The investigation into why poorer women have a higher risk of the disease found they tended to have sex about four years earlier than more affluent women.

Previously, it had been thought the disparity was the result of low screening uptake in poorer areas.

The International Agency for Research on Cancer findings are published in the British Journal of Cancer.

Although the difference in cervical cancer incidence between rich and poor – across the world – had been noted for many years, it was not clear why this is the case.

Especially as rates of infection with human papillomavirus (HPV) – the sexually transmitted infection linked with the vast majority of cervical cancers – seemed to be similar across all groups.

The study confirmed that the higher rates of cervical cancer were not linked to higher HPV levels.
   
But what it did reveal is that the two fold increased risk was largely explained by women from poorer backgrounds starting to have sex at a younger age.

The age at which a woman had her first baby was also an important factor. Screening was found to have some effect on the level of risk.

But the number of sexual partners a woman has and smoking did not account for any of the difference.

Study leader, Dr Silvia Franceschi, said the findings were not restricted to adolescence and the risk of cervical cancer was also higher in women who had their first sexual intercourse at 20 rather than 25 years.

“In our study, poorer women had become sexually active on average four years earlier. So they may have also been infected with HPV earlier, giving the virus more time to produce the long sequence of events that are needed for cancer development.”

Dr Lesley Walker, director of cancer information at Cancer Research UK, said the study raised some interesting questions.

“Although women can be infected by HPV at any age, infections at a very young age may be especially dangerous as they have more time to cause damage that eventually leads to cancer.

“Importantly, the results back up the need for the HPV vaccination to be given in schools at an age before they start having sex, especially among girls in deprived areas.”

Much of the money has gone to external consultants and contractors.

In total, £3.96 million has been spent on redesigns and upgrades since June 2007. The figure does not include the estimated £220 million annual cost of running the government sites.

David Davies, Conservative MP for Monmouth who asked for the information in a string of parliamentary questions, said: “Dfid ministers should be giving financial support to the poorest people in the world not the wealthiest web designers.

“The money spent on a web upgrade could have paid the wages of 100 nurses in one of the poorest African nations for a year, but for Labour ministers, internet propaganda is far more important.

The Central Office of Information (COI) is conducting a study, to be published in June, into whether government websites offer value for money. The investigation was prompted by a National Audit Office report that said over one quarter of government organisations did not even know the running cost of their own websites, making it impossible to assess whether they provide value for money.

The NAO also found that one in six government bodies had no data about how their websites were being used.

Matthew Elliot, the campaign director for The TaxPayers’ Alliance, said: “This astonishing £4 million figure shows departments must concentrate on content rather than the appearance of government websites. Many of these sites look a lot better than they actually are.”

What departments said they spent on redesigns since June 2007:

Department for International Development £970,419
Department for Business, Enterprise and Regulatory Reform £528,912
Department of Health £513,000
Intellectual Property Office £355,000
Electoral Commission £283,744
Department for Environment, Food and Rural Affairs £181,000
Ministry of Defence £150,000
Electoral Commission voter information site £140,600
Serious Fraud Office £113,309
Office of Rail Regulation £107,169
Department for Innovation, Universities and Skills £105,167
British Army £75,000
Crown Prosecution Service £60,085
Attorney General’s Office £59,184
Revenue and Customs Prosecution Office £58,741
Office of Government Commerce £54,000
Bona Vacantia £42,598
UKTI Defence and Security Organisation £42,000
National School of Government £27,683
National Measurement Office £20,649
Government Actuary Department £19,461
Scotland Office £12,880
Disposal Services Authority £12,000
Wales Office £10,500
NI Organised Crime Office £6,825
Forensic Science NI £6,187
NI Youth Justice Agency £4,802
Treasury Pre-Budget £4,578
TOTAL £3,965,493

Junior doctors on average fill out five or six prescription forms during their whole time in medical school only to have to complete dozens on their first day on the wards.

The inadequate preparation helps contribute to almost one in 10 prescriptions containing errors that could harm patients, it was said.

Now the British Pharmacological Society (BPS) is calling on the doctors to take an exam called the National Prescribing Assessment before being qualified.

They also want a “prescribing simulator” to be introduced to the curriculum so that medics are better prepared when they start in hospitals.

Professor Simon Maxwell, chairman of the BPS, said: “Everybody thinks that the system should and can be overhauled.

“We would not accept this kind of error rate in other industries such as aviation. It is a recipe for problems.”

The call for change, outlined in a blueprint by the BPS, comes after the General Medical Council revealed that 10 per cent of all prescriptions issued by doctors contained errors.

The mistakes included omitting drugs, wrong doses, not taking account of a patient’s allergies, illegible handwriting or ambiguous orders.

When the hospital doctors were interviewed about their mistakes, some admitted that they used pharmacists or nurses as a “safety net” to correct them afterwards.

The most senior doctors made the fewest mistakes, while doctors in their second year after qualifying made the most, it was found.

In the study, 124,260 prescriptions were checked by pharmacists in 19 hospital trusts in north-west England and 11,077 errors were detected.

While doctors are trained in a “piecemeal way” on symptoms and treatments, they rarely actually fill out a prescription forms before they start work, said the BPS.

A recent survey showed that in training they filled out as little as one a year whereas on the job that jumped to 50 or 60 a day.

That meant that doctors were ill prepared, it concluded.

Prof Maxwell, and his chairman Dr Jeff Aronson, said that it was hoped that the new assessment would be ready for the 2011 intake of medical students.

It was also hoped that an online training programme – including a prescription simulator complete with virtual patients – would be ready by the following year.

Prof Maxwell said: “It doesn’t take to much of a wrong dose or too long for the monitoring to be left before there are potentially serious problems. There is a big push now to eliminate this high risk.”

The multinational is suing Henrik Thomsen, a Danish academic, after he described his experiences of one of the company’s drugs as a medical “nightmare”. He said some kidney patients at his hospital contracted a potentially deadly condition after being administered the drug Omniscan.

GE Healthcare, a British subsidiary of General Electric, has run up more than £380,000 in legal costs pursuing Thomsen.

“I believe the lawsuit is an attempt to silence me,” he said last week. “It’s dangerous for the patient if we can’t frankly exchange views.”

The company admits its product has been linked to serious side effects in some patients, but said Thomsen accused the company of suppressing information in a presentation at a scientific congress in Oxford in October 2007.

A summary of Thomsen’s presentation for the High Court writ, provided by GE Healthcare, appears to show that it was an even-handed account of his clinical experience.

When asked by The Sunday Times to highlight any part of the presentation that explicitly stated wrongdoing by GE Healthcare, a spokeswoman for the company was unable to do so. The writ states that the defamation may have been “by way of innuendo”.

His case will trigger a fresh row over the draconian use of Britain’s libel laws to stifle scientific debate and silence critics. Thomsen now refuses to discuss the possible risks of the drug in any UK public forum.

Evan Harris, a former hospital doctor and the Liberal Democrat science spokesman, who is leading the parliamentary campaign to reform the libel laws, said: “It is hard to conceive a stronger public interest than scientists and clinicians being able to discuss freely their concerns about drugs or devices used on patients. Libel laws should not be used in this way.”

More than 48m doses of Omniscan have been given worldwide and it is safe for the vast majority of people. It is one of a number of “contrast agents” containing the potentially toxic metal gadolinium, which are used to enhance images for magnetic resonance imaging scans.

Omniscan and other products have been linked with a skin condition in kidney patients, known as nephrogenic systemic fibrosis. Sufferers can be confined to a wheelchair and may even die from related causes.

Regulators in Europe and the US are now taking action over the potential risk from Omniscan and two similar products.

Five people in Britain have died from possible side effects after being administered Omniscan, according to the Medicines and Healthcare Products Regulatory Agency.

Patients have launched legal actions in America involving more than 170 deaths where it is claimed Omniscan and similar drugs may have been a factor. Safety problems with the drugs have been highlighted in the US by the independent investigative news organisation ProPublica.

Paul Flynn, the Labour MP, said, “It is a scandal that a company should take action against someone acting in the interests of patients.”

GE Healthcare said it had launched a libel action against Thomsen as a “last resort”. It is also suing Thomsen for an article in a medical magazine published in Brussels, but he said his name had been put on an article that he had not written.

From:
http://business.timesonline.co.uk/tol/business/law/article6962865.ece

The substances, including GBL and BZP, become Class C drugs, with a possible two year jail sentence for possession.

Labour ministers moved to classify them after a recommendation from the Advisory Council on the Misuse of Drugs and fears they are a threat to user health.

GBL was linked to the death of medical student Hester Stewart, 21, in Brighton last April. Her mother, Maryon, campaigned nationally for the ban.

So called legal highs are typically man made chemical substances designed to act like banned drugs.

Scientists, officials and police officers have been concerned for several years that GBL, BZP and other so-called “legal highs” have been sold openly across Britain and on the internet, despite evidence that they can be harmful to health.

GBL, which metabolises in the body into the already banned drug GHB, will become a Class C drug carrying maximum jail terms of two years for possession and 14 years for supply.

Piperazines, of which BZP is the most popular, are also being made Class C drugs.

This group of drugs is popular on the club scene as an alternative to ecstasy and amphetamines.

Synthetic cannabis has also been banned and become a Class B drug. Possession of products such as “spice”, a herbal mixture laced with psycho-active chemicals, now carries a maximum five-year jail term.

Fifteen anabolic steroids, associated with drug abuse in sport, have also been classified as Class C.

Police chiefs say their response will be proportionate and focused on dealers.

Home Secretary Alan Johnson said the government was committed to raising awareness of the dangers of psychoactive substances through its Frank campaign, but also wanted to send a clear message to those thinking of using the drugs.

“We are cracking down on so-called ‘legal highs’ which are an emerging threat, particularly to young people,” said Mr Johnson.

“That is why we are making a range of these substances illegal from today with ground- breaking legislation which will also ban their related compounds.”

Scientists at the Forensic Science Service laboratories have recently discovered that drug dealers in London have been using one of the newly-banned drugs to manufacture fake “crack cocaine”.

Piperazines were first developed as a worming agent and are also used in some manufacturing processes. The FSS says “legal highs” based on the chemical have become more prevalent than ecstasy.

Friday’s ban is unlikely to be the last. The Advisory Council on the Misuse of Drugs will next year consider a new wave of so-called “legal highs”, which are based on a group of chemicals known as cathinones.

However, the recent controversy over the sacking of the council’s chairman, Professor David Nutt, and the subsequent resignation of council members in protest, could mean any final recommendations are delayed.

From:

But new research and a survey among staff and patients at the Royal Brompton Hospital and the Chelsea & Westminster Hospital, both in London, found there is little evidence to support some of the concerns around the presence of blooms on wards.

In a study by Giskin Day and Naiome Carter of Imperial College London, and published in bmj.com, it was even claimed flowers could help improve a patient’s health and recovery.

One of the reasons given to support the ban was that flower water contained high levels of bacteria, but subsequent research has found no evidence to suggest that it has ever caused a hospital acquired infection.

Southend University Hospital recently imposed a ban on flowers on the grounds that they posed a health and safety risk around high tech medical equipment.

But the report argues that flower vases are no more risky than having crockery containing drinks or food around bedsides.

Interviews with staff in this study however found that nurses were generally more concerned about the practical implications of managing flowers than risks of infection.

Other studies report that flowers have immediate and long term beneficial effects on emotional reactions, mood, social behaviours, and memory for men and women alike.

One trial found that patients in hospital rooms with plants and flowers had reduced systolic blood pressure and heart rate; lower ratings of pain, anxiety, and fatigue; and had more positive feelings.

The authors of the report said given that flowers and herbs have been used as remedies in the earliest hospitals, and as a means of cheering up the hospital environment for at least 200 years, it seems remarkable that flowers still tend to be treated in an ad hoc fashion in hospitals.

Although flowers undoubtedly can be a time consuming nuisance, the giving and receiving of flowers is a culturally important transaction, the report concludes.

In an accompanying editorial, Simon Cohn, a medical anthropologist at Cambridge University argues that flowers have fallen victim to new definitions of care.

Describing the decision to ban flowers, he said: “[The decision] seems to reflect a much broader shift towards a model of care that has little time or place for more messy and nebulous elements.”

Katherine Murphy, director of the Patients Association, said: “Most patients love flowers. The job of nurses is to be the patient’s advocate and carer. Surely it is not beyond management capabilities in a trust to ensure that the needs of patients and staff are accommodated.

“If flowers on wards pose such a problem, it’s no wonder that critical patient safety issues appear to be insoluble.”

Flowers are just one of the items to have fallen foul of strict hospital health and safety regulations.

Mobile phones have long been forbidden on many hospital wards, even though a government report in 2007 said there was no justification for a blanket ban.

Doctors were banned from wearing watches and jewellery last year because of fears that they were an infection hazard.

An NHS Trust in Sheffield also banned nurses from wearing Crocs shoes at work, as the static electricity they generated could disable hospital equipment.

Perhaps the strangest ban, though, was at the Fazakerly Hopsital in Liverpool, where the controversial ITV television programme The Jeremy Kyle Show has been banned after complaints that it was upsetting patients. Well you win some, you lose some.

Previous research has suggested rates in England may be levelling off. But the University College London team found this was happening most in children aged two to 10 from wealthier backgrounds.

Researchers said obesity rates among the lower classes were likely to be significantly higher by 2015 – for girls the levels may even be double.

They analysed data gathered by the government-funded Health Survey for England.

Currently 6.9% of boys and 7.4% of girls are obese – with the difference between the lower and higher classes 0.6% and 1.5% respectively for boys and girls.

But using historical trends, they predicted that by 2015 obesity rates could be above 10% for boys and 8.9% for girls.

Depending on the extent of the “levelling off” reported last month, the overall rates could be even lower.

However, it is the findings for social class that have shed even more light on the obesity problem. The obesity rates for girls are likely to diverge from now on, the team said.

Among those from lower classes it is expected to keep rising to 11.2%, while for those from professional backgrounds it is likely to fall to 5.4%.

Among boys, both groups are likely to see a rise, but it will be faster in the lower class group, meaning 10.7% of this class boys will be obese compared with 7.9% of those from wealthier backgrounds.

Similar trends will also be seen in older aged children, the report in the Journal if Epidemiology and Community Health found.

Lead researcher Dr Emmanuel Stamatakis said: “This highlights the need for public health action to reverse recent trends and narrow social inequalities in health.”

“The widening socio-economic gap may be partly due to difficulties to reach and communicate health messages to families from lower socio-economic groups.”

Tam Fry, of the National Obesity Forum, agreed awareness was more likely to be greater among wealthier families.

But he added: “It is also often quite expensive and time-consuming to buy healthy food and that puts wealthier parents at an advantage.”

He said it was not clear why the differences were so marked in girls, although he said he suspected it was partly to do with the fact that boys tend to be more active generally.

From:
http://news.bbc.co.uk/1/hi/health/8412796.stm

The increase– the seventh successive quarterly rise in NHS employment taking it to above 1.6m people for the first time– took even seasoned observers by surprise following an 18,000 rise in the second quarter.

Most had been predicting at least a levelling off in the workforce despite continued growth in spending, as health authorities and hospitals prepared for the real-terms freeze that is to come.

Nigel Edwards, policy director for the NHS Confederation, said: “We suspect this is the last stage before the tanker slows down and finally turns.”

The confederation runs a website on which most NHS jobs are advertised and the numbers on it at any one time have fallen from 10,000 at the turn of the year to 7,500. “People still do have growth money this year,” he said, “and they are pursuing targets and other government objectives. 

Having launched the Identity and Passport Service last week- which 96% of the population doesn’t want, the labour govt are still going ahead with their health database.

The Department of Health has declared it will push ahead with a mass roll-out of its controversial Summary Care Record (SCR) – uploading parts of your medical record and personal details to a centralised system that is ultimately intended to hold your complete medical history.

So far, only London and the East of England have been mentioned but other regions may be targeted too.

A University College London report found scant evidence for any of the claimed benefits in SCR pilot areas but it appears the Department of Health still wants to ride roughshod over patient consent and medicalconfidentiality.

Having outraged medics and patients with its ‘implied consent’ model – where it is assumed you have consented to having your sensitive information uploaded if you do not respond to a single notification
letter – the Department has adopted a bizarre approach it calls ‘consent to view’.

Under this scheme, you will still only be sent a single letter. If you do not respond, your details will still be uploaded onto the system where they will be accessible to all sorts of non-clinical staff including administrators, bean-counters and bureaucrats, without your knowledge or consent. 

Sufferers living in some parts of the North are far more likely to undergo the major operation, rather than having the “breast conserving” surgery more common elsewhere, according to NHS figures revealing a “postcode lottery” in cancer care.

Statistics showing the ratio of mastectomies to less invasive procedures to treat breast cancer, show that Redcar and Cleveland, in the North East, is the place where patients were most likely to have at least one breast removed.

Those in the London borough of Richmond and Twickenham were the most likely to receive treatment which removed just part of their breast, with radiotherapy used to prevent the spread of tumours.

The statistics show that those living in Wolverhampton, West Midlands, the London borough of Kingston, South Staffordshire and Telford in Shropshire were also more likely to have mastectomies.

Research has found that for many women with breast cancer, either treatment has a similar survival rate, if the tumour is of a size where it can be removed without the whole breast being lost. The chance of drastic surgery was highest in the North. 

The so called tariff, or price paid per treatment, which covers about 70 per cent of the income of a typical NHS hospital as well as private ones that take NHS patients, is to be frozen for the next year. It will go up by a “maximum” of zero per cent for the subsequent three years – implying that it could actually be cut.

NHS hospitals will also have to make efficiency savings of 3.5 per cent next year. Where they treat more unplanned admissions than in 2008 they will be paid only 30 per cent of the tariff price – a move aimed at getting them to work with their primary care trusts to prevent unnecessary unplanned admissions.

The moves “will drive all providers to become as efficient as the highest performers”, Andy Burnham, health secretary, said in a document that sets out how he believes the NHS needs to change over the next five years.

Family doctors, who face a pay freeze next year, will also be told they have to hand back at least 1 per cent of their expenditure to primary care trusts in ­cash-releasing efficiency savings.

The strong pressure on prices will either help drive the productivity improvements that the NHS needs to achieve savings of £15bn to £20bn over the next few years, or plunge hospitals that fail to adapt into financial crisis.

Mr Burnham denied that this could mean hospital closures, but said “that hospitals will have to change” with more patients treated in the community.

The best Foundation Trusts were to be allowed to take over community services in an attempt to provide more integrated care, possibly including GP services. And over the next few years up to 10 per cent of the treatment price would depend on surveys of patient satisfaction, the aim being to create “a people-centred service”, Mr Burnham said.

The NHS was to be protected from inflation after 2011, meaning the big spending rises of recent years were being “locked in”, he added.

The Conservatives, however, pointed out that NHS employers would have to pay more than £400m in higher national insurance contributions from that year, creating “a real terms cut” in NHS spending.

Across the country, it will raise more than £9bn, while the Treasury says the inflation protection the NHS is being offered will add about £3.7bn to spending by 2012-13.

From:

The new scheme will allow patients with rare diseases to receive important new drugs which have not been appraised by the NHS rationing body, NICE (National Institute for Curbing Expenditure).

It will allow the makers to build up sufficient evidence on the benefits of the drugs which will then be used by Nice to decide if the medicine is cost effective enough for the NHS.

Currently, it is very difficult to provide enough evidence of a drug’s benefits if only small numbers of people take it.

A pilot scheme of the so-called Innovation Pass has been launched by ministers.

The Innovation Pass pilot will be funded from a ring-fenced £25m budget in 2010/11.

Health Minister Mike O’Brien said: “I am extremely pleased to launch this consultation that will help patients with the greatest need to benefit from and get access to exciting new innovative drugs.

“The Innovation Pass pilot will help collect the essential data needed to demonstrate that such drugs, which would not otherwise be available to patients, are making a big difference to their lives.”

Andrew Dillon, Chief Executive of Nice, said: “We recognise that for a small number of very promising new treatments, the evidence available may not reveal their full potential benefits for patients.

“Where there is a high risk that a Nice appraisal of a new treatment at the point of its first use in the NHS might underestimate its benefits, providing the opportunity to gather more evidence and making the treatment available before undertaking an appraisal is the right thing to do.

“We’re happy to play our part in making this new arrangement work well, and that it works in the interests of patients and the NHS.”

The Innovation Pass pilot consultation will run for 10 weeks, closing on 8th February 2010. Input and comments are welcome from all groups including stakeholders, industry, the NHS and patient groups.

From:

GPs are already immunising people with health problems and pregnant women.

But the British Medical Association and labour government have ended talks on children after they failed to agree a deal.

Health visitors and district nurses are now to be asked by local NHS managers to step in – but the programme may will now start in December as planned.

However, the vaccination of the first wave groups, which also include health workers, is continuing as normal as they were covered by a deal that was brokered in early autumn.

It is thought the latest talks broke down over the amount of flexibility the government was willing to give doctors over the rest of their workload.

Negotiators had offered doctors £5.25 per dose – the same as they are getting for the first priority group.

But the BMA had argued doctors should be given leeway over fulfilling their obligations on access to appointments.

Under the terms of their contract, doctors are paid bonuses to give most patients appointments within 48 hours as well as allowing them to book in advance.

Without this, the BMA argued vaccinating 3m children during the busy winter period would leave doctors out of pocket – doctors consider young children to be time-consuming as parents often have to be reassured.

Dr Laurence Buckman, chairman of the BMA’s GPs committee, said: “We sincerely wanted to be able to reach a national agreement. Unfortunately this has not been possible, because the government would not support adequate measures to help free up staff time.”

“At the busiest time of the year for general practice, with surgeries already dealing with the additional work of vaccinating the first wave of at-risk groups, we felt this was vital in order to ensure this next phase could be carried out quickly.”

Health Secretary Andy Burnham said the breakdown of talks was “disappointing”, but he still hoped to get the vaccination of children going by Christmas.

It is still possible that some doctors will agree to vaccinate children if they can reach individual deals with their local health managers.

However, the government has asked health chiefs to focus their attention on other NHS workers.

District nurses routinely carry out vaccinations for housebound patients as part of other immunisation programmes, but it remains to be seen whether they will be able to vaccinate large numbers of children.

Health visitors are also likely to be asked to help, but many of them do not have experience of vaccinating and will need extra training.

The British Medical Association believes it will be “very difficult” to get this all in place this year.

And David Stout, of the Primary Care Trust Network, which represents local health managers, agreed there was still a lot of work to do.

“It is more complicated to get separate agreements in place and will take several weeks. We don’t know who will want to do this so from that point of view it is untested. I can’t see it happening before Christmas.”

The amount spent on employing managers has risen by a quarter, or £78 million, in the past two years, the study shows. NHS Trusts blamed Whitehall targets for the increase.

It comes a day after NICE, the drugs rationing watchdog, refused funding for life prolonging bowel cancer drug Avastin, saying it was not cost effective.

Pulse, a magazine for GPs, found that projected spending on management salaries has increased by 25 per cent between 2007/08 and 2009/10 in primary care trusts, which look after community services. It was up from £312million to £390million.

But the true figure is likely to be far higher, because only a third – 55 – of the 152 trusts responded.

The rise is largely down to trusts taking on more managers, with 15 that provided headcounts saying the number of posts had gone up 14 per cent.

These trusts also reported that the cost per manager had risen by 11 per cent. David Stout, director of the NHS Confederation’s PCT Network, said it was “unrealistic” for such increases to continue.

“A lot of this is spending trusts are carrying out in response to what the Department of Health has asked for,” he told the Daily Mail.

Conservative health spokesman, Mike Penning said: “It is inevitable the rises must be keeping money away from patient care and the front line.

“Labour ministers must explain why so much more is being spent on management after a reorganisationof PCTs that was intended to produce efficiency savings.”

The editor of Pulse, Richard Hoey, added: “What we’re seeing exposed here is the bureaucratic machinery that has been put in place to implement Government policy priorities.

“These are policies which look good on paper, but in practice create whole new chains of managerial command.”

A “Public Sector Rich List”, compiled by the TaxPayers’ Alliance and covering 350 public bodies, shows that 806 executives collected more than £150,000, with eight on packages worth more than £1 million.

The list, which covers Whitehall departments, quangos and nationalised industries, shows that average pay among those identified was £225,000, with 120 chiefs on more than £250,000. More than 250 quango heads were on more than £150,000 in 2008-09. Nearly 80 NHS executives earned more than the Prime Minister.

At a time when all three main parties are proposing a squeeze on public sector pay, salaries at the top have been shooting up, the figures show. While some private companies froze or cut pay, that of the 800 public sector chiefs identified rose by 5.4 per cent, the TaxPayers’ Alliance says.

George Osborne, the Shadow Chancellor, has already pledged to publish the salaries of all public sector staff earning more than £150,000 if the Tories win power. He has also said that anyone earning more than the Prime Minister’s salary of £194,000 would need his approval.

Many of the highest earners in the list include present and former employees of recently nationalised banks. Mark Fisher, former executive director of Royal Bank of Scotland, tops the list with a package of £1.39 million. Sir Fred Goodwin, the bank’s former chief executive, was on £1.3 million.

Vince Cable, the Liberal Democrat Treasury spokesman, said: “With 806 public sector employees taking home more than £180 million a year between them, it is clear that even in these difficult times, profligacy at the top of the public sector lives on.”

The NHS figures show substantial rises for some staff as trusts compete for the best managers. Nearly 60 NHS chiefs earn more than the Prime Minister, with one said to be earning nearly twice as much. A further 290 earn more than £150,000.

Professor Salman Rawaf, who recently retired as director of public health at Wandsworth Primary Care Trust in West London, earned £370,000 last year, comprising a salary of £150,000 and £175,000 of other remuneration.

Sian Thomas, director of NHS Employers, said that many of the individuals’ pay combined salary and clinical excellence awards, all set nationally. “Pay of senior managers in NHS organisations is set by their remuneration committees and boards,” she said. “Therefore these arrangements will vary. Across the public sector the practice of linking remuneration to performance varies.”

Philip Hammond, Shadow Chief Secretary to the Treasury, said: “Nobody objects to paying public sector executives properly if they are delivering excellent results for the taxpayer. But over the last decade, public sector pay has risen while performance has languished. Under a Conservative government, only those who deliver value for the taxpayer can expect high salaries.”

From:

The chancellor told the BBC’s Andrew Marr Show the £12.7bn NHS IT programme – already running years late – was “something that I think we don’t need to go ahead with just now”.

Treasury officials rushed to explain that the government was looking for “significant savings” of up to perhaps £600m over the medium term by cutting back some features that are less important for patients.

Andy Burnham, the Health Secretary, told The Times that millions of pounds would be “reprioritised” from health research and development to pay the costs of the Social Care Bill..

Money will also be diverted from public health campaigns such as those on swine flu, sexually transmitted diseases and obesity.

The Bill, a key plank of Gordon Brown’s pre-election legislative agenda, has been condemned by Labour peers, scientists and health campaigners. It would guarantee free care at home or other support for up to 400,000 elderly and disabled people from next October, at a cost of £670 million a year.

Mr Burnham, disclosing for the first time how he planned to pay for the proposal, said that £60 million would be diverted from the health service’s research and development (R&D;) budget and £50 million from public health promotions.

The new website www.isdscotland.org/ — unveiled by Malcolm Chisholm, the health minister, was meant to allow patients to choose a clinic with the shortest waiting time but contains information that is up to nine months old.

The leader of Scotland’s GPs condemned the figures as “virtually useless” and patients’ groups described the initiative as “flawed”.

The database should provide the latest waiting times for first outpatient appointments at 3,030 clinics across Scotland. Until now the information had been available only to GPs.

Speaking at the website’s launch, Chisholm said: “This database is good news for patients and will support patient choice.”

However, detailed examination of the information has revealed that waiting times for more than 260 clinics are at least three months out of date.

The figures for outpatient clinics across Fife were last updated at the beginning of July. In Lanarkshire and Glasgow waiting times for more than 100 clinics dated back to February. Two clinics in Lanarkshire even listed waiting times for January. And most hospital waiting times were for early October.

Dr David Love, joint chairman of the British Medical Association’s Scottish GP’s committee, said information dating back several months was “virtually useless”.

He said: “It is a good idea and could be quite useful if patients do their homework before coming to the GP, but the whole thing hinges on the information being accurate. If it is not, it could create more work.”

Margaret Davidson, chief executive of the Scotland Patients’ Association, added: “This website is flawed. The figures have to be up to date for them to be any use.

“Questions also have to be asked as to whether patients will be treated at the hospitals they choose. I don’t think they will.”

Dr Ian Johnston, a member of the local GPs’ committee in East Lothian and a family doctor in Musselburgh, said waiting times should be no more than six weeks old if they were to be of any use. “There is no point in having something on a website that was done in February,” he added.

The launch of the website has been used by opposition politicians to highlight long waiting times of up to 2½ years. According to the target set by the executive, by the end of 2005 nobody should have to wait more than six months for a first outpatient appointment.

A spokeswoman for the executive said the Information and Statistics Division (ISD) of the NHS was responsible for the website. She added that most of the waiting times were up to date.

The ISD admitted that it had decided to launch the website even though some data was many months old. A spokesman said the out-of-date waiting times were the result of old data collection systems which were being modernised.

The country’s biggest cancer charity has expressed shock at government figures revealing huge variations in patients’ chances of surviving from one area of the UK to another. The biggest survival gap was in lung cancer, where Department of Health figures showed patients in Herefordshire were three times more likely to die within a year of diagnosis than those in Kensington and Chelsea. 

Patients are being admitted to hospital to avoid breaching a labour Government target on waiting times, NHS figures suggest.

More than one in twenty patients attending hospital in an emergency are being admitted to wards just minutes before the maximum four hour wait.

Health unions have complained that staff are being “pressured” into manipulating data and admitting patients unnecessarily to meet the target, which aims to treat or discharge all accident and emergency (A&E;) patients within four hours.

Figures from the NHS Information Centre show that almost all patients in England are seen within the four hour deadline, but there is a peak in the number of people admitted to a ward with just ten minutes to spare. Two-thirds of those treated as the deadline approaches are admitted to hospital, compared to just over one in five patients coming from A&E; overall.

It is the first time such analysis has been done and the statistics are categorised as “experimental”.

The Royal College of Nursing warned that the four hour target meant some nurses were “pushed into practices” that were risky for patients.

It said that there were “negative consequences” for patient care, especially those needing treatment in A&E; wards, but not necessarily requiring an overnight stay.

A survey of its members found that nine out of ten accident and emergency nurses claimed they had been unduly pressured to meet the four hour target.

Mark Porter, chairman of the British Medical Association’s consultants’ committee, said that the admission rates were worrying.

“This suggests that when patients have been waiting close to four hours, there is a rush to discharge or admit them so that the hospital meets the four-hour target,” he said.

“Patients must always be treated on the basis of their clinical need, not simply because they have been waiting close to four hours.”

Katherine Murphy, director of the Patients Association, agreed that the right patients are not always made a priority under the target.

“This results in doctors making rushed decisions at three hours and 50 minutes, with patients having to be admitted inappropriately at huge cost to the NHS,” she said. “We have heard instances of ambulance drivers being forced to wait outside A&E; with seriously ill patients, until staff have cleared a backlog of people who need to be seen within the four hour target.

“It is unfair to make NHS staff feel like they have to put meeting this target ahead of what’s in the best interests of patients.”

From:
http://www.timesonline.co.uk/tol/news/uk/health/article6921466.ece