Obese patients are being “effectively encouraged” to pile on the pounds to qualify for weight-loss operations on the NHS, the Royal College of Surgeons warns.

The college claims lives are being put at risk as some health trusts require patients to reach higher body mass index (BMI) levels than others before they receive surgical treatments.

The postcode lottery means that access to NHS weight-loss surgery is “inconsistent, unethical and completely dependent on geographical location”, according to the college.

Last year 4,300 operations to reduce body weight were carried out on the NHS, but as many as 1 million people could meet the National Institute for Curbing Expenditure (Nice) criteria for being classed as having severe obesity.

Bariatric, or weight-loss, surgery is carried out after diets, drugs and lifestyle-altering interventions are seen to have failed. It is not generally recommended for children or young people.

“Constraints on NHS funding mean that in some areas NHS decision-makers are opting to ignore professional guidelines and are denying patients’ access to surgery,” the college maintains. “In others, patients who already meet the [Nice] criteria are forced to wait until either they become more obese or develop life-threatening illness like diabetes or stroke.”

According to the Nice guidelines, bariatric surgery is recommended for adults with a BMI of more than 40, who have other significant diseases (for example, type 2 diabetes) that could be improved if they lost weight, and who have tried but failed to lose weight using non-surgical techniques.

The college, which is holding a conference on the issue today, says hospitals are assessing patients referred from primary care trusts under different eligibility criteria, resulting in some patients with a BMI of 60 or greater being refused surgery while others with a BMI of 40 or less are undergoing operations.

“Nice guidelines are meant to signal the end of postcode lotteries yet local commissioning groups are choosing not to deliver on obesity surgery,” said the college’s director of education, Prof Mike Larvin. “In many regions the threshold criteria are being raised to save money in the short term, meaning patients are being denied life-saving and cost-effective treatments, and are effectively encouraged to eat more in order to gain a more risky operation further down the line.”

One bariatric surgeon, Peter ­Sedman, said: “There is absolutely no doubt that some patients more needy of surgical treatment than others are being denied it. I will treat the patient, my hospital will offer the service, but unless the patient moves house they will not be referred and if they are, the treatment is subsequently blocked.”

David Haslam, chair of the National Obesity Forum, said: “Bariatric surgery is amongst the most clinically effective and cost effective specialities in any field of medicine, preventing premature death and transforming lives, whilst saving vast amounts of money for the NHS and the economy.

“Even the most cynical taxpayer should support bariatric surgery, alongside clinicians, in opposing the unethical and immoral barriers to surgery imposed by NHS purse-string holders.”

The college is calling on the Department of Health to ensure all patients have equal access to treatment. It estimates that obesity problems cost the NHS £7.2bn a year.

Alberic Fiennes, president-elect of the British Obesity and Metabolic Surgery Society, said: “We recognise the difficulties faced in dealing with a ‘new’ disease of epidemic proportions, but to limit surgery to the most severely obese is unfair and short-sighted and against basic professional ethics. It is also contrary to strategies that are standard for diseases that overwhelm resources.”

From:

“As public expenditure tightens, the natural response of governments of any colour is to think that central control and central dictation is the only way to keep control of the money,” William Moyes, who stands down at the end of the month, told the Financial Times.

The autonomy of foundation trusts, the growing separation of the commissioning of care from its provision, the use of diverse providers, with a degree of competition and choice, might be seen as “just too risky” so “everything becomes pulled into the centre”. 

The Government’s drugs rationing body, the National Institute for Curbing Expenditure (Nice), has provisionally said that it does not intend to recommend the use of the drug, called Tocilizumab, or Roactemra.

Nice claims that the £9,000 a year drug, for rheumatoid arthritis, has not proved that it is cost effective.

But patients in Scotland are to receive the treatment after it was recommended by the body which regulates drugs on the Scottish NHS, the Scottish Medicines Consortium (SMC).

The move will reopen accusations of medical ‘apartheid’ within Britain.

It follows an outcry after patients in Scotland were given access to expensive cancer drugs denied on the NHS in England and Wales.

Roactemra has been described as a “life changing” drug because it can be taken after other medications have failed, a common problem in the treatment of rheumatoid arthritis.

Patients groups last night said that denying the medication to tens of thousands of patients with the crippling condition in one part of the country was “cruel”.

Ailsa Bosworth, chief executive of the National Rheumatoid Arthritis Society (NRAS), said: “I have heard patients stories that would make you weep.

“People are virtually suicidal because they have nowhere else to go and yet they know that there are other drugs out there that they could have access to but cannot because of Nice.”

She added that it was “ludicrous” that the drug would be available in Scotland “and yet two miles on over the border you can’t get it.”

The drug – the first new arthritis treatment for a decade – is already used in most other European countries, including France and Germany.

It offers another option for patients for whom other treatments have failed or no longer work and is used in combination with a standard anti-inflammatory drug, called methotrexate.

Currently many rheumatoid arthritis patients receive methotrexate as a first-line treatment to ease their symptoms.

In later years they are offered another class of drugs, called anti-TNFs, together with methotrexate, but even combined the effects of the drugs can wear off.

In combination Roactemra has been found to improve the rates of remission of the illness sixfold in comparison with just methotrexate alone.

The SMC – set up in the aftermath of devolution to make decisions about drugs north of the border – has agreed that the drug can be used for patients suffering from moderate to severe forms of the disease for whom other medications no longer work.

Prof John Isaacs, from Newcastle University, said: “This is fantastic news for people in Scotland who suffer from this disabling, lifelong disease.

“However, it also highlights the disparities in accessing treatments between Scotland and the rest of the UK.

“Because Roactemra works in a completely different way to the existing drugs it is likely to be effective in some patients where the other drugs don’t work or have stopped working, providing an extremely important option for these individuals.”

Neil Betteridge, chief executive of Arthritis Care and vice president of the European League against Rheumatism (EULAR), said: “There are a number of treatments for RA currently available but they simply don’t work for everyone.

“There are people who are most severely affected by this debilitating condition – living in intense pain, unable to work, often struggling even to walk – who have been failed by existing treatments, and it’s for them that tocilizumab could provide real hope.”

He called on Nice to follow the lead of the SMC and approve the drug for use in England and Wales.

Up to 37,000 patients across Britain would be eligible for the drug. But local health care trusts do not have to pay for drugs which have not been approved by Nice.

In December Nice took the unusual step of challenging Roche, the drug’s manufacturers, to provide more evidence of that the drug was cost effective.

A final Nice appraisal of the drug is expected later this year.

Around 646,000 people in Britain are though to suffer form rheumatoid arthritis, in which their own immune systems start to attack their joints.

Herceptin, a £21,000-a-year drug for breast cancer, was initially turned down by Nice but available in Scotland, which has its own health budget.

A climb-down, ordered by Patricia Hewitt, the then health secretary, allowed the drug in England and Wales.

Patients in Scotland also had access to Tarceva, a lung cancer treatment, which costs about £1,700 a month, two years before the rest of the country.

Nice also provoked outcry by turning down Lucentis, a £20,000-a-year treatment available in Scotland for wet age-related macular degeneration, one of the most common causes of blindness, although it later also reversed that decision.

From:

A series of botched IT projects has left taxpayers with a bill of more than £26bn for computer systems that have suffered severe delays, run millions of pounds over budget or have been cancelled altogether.

An investigation by The Independent has found that the total cost of Labour’s 10 most notorious IT failures is equivalent to more than half of the budget for Britain’s schools last year. Parliament’s spending watchdog has described the projects as “fundamentally flawed” and blamed ministers for “stupendous incompetence” in managing them.

Further evidence has emerged over the failings of Labour’s most costly programme, the mammoth £12.7bn IT scheme to revolutionise the NHS. 

A series of botched IT projects has left taxpayers with a bill of more than £26bn for computer systems that have suffered severe delays, run millions of pounds over budget or have been cancelled altogether.

An investigation by The Independent has found that the total cost of Labour’s 10 most notorious IT failures is equivalent to more than half of the budget for Britain’s schools last year. Parliament’s spending watchdog has described the projects as “fundamentally flawed” and blamed ministers for “stupendous incompetence” in managing them.

Further evidence has emerged over the failings of Labour’s most costly programme, the mammoth £12.7bn IT scheme to revolutionise the NHS. 

Officials have cancelled further orders from Baxter, and are finalising a deal to limit purchases from GlaxoSmithKline, in an effort to recoup part of a £500m deal with the two companies for sufficient vaccine to cover the entire population.

Ministers have decided to abandon the aim of a universal flu vaccination programme, although they are pursuing the drive to vaccinate children under five as well as pregnant women, people with underlying health problems and health and social care workers.

The mild nature of the swine flu virus, the need for only a single rather than a double dose of vaccine and public suspicion and indifference to vaccination have led to lower take-up than anticipated in the UK and other countries.

The government’s decision – in the context of severe pressure on public spending – comes at a time of similar moves by other countries including France, Germany, the Netherlands and Spain.

Sir David Salisbury, director of immunisation at the Department of Health, said a break clause had now been activated in the contract agreed with Baxter of the US, while discussions were under way with GSK, from which most of the vaccine had been purchased.

Similar formal break clauses were not included in many countries’ contracts with vaccine suppliers, because they were drawn up at a time when governments and manufacturers expected demand would substantially outstrip supply.

However, GSK, like other large suppliers, including Sanofi-Aventis of France, is coming under political pressure to accept a scaling back of previously agreed volumes of orders.

GSK stands to lose tens of millions of pounds alone from the UK renegotiations and smaller amounts from other large purchasers such as France.

The drugmaker had previously estimated total sales of its pandemic flu vaccine across more than 70 countries at £2bn over 2009 and 2010.

It may be able to recover some losses from sales to other countries including in Latin America. Sanofi-Aventis, the world’s largest supplier of flu vaccine, stands to lose significant sales, with smaller losses from Novartis, while other suppliers such as Baxter, CSL and MedImmune – part of AstraZeneca – had lower initial sales and much lower exposure.

The UK and other countries are in talks about making donations of surplus vaccine stocks available to poorer countries and selling excess stocks to richer ones – although there are concerns about the issue of liability in such cases.

Sir David said the UK would keep some surplus stocks, both to prepare for any possible third wave of the pandemic and for a future different infection.

The vaccine contains an antigen to protect the body against the current H1N1 virus which would not be useful against future mutations.

But it has an adjuvant stored separately until just before vaccination, which enhances the body’s immune response and could be stored over longer periods to help fight a future pandemic.

The latest figures from England show that fewer than 3.8m people have been vaccinated against pandemic flu since last autumn, although 12.5m doses of vaccine have been sent out for health services ready to be used.

Previously, the HMRC has focused on people in blue collar jobs, such as publicans and taxi drivers, when fighting tax evasion.

However, it emerged that they are now focusing their attentions on the accounts of white collar professionals earning more than £100,000. Tens of thousands of professionals are set to be targeted.

Experts were surprised at the nature of the middle class clampdown, with the Governments tax inspectors accused of unfairly targeting middle class professionals as “easy pickings”.

They suggested that chasing middle-class professionals for unpaid taxes had been forced on HMRC by the Treasury, which is desperate to raise funds to reduce the national debt.

HMRC said a “significant” minority of medical professionals were engaged in tax evasion.

Examples included not declaring fees for private work done for medical care providers, payments for private consultation work or cash sums for drafting medical reports.

Under a three-month ‘amnesty’, hospital consultants, GPs and dentists now have until March 31 to make a voluntary disclosure about any income they have not declared to HMRC.

In exchange, they will have to pay the outstanding tax on the undeclared income. They will also face a ‘fine’ of 10 per cent of the amount they owe – but, as long as they have admitted their undeclared income, the action will stop there.

However, anyone who refuses to reveal their unpaid earnings, and tax and is caught after the deadline has expired, faces criminal prosecution. They could also find themselves ‘named and shamed’ on HMRC’s website.

In certain circumstances, those found guilty of tax evasion can face a prison sentence of up seven years.

HMRC inspectors can issue formal notices asking people to hand over personal bank statements and business records if they have suspicions about them. They can also legally inspect business premises using their civil powers.

Potential tax evaders could also be tracked down by examining their previous tax returns, which might reveal that their latest tax situation was wrong.

Mike Wells, HMRC’s director of risk and intelligence, said that once the amnesty had expired at the end of March, HMRC would be “using the information at our disposal to investigate medical professionals who have not declared their full income”.

Phil Berwick, director of tax investigations at law firm McGrigors, said tens of thousands of people could be hit across several different professions. Targeting the medical profession alone was “without precedent”, he said.

“You are dealing with people in a position of trust and responsibility who do not want to be named and shamed. It is people who are going to be averse to naming and shaming and probably in a position to make a payment to the revenue,” he said.

“Compliance activity is usually costly and time-consuming for HMRC. By offering an amnesty HMRC is hoping to get a significant amount of tax into the Treasury’s coffers very quickly and at a reduced cost to itself.

“The parlous state of the public finances and the pressing need to reduce the deficit has probably forced HMRC’s hand to an extent.”

The middle-class initiative follows a previous HMRC amnesty scheme to allow people with off-shore bank accounts to declare how much tax they owed and pay a small fine. Around 10,000 people made use of the scheme.

Stephen Camm, tax partner at accountancy firm Pricewaterhouse Coopers, said: “In the past they looked at publicans, fish and chip shop owners and tax drivers – typical working class jobs. Now they are looking at professionals. And the middle classes will bear the brunt.”

Richard Limburg, from accountancy firm Vantis Medical Group, added: “It is likely that HMRC sees the medical profession, especially consultants, as easy pickings and this could raise substantial amounts.”

A British Medical Association spokesman said: “The BMA recommends that doctors who may have any concerns consult their financial adviser to ensure their tax affairs are in order.”

A spokesman for the British Dental Association said: “Dental practitioners work in NHS, private and mixed economy settings. Many are therefore used to dealing with their own tax affairs.

Both adults were at Basildon University Hospital in Essex when they began to show signs they were affected by the bacteria legionella.

A spokeswoman for the hospital said the patients, who were staying in different parts of the hospital, have responded to antibiotic treatment but one of them is still in a critical condition.

The bacteria is commonly found in sources of water such as rivers and lakes but can sometimes find their way into artificial water supply systems.

Alan Whittle, Chief Executive at the Basildon and Thurrock NHS Foundation Trust, said the hospital was the probable source of the infections, based on tests of water samples. No more suspected cases have been identified.

“Experts agree that the legionella bacteria is a common risk in large buildings with an extensive plumbing system,” Mr Whittle said.

“Based on the results of laboratory tests of water samples, we accept that the hospital is the probable source of the infection, despite our determined efforts to minimise the known risks of legionella.

In November, inspectors from the Care Quality Commission criticised Basildon and Thurrock University Hospitals NHS Foundation Trust after they found blood stains on floors and curtains, blood splattered on trays used to carry equipment and badly soiled mattresses in the A&E; department, with stains soaked through.

Andy Burnham, the Health Secretary, told MPs last week that the more work needs to be done to improve standards at the trust.

On Jan 5th 2010 in the House of Lords Lord Warner (Labour) asked how many (a) acute trusts, (b) mental health trusts, (c) general practitioners, and (d) community services, are using an electronic summary patient record under the NHS National Programme for IT.

Baroness Thornton (Baronesses in Waiting, HM Household; Labour) replied:
As at 16 December 2009, two acute trusts, one mental health trust, 152 general practitioner practices, and additionally three out of hours providers and two walk in centres were using electronic summary care records delivered under the national programme for information technology. No community trusts were doing so.

http://www.publications.parliament.uk/pa/ld200910/ldhansrd/text/100105w0012.htm#10010561002177

What a waste of taxpayers money- a grand total of 160 health organisations were using the £12 billion scheme.

http://www.theyworkforyou.com/wrans/?id=2010-01-05a.64.3&s;=speaker%3A12896#g64.4
Hansard source (Citation: HC Deb, 5 January 2010, c64W)

According to Wikipedia, Dorothea Glenys Thornton, Baroness Thornton (born 16 October 1952), known as Glenys Thornton, is a Labour and Co-operative member of the House of Lords.

A graduate of the London School of Economics, Thornton was Political Secretary of the Royal Arsenal Co-operative Society from 1981, joining the public affairs team of the Co-operative Wholesale Society upon their merger in 1985 and working there until 1992. 

On Jan 5th 2010 in the House of Lords Lord Warner (Labour) asked how many (a) acute trusts, (b) mental health trusts, (c) general practitioners, and (d) community services, are using an electronic summary patient record under the NHS National Programme for IT.

Baroness Thornton (Baronesses in Waiting, HM Household; Labour) replied:
As at 16 December 2009, two acute trusts, one mental health trust, 152 general practitioner practices, and additionally three out of hours providers and two walk in centres were using electronic summary care records delivered under the national programme for information technology. No community trusts were doing so.

http://www.publications.parliament.uk/pa/ld200910/ldhansrd/text/100105w0012.htm#10010561002177

What a waste of taxpayers money- a grand total of 160 health organisations were using the £12 billion scheme.

http://www.theyworkforyou.com/wrans/?id=2010-01-05a.64.3&s;=speaker%3A12896#g64.4
Hansard source (Citation: HC Deb, 5 January 2010, c64W)

According to Wikipedia, Dorothea Glenys Thornton, Baroness Thornton (born 16 October 1952), known as Glenys Thornton, is a Labour and Co-operative member of the House of Lords.

A graduate of the London School of Economics, Thornton was Political Secretary of the Royal Arsenal Co-operative Society from 1981, joining the public affairs team of the Co-operative Wholesale Society upon their merger in 1985 and working there until 1992. 

Andrew Lansley, shadow health secretary, cited examples of NHS Trusts paying “hugely inflated” salaries to temporary workers for covering shifts.

A nurse in Yeovil was paid £146 an hour, another in Derby £136 an hour, and an IT manager in Whittington received £400 an hour.

The freedom of information disclosures also show that an agency doctor in King’s Lynn was paid £375 an hour – equivalent to an annual salary of £660,000. Mr Lansley said that such payments divert funds from the front line and prove that Labour’s attempts to control health agency expenditure are failing.

The NHS spent £1.25bn on temps in 2008-09, according to figures provided by the department of health to the Tories. This was a sharp increase on the £831m spent the previous year and the £785m in 2006-07.

But it is below the £1.4bn bill that agencies presented to the NHS in both 2002-03 and 2003-04, when agencies accounted for 5.5 per cent of the payroll.

Patricia Hewitt, former health secretary, described agency pay as “massively expensive” and called for hospitals to use permanent staff instead.

About 130,000 workers in the health service are not permanent staff.

While most trusts did not disclose fees paid to agencies, some of them received as much as 43 per cent of each payment, according to the Tories. The typical agency fee, among the 33 trusts that replied in detail, was 26 per cent.

Trusts and local authorities have been urged to pool resources to improve their purchasing power.

A report last year by Leeds university and the Economic and Social Research Council found that, although fees had dropped in recent years, temps were still generally more expensive than permanent staff.

The presence of temps, while “unavoidable”, could also damage the morale of permanent staff because they were often given easier tasks.

But the National Audit Office said last year that agency workers could be used as a way for the NHS to control costs. Temps could be cheaper because they did not receive the same training and perks as permanent staff.

Bureaucracy, low recruitment rates and the slow uptake of new drugs are pushing pharmaceutical companies to undertake more research in other countries in Europe and North America, as well as increasingly in low cost developing nations.

In spite of efforts by the labour government to make trials cheaper, faster and easier to conduct, the UK’s disproportionately strong historic role in the development of medicines is being undermined. 

The new approach by the NHS means that doctors will tell patients their percentage chance of having cancer, based on factors like their age, weight and symptoms such as bleeding or sudden weight loss.

Professor Mike Richards, the government’s cancer tsar, who unveiled the move in an interview with the Guardian, said that within five years every GP in England should be using the software as part of a new drive to reduce the huge toll of avoidable cancer deaths.

Computer-assisted cancer risk assessment will help GPs estimate whether a patient’s symptoms could indicate the presence of a cancer and decide whether they needed to refer them for urgent tests in hospital, Richards said.

The computer would assess a patient’s age, weight and symptoms – such as rectal bleeding and constant fatigue – and if the risk were above a certain level, the person would be referred to hospital for urgent exploratory tests within two weeks.

Cancer is the UK’s biggest killer after heart disease and strokes. Every year 293,000 people are diagnosed with cancer, and about 155,000 die of it. GPs are vital because they spot the signs of cancer in 90% of patients, with screening picking up the other 10%. But a typical GP sees only eight or nine cases of cancer a year.

Britain is far worse than many European countries at diagnosing cancer early, when it is more likely to be treatable and the patient has a much better chance of surviving. That is partly because some patients who develop symptoms delay seeking help, but also because GPs sometimes fail to correctly identify signs of cancer.

Support technology is needed because of that poor record, the difficulty of diagnosing cancer and the sheer number of other ailments that GPs have to know about, Richards said.

There are more than 200 forms of cancer, and many of their symptoms are the same as for a range of other, often less serious, conditions. Computers could help doctors get it right more often when deciding whether to investigate a patient further, discharge them or refer them to hospital.

“This is helping GPs because none of us can retain this sort of information [about cancer symptoms] and having to retain it for bowel cancer, lung cancer and ovarian cancer, as well as for heart disease, it would take a remarkable human brain to be able to do that, so why not get computers to support it?” said Richards.

“The benefit of this will be that GPs will know who should be investigated and who shouldn’t. It will also help patients to know that whether they are being reassured, or referred, or getting a test, that is the right thing to do.”

Richards said the system would mean “better decision-making by GPs, leading also to earlier diagnosis of cancer patients”.

Professor Steve Field, chairman of the Royal College of General Practitioners, welcomed the move. “The future of medicine will be that GPs will be using more and more computer-aided diagnostic tools for more and more conditions, and ultimately in years to come genetic information will be part of that,” he said.

“GPs will welcome this because it will make their diagnoses quicker and better. Over time this will save lives.”

Family doctors rather than computers will continue to make the key judgments, even after software has become routine in surgeries, Richards emphasised.

“The GP will always have the final say. If he wants to refer a patient to hospital, he will always have the right to do so,” he said.

England is understood to be the first country in the world to move to introduce such technology, according to the Department of Health. A number of GP practices across the country will take part in a pilot programme to assess the effectiveness of assisted cancer risk assessment, starting in the spring.

GPs have recently begun using similar software to help them assess a patient’s risk of developing cardiovascular disease. It analyses blood pressure, family history, cholesterol, smoking history and current symptoms before producing an odds ratio.

The plan to extend the approach to cancer is underpinned by a series of recent DH-funded research studies by Dr Willie Hamilton, an Exeter GP and expert in cancer diagnosis at Bristol University. Richards said the tests had shown, for example, that a man aged over 40 who develops diarrhoea has less than a 1% chance of that indicating bowel cancer, but two visits to the GP with the same symptom produce a 1.5% risk. This rises to 3.4% if there is a combination of diarrhoea and rectal bleeding and 6.8% if he visits his GP twice with rectal bleeding.

Sarah Woolnough, head of policy at Cancer Research UK, said: “We welcome any initiative that encourages the earlier diagnosis of cancer. Late diagnosis is the reason behind thousands of avoidable cancer deaths every year so it has to be a huge priority to make every effort to diagnose cancer earlier. We need to think imaginatively and innovatively about how we encourage earlier diagnosis, so initiatives like this are very promising for the future.”

From:
http://www.guardian.co.uk/society/2009/dec/29/cancer-diagnosis-computer-programme

Health Direct questions the sanity of this new spin.

Firstly, labour has an appalling track record on IT projects- the failed NHS records £12 billion NPfIT project is a prime example.

Secondly, this scheme undermines GPs, doctors and health professionals in general. If this new technology really does work- there will be a logic to save money by sacking them all.

Is this yet another example of hope over adversity. Having utterly failed UK patients with some of the worst cancer rates in europe over the past 13 years- is this a dying labour spin clutching at a straw?

The health secretary pledged a “fairer” system for relatives and friends of people admitted to hospital in England.

He is looking at whether to abolish fees for all in-patients’ visitors – or just those admitted for a long stay.

For out-patients he will look at free parking, or a cap on charges, for those who need to make regular appointments.

Parking is already free at most hospitals in Scotland and Wales and for certain priority groups of patients in Northern Ireland. Although all PFI hospitals and clinic still charge for car parking.

Mr Burnham announced in September he wanted to phase out over three years charges at hospitals in England for patients who are admitted.

But the eight-week consultation – which runs until 23 February – will also look at charges for out-patients who have to make regular appointments – like cancer patients with regular chemotherapy sessions.

Mr Burnham told the BBC: “I think the time has come for a fairer, more consistent approach to parking across the NHS. Frankly I think it’s confusing at present, there are a wide variety of parking schemes.”

He added it had “caused great resentment” but the government had to ensure that the costs of running secure car parks were covered.

NHS trusts have argued that some parking charges are necessary to ensure health funds are not diverted towards managing and maintaining car parks.

Mr Burnham said: “We want to have the consultation so we get the balance right, that we don’t ask the NHS to do something at a time when there is pressure on its finances that it can’t afford. But I believe what we’re proposing is affordable.”

When Mr Burnham announced plans to phase out charges for in-patients in September, Macmillan Cancer Support raised concerns that it would not apply to people with cancer having treatment as out-patients.

The charity’s head of campaigns, Mike Hobday, told the BBC: “MacMillan is really pleased that this consultation could mean free parking for cancer patients who have to go to hospital on average 53 times during the course of their treatment.

“What we need of course is for all political parties to commit to abolishing this unnecessary tax.”

http://news.bbc.co.uk/1/hi/uk_politics/8433395.stm

In the UK, hospital acquired infections (HAI) such as MRSA and clostridium difficile affect 300,000 patients each year and cause about 5,000 deaths- nearly double the number of people killed in road accidents.

The problem is worse in the US, where HAIs are estimated to be one of the top 10 causes of death, claiming close to 100,000 lives every year.

And the costs are mounting. In the US, government studies estimate that the extra cost of treating a patient with HAI averages almost $9,000 (£5,600).

UK companies are among the leaders in the fight against superbugs but they say that they are encountering problems in getting their products adopted by UK hospitals. They complain that hospital managers lack accountability for deaths relating to HAIs.

In November, a report by the Department of Health criticised the NHS for not achieving “measurable reductions” in HAIs outside of MRSA and C.difficile.

“The heart of the problem is that whatever DoH says or decrees, it doesn’t necessarily impact hospitals,” says Nick Adams, chief executive of Bioquell, the decontamination technology provider. “In the US, a hospital can be sued and that’s a big deal because they’re desperate to keep it out of the press, so they’ll settle. In the UK, hospitals pass the issue very quickly on to the NHS litigation board, so it’s not the hospital’s problem.”

Synergy Health is another company that produces decontamination technology. It has concentrated its sales efforts in Asia and Europe.

One of Synergy’s decontamination products uses a disinfectant technology produced by another company, Byotrol, that has been tested by the NHS in an 11-month study. The Byotrol technology was deployed against a bleach-based product currently used by the NHS.

Despite positive results showing superior effectiveness and lower side effects, the product has not been taken up, even by the Manchester Royal Infirmary where it was tested.

Richard Steeves, Synergy’s chief executive, says that his group is making more sales to countries where hospitals are encouraged to innovate, such as in the Netherlands, where “hospitals are competing for patients”.

Although there is state-funded national insurance for health care in the Netherlands, hospitals compete with each other to provide services for a number of private insurers.

Most UK hospitals are run by the NHS, and Dr Steeves points out that many of the UK’s private hospitals are owned by private equity, and that there is financial pressure to reduce costs.

However, there are those in the sector that say that innovation by UK companies is a direct result of the “laissez faire” environment.

Paul Swinney is chief executive of Tristel, which produces a chlorine dioxide-based disinfectant that treats everything from salads in supermarkets to surgical instruments and surfaces.

Its product is used throughout the UK, which Mr Swinney says is “de facto approval”. Moreover, he says, companies here do not have to pass the expensive regulatory procedure of the US Food and Drugs Administration or the Environmental Protection Agency.

From:
http://www.ft.com/cms/s/0/f989ee86-f405-11de-ac55-00144feab49a.html?nclick_check=1

Ministers are imposing new rules on NHS charities requiring all donations — including those to specialist children and cancer units, local fundraising campaigns, teaching hospitals and local community trusts — to be listed on a hospital’s balance sheet.

The Charities Commission says that this is “wholly inappropriate” because combining the trust and charity accounts will jeopardise the charity’s autonomy and discourage donations. 

The rate of drug and drink related admissions of homeless people has risen by 117 per cent since 2004, with six out of 10 hospital trusts reporting that numbers have gone up in the last five years.

Many of the rough sleepers had overdosed or suffered infections from using dirty needles to inject drugs such as heroin, while others needed their stomachs pumped after drinking too much.

The figures, contained in a series of answers to freedom of information requests put in to 173 hospital trusts, were released by the Conservatives, who issued a report setting out the importance of understanding the health needs of homeless people.

In particular, the party wants the availability of cheap alcohol in supermarkets to be curtailed, and for health boards to work with local homeless charities such as Shelter to consider the best ways to help homeless people in their area.

Grant Shapps, the shadow housing minister, said: “A refusal to confront the extent of the homlessness issue in the United Kingdom leaves our frontline services such as the NHS struggling to cope.

“Our report demonstrates how drugs and alcohol frequently play a major role in perpetuating the chaotic lives lived by many people trapped in homelessness. This is one of the reasons why Conservatives will fix the crazy situation whereby supermarkets are selling high strength larger for less than they charge for a bottle water.”

The report shows that nearly 14,000 homeless people were admitted to hospital with drink and drug-related conditions in the last five years, the equivalent of eight a day or one rough sleeper every three hours.

London had the most admissions, followed by Liverpool and Leeds.

More than 10 per cent of rough sleepers who ended up in hospital for alcohol or drugs were under the age of 25, even though young people are estimated to account for between six and seven per cent of the homeless population.

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Launching the Conservatives’ election campaign, Mr Cameron said that health care was his top priority and that he represented “the party of the NHS”.

The Conservative leader pledged to channel more health spending to poorer areas to tackle the growing gap in life expectancy between the wealthier and less well off.

A new maternity service giving mothers greater choice will also be set up if the Tories are elected.

Mr Cameron published the first chapter of a “draft manifesto” detailing twenty Conservative policies for the NHS.

These included a pledge to end mixed sex hospital wards, a plan to withhold funding from hospitals which infect patients with MRSA, and new proposals to give patients detailed information about the quality of treatment from each doctor, hospital or surgery.

Patients will also be given more opportunity to manage their own care and could receive treatment for minor ailments at their local pharmacist.

In a speech to Conservative activists, Mr Cameron said: “Today, the Conservatives are the party of the NHS. But talk is cheap. You’ve got to back that with action, and we have.

“We are the only party committed to protecting NHS spending. I’ll cut the deficit, not the NHS. And don’t for one minute buy the Labour claim that they’ll do the same. They won’t – and their own figures show they won’t.

“Unlike us, they have not committed to protecting areas of the health budget such as public health and capital investment.”

Mr Cameron accused Labour of failing to tackle the gap in health between rich and poor, describing it as “one of the most unjust, unfair and frankly shocking things about life in Britain today”.

“Health inequalities in 21st century Britain are as wide as they were in Victorian times,” he said.

He promised the Tories would introduce a new health premium that would divert cash to the poorest areas and “banish health inequalities to history”.

“With our plans, the poorer the area, the worse the health outcomes tend to be, so the more money they can get,” he said, adding that local people would decide how it was spent.

Already hospitals have been told that they will receive no increase in the amount of money that they are paid per procedure, essentially a real terms cut in the cash they will receive.

Overall, the health service has also been set a goal to make between £15 million and £20 million of efficiency savings over the next four years.

The fact that McKinsey, the management consultancy firm, estimates that to achieve such that a goal would take making 10 per cent of NHS staff redundant and abandoning procedures such as varicose vein operations suggests the scale of the challenge.

Patients’ groups will continue to keep a close eye on the labour government’s drugs rationing body NICE in 2010. Over the last year the National Institute for Curbing Expenditure (NICE) began looking more favourably on drugs which prolong life for terminal patients, as it was instructed to do so by Government.

2009 also saw a number of drug companies come forward with innovative deals that allowed the NHS to pay less for some medicines.

But with expensive drugs for cancer and other illnesses coming through the pharmaceutical pipeline at all times patients will continue to monitor how Nice makes decisions about which drugs it will allow on the NHS.

The Government will scale up its Change4Life campaign, which so far has concentrated on children and families, to focus on adult obesity.

Despite data which suggests that rises in childhood obesity could be levelling off, ministers and health planners are still worried about the strain on the NHS if predictions that half of adults could be heavily overweight by 2050 come true.

2010 should be the defining year for the Swine flu pandemic. Will cases continue to drop or will swine flu return either early in the new year or next winter?

Sir Liam Donaldson, the Chief Medical Officer, warns that we cannot be complacent about the threat that the virus still poses and points to pandemic flus in the 1960s in which death rates were higher in the second winter than the first.

The H1N1 vaccine could be the deciding factor, but to what extent remains to be seen.