figures released to shadow health secretary Andrew Lansley.

New analysis by the Conservatives reveals that:

NHS dental patients have paid £4.5 billion in charges under Labour since 1997, despite 2 million people losing their NHS dentist.

Although spread between fewer patients, the annual amount paid in dental charges has soared by 22 per cent since 1997. Patients are now on average paying 35 per cent more for NHS dental treatment than they were in 1997.

Shadow Health Minister Mike Penning said: “Labour’s dental legacy is one of shameful failure.

“Not only are people now paying 35 per cent more when they see their NHS dentist, but Labour’s botched policies mean that millions of hard-working families have completely lost access to affordable dental care.

“Labour ministers need to own up to their mistakes, stop dithering and take action now to rectify the mess they’ve got the country into.”

From:
http://www.hsj.co.uk/announcements/2008/08/tories_report_dental_charges_rise.html

Frank Field, the former Labour social security minister, wrote to Alan Johnson, the health secretary, yesterday to urge further action against the businesses over a conspiracy that was allegedly taking place while prices of dozens of basic remedies rose as much as 800 per cent.

Mr Field made his intervention as lawyers acting for the National Health Service press for further “substantial recoveries” through a damages action against the companies that has already netted £34m. Many observers say the companies named have never been forced to account fully for their actions, bec-ause of weaknesses in the way Britain deals with financial misconduct.

Mr Field, a former member of the Commons’ public accounts committee, said the companies should be “on their knees thanking their lucky stars” at the decision by Mr Justice Pitchford last month to stop their criminal trial on conspiracy to defraud charges.

Peters & Peters, the law firm acting for the NHS, is pressing ahead with a damages action founded on allegations that the companies were involved in a conspiracy to rig the prices of drugs including penicillin and warfarin, a blood thinner.

Jonathan Tickner, a Peters & Peters partner, said: “The obvious success of the civil proceedings . . . speaks for itself and we, on behalf of the Department of Health, fully expect further substantial recoveries to be made.”

The main company still in the department’s sights is Ashford-based Kent Pharmaceuticals, supplier of many basic antibiotics to NHS hospitals, retail pharmacists and dispensing doctors.

Kent declined to respond to questions on the case. All the other companies that faced criminal charges – Goldshield, Ranbaxy, Generics and Norton Healthcare – declined to comment when asked if they denied colluding with each other, saying they could not speak while the threat of criminal proceedings remained.

Mr Justice Pitchford last month scrapped fraud charges laid by the Serious Fraud Office against the companies after the House of Lords criticised the way the indictment was drafted but left open the possibility it could be amended. The SFO has launched an appeal against the judge’s decision, arguing it should be allowed to reformulate the charges.

Since the trial collapsed, some senior executives – notably those at listed Goldshield, which is chaired by Keith Hellawell, the government’s former drugs “tsar” – have gone on the offensive and complained £25m of taxpayers’ money was wasted in mounting the trial. The companies have always argued that price-fixing was not a crime at the time of their alleged activities.

But lawyers said there seemed to be evidence of subterfuge to justify a prosecution, alleging companies conspired to defraud the government – and hence the taxpayer. Documents seized in the penicillin investigation included a presentation, known as “The Scenario”, that contained a bullet-point overview of how to operate a price-fixing cartel.

The case could be picked up by the Office of Fair Trading, which has imposed fines totalling hundreds of millions of pounds over the past year or so on companies involved in cartels in industries such as aviation, supermarkets and tobacco.

Another possibility is that the NHS could launch a private prosecution. It declined to say whether it had plans to do so.

Health checks

2000 SFO starts probe into price-fixing in supply of generic drugs to NHS April 2002 More than 30 premises raided April 2006 Five companies and nine executives charged with conspiracy to defraud January 2008 Lords hear submissions from Goldshield and Ian Norris that price-fixing cannot be prosecuted under the common law offence of conspiracy to defraud March 2008 Lords rule in favour of Mr Norris and Goldshield July 2008 Judge quashes indictment against the five companies and nine executives charged

http://www.ft.com/cms/s/0/32776f1c-6806-11dd-8d3b-0000779fd18c.html

The drug – abiraterone – received an enthusiastic endorsement from the institute, Europe’s largest cancer research laboratory, and its associated Royal Marsden hospital, as the first clinical trial results were published online by the Journal of Clinical Oncology.

Ten thousand British men a year, diagnosed with the most aggressive (and normally fatal) form of prostate cancer, could benefit, says the ICR.

Johann de Bono, head of the abiraterone clinical programme, said: “This is the biggest step forward in prostate cancer treatment since the 1940s.”

The ICR and Royal Marsden are usually too cautious to enthuse about a new treatment, for fear of raising excessive expectations among desperate patients. But Dr de Bono said their confidence was based on a substantial amount of unpublished data, as well as the formal analysis in the Journal of Clinical Oncology of the Phase 1 trial with 21 men.

“The Royal Marsden patients have very aggressive prostate cancer which is exceptionally difficult to treat and almost always proves to be fatal,” he said. “They have been monitored for up to two-and-a-half years and with continued use of abiraterone they were able to control their disease with few side-effects.”

Patients showed big falls in levels of prostate specific antigen or PSA, the blood protein associated with prostate cancer activity. “A number of patients were able to stop taking morphine for the relief of bone pain,” Dr de Bono added.

Abiraterone works by blocking the generation of male hormones that drive growth of prostate cancers.

Cougar Biotechnology, a Los Angeles company, is funding extensive further trials, including an international study with 1,200 patients under Dr de Bono’s supervision. He hopes abiraterone will be available for general use from 2011.

From:
http://www.ft.com/cms/s/0/733f85e4-577a-11dd-916c-000077b07658.html?nclick_check=1

Health Direct ask s if this new treatment Abiraterone will be approved by the female biased NICE at the same speed with which they approved Herceptin?

The Rarer Cancers Forum said the appeal system was chaotic and the result often depended on where the patient lived.

One in four appeals made in a 20-month period was rejected. But one primary care trust had no successful appeals, compared to 96% in a nearby trust.

“In the last 20 months, 5,000 cancer patients have been forced to plead for their lives. There has to be a better way.” Penny Wilson-Webb of Rarer Cancers Forum

The recent decision by the National Institute for Health and Clinical Excellence (NICE) advising against the use of four drugs for advanced kidney cancer in England and Wales has thrown the spotlight on the patients fighting to receive them.

One of the routes a patient can take if the drug they believe they need is not funded by their local NHS is to lodge an “exceptional request” directly to the primary care trust, and put forward their particular medical or personal circumstances which they say means it should be funded for them.

The latest report, compiled using information obtained under the Freedom of Information Act, reveals that approximately a quarter of appeals are rejected. In total, 5,000 appeals were made, mostly by patients with advanced cancer, over a 20-month period.

There is no national guidance on how appeals should be run by individual primary care trusts, with some choosing to appoint committees including experts, while others do not.

The forum said there was not even a definition of what constituted an “exceptional case”.

It is calling for the appeals to be handled on a regional, or even national level, rather than left in the hands of local NHS managers.

Its chief executive Penny Wilson-Webb said: “This audit shows that the exceptional cases process is in chaos and patients are suffering.

Expert criticism

Dr Steve Schey, a consultant haematologist at King’s College Hospital in London, who has appeared before appeal committees, said that the process seemed to be a “lottery”.

“We urgently need some standardisation and transparency in the decision-making process.”

NICE guidelines cover England and Wales, where similar appeals process is in force.

Scotland and Northern Ireland have their own guideline bodies, and systems for patients to challenge decisions not to fund drugs.

A spokesman for the Department of Health said: “We have heard from patients that one of their major concerns is the perceived ‘postcode lottery’ in access to drugs – that there are too many variations around who gets access to prescribed drugs and that these variations are a lottery depending on where you live.

From:
http://news.bbc.co.uk/1/hi/health/7549564.stm

It coincides with the publication of a report which found that more than 1,000 patients have been turned down for cancer drugs in the past two years because of a postcode lottery.

Immediately after the decision on kidney drugs last week, campaigners denounced it as akin to a “death sentence” for thousands of people.

Now experts and patients’ representatives invited to participate in the consultation process have claimed it was “flawed and irrational”.

Charity Kidney UK is expected to make an official complaint that its advice was ignored, while three out of the four patient representatives asked to attend have registered protests.

One patient representative, Bill Savage, a retired management consultant who had a kidney removed, claimed that he and other patients were made to sit through a 101-page Powerpoint presentation focusing solely on the costing of the drugs.

“We were patronised and bullied by a process that marginalised us,” Mr Savage, 61, said.

Kate Spall, who won treatment for 80 patients this year by challenging the priorities of local primary care trusts, drew up advice for Nice with the help of a large number of cancer sufferers, but was so appalled by the process that she declined to be named as a consultee and made a written complaint.

“We waited for our opportunity to contribute – and it never came,” she said.

The four prohibited medicines include Sutent, which can prolong life in kidney cancer patients by up to two years. The draft guidance also rejected Avastin, Nexavar and Torisel.

Nice has said it has sent responses to all complaints but would not comment further.

From:
NHS-drugs-body-Nice-bullied-ignored-and-patronised-patients-say-charities.html

Patients with advanced kidney cancer are to be denied four life-extending treatments because the NHS says they are too expensive.

Charities expressed outrage at the decision, saying it left patients only one treatment option – interferon – to which many do not respond.

Professor John Wagstaff, from the South Wales Cancer Institute, said there was “no point” in him accepting referrals for people with advanced kidney cancer as around 75% of them “do not gain any real benefit” from interferon.

Broadcaster James Whale, who lost a kidney to cancer in 2000, said the guidance would “mean an early death sentence for many” if it were not revised.

” This is a reckless decision by people who have no idea of the consequences of what they are doing.” Broadcaster James Whales tells Sky News.

The medicines do not cure the cancer but extend a person’s life by a matter of months.

Patients already on the therapies should continue until they and their doctors consider it appropriate to stop, the guidance said.

Every year, up to 7,000 people in the UK are diagnosed with kidney cancer.

Professor Peter Littlejohns, clinical and public health director at Nice, said: “The decisions Nice has to make are some of the hardest in public life.

“NHS resources are not limitless and Nice has to decide what treatments represent best value to the patient as well as the NHS.

“Although these treatments are clinically effective, regrettably, the cost to
the NHS is such that they are not a cost-effective use of NHS resources.”

Prof Littlejohns said there were no treatments that reliably cured advanced kidney cancer.

From:
Kidney-patients-denied-too-expensive-life-extending-drugs.html
Kidney-Cancer-Patients-Denied-Treatment/Article/

Health Direct finds it disgusting that cancer sufferers are being condemned to an early death by labour’s pathetic cost cutting. They they find £80 million to fund a website and pay for the removal of 178,000 tattoos. Where’s the logic and fairness in their dithering?

Mice, rats, squirrels, bedbugs, fleas, cockroaches, ants, flies, silverfish and even foxes have all been reported by hospitals responding to Conservative freedom of information requests.

Responses from 127 trusts show that 70 per cent had to call out pest controllers 50 or more times between January 2006 and March 2008.

Examples include maggots found in patients’ slippers; rats in a maternity unit; wards “overrun” with ants; mice “all over” wards; cockroaches in a urology unit; fleas in a neonatal unit; and a store for sterile materials infested with mice.

Andrew Lansley, the Shadow Health Secretary, said: “Labour have said over and over again that they will improve cleanliness in our hospitals but these figures clearly show that they are failing.

“It is difficult for health service estates to maintain a completely pest free environment but the level and variety of these infestations is concerning.

“We need greater transparency in NHS infection control, and publishing data like this is one way in which we can drive up overall hygiene standards.”

The data does not show whether infestations are increasing or diminishing, nor does it show that, unpleasant as they may appear, the pests found in hospitals have any clear implications for the health of the patients.

Few households can claim to be free of ants, mice, or silverfish all the time, and rats are never far away. Given the scale of the NHS, the size of its buildings, and the constant flow of patients in and out, the levels of infestation do not appear remarkable.

Malcolm Padley, a spokesman for Rentokil, which provides pest control for hospitals nationwide, said: “Pests are attracted to most buildings whether they are in the private or public sector. You are likely to see pests at some point in some form or another.

“There is a problem with large buildings, like hospitals, in particular and many buildings with a lot of grounds are also attacked.

“We have definitely seen an increase in the number of call-outs about bed bugs and rodents nationally. A lot of people could be going into hospitals with bed bugs on their clothing.

MOST PEST CONTROL VISITS
Nottingham University Hospitals NHS Trust: 1,070
Hull and East Yorkshire Hospitals NHS Trust: 898
Portsmouth Hospitals NHS Trust: 857
Pennine Acute Hospitals NHS Trust: 855
Guy’s and St Thomas’ NHS Foundation Trust: 813
Barts and the London NHS Trust: 801
York Hospitals NHS Foundation Trust: 690
Leeds Teaching Hospitals NHS Trust: 658
Southampton University Hospitals NHS Trust: 450
East Kent Hospitals NHS Trust: 416
Source: Figures obtained by the Conservatives for January 2006 to March 2008

A spokesman from the Patients Association was unconvinced, saying: “Such findings are truly revolting. How can patients be safe amid bedbugs, fleas and rats? These findings reveal what happens when money is taken away from where patients expect to see it spent.

“If these hospitals were restaurants they would be closed down and out of business.”

From:
http://news.bbc.co.uk/1/hi/health/7542718.stm

The evidence that top-up payments have previously been allowed, apparently without difficulties, undermines the labour government’s claim they are contrary to the fundamental principles of the NHS.

At one trust, the Royal Cornwall Hospitals NHS Trust, 20 patients were allowed to co-pay for cancer drugs that the health service refused to fund before the labour ban was introduced.

The figures also provide further evidence that many trusts are allowing patients to top up with additional drugs without removing the remainder of their NHS care.

Freedom of information data shows that Nottingham University Hospitals NHS Trust has allowed patients to pay for drugs their consultant has recommended without losing the rest of their NHS treatment.

John Baron, MP for Billericay, who obtained the figures, said: “This undermines the case of those who argue co-payments cannot exist within the NHS.”

Other trusts that have allowed co-payments include the University Hospital Birmingham NHS Foundation Trust, ABM University NHS Trust in Bridgend, south Wales, and Weston Area Health NHS Trust in Somerset.

From:
http://www.timesonline.co.uk/tol/life_and_style/health/article4449529.ece

Health Direct wonders whether NICE and labour would rather have people die than fund some treatments. Kill the quango, not the patients.

Appalling standards of care, crowded wards, financial problems, a shortage of nurses and poor hygiene all led to the outbreak the Healthcare Commission found in a highly critical report in October.

However after studying that report, Kent Police and the Health and Safety Executive said there would be no charges over the deaths at hospitals run by the Maidstone and Tunbridge Wells NHS Hospital Trust.

Assistant Chief Constable Allyn Thomas said: “Whilst the report makes for grim and at times distressing reading, our review has not identified any information that would indicate a need or duty to conduct a criminal investigation into the Trust at this time.”

Relatives of those who died in the outbreak reacted angrily to the announcement.

Steve Stroud, whose 77-year-old stepmother Doreen Ford died in Maidstone Hospital said he was “disgusted” by the decision.

Mr Stroud, husband of former Bucks Fizz singer Cheryl Baker, said: “This is disgusting. Someone has got to be held to account over all these deaths and if it is not the hospital trust, then who the hell can it be?

“Someone really should have to carry the can over this… for no charges to be pressed is really disgusting. I can’t believe it”.

Baker, described the death of her mother-in-law as “legalised killing”.

She said: “The Trust is to blame, I know that, everyone knows it and it makes my blood boil.

“Those patients didn’t die by chance, they died because they contracted C diff at the Trust because of poor hygiene and care, so they are to blame, without a shadow of a doubt.”

The Healthcare Commission had found the infection probably or definitely killed 90 people and was a factor in a further 241 deaths.

It also criticised the then chief executive of the trust, Rose Gibb, who left before the findings were published and is now reported to be fighting for a payout of several hundred thousand pounds.

But police said the report held no evidence that the deaths amounted to manslaughter.

For the trust or one of its employees to have committed gross negligent manslaughter, it would be necessary to identify a single act that was grossly negligent and caused a death.

Geoff Martin, of campaign group Health Emergency, said: “The decision not to bring charges over the catastrophic management failures at Maidstone and Tunbridge Wells sends out a signal that no matter how many people die, those at the top can bail out without taking the rap.

“Maidstone and Tunbridge Wells was possibly the worst single, corporate failure in the history of the NHS. It doesn’t get any worse than 90 deaths and it’s massive kick in the teeth to the friends and relatives of those who died that no-one will be properly called to account.

David Nicholson, NHS chief executive, said: “Whilst criminal proceedings have not been brought in this instance, the Trust’s failure to protect and care for patients during the outbreaks of Clostridium difficile between 2004 and 2006 was wholly unacceptable.”

From:
http://www.telegraph.co.uk/news/2474303/Superbug-hospital-escapes-criminal-charges.html

The move means that for the first time it will be possible to make direct comparisons between the quality of treatment in the two sectors.

Another side-effect should be more information than has previously been available on how many patients the private sector treats.

The requirement for private hospitals, like their NHS counterparts, to publish figures on death rates and other quality measures was revealed by Mr Nicholson to MPs on the Commons health committee. It follows the decision to bring the two halves of the system under the same regulatory umbrella from next year.

David Worskett, director of the NHS Partners Network, which represents private providers of NHS care, welcomed the move. He said yesterday that his members, which include Spire, Care UK, Nuffield Hospitals and General Healthcare, were commissioning “an independent sector-wide approach to collating and presenting patient outcome data”.

“Independent sector providers live or die by their quality,” he said, “so we have no problem at all with that. There may be some arguments over the technicalities of what is presented in annual quality reports and how. But there will be absolutely no argument about the principle.”

In a separate development, Mark Britnell, the health department’s director-general of commissioning, has written to the independent sector laying out more than a dozen areas where it can play a role in NHS care. The move is aimed at reassuring the providers that their role in supplying public services – apparently under threat last year – is assured.

He lists policy changes that could lead to business for the private sector, including the patient’s right to choose both treatment and providers, providing more information on the quality of care in both the NHS and private sectors, and piloting new integrated care organisations in which the private sector could play a role, along with opportunities to support NHS staff who leave the NHS to sell their services back through social enterprises.

In addition, the jobs of chief executive and chairman of a new competition and co-operation panel have been advertised at what are understood to be attractive salaries. The panel will act as an appeal body for the NHS, private and voluntary sectors if primary care trusts fail fairly to tender new or significantly changed services.

All these and more offer “real potential for private sector involvement”, Mr Britnell says in his letter.

Mr Worskett said his members had reservations about one or two of the items. But the private sector’s fear last autumn that its potential role in the NHS was shrinking as independent treatment centre contracts were being cancelled had diminished sharply.

“The feeling that it is all going backwards has gone away. A framework [for the independent sector] is now being put in place that looks much more robust for the future. There is still some uncertainty about the best way to achieve change. But there is absolutely no doubt now that the process is continuing and the position has stabilised,” he added.

http://www.ft.com/cms/s/0/88ee15b0-5d04-11dd-8d38-000077b07658.html

The site is called NHS Choices, and it occupies the URL nhs.uk. The site already combines the roles of medical encyclopedia, NHS guidebook and users’ forum.

The interactive health guides are as readable as commercial handbooks, and presumably as authoritative. My personal favourite feature is Behind the Headlines, inherited from the old National Electronic Library for Health, which sets out the facts behind those “Two cups of tea a day can cure dementia” headlines you see in the red tops.

NHS Choices is also gatekeeper and evangelist for labour’s government policy of encouraging patients (in England) to be picky about their hospitals. As labour rightly stresses, choice must be based on information. Thus the site publishes patients’ (moderated) comments about care they receive in individual institutions, as well as official data such as survival rates from some surgical procedures.

What, then, is the worry? The answer lies in the scale of the undertaking and what it means for the rest of the e-health economy.

In the words of a vision paper published earlier this year, NHS Choices is to become “the digital wing of the NHS”. This is in keeping with the government-wide strategy of rationalising the number of official websites down to a handful of “supersites”, both to save money and make life easier for users.

The trouble with being a supersite is that it tends to make you slow, bureaucratic and a big fat target. Every time an NHS organisation says it can’t afford a new drug or procedure, you can guarantee the cry will go up: “But you can afford £80m for a website?”

Especially as some of the services – collecting patients’ feedback, for example – seem to duplicate those of independent ventures such as Patient Opinion (patientopinion.org.uk) and the newly launched Iwantgreatcare (iwantgreatcare.org).

And, busy as it is, the current NHS Choices site is just the start of the project. This autumn, under the new contract, it will integrate with the online element of the NHS Direct health helpline.

Next year it will take on information about social care, which is provided mainly by local authorities rather than the NHS. And all of this is just a preliminary for the real challenge – becoming the front end of HealthSpace, the ambitious system of personal electronic health records being created by the NPfIT white elephant NHS National Programme for IT.

Any one of these initiatives has the potential to become labour’s next IT-enabled public relations disaster. Let’s hope the Department of Health and its supersite contractor, Capita, knows what it’s doing this time.

NRAS is preparing itself for a flood of calls from distressed patients who are effectively seeing their future quality of life taken away from them.

Ailsa Bosworth, Chief Executive of the National Rheumatoid Arthritis Society, comments:

“This decision is another nail in the coffin for the treatment of RA in England and Wales. NICE are re-writing the rules of RA treatment in this country ignoring the clinical effectiveness of drugs and ignoring the views of patients and clinicians.”

NICE are refusing to let patients have access to a second Anti-TNF if their first attempt at Anti-TNF therapy fails. Moving from one TNF therapy to a second and even a third has been established practice in the UK for some years, so this is not ‘new’ treatment which is being banned.

Together with the NICE decision in April to reject abatacept, they are effectively reducing clinically effective treatment options for people with RA from five drugs to just two. Patients diagnosed with the disease in their 20’s and 30’s could face 40-plus years with increasing disability and be forced out of work if access to these drugs is denied.

Ailsa continues:

“NICE is systematically taking away clinically effective and proven treatments from patients and giving them just one roll of the dice when it comes to Anti-TNF treatment.”

This decision flies in the face of the recommendations in Dame Carol Black’s recent report – Working for a healthier tomorrow – about supporting people to remain in work and the Department of Work and Pensions’ aspirations to have 80% of working age population in work by 2010/11

Ailsa, an RA sufferer herself for 28 years and who is on her third anti-TNF treatment which enables her to work 50-60 hours a week and run an organisation employing 14 people, is concerned that the views of patients have been totally ignored by NICE:

“The involvement and views of patients and patient groups in the NICE process is just a token gesture and is not taken seriously.”

“As a patient expert for many years now, I have attended at least 6 NICE Appraisal/Appeal meetings. I can confirm that with the exception of the Chair of the Appraisal Committees only on one occasion have I or any other patient expert with me ever been asked a question by any other member of the Committee – they seem fundamentally uninterested in the patient quality of life issues which matter to real people.

Any patients concerned about this decision can contact NRAS on 0800 298 7650 or visit the website: www.rheumatoid.org.uk.

From
http://www.rheumatoid.org.uk/article.php?article_id=535

Barrie Clark, 61, was told in May that he could receive a free supply of a new kidney cancer drug on compassionate grounds from the pharmaceuticals company that makes it.

Clark was then astonished to be told by the NHS that he could not take up the offer at his local hospital because it was against management policy.

He could receive the drug, which has been approved as safe, only by paying for nurses to administer it privately.

Cancer patient sent home to die by the NHS sees health improve after cashing in pension and paying privately for drugs

Linda O’Boyle was denied free treatment in her final months because she had gone private to try to prolong her life

Clark is in a similar predicament to patients being denied NHS care if they choose to pay for drugs that the health service does not fund. Campaigners are outraged that the ban on allowing NHS patients to pay for private drugs has now extended to letting them receive additional medicines for free.

In a letter of complaint to NHS Grampian, which runs Aberdeen Royal Infirmary where Clark is being treated, the father of four said: “I have been denied a free drug for a long time when there was no alternative treatment.

“We find this appalling and demand that the drug be offered free of charge immediately. How many other people has this happened to? You have jeopardised my life and caused great anguish to me and my family. That is disgraceful.”

The medicine, temsirolimus, which has the brand name Torisel, was granted a licence for the European Union in November. The European Medicines Agency (EMEA) has ruled that its benefits outweigh the risks. Dozens of NHS patients have received it on compassionate grounds from Wyeth, the manufacturer, in advance of its commercial launch in Britain.

The National Institute of Health and Clinical Excellence (Nice) is assessing whether Torisel is cost-effective enough to be prescribed on the NHS.

Managers at NHS Grampian told Clark that he could not receive it because it was not yet on its list of prescribed drugs, known as the hospital formulary. The trust says it will not be placed on the formulary until it is assessed by Nice or the Scottish Medicines Consortium.

Clark, a manager in the oil industry, has been helped by Kate Spall, a cancer drugs campaigner with the Pamela Northcott Fund.

Spall said: “I have never heard such rubbish. They are saying this medicine cannot be given because it is not on a drug list, but patients elsewhere across the country are getting it. Are we now in a position where a terminally ill patient is denied a free medication?”

Cancer professors dismissed the explanation as “bureaucratic nonsense”. Will Steward, a consultant oncologist at Leicester Royal Infirmary, said: “I really do not understand the decision not to allow a free drug to be administered from the hospital. We do this frequently.

“Many trusts have allowed this in the past and this decision is perverse.”

Jonathan Waxman, a consultant oncologist at the Hammersmith hospital in London, added: “This is an effective treatment. This shows the mess we are now in.” After Clark told the hospital he was going to speak to the media, managers said he could pay to have the drug administered privately. He would need to pay about £1,000 a month as it is taken intravenously.

Clark said that, although appalled at his treatment by the NHS, his own oncologist had done his best. NHS Grampian declined to comment on the individual case.

The Sunday Times has been campaigning to end the ban on NHS patients paying for private drugs that the state does not fund. Last week two patients won appeals to receive cancer drugs on the NHS after they featured in the Sunday Times Right to Pay campaign.

Sheila Norrington, 59, a cancer patient from Maidstone, Kent, was denied NHS care after paying privately for Erbitux, which costs about £3,000 a month. After the paper highlighted her case, the Peggy Wood Foundation, a charity, agreed to pick up the bills, but last week West Kent Primary Care Trust reversed its decision.

Barry Humphrey, 59, from North Walsham, Norfolk, was told that if he paid for Nexavar, the only available treatment for his advanced liver cancer, he would be billed for his NHS care. His local trust refused to fund the drug but neighbouring Suffolk Primary Care Trust has recommended that the NHS should provide it.

The British Medical Association and the NHS Confederation, which represents hospital managers, support a patient’s right to co-pay for cancer drugs without losing NHS care.

From
http://www.timesonline.co.uk/tol/life_and_style/health/article4364419.ece

Graham Tanner, chairman of National Concern for Healthcare Infections, said: “It should be remembered that over four years, more than 20,000 patients have suffered an MRSA infection, and in excess of 200,000 contracted C. difficile.”

In 2007-08 the number of MRSA cases fell to 4,438 – 588 above the target, Health Protection Agency data show. However, in the first quarter of this year a trend of falls in C. difficile bloodstream infections was reversed, with a 6 per cent rise: there were 10,586 cases of C. difficile blood infections in patients aged 65 and over.

A total of 966 cases of MRSA were reported – an 11 per cent drop on the previous quarter and an average of 322 cases a month. In 2004 John Reid, as the Health Secretary, said that infections of methicillin-resistant Staphyloccocus aureus should be cut to a monthly average of 321. At the time that was said to be unachievable. Even within the Department of Health, leaked documents last year showed there was serious concern it would not be met.

But the recent fall in cases suggests that high-profile initiatives such as the “deep clean” of all hospitals and introduction of a mandatory “hygiene code” may have had the desired effect.

MRSA and C. difficile are carried by some healthy people, but the bacteria can cause illness when they grow unchecked, elderly hospital patients being particularly at risk. Annual figures showed a decline for both infections.

Alan Johnson, the Health Secretary, described the decreases as a remarkable achievement.

“Our strategy is clearly having an impact, with our challenging target now within touching distance, but this is not an issue we can be complacent about and we will continue to focus our efforts on reducing infections further,” he said.

Andrew Lansley, the Conservative Shadow Health Secretary, said that the Government would not have met its MRSA target had it measured the yearly rates to March.

To achieve half of the 7,700 MRSA infections in 2003-04, the NHS would have had to limit rates to just 3,850 cases this financial year, he said.

“Every case of a hospital infection is one too many, but in four years Labour hasn’t even been able to halve MRSA rates, he said. “They have only got round to admitting they have missed the target by moving the goalposts. This shows just how much they’ve dithered and delayed over tackling hospital infections.”

Murray Devine, Safety Advisor for the Healthcare Commission, the NHS regulator, added: “This is great news for patients. There’s no question that there has been a very significant turn around, but the challenge isn’t over. This improvement has got to be sustained and infection rates brought down further.”

From
http://www.timesonline.co.uk/tol/life_and_style/health/article4353861.ece