It comes as ministers also revealed that Labour will have to raise taxes and cut capital spending on major projects if it wins the next election. Capital spending projects will bear the brunt of cuts.

Labour and the Conservatives are locked in a bitter battle over spending plans.

The Tories seized on comments made by Andy Burnham, the new Health Secretary, in which he said Labour would continue to maintain NHS spending in the period after the current Budget period, up to 2011.

At the NHS Confederation annual conference in Liverpool, Mr Burnham admitted: “I can’t write the spending review – it would be ridiculous. We have stability for two years but the Prime Minister indicated the NHS will remain the priority for a Labour Government.”

The Tories said this contradicted what he had previously said and it should “worry NHS patients and staff.”

Labour also had to admit that taxes were likely to increase in try and fend off other cuts.

Liam Byrne, the Chief Secretary to the Treasury, said: “Alistair Darling has been really clear that there are going to be some pretty tough choices to be made. There are going to be conditions of constraint and there are going to be difficult decisions on, for example, tax.”

Gordon Brown has been able to appear as if he is maintaining spending on services but cutting public expenditure by looking to savagely cut planned capital projects. That means transport infrastructure, school and hospital building projects, as well as major defence procurement deals.

The Prime Minister has been reluctant to admit that the Government plans to cut capital spending by almost 40 per cent between 2011 and 2014.

Mr Byrne admitted that capital spending would be reduced.

He said: “Once you have built a school you have got a school.”

Philip Hammond, the shadow chief secretary, accused My Byrne of being “disingenuous” about public spending. Gordon Brown has, over successive elections, painted the Tories as a party that will cut public services, but David Cameron has made great efforts to blunt that line of attack by promising to match Labour’s commitments.

George Osborne, the shadow chancellor, said: “We now see how Labour plans involve spending cuts in a dozen departments next year. But Labour politicians continue to claim that they won’t cut spending.

“That’s just plain dishonest. Why can’t the Prime Minister just be honest with people and admit to the cuts which are in his own Budget?”

From:
http://www.telegraph.co.uk/Labour-admits-it-cannot-increase-NHS-funding.html

Figures show that the number of patients waiting more than eight weeks for an outpatient appointment increased by 31.5 per cent between March and April this year.

There were 43,400 people waiting more than eight weeks for an outpatient appointment in April, 82.7 per cent higher than the previous year, according to Health Service Journal.

Officials said a backlog of appointments has built up after the bad weather in February which saw much of Britain gridlocked under snow.

The NHS suffered an extremely busy winter as the coldest weather for 30 years, coupled with high levels of seasonal flu and norovirus outbreaks.

The Daily Telegraph revealed the extent of the pressure on the ambulance service as national director, Peter Bradley, said the service had seen its busiest ever week in December and others warned staff were ‘performing near miracles’ to keep the NHS running.

From:
http://www.telegraph.co.uk/health/healthnews/5497044/NHS-waiting-times-have-risen-by-a-third-in-a-month.html

The chief executive, who wished to remain anonymous, said he thought that the company had completed the procurement process after submitting a 206 point questionnaire, with 9 attachments, followed by a 122 question tendering document with 18 attachments in February.

“We heard nothing for a month, which was odd given the contracts were to start on April 1. Suddenly we were told, ‘Congratulations. You have been selected to take part in a reverse e-auction’.”

On May 19 the chief executive sat down with his finance director, logged into the LPP website and waited for the bidding to start.

The company had submitted tenders to provide palliative care and care for physical frailty and dementia. It had made bids of more than £1,000 a week for places in its homes. To take part in the e-auction it had to drop its price by at least £8 at a time. When bidding began the company was told its price was in the bottom five in the shortlist of 20.

“We wanted to test the system so we gingerly put in a bid of £10 below what we had tendered. Our position didn’t change,” he said.

“After a few more bids our position had not changed at all. By then we had reached the point where we could not cut the price further without undermining the quality of care so we stopped.”

In all, the company took part in three e-auctions. “In the end we really pushed it and cut our price by over £100 really just to see what would happen. I think we moved up a few places to 15th. It was a very depressing experience.

“You are filled with dread about what you are going to have to cut back on to get within the winning price. It is devoid of any human consideration. It’s fine if you are supplying stationery, but we are talking about human beings. This is an open invitation to companies to cut standards.”

From:
http://www.timesonline.co.uk/tol/life_and_style/health/article6401125.ece

Health Direct points out that reverse auctions are the result of the desire to get something for nothing.

They very rarely work as the winning company often has to come back for more money when they find they cannot provide the service to the standard required for the winning bid. It is a fallacy that it saves money!!

The couple have spoken of how their lives were “shattered” when the University Hospital of Wales’ IVF clinic in Cardiff discovered the error.

They were further distressed when they learned the other woman had chosen to have a termination.

The Cardiff and Vale NHS Trust has apologised for the blunder and paid the couple an undisclosed sum in damages.

The woman said: “I will never forget the moment the hospital broke the devastating news to us. I just could not believe what I was hearing. Initially the hospital staff told me there had been an accident in the lab and that the embryo had been damaged, I thought that someone had perhaps dropped the embryo dish.

“I remember thinking, ‘That’s our last hope gone – we will never have another child.’ I left the hospital feeling totally shell-shocked.

“When we went back to the hospital two days later and we were told the truth about my embryo being given to someone else; I was so angry.

“I had been given a handbook before every course of IVF explaining all the elaborate precautions the clinic undertook to ensure this sort of mix-up was impossible – and yet despite everything, it had still happened. “

The couple’s solicitor, Guy Forster, from the firm Irwin Mitchell, said there had been two previous “near misses” at the clinic the year before.

The couple were originally referred to IVF Wales after an ectopic pregnancy in 1996 caused damage to the woman’s fallopian tubes. The couple began fertility treatment in 2000.

Following the third cycle of treatment, the woman became pregnant and in April 2003 gave birth to a son.

The remaining embryos were frozen and, in line with the clinic’s policy, were kept for five years.

In November 2007 the clinic contacted the couple with the news that just one embryo had survived and was in good condition. The woman, who was then 38, and her husband decided to take “this last chance” to add to their family, Mr Forster said.

The couple, named by Mr Forster only as Deborah, a health care assistant, and Paul, a printing firm supervisor, from Bridgend, south Wales, attended the clinic on Dec 5, 2007, for their final embryo to be transplanted.

They were told a trainee embryologist had mixed up their embryo after taking it from the wrong shelf of the incubator.

Mr Forster said that against all guidance, more than one patient’s embryos were being temporarily stored in the incubator.

The trainee embryologist failed to carry out ‘fail-safe’ witnessing procedures to ensure the embryo being taken from the incubator and implanted, belonged to the correct patient, he said.

The mistake was only discovered when another colleague later found that Debroah’s embryo was missing from the incubator.

Mr Forster said: “A report by the Human Fertilisation and Embryology Authority showed that the error occurred primarily due to failures by laboratory and theatre staff to carry out basic procedures.

“However, it is clear that there were a number of system failings, in that the clinic had failed to implement the procedures set out in the HFEA’s Code of Conduct, workloads were above safe levels and there were staff shortages.

“IVF Wales reported two ‘near miss’ incidents to the HFEA in 2006 and an HFEA inspection in February 2007 had warned the clinic to tighten its witnessing procedures, yet it would seem nothing was done. This was an accident waiting to happen.”

Ian Lane, the health trust’s medical director, said: “We apologise unreservedly for this mistake.

From:
http://www.telegraph.co.uk/IVF-baby-given-to-wrong-woman-was-an-accident-waiting-to-happen.html

People arriving at Accident and Emergency departments with symptoms which could indicate the aggressive spread of the disease are waiting weeks for diagnosis and treatment while “routine” cases are prioritised.

Hospital managers told researchers that treating desperately sick patients more quickly would “reflect badly” on their performance against Government cancer targets which only cover those referred to specialists by GPs.

Doctors, patients groups and politicians were appalled by what one described as a “breathtaking admission” which confirmed their “very worst fears” about how far the NHS target culture has gone in distorting clinical priorities.

Although most people with suspected cancer are referred to hospitals by their GPs, more than 30,000 people diagnosed with the disease each year are first alerted to tumours by violent symptoms, such as seizures, vomiting and jaundice, which cause such alarm that patients go straight to their local A&E; departments.

The report by the NHS Institute for Innovation and Improvement, an official health service agency which issues advice to hospital managers, says that many of these emergency patients waited six weeks or longer for basic tests.

It said they were “often” not given the same priority as patients who had been referred by GPs, who were covered by two targets, ensuring that they see a specialist within two weeks, and start treatment, following diagnostic tests, within two months.

“As a result, they can end up with a very poor experience before finally receiving a diagnosis and the right care,” it warns.

The report, added: “Many trusts recognised the need to get some patients in this group onto the same pathway as people on the cancer two week wait [target] but were concerned this would reflect badly on their cancer figures”.

Some A&E; departments failed to recognise the risk of cancer in seriously ill patients. In cases where the disease was suspected, patients were sent home to wait six weeks or longer for diagnostic tests. Others waited weeks on wards before seeing a specialist or having scans, the report, which is endorsed by the Government’s cancer tsar, found.

Nigel Beasley, the NHS Institute’s lead for cancer, and head and neck surgeon from Nottingham University Hospitals said: “Targets are very effective, but they do have side-effects. The risk is that these patients are not being prioritised because of the focus on the two-week target for patients referred by GPs.”

Mr Beasley said: “Patients can be stuck in hospital for a long time, waiting for scans, and other diagnostic tests. Once they are in hospital, they can end up waiting two, three, or even four weeks before there is a diagnosis and any decision to treat.”

The admission about the effect Government targets were having on emergency cancer patients horrified clinicians and patients groups.

Shadow health secretary Andrew Lansley described it as “one of the clearest examples yet of how Labour’s tick-box targets are failing NHS patients”.

He said decisions about which patients should be seen first must be taken by doctors, based on the patient’s clinical needs, not by managers following Government diktats.

Katherine Murphy, from the Patients Association, said the report provided “breathtaking” evidence of a confidence trick being played on the public, repeatedly told that waiting times for patients with suspected cancer are falling, while desperate cases were forced to the back of the queue.

She said: “This confirms our very worst fears, and exposes the scandal of what pernicious targets are doing to patients. We have seen other targets being used in ways that damage patient care, but of everything we have seen, this really is the cruellest of the cruel”.

Leading cancer specialist Prof Karol Sikora said: “I think it is absolutely horrifying that hospital managers are playing around with targets that can delay treatment for people who may well be at an advanced stage of the disease.”

“I know of many cases where people who have been admitted to NHS hospitals as an emergency have languished for weeks before even seeing an oncologist,” added Prof Sikora, Medical Director of independent company CancerPartnersUK.

The British Medical Association said many trusts were bullying doctors into delaying urgent referrals.

Dr Jonathan Fielden, chairman of the BMA’s consultants committee, said: “A number of our members have already expressed fears about the two-week cancer target, because it means all the cases referred by GPs are given the same priority, regardless of whether they are expected to be benign or high risk. When this same target is delaying patients who have been admitted as an emergency that is an even greater cause for concern”.

Several oncologists said they supported two-week waiting time targets for cancer patients referred by GPs, but called for the target to be widened to include all patients.

Ian Beaumont, from charity Bowel Cancer UK said it “beggared belief” that anyone would value statistics over efforts to save lives.

Dr Jane Maher, chief medial officer at Macmillan Cancer Relief described the revelation in the report as worrying, but said the biggest obstacle to getting the right care for patients admitted to hospitals as an emergency was getting the right diagnosis, as cases were often complex, meaning cancer could be mistaken for other conditions.

From:
Patients-with-suspected-cancer-forced-to-wait-so-NHS-targets-can-be-hit.html

More than 20,000 people with HIV are unaware they are carrying the virus and are infecting thousands of others, setting a devastating health “timebomb”, medical experts have warned.

Senior doctors have accused the Department of Health of failing to take the spread of HIV seriously and neglecting to test enough people in high-risk groups, including gay men and heterosexual black Africans.

HIV specialists say they are seeing people in clinics with full-blown Aids who have no idea they have been carrying the virus. They now want all sexually active people to be routinely offered an HIV test.

The Lancet medical journal has published an editorial accusing ministers of an “appalling failure to tackle HIV” and of having “no credible strategy to diagnose and care for those living with, but unaware of, HIV in Britain”.

The Health Protection Agency (HPA), the labour government’s health watchdog, warned that about 77,000 people in the UK have HIV but 21,000 of these do not know they are infected. In 2007, the number of infections through heterosexual contact increased to 960, up from 540 in 2003.

Doctors warn that a third of people with HIV are being diagnosed when their virus is advanced. One London hospital recently treated two teenage sisters, one of whom was pregnant, infected with HIV from the same man. Hospitals are also concerned about men who are diagnosed with HIV but abscond before they can be treated.

They called on the government to take testing more seriously, warning that an A&E; target to treat patients within four hours meant people with early symptoms of HIV were not being tested in emergency rooms because of time pressure.

Dr Phillip Hay, reader in HIV medicine at St George’s hospital in Tooting, south London, said testing for the virus should be routine to stop its spread through unprotected sex.

He said: “We have identified some people who have infected multiple individuals”, including couples “where there is a big difference in age between an older adult and a teenager. All men and women accessing medical care should be routinely offered a test”.

The HPA said high-risk groups should be targeted for testing.

“It is a matter of concern that so many individuals in the UK are unaware that they are HIV-infected,” it said.

All the Department of Health could say was that HIV prevention was still a priority.

From:
http://www.timesonline.co.uk/tol/news/uk/health/article6447107.ece

Giving his first speech since taking office, Andy Burnham said that while the challenges faced by the NHS were substantial, the opportunities to streamline reforms and focus on the prevention of ill health could bring savings.

He added that he would reward the best primary care trusts with even greater control over how they operated, and a “lighter touch performance management”.

Mr Burnham, who was speaking at the NHS Confederation’s annual conference, said he could not make pledges on future spending or budget cuts, but insisted that he would not cut back on agreed funding programmes.

His statement followed revelations in The Times of Government advisers withholding money from a £750 million programme set aside for the building and refurbishment of community hospitals.

A letter sent between health chiefs highlights a Department of Health strategy to divert health authorities away from the programme – which still has £500m to spend – because “the Treasury is unlikely to agree further releases of funding”.

Mr Burnham again sought to allay fears of substantial cuts after a report from the NHS Confederation warned of a multibillion-pound budget shortfall over the next decade. The report, published yesterday, prompted angry exchanges in the Commons as Gordon Brown accused the Tories of planning deep cuts in public services to allow for real-terms increases in health spending.

Mr Burnham refused to say if a Labour Government would allow real-terms growth, saying that he “could not pre-empt Treasury decisions”. But he added that the NHS would improve from stripping away unhelpful targets and concentrating on preventive public health measures.

“I want to deep clean the target regime,” he said.

“Targets have their time and place but where they have served their purpose and they are subsidiary to wider objectives, they should now be removed. And believe me I will do that.”

Mr Burnham said that core targets – such as the 4-hour waiting time target in A&E; and the 18-week target from GP referral to treatment – would remain in place as “minimum standards”, but others which had served their purpose and now “alienated people” would be up for review. He said that targets surrounding inpatient waiting times – which include a 13-week target from decision to operate to hospital admission – might be expected to be removed.

“I think there’s scope really now to take away stuff that does not need to be there any more,” he said.

The Health Secretary said that “prevention” needed to be added to the bywords of “quality, innovation and productivity”, adding that smoking, drinking and obesity related admissions to hospital accounted for £10 billion of NHS costs per annum.

“We have, at times, possibly been too timid on public health. Health trusts should not feel they have to wait for permission to invest in prevention. If we believe in investing in people’s health we should go on and do it.

“The Department of Health is in a position of great health,” he added. “There are challenges ahead, as always, but let’s not talk ourselves into a crisis. This is a moment of opportunity not threat.”

From:
http://www.timesonline.co.uk/tol/life_and_style/health/article6479588.ece

He said the £350m reportedly spend on independent management consultants in the NHS in England last year should be spend on patient care instead.
* NHS consultancy bill is £350m
* NHS could have hired 10,000 nurses with money spent on management consultants

This is even more important as in the coming years investment in the NHS is likely to fall, he said.

Dr Fielden said: “For the first time in working memory, we may see real cuts in health spending. This will provoke some stark choices: what is kept, what is cut, what can the NHS afford? Let’s ensure that it’s doctors making those difficult decisions in partnership with our patients and health care colleagues, not faceless bureaucrats, accountants, and those out to fleece the taxpayer.”

He said that an estimated £927m was also spent on contracts with independent sector treatment centres for work that was not carried out as patients shunned the private centres.

This was a ‘dangerous waste’, Dr Fielden said, and he urged the Treasury not to snatch back the £1.7bn surplus currently in the NHS and for it to be spent on patients instead.

Dr Fielden said overall the NHS has been improving but there have been ‘dreadful blots’ on the landscape where care has been poor.

He told the BMA’s Consultants Conference: “In each of these there is a common theme: targets being put in front of quality, staff not being listened to, aberrant corporate cultures suppressing concerns and disregarding safety. Doctors must challenge this culture of denial and lead a better way forward.”

From
http://www.telegraph.co.uk/health/healthnews/5437279/Ditch-management-consultants-from-the-NHS-leading-doctor.html

Andrew Wilson, 78, was one of the elderly people who received poor treatment after a reverse e-auction. This was run by South Lanarkshire for the provision of home care.

Domiciliary Care, a big provider in Scotland, won the contract after companies had driven down their prices. It won with a bid to provide care for £9.95 an hour.

Mr Wilson is hard of hearing, blind in one eye and unable to walk more than a few steps. With no close family, he lives alone and depends on carers. He allowed Panorama to fit secret cameras in his home for 19 days.

The cameras showed Mr Wilson being given a bed bath while his carer was constantly on her mobile phone complaining to the office about her workload. The cameras also recorded that, of his four half-hour visits a day, those at lunch and teatime were often curtailed.

His care assessment makes clear that his lunchtime carer should prepare a meal. However, he was routinely fed sandwiches, crisps and toast.

One GP who specialises in old age care said she was shocked by what she saw. “He has been treated with a complete lack of dignity,” she said.

At the time Domiciliary Care denied that Mr Wilson was neglected. It said that carers were under no obligation to go shopping for Mr Wilson but often did so. However, Care Choices Group, which took over the company last September, admitted that an internal inquiry had found that a number of the allegations were correct, and apologised.

From:
http://www.timesonline.co.uk/tol/life_and_style/health/article6401122.ece

William McCann said Jack, aged 14 days, died after a “brave fight” at the special-care baby unit at the Royal Alexandra Hospital in Paisley, Renfrewshire.

His partner, Jacqueline Fleming, 38, died at the same hospital on Sunday. Last night Mr McCann said: “Coming so soon after the death of his mum, this is an extremely distressing and difficult time for our family.”

Jack was born 11 weeks early, reportedly weighing just over 3lbs, and suffered complications. He did not have swine flu. His mother, who was being treated in intensive care, was described as having underlying health conditions.

Earlier her relatives said in a statement from the health board: “Our whole family is absolutely devastated and we are doing everything we can to support Jacqueline’s two sons and her partner. Jacqueline had been ill in hospital for a number of weeks but nothing can prepare you for such shattering news.”

Ms Fleming was the first reported swine flu fatality outside the Americas. Details of her other health problems have not been given officially. A neighbour in the Carnwadric area of southwest Glasgow said that she had had strokes or seizures. It was reported she had suffered a stroke two years ago and was admitted to hospital with double pneumonia four weeks ago.

A nurse aged 26 who treated her has also tested positive for swine flu but is said not to be seriously ill. Ms Fleming is understood to have been infected before going to hospital and it is believed that she may have contracted the disease locally.

Nicola Sturgeon, the Scottish Health Secretary, said that in any flu outbreak a small number of victims would develop complications, and some would die. “That said, the vast majority of people will continue to suffer mild symptoms,” she added.

Harry Burns, Scotland’s Chief Medical Officer, said that three distinct clusters of cases had been identified in Scotland — one linked to a Rangers supporters’ bus, one involving contact with people in the West Midlands and the last centred in south Glasgow.

There have been 498 Scottish cases of swine flu. Scotland’s government said yesterday that no more cases had been confirmed by laboratory tests but doctors in Greater Glasgow and Clyde had diagnosed a further 71.

Mr Burns said that the H1N1 strain was unlike common flu in that it appeared to be more prevalent among young people. This could be because those who had lived through a pandemic of Asian flu in 1958-59 had a resistance to it. Those who had survived Hong Kong flu in the Sixties might also have some immunity.

From:
http://www.timesonline.co.uk/tol/life_and_style/health/article6506806.ece

The World Health Organisation (WHO) has declared that H1N1 swine flu has reached the status after more than 27,000 cases were confirmed across several continents.

The decision to raise its global alert level from five to six — officially signalling a pandemic — came after a day-long emergency meeting of the WHO to discuss the implications of widespread outbreaks of illness in the Americas, Europe and Asia.

A disease is classed as a pandemic when transmission between humans becomes widespread in at least two regions of the world.

The last global flu pandemic came in 1968 over the so-called “Hong Kong” flu, which killed about 1 million people worldwide.

The latest H1N1 viral strain — a combination of previously circulating animal and human strains — emerged in Mexico in April and since then 27,737 cases have been confirmed in 74 countries worldwide since March.

Community spread – in which infections cannot be traced to known cases – has already been confirmed in the North and South America. But WHO officials are reported to have been alarmed by a sudden spike of cases in Australia, and also by rising numbers in Europe.

A total of 25 new cases of the H1N1 virus in England confirmed today by the Health Protection Agency increased the British total to 822. At least 20 schools have been forced to close.

The Department of Health said that the WHO announcement had no immediate implications for the public, but could prompt Governments to take extra prevention measures, such as imposing travel bans and ordering increased vaccine production.

In a statement, the NHS Confederation, which represents health service managers, said: “The confirmation of a level-six global pandemic reinforces the need for the NHS to ensure all the flu plans already in place at local level are as comprehensive as possible and thoroughly tested. We need to avoid complacency in dealing with a virus that is an unknown and seems to be spreading quickly.”

The Government’s chief medical officer Sir Liam Donaldson said before the announcement that a WHO pandemic declaration would not significantly change the way the UK was dealing with swine flu.

But he said that the Health Protection Agency was planning to focus the use of anti-viral drugs on close contacts of people carrying the virus, rather than the wider circle of contacts who have been treated so far.

Sir Liam said: “The declaration of a pandemic per se doesn’t make a big difference to the to the way we are handling the outbreaks we have.”

He added: “We are going to continue to investigate every case that occurs and treat their contacts with anti-virals even though they may not be ill.”

Official guidance from the WHO states: “Assessment of the severity of a pandemic is complex. Experience has shown that past influenza pandemics have varied in terms of severity and that the associated health impacts may vary significantly based on a variety of factors.”

From:
http://www.timesonline.co.uk/tol/news/world/article6479389.ece

Pneumonia and urinary tract infections are among those which deserve more attention, its report said.

The Care Quality Commission said they would “keep up the pressure” on trusts.

Two previous reports from the NAO have played a big role in highlighting the problem of healthcare-associated infections in the NHS.

It led to targets to reduce rates of MRSA and C. difficile – a pressure which has successfully cut those infections.

But they account for only a small proportion of the one in 12 patients admitted to hospital who end up with an infection they did not have before.

Urinary tract infections, largely associated with the use of catheters, are responsible for 20% of these.

Other bloodstream infections with bacteria such as E. coli are also important, the NAO said, and limited data suggests they are on the rise.

Compulsory monitoring of healthcare-associated infections should be widened to cover far more infections and checks should be done to ensure that antibiotics are being used effectively, it concluded.

Karen Taylor, report author, said MRSA and C. difficile rates started to come down only once targets were imposed, although local goals may be more appropriate for other infections.

“It’s looking better for MRSA and C. difficile, which have been subject to targets, but the main focus of our report is they only account for about 15% of healthcare associated infections in hospitals and in the rest of the infections there’s very poor data.

“Some of the bloodstream infections are just as significant on the impact on the patient.”

The report also found that government funding for tackling infections had saved the NHS money overall.

It added that the controversial “deep clean” programme had boosted staff and patient confidence – but it was impossible to measure what effect it had had on the number of infections as other strategies were being implemented at the same time.

HOSPITAL INFECTION BREAKDOWN
Urinary tract infections – 20%
Lower respiratory tract infections – 20%
Gastrointestinal infections – 22%
Surgical site infections – 14%
Bloodstream infections – 7%
Skin and soft tissue infections – 10%

However, even with MRSA and C. difficile there was variation, with 12% of trusts reporting an MRSA infection.

Amyas Morse, head of the NAO, said that in 2004 the problem with MRSA and C. difficile had seemed to be “an intractable problem” and hitting the targets was a “significant achievement”.

“Inevitably, with a focused and centrally driven initiative of this kind, the improvements are not uniform across the NHS and we still don’t know in any meaningful way what impact there has been on other healthcare-associated infections.”

Health minister Ann Keen said: “We remain totally committed to eliminating all preventable healthcare-associated infections.

“As a nurse myself, I am especially pleased to see that the National Audit Office has recognised the contribution that nurses and the reintroduction of matrons onto our wards have had in delivering the reductions in MRSA and C. difficile infections.”

From:
http://news.bbc.co.uk/1/hi/health/8095074.stm

One quango boss made 12 trips abroad during two years in which she claimed £70,000 in expenses. Another claimed nearly £800 for a 42in flatscreen television which he said he would watch only in “times of emergency”. Another spent £16,500 on chauffeur-driven cars.

Details of the claims, released under freedom of information laws, reveal how quangocrats earning six-figure salaries routinely claim tens of thousands of pounds extra in expenses, paid for by taxpayers.

Matthew Elliott, director of the TaxPayers’ Alliance, said: “Quango expenses are potentially even worse than MPs’. Quangocrats are unelected and hidden from public view. They should have all their expenses published on the internet.”

Some of the most controversial claims were made by Paul Evans, former chief executive of the Royal Armouries in Leeds. Evans, who was paid £100,000 a year, claimed nearly £24,000 in 2007-8 including £180 in Farlows, a shooting accessories shop, and £62 in Graingers, a supplier of fishing equipment. He also spent £69 of taxpayers’ money in Davidoff, a London tobacconist renowned for its cigars.

He claimed a further £3,000 on expenses at top bars and restaurants in Leeds and London, £1,170 on an Apple laptop and accessories and £259 on an Apple iPhone.

His claims caught the eye of accountants at the Royal Armouries and he was suspended on full pay in April 2008 over alleged “financial irregularities”. He resigned in September after agreeing to return his computer equipment and to reimburse the Royal Armouries for £289.70 of “personal” expenses claims. An internal investigation later cleared him of any impropriety. Evans last week declined to comment.

Although Evans’s case is unusual, other quango chiefs are making large claims regarded as legitimate.

Dr William Moyes, chief executive of Monitor, a quango that regulates National Health Service trusts, claimed more than £35,000 in expenses in 2007-8 and 2008-9.

His biggest charge was for chauffeur-driven cars, which cost £16,500. Moyes, whose basic salary is £215,000 a year, also spent £7,500 on meals at some of London’s finest restaurants with public servants and consultants.

His favourite venue was the Cinnamon Club, an Indian restaurant in Westminster where he dined on 24 occasions, spending a total of £2,600. A spokeswoman said the meals were important for maintaining relationships with “key stakeholders”.

From:
http://www.timesonline.co.uk/tol/news/politics/article6396004.ece

The NHS in London has held a series of 30 “reverse e-auctions”, where bids are driven down instead of up, for £195 million worth of contracts for palliative and dementia care for patients leaving hospital.

Reverse auctions to buy care for the elderly are relatively new and The Times has found that standards and quality have deteriorated rapidly where they have been used.

In one case a company that won a local authority’s reverse auction in the North East of England was struck off the national register of approved providers weeks later because the palliative care it offered was of such poor quality.

The results of another auction in South Lanarkshire to buy domiciliary care were so disastrous for elderly people that the Scottish Parliament is to hold an inquiry into whether they should be banned.

Companies who took part in the London NHS auction told The Times that they were asked hardly any questions about the quality of palliative or dementia care that they provided, beyond whether they complied with minimum standards.

During the e-auction, companies were invited to reduce their prices for one bed with round-the-clock specialist care for one week by £8 a time.

The NHS and local authorities are under increasing pressure to drive the hardest bargain they can for services, such as care for the elderly, which they buy in from the private sector. Reverse e-auctions, though, were intended to be used to drive down prices for basic goods such as office furniture, IT or stationery, which have limited and exact specifications and where quality is not a serious concern. Critics of care e-auctions say that those who hold them are aware that driving prices down affects the quality of care.

Richard Jones, director of adult social services for Lancashire County Council, said that he would never use an auction to buy care. “If you put your providers into an auction, pushing them to a lower and lower price, somebody is going to lose out, and the losers in this case are vulnerable elderly people and their carers,” he said.

Information given to The Times by the BBC programme Panorama showed that four local authorities — Walsall, Bedfordshire, South Lanarkshire and Edinburgh — had used the system to buy care for elderly people.

In Walsall, the Working Together Specialist Care Agency won a contract to provide palliative care to elderly people in the last few months of their life. Within weeks, the local authority stopped the company taking on any new cases, and then terminated the contract after it emerged that dying people were not receiving the pain relief and help with feeding and washing that they required.

The Care Quality Commission (CQC), the health regulator, confirmed that the agency had been deregistered after an investigation. The agency could not be reached for comment.

Walsall said that price was not the sole consideration in awarding the contract to Working Together. Sue Ryder Care, the specialist charity that held the palliative care contract before the auction, said that it could not even afford to start bidding at the opening price because it was so low.

Domiciliary Care has since been taken over by Choices Care Group, which said that it was appalled by what Panorama found and had apologised for the shortcomings. The Scottish Parliament has started a cross-party investigation into the use of reverse e-actions with a view to having them banned for purchasing care.

In England, the CQC warned NHS purchasers and local authorities that it would examine closely what happened to standards of care in areas where e-auctions were used. “We’ll be keeping a very close eye on standards across the health and adult social care sector. Where we see standards slipping, we won’t hesitate to act,” a spokesman said. Martin Green, chief executive of the English Community Care Association, has written to Alan Johnson, the Health Secretary, to alert him to the practice.

The London Procurement Programme, which ran the NHS reverse e-auction, defended its use of the system. Stuart Saw, chairman of the steering board, said: “We are confident the framework will deliver consistent high-quality standards in nursing home care across the capital. Quality has been embedded throughout the procurement process while making the most of taxpayers’ money.”

From:
http://www.timesonline.co.uk/tol/life_and_style/health/article6401002.ece

Junior doctors are being asked to lie about their working hours to meet new European rules, research suggests.

A survey of 31,360 junior doctors who comply with new limits on their working week found that one in 10 had actually worked longer hours, with some asked to submit different data.

Of the 3,938 junior doctors who said in the survey by the Health Service Journal (HSJ) that their hours were not compliant, 17% said they had been asked to submit hours that showed they were in line with the new rules.

The new European Working Time Directive (EWTD), which fully comes into force on 1 August, limits the number of hours that junior doctors can work each week to 48.

Richard Marks, a consultant who is also head of policy at the campaign group Remedy UK, said the findings were interesting and should not be ignored.

But he said his own experience of talking to junior doctors had revealed that many wanted to work more than 48 hours, to ensure good patient care and maximise their training.

He said: “I’ve been asking lots of trainees about this question. It’s true that they are being economical with the truth but it’s because they think reduced hours, in line with the EWTD, is bad for patient care and it’s also bad for their training.

“They want things to stay as they are – they want good training and exposure.”

The Liberal Democrat health spokesman, Norman Lamb, said: “This demonstrates just how ludicrous the imposition of these rules are on the NHS.

“Doctors have been warning for months about the chaos that will happen in the summer when the rules are applied.

“The labour government must take its head out of the sand and recognise the damage that will be done to patient care if it insists on imposing these working hour restrictions. It is vital that we don’t see another repeat of the farce that engulfed the recruitment of junior doctors two years ago.”

From:
http://www.guardian.co.uk/society/2009/may/28/junior-doctors-working-hours

Before the reshuffle Andy Burnham declared a desire to remain in his dream job of Culture, Media and Sport but promotion to the Department of Health proved too tempting.

Alan Johnson has been given the home secretary job in prime minister Gordon Brown’s post regional election cabinet reshuffle.

King’s Fund chief executive Niall Dickson said it was “frustrating” to have a new secretary of state when Alan Johnson had been in post for less than two years. This move has nothing to do with what is best for the health service,” he said.

Ambition has always been at the core of the 39 year old Cabinet minister who grew up in Leigh, the part of Merseyside he has represented since 2001 and who is often spoken of as a future Labour leader.

Initially considered a Blairite, having worked for New Labour stalwarts Tessa Jowell, Chris Smith and Ruth Kelly, his appointment to DCMS on Gordon Brown’s arrival at No 10 was considered a conciliatory gesture.

It was a job which suited an Everton fan with a penchant for indie music, and he had been content to remain in post, particularly after his clean cut image was somewhat tarnished by the Daily Telegraph’s recent disclosures about his expenses.

In one of the most cringe-worthy revelations about a Cabinet minister, a letter from Mr Burnham to the Commons fees office was made public, in which he begged for a £16,000 decorating bill to be paid, saying: “Otherwise I might be in line for divorce!”

More seriously, he also came to an arrangement whereby a windfall from his landlord was added to his allowances and repaid in expenses, leading to questions over whether he should have paid tax on the transaction.

Mr Burnham’s humiliation was complete when it emerged that he had a £19.95 claim for an Ikea bathrobe rejected.

However, Health came as a reward for denouncing the decision of his close friend James Purnell to turn on Mr Brown, and he now commands the largest workforce and one of the biggest budgets of any government department.

Married to Dutch born Marie-France van Heel, a former marketing executive, the couple have three children.

From:
http://www.telegraph.co.uk/news/newstopics/politics/5455058/Cabinet-reshuffle-Andy-Burnham-moves-from-best-job-in-the-world-to-the-hospital-ward.html

An appeal panel will listen to experts who believe the numbers must remain confidential after the Information Commissioner ruled that they must be disclosed.

Such data – involving abortions carried out for reasons like cleft palate, club foot and webbed fingers or toes – was published up until 2002.

But ministers stopped the practice if fewer than 10 cases were involved, saying there was a risk the women or doctors involved could be identified.

The ProLife Alliance challenged this stance in 2005 and requested a release of the figures under the Freedom of Information Act.

The Information Commissioner ordered ministers to publish the data, but the Department of Health refused and appealed against the commissioner’s decision.

Ministers originally called for the hearing to be held in private so the data could be discussed.

An agreement has since been reached with the Information Commissioner’s Office for only part of the hearing to be heard in private.

Abortions can be carried out up until birth under category E, which relates to disability, as long as two doctors agree the procedure should be performed.

There is no list exempting certain conditions such as cleft palate or club foot.

A spokeswoman for the ProLife Alliance said: “We believe there should be absolute transparency and openness about these statistics. Abortion is not a right; it can be performed if you fulfil certain conditions under law. Otherwise it remains a criminal act. We have been very clear that we have asked for information about all abortions, not just those after 24 weeks. This case is about transparency.”

She said it was “nonsense” for the Department of Health to suggest doctors could be at risk of being identified.

People who wished to campaign or pray outside abortion clinics only had to go on the internet to find a clinic rather than looking through Department of Health figures, she said.

She said it was the department’s job to adopt a neutral position on the issue rather than “taking sides” in the debate.

A spokesman for the Department of Health said: “Data on abortions is considered highly sensitive personal data.

“The Office for National Statistics guidance does not recommend releasing any data with a count of less than 10. Releasing such data could increase the risk of identifying individuals.

“The guidance provides clear boundaries to make as much information about abortions available as possible, whilst protecting the individuals concerned – both patients and doctors.

“When the ProLife Alliance asked the Department to release the full data in 2005, we withheld it to secure individuals’ confidentiality.

“However, following an appeal from the ProLife Alliance, the Information Commissioner ruled that the department should release the full data.

From:
http://www.telegraph.co.uk/health/healthnews/5404825/Government-fights-to-keep-abortions-secret.html

Nervousness over ContactPoint, which has been delayed twice while ministers met security concerns, has risen following a string of data losses from government departments. These included the 2007 case of two discs containing the child benefit details of 25m people.

Information stored on ContactPoint will be accessible to hundreds of thousands of government and voluntary sector workers, and will span health, education, social work and youth offending.

“We have serious child protection concerns about this database, which will give too many people access to sensitive information about every child in the country,” said Isabella Sankey, policy director at Liberty, the civil rights group.

“Kids in most need of urgent attention could be lost like needles in a haystack, while all of this information will be vulnerable to accident and abuse.”

David Laws, the Liberal Democrat schools spokesman, said: “The government has shown it can’t be trusted with sensitive data. Parents have every right to demand that their children’s personal details aren’t put at risk.”

But Martin Narey, chief executive of Barnardo’s, the children’s charity, which will share in ContactPoint, said the directory would provide a quick way for professionals to find out who else was working with a child, making it easier to deliver better co-ordinated services.

“ContactPoint has the potential to make the world a safer place for vulnerable children,” said Mr Narey.

The database will supply limited information about children, and any “warning flags” – for example, telling users whether social workers have become involved. It began in the north-west yesterday, prior to a planned national roll-out.

It was first proposed after the 2003 Laming report into the death of Victoria Climbié, the eight-year-old girl who died after failures by social services.

The August 2007 death of “Baby Peter” amid further mistakes by welfare services has heightened concerns about how the state can prevent such extreme abuse, although child care experts say it is not clear that ContactPoint would have prevented either death.

Christine Blower, general secretary of the National Union of Teachers, said: “The solutions to preventing future tragedies lie in the provision of proper resources, back-up and training for frontline services such as social work, and in enabling local authorities to construct effective co-ordinated services in the know-ledge that they will face tough action if they fail.

“This database can very easily be viewed as a bureaucratic response to a failure in communications at local level, where face-to-face work plays a crucial role in early intervention.”

From:
http://www.ft.com/cms/s/0/dfd694a8-440b-11de-a9be-00144feabdc0.html?nclick_check=1

Health Direct notes that labour has an appalling record of protecting our data. To endanger every single child in the country with this useless database is not only dangerous but a crass waste of tax payers’ money.

It is the first time that the National Institute for Curbing Expenditure has explicitly backed the use of complementary therapies.

The rationing watchdog said evidence suggests they help and will be cost effective if doctors stop providing less proven back services like x-rays.

The move was welcomed by some charities and experts but criticised by others.

Low back pain is a very common problem affecting one in three adults in the UK each year, with an estimated 2.5 million people seeking help from their GP.

For many people the pain goes away in days or weeks. But for some, the pain can persist for a long time and become debilitating.

NICE says anyone whose pain persists for more than six weeks and up to a year should be given a choice of several treatments, because the evidence about which works best is uncertain.

Complementary therapies

In addition to painkillers and regular advice to stay active and carry on with normal activities as much as possible, patients, together with their doctor, can decide to opt one of three complementary treatments.

This includes up to eight exercise sessions or 10 sessions of acupuncture over 12 weeks, or a course of manual therapy, which includes up to nine sessions of spinal manipulation, mobilisation or massage.

Professor Peter Littlejohns, NICE said NHS providers now had the opportunity to look at the services they provide and decide what changes are needed.

He said: “There is variation in current clinical practice, so this new NICE guideline means that for the first time we now have the means for a consistent national approach to managing low back pain.

“Importantly, patients whose pain is not improving should have access to a choice of different therapies including acupuncture, structured exercise and manual therapy.”

Patients who fail to benefit from their first choice may be offered another of these options, he said.

If that doesn’t work, they can try an intensive treatment programme combining exercise and psychological therapy.

He said the costs to the NHS would be minimal – in the order of £77,000 – because they are offset by the savings in terms of reducing future disability and healthcare needs and moving away from treatments with little supportive evidence.

The guidelines, which apply to England and Wales, say doctors should no longer offer spinal x-rays or MRI scans or injections of therapeutic substances into the back for non-specific low back pain.

The Chartered Society of Physiotherapy welcomed the guidelines, as did Dr Dries Hettinga of the charity BackCare.

He said: “This offers a real choice for patients. This guideline will help patients understand what treatment and care can help them with their back pain and shows that there can be a positive outlook for treating this condition.”

From:
http://news.bbc.co.uk/1/hi/health/8068427.stm

Teenagers who agree to be tested for the sexually transmitted disease chlamydia are being entered in prize draws to win Nintendo Wii games consoles.

Under a pilot scheme run by NHS Fife, smokers who give up cigarettes for three months are entered into a prize draw for a helicopter trip across the River Forth or an overnight stay for two in a luxury hotel. Other gifts on offer include iPods, toiletries and cinema vouchers.

Bexley NHS Care Trust and NHS Lothian have offered smokers who quit cash prizes of up to £500; another authority offers Asda food vouchers worth about £150. In Lanarkshire, recovering alcoholics and drug abusers are offered free passes to leisure centres.

NHS Northamptonshire offers people the chance to win Nintendo Wii games consoles worth about £160 in a monthly prize draw if they agree to be tested for chlamydia. It has also spent about £4,000 on book vouchers for 14 15 year olds who take part in the scheme.

Camden Primary Care Trust in London has spent almost £5,000 on Wiis and iPods for a chlamydia scheme; in Nottinghamshire, participants could win a £1,000 Fujitsu laptop.

The schemes, details of which have been obtained by The Sunday Times under the Freedom of Information Act, have been criticised by politicians and taxpayers’ groups.

They question the efficacy and ethics of using hundreds of thousands of pounds of public money to reward people for giving up vices that they chose to take up in the first place.

“We are extremely sceptical about whether public money should be handed over in this manner,” said Andrew Lansley, shadow health secretary for the Conservatives.

“Incentives should be geared around helping people to live healthier lives, for example by encouraging them to do more exercise, not simply handing over taxpayers’ hard earned money.”

Mark Wallace, campaign director for the TaxPayers’ Alliance, added: “A lot of people would be concerned that this is not what they pay their taxes for. Particularly when a lot of these things people should be doing anyway of their own accord. It’s in people’s own interests to get their health checked out and there are serious questions about the effectiveness of these incentives.”

However, health officials insist that the incentive schemes are cost-effective because they raise awareness and save the NHS money in the long run by preventing disease.

The cost to the NHS of treating smoking related diseases is £3 billion a year. An estimated 1% of women aged 16 to 19 have chlamydia, which can cause infertility. More than 2,000 15-year-olds contracted it in 2008 due to underage, unprotected sex.

From:
http://www.timesonline.co.uk/tol/news/uk/health/article6350486.ece

Health Direct asks when will the insanity stop?

Labour’s nanny state rewards those that do wrong then reform. Why don’t we try rewarding those that do right in the first place- how about IPods and helicopter trips for kids that are drug free and don’t have sexually transmitted diseases?

It’s yet another example of how they have created a society that rewards failure.

Despite concern over a shortage of police officers on the beat and frontline medical staff, an investigation by The Sunday Times has revealed that £1.5m a year is being lavished on unnecessary jobs.

The roles, which have little to do with the delivery of core services, include a £40,000 a year wellbeing unit manager and £22,000 a year events planner employed by Lothian and Borders police. The force also pays £17,000 a year for a chauffeur for David Strang, its chief constable.

NHS Fife has a buddy project worker “to support volunteers who help people stop smoking” (between £20,000 and £26,000 a year), a graphic designer (£25,000-£33,000) and a librarian, to help ensure “professional staff keep up to date” (£20,000-£26,000). In the past, the health board has also employed an artist-in-residence.

Most health boards employ chaplains or “spiritual care providers” on salaries of about £30,000 a year. NHS Dumfries and Galloway also has an organist. The National Secular Society has called for an end to NHS funding for chaplains, and says the cost should be borne by churches.

Matthew Elliott, the chief executive of the Taxpayers’ Alliance, said the jobs were evidence of unacceptable public sector profligacy at a time when private firms were shedding jobs or imposing pay cuts.

“We’re in the grip of a recession, and it’s high time those in the public sector started cutting back on these ridiculous non-jobs that would be an extravagance even in good economic times,” he said.

“The public sector must wake up and realise taxpayers want value-for- money, frontline public services, not unnecessary frills that are of no tangible benefit to most ordinary people. Any right-minded person can see this money would be far better spent on more nurses, doctors and bobbies on the beat.”

Margaret Watt of the Scotland Patients Association added: “This is quite obscene when we are short of GPs, consultants, nurses and midwives.

“The health boards seem to have their responsibilities all back to front — these jobs should not be a priority. It is more important that we have the staff to take care of our patients than anything else.

“They should be dealing with the core business at the moment where we have insufficient staff in hospitals across the country.”

NHS Fife said it did not consider any of the jobs “nonessential”.

“The modern NHS requires a range of staff to work together to enable it to develop a service for the 21st century,” said a spokeswoman.

From:
http://www.timesonline.co.uk/tol/news/uk/scotland/article6301788.ece