Two thirds of patients fail to get GP's appointment within 48 hours

Two thirds of NHS patients cannot get an appointment with their GP within 48 hours, a wide ranging report by the healthcare watchdog has found- and the situation is getting worse as last year 80 per cent of patients could see their GPs within 48 hours.

The most comprehensive study of its kind has shown that millions of people are being failed by their local surgeries.

Under key NHS targets, patients should be able to see their family doctor within two working days. However, the report said that just one third of people were able to see their GP within this time.

The findings come at a time when the relationship between patients and their doctors is already under strain.

There has been widespread anger over the large pay rises enjoyed by GPs under the new contract.

And ministers and GPs have been locked in bitter negotiations about forcing surgeries to open for extended hours, offering appointments into the evening, early in the morning and on Saturdays.

Gary Needle, at the Healthcare Commission, said: "Patients are not getting sufficient access to their GPs is the message from this measure."

Andrew Lansley, Shadow Health Secretary said: "Despite all their talk, Labour are still failing patients when it comes to choice and access to a GP.

"It's appalling that in seven out of ten areas, people aren't able to see their doctor within 48 hours when they wish. It shows the utter failure of Labour's top-down targets to bring about the best results for patients."

Liberal Democrat health spokesman Norman Lamb said: "For years people have known that ministers' complacent assurances about how easy it was to see a GP were wrong.

"At last a proper assessment has taken place so we can see the reality of the situation. This scandalous finding must force the Government to act now."

Last year the report found that 80 per cent of patients were able to see their GPs within 48 hours.

However, the data was gathered by using 'mystery patients' to carry out spot checks to see if they could get an appointment rather than asking patients.

This year, for the first time, the commission included information from a patient survey. The report has sparked a row with doctors who have said the figures are misleading.

Dr Hamish Meldrum, chairman of the British Medical Association said: "The report's conclusion that there has been a dramatic decline in primary care trusts meeting the GP 48-hour access target is misleading.

"There has been such significant change in the way the research has been compiled compared to last year that it is impossible to compare the data for the two years in question. The access figures are even more confusing when you consider that a recent survey showed almost 9 out of 10 patients were satisfied that they were able to get an appointment within 48 hours.

"GPs are working hard to offer as much flexibility as they can to patients, as well as providing speedy access, and delivering an expanding range of services to patients."

The latest figures show the average annual earnings of GPs, who are paid to hit the targets on appointments, are £103,530 - a drop of 2.6 per cent on last year after years of rising pay. They also showed 258 doctors earned more than £250,000 before tax last year.

The commission's healthcheck is an in-depth investigation into the NHS with each hospital trust, primary care trust, mental health trust and ambulance trust measured on waiting times, hygiene, confidentiality, management of records, reducing deaths from cancer and heart disease, cutting superbug rates and treating patients with dignity and respect.

While the report found there had been improvements in many areas, it found that infection control was a serious problem with 'lapses at almost every trust visited' and six out of ten trusts failing on at least one measure.

The Commission warned that other infections such as norovirus - the winter vomiting bug that reached record levels last winter - should be included in the measures in the future alongside Clostridium difficile and MRSA.

Of the 114 trusts that failed on at least one infection control measure, 11 said they were compliant only for this to be overturned by inspectors.

There is concern about infection control in community hospitals, district nursing, ambulances and midwifery and these areas will have extra focus in the next inspections.

From:
Two-thirds-of-patients-fail-to-get-GPs-appointment-within-48-hours.html

Polyclinics will destroy trust between patients and GPs

Plans for polyclinics or so-called "super surgeries" could destroy the trust patients have in GPs, according to a new study.

A breakdown in the patient-doctor relationship would in turn lead to more ill health, researchers warn.

More than 1.3 million patients signed a petition against the proposals for large scale polyclinics earlier this year.

GPs argue that patients will lose the bond with their family doctor under the plans, which include housing large numbers of GPs under one roof along with specialisms such as minor surgery and dentistry.

The British Medical Association (BMA) has warned that patients will be unlikely to see the same doctor each time they visit a polyclinic.

The labour Government insists that the changes are necessary to give patients a "world class" service and that, outside London, the clinics will provide extra capacity in so-called under-doctored areas.

The new study shows that patients trust family doctors less if they often have to see different GPs.

Researchers surveyed 243 patients registered at three different surgeries.

They found that 83.5 per cent of patients who always saw their regular GP had a high level of trust in their doctor.

That figure fell to just 72.6 per cent of those who often saw different GPs, the research, published online in the British Journal of General Practice, shows.

Dr Carolyn Tarrant, part of the team which carried out the study at the University of Leicester, said: "The government is setting up numerous polyclinics, super-surgeries, and walk-in centres all over the country.

"I'm sure they will have various benefits for patients and GPs, but they are bound to reduce continuity of care, and our research shows that this may lead to a decline in patient trust. If patient trust declines, then medical outcomes may be adversely affected."

Dr Laurence Buckman, chairman of the BMA's GP Committee, said: "Trust and continuity of care are exactly the reasons why general practice can't be delivered supermarket style, where choice and convenience come above everything else.

"For someone with a chronic condition, a long-term relationship with a doctor they trust and who knows their history is vital.

"GPs and patients believe polyclinics will damage that relationship, it's just the labour Government that doesn't."

The proposals were set out by Lord Darzi, the health minister, as part of his root and branch review of the health service.

A spokesman for the Department of Health said that the "overriding objective" of the new centres was to deliver the best possible service to patients.

From:
Polyclinics-will-destroy-trust-between-patients-and-GPs.html

Dying patient forced to pay £20,000 for NHS care

The grieving family of a woman who died last week tells why health service rules on top-up co payments for cancer drugs must be changed.

A mother of three has died from cancer after her family was forced to pay £20,000 for treatment she was denied by the National Health Service because she had bought a drug privately.

Carole Simmons, 59, died last Tuesday, the third person known to have died after suffering from the labour government’s policy of withdrawing NHS care from patients who buy top-up drugs.

Her death comes in the middle of a government review of top-up treatment, which was ordered after a campaign by The Sunday Times exposed the scandal. The review panel is due to report to Alan Johnson, the health secretary, later this month.

This weekend relatives of Simmons, who lived in Yapton, West Sussex, spoke out in the hope of sparing other families from suffering the same tribulations. Simmons’s husband Kevin, 59, a former divisional officer in the fire service, described what happened when she was diagnosed with bowel cancer last December.

“They more or less said that Carole had no hope, that she only had weeks to live,” he said. “They were sending Carole home to die.”

In an attempt to give Simmons more time, her family paid privately for a drug called Avastin, which was not available on the NHS. They believe it prolonged her life.

However, under labour government rules their NHS treatment was then withdrawn. As well as the cost of Avastin, the family had to pay about £20,000 for routine drugs, scans and consultant appointments that would otherwise have been available on the NHS.

“We got nine precious extra months with Carole which we may not have had if we didn’t have the money,” said Simmons. “We want Carole’s legacy to be that this policy will be changed so that this doesn’t happen to anyone else and top-ups are allowed.”

During the extra time she was given, Simmons, a former teaching assistant, saw a grandchild start school, enjoyed a family holiday in France and attended her sister’s 40th wedding anniversary in Jersey.

Simmons’s youngest son, Chris, 28, a solicitor, said: “Some people may be able to raise the money for the extra cost of the drug but they may not be able to pay for all the treatment, such as scans and consultant fees. Instead of ordering a review, Gordon Brown should have ended this immediately and allowed people to pay just for the extra cost of the drugs.”

He added that paying for Avastin had given “us time to put our affairs in order and to say our goodbyes”.

Simmons’s daughter Kate, 30, a civil servant, points out that her mother had paid for her NHS care. “Our mum worked all her life, apart from when she was bringing us up. She never claimed unemployment benefit and always paid her national insurance and taxes,” she said.

“Our mum really wanted us to speak out so that this would not happen to another family.”

The Simmonses paid for the drug and basic NHS care from savings and a loan. “This was my parents’ pension savings. They didn’t have the money lying around,” said the eldest son Colin, 35, a local government manager.

Simmons was treated at St Richard’s hospital in Chichester before her NHS care was withdrawn. She then paid for Avastin and her treatment, including scans using NHS equipment, at the Spire Portsmouth hospital in Havant.

The Royal West Sussex NHS Trust, which runs St Richard’s hospital, said it was following government guidance by refusing to allow Simmons to continue to receive NHS care while paying for the Avastin.

The government inquiry, which is being carried out by Professor Mike Richards, the government’s cancer czar, was ordered in June following the disclosure in The Sunday Times that another bowel cancer patient, Linda O’Boyle, 64, from Billericay, Essex, had died after her NHS care had been withdrawn because she paid privately for the drug Erbitux.

In May last year Sandra Baker, 62, from Walgrave, Berkshire, died of bowel cancer after being denied NHS treatment because she paid for a drug.

Simmons is the first patient known to have died during the government inquiry after being denied NHS treatment. She would have celebrated her 40th wedding anniversary today.

Her local MP, Nick Herbert, the shadow justice secretary, said: “I am horrified that my constituents have had to use their savings in this way. The awful situation at the moment is that if you do manage to scrape together the money to buy these drugs yourself, your NHS treatment is withdrawn. This puts patients in a terrible dilemma.”

Most leading health organisations, including the British Medical Association, the Royal College of Nursing (RCN), the NHS Confederation, which represents hospital managers, and the King’s Fund and Reform think tanks, have said top-ups must be allowed.

The Roy Castle Lung Cancer Foundation and the Patients Association have both backed top-ups in their submissions to the inquiry.

While the RCN accepts that allowing top-ups is necessary, nurses’ leaders warn that the change could create “business class” treatment for NHS patients who can afford it and thus potentially undermine the founding principles of the NHS.

Others argue that there is already a two-tier health service, as those who can afford to pay for all their care go to private wings of NHS hospitals.

The government inquiry, to be published at the end of this month, is expected to propose that patients should be allowed to pay for additional drugs without losing their NHS care.

Kate Spall of the Pamela Northcott Fund, which campaigns on behalf of patients denied drugs on the NHS, said: “Let us hope that Carole’s tragic story will bring about the end of this situation for patients.”

From:
http://www.timesonline.co.uk/tol/news/uk/article4882645.ece

Labour U Turn on medical data- NPfIT medical records a step closer

After another labour U turn the national electronic record of patients’ health (NPfIT) looks finally on the cards – five years late – after the NHS IT programme on Thursday changed the way patients will give their consent to the system.

Providing a brief, summary electronic patient record has been a key driver for the £12bn ($22bn) NHS IT programme, which will create a detailed, local electronic record as well as the shorter one available nationally, providing doctors with recent medical history, medications and allergies in an emergency or out of hours.

Tony Bliar, then prime minister, declared as long ago as 1997 that the electronic record would mean that “if you live in Birmingham and have an accident while you are, for example, in Bradford, it should be possible for your records to be instantly available to the doctors treating you”.

Development of electronic records, however, has been devilled by a long and bitter dispute, chiefly with general practitioners, over whether patients should explicitly give consent to having such a record – a more complex, lengthy and costly approach – or whether they should be presumed to give consent with the right to opt out – the approach that the IT programme originally backed.

On Thursday, however, Connecting for Health, which delivers computer systems and support to the NHS, announced a change of tack. Patients will now be written to and given the chance to opt out before a summary record is created.

They will in future be asked at each consultation if the clinician can look at their record and will have the right at that point to opt out entirely, to refuse for that episode of care, or to agree to the record being viewed. They will also be able to agree to the record being permanently available to accredited clinicians.

Dr Gillian Braunold, the lead GP for the programme, said the change “gives the patient control to say yes or no and it is much simpler”. The default position will be “Ask me first”, she said. The decision had been reached after consultation with GP leaders, the Information Commissioner and a wide range of others, she added.

The British Medical Association said it welcomed the changes “pending finer details”, believing patients should opt-in rather than opt-out.

The record has been piloted in five parts of the country, with fewer than 1 per cent of 160,000 patients refusing to have a summary record. Connecting for Health said it hoped to roll the record out nationally, starting in 2009 or early 2010. It is likely to take at least 2-3 years to cover the country.

http://www.ft.com/cms/s/0/ff2823e8-85d0-11dd-a1ac-0000779fd18c.html?nclick_check=1

NHS hospital car parking charges to be abolished

Health chiefs in England were under pressure to scrap hospital car parking charges after a move by the Scottish government to abolish the charges at 14 NHS hospitals.

The move to scrap the charges on December 31 this year comes after a review of the car parking policies of NHS boards across Scotland.

A temporary cap of £3 a day on parking charges at hospitals has been in place since January.

The charges will remain at three of Scotland's biggest hospitals which were built under the Private Finance Initiative (PFI) - Edinburgh Royal Infirmary, Glasgow Royal Infirmary, and Ninewells Hospital in Dundee.

The charges have been particularly unpopular with staff and visitors but some health boards argued that they need to apply them to deter commuters and others not visiting hospitals leaving their cars on site.

By removing the hospital parking charges, the Nationalist government has again demonstrated its populist touch, leaving its opponents with no option but to agree with the move.

However, the decision will irritate patients and staff south of the Border who will ask why English hospitals cannot do the same.

Scrapping the charges will cost Scottish health boards about £5.5million in lost income each year. The boards will get £1.4million from the Scottish government this financial year but will get no more cash. The £1.4million is roughly equivalent to the income lost in the final three months of this financial year once the charges are scrapped.

Nicola Sturgeon, the Scottish Health Secretary, said that it was “simply not fair” to expect patients or visitors to have to pay when they come to hospital. “Put bluntly, a car parking charge is often the last thing people need,” she added.

Ms Sturgeon said she was “determined” that the founding principles of the NHS should remain. “Chief among these is that the NHS should be free at the point of delivery and it is my firm belief that this would apply whether one comes to hospital as a patient, visitor or member of staff,” the health secretary added.

She said that the only exception to the initiative would be car parks in hospitals built through PFI where the cost of early termination would be “prohibitive”, because of the nature of the contracts. However, even in these hospital, she said that boards should work with contractors to limit and reduce charges until the contracts came to an end.

The 14 hospitals where charges will be scrapped are: Aberdeen Royal Infirmary; Dr Gray's Hospital, Elgin; Gartnavel General Hospital and Gartnavel Royal Hospital; the Southern General Hospital, Stobhill Hospital, Victoria Infirmary, Western Infirmary and Yorkhill Hospital, all in Glasgow; Raigmore Hospital in Inverness; the Lauriston Building, Royal Hospital for Sick Children and the Western General Hospital, all in Edinburgh; St John's Hospital in West Lothian, and Perth Royal Infirmary.

Before the charges are scrapped the five health boards which apply them will be asked to bring forward plans for meeting increased demand and promoting environmentally-friendly transport.

The move was welcome by the AA motoring organisation, which urged hospitals in England to do the same.

Edmund King, the AA President, said that the scrapping of car park charges at these 14 hospitals was “great news”, particularly for long-term sufferers and their families.

“For cancer sufferers undergoing chemotherapy on a day-patient basis the parking costs soon add up. Also, due to the risk of infection many such sufferers are unable to use public transport,” he added.

Unison, the NHS union, criticised the decision not to scrap charges at PFI hospital car parks. Cathy Miller, the Glasgow and Clyde branch secretary, said that Ms Sturgeon seemed unwilling to be bold enough to remove charges from these sites.

“This decision will create a two-tier system with staff and patients who are unlucky enough to be on a PFI site, such as Glasgow Royal Infirmary, being charged for the pleasure”, she added.

Organisations representing doctors and nurses welcomed the move. Charles Saunders, chairman of the BMA's Scottish consultants committee, said that charging to park at hospitals was an indirect tax on healthcare.

“The founding principle of the NHS is that healthcare should be free at the point of delivery and we are pleased that the Scottish government has recognised the burden that these charges have put on patients and their relatives when they are at their most vulnerable,” he added.

From:
http://www.timesonline.co.uk/tol/news/uk/scotland/article4663759.ece

Health Direct wonders if Gordon Brown had any sense he would have rather done the same for England.

A majority of people in England would have benefited from this simple measure. Stamp duty holiday for houses under 175000 for a handful of people for a year is neither here nor there.
I wonder who advises him?

NHS spurns gift of free cancer drug

Bosses in the National Health Service have refused to administer a drug to a patient with advanced kidney cancer even though the medicine is being provided free.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Ban on NHS top up is cruel rationing, says BMA

Doctors believe patients should be allowed to pay for drugs that are not available on the NHS as they called for an independent inquiry into the controversial problem.

They warned that not allowing patients to top up their NHS treatment with private medication was a "cruel form of rationing".

In a close debate, doctors at the British Medical Association conference in Edinburgh voted in favour of a motion saying patients should have the choice to purchase non-health service treatments and medications if they wish and still receive the rest of their treatment free. The motion was passed with 62.8 per cent of the vote in favour.

The debate comes after a woman dying of cancer was denied free NHS treatment in her final months because she had paid privately for a drug to try to prolong her life.

Linda O’Boyle, 64, from Billericay, Essex, was receiving chemotherapy on the NHS, but she paid for the drug cetuximab to boost her chances of fighting bowel cancer. She was banned from free NHS care and died in May.

At present, patients who want a drug or treatment that has not been through an appraisal system or has not been licensed can have NHS funding refused by their primary care trust.

If they choose to pay for the treatment they have to have all their care privately. Many trusts are flouting the rules and allowing patients to purchase drugs which are administered within the NHS and continuing with their health service care.

But in a second motion, members of the BMA stopped short of demanding top-ups be introduced now by the narrowest of margins, 154 to 153, and have called for a Royal Commission to look at the issue further. The labour government has already ordered Prof Mike Richards, national director for cancer services to review the position and the report is due in October.

Some labour ministers claim that allowing private top up treatment would bring about the downfall of the NHS by allowing richer patients to pay for improved treatment, while drugs available to poorer patients may be limited.

At the highly charged debate, one doctor, Gordon Matthews, spoke movingly about his own wife with end stage cancer who wants to buy drugs. He argued that it was not ethical to exclude patients from the NHS because they had chosen to pay for drugs when they are 'clinging to their lives'. Another doctor said the worst moment of his medical career was hearing women screaming while undergoing abortions because they could not afford the anaesthetic.

Proposer of the motion Stephen Austin of the BMA consultants committee said the current rule is "healthcare rationing in its most brutal and cruel form" and that it placed patients in an "impossible" position.

But Dr Jackie Davis of the BMA Council said pharmaceutical companies would put pressure on vulnerable patients and insurance companies would be lining up to offer cover for drugs that the NHS will not pay for. Dr Kevin O'Kane, from the London region, said the motion was 'poisonous' and a 'nail in the NHS coffin'.

He added that the review of the NHS carried out by Lord Darzi meant the appraisal of new drugs by the National Institute for health and Clinical Excellence (Nice) would be speeded up and the postcode lottery in treatment ended, so there was no need for the motion.

Just over 70 per cent voted in favour of a Royal Commission to look into the issue and then supported supplementary motions that co-payments must not be a route to extension of NHS charges.

Commenting after the debate, Dr Hamish Meldrum said: “In principle doctors believe that patients should have the choice to buy additional treatment that is not available on the NHS, without being forced to pay for all their treatment privately.

“However, they stopped short of asking for co-payments to be introduced until there has been a wider debate with the profession and public and the evidence has been collected and examined. Doctors recognised that there were many potential problems with introducing co-payments and suggested a number of safeguards they would wish to see considered were they to be introduced.”

Ian Beaumont, Director of Communications, Bowel Cancer UK said: “We are concerned that while co-payments will enable some patients to receive treatments privately, those who can’t afford to pay will not be able to access them. Co-payments also give the Government, NICE and Primary Care Trusts an excuse to deny patients access to new, effective treatments on the NHS.”

From:
Ban-on-NHS-top-up-is-cruel-rationing%2C-says-BMA.html

Health Direct posts that people who can afford to opt out of the NHS completely and purchase private health care should be able to do so, and they do.

Any one who could afford to top up should be alowed to do so. People who can afford neither will still benefit from free health care from the NHS. Yes this is a multi-tiered health care system , but what is so wrong with that?

The idea that this would spell the end of the NHS is laughable, unless some factions of the BMA are so worried that all their members will do as dentists did and dump NHS practice all togethar.

Pharmaceutical companies cannot pressurise poor people because they are not permitted direct patient advertising as they are in the US. They could pressurise GPs, but you have to hope that the unscrupulous fat cat, pound chasing, sloppy GPs who would in turn pressurise patients are struck off.

Insurance companies will queue up to offer potential NHS blacklisted treatments, but again if someone chooses to invest in their future health provision why shouldn't they? It is no different than buying critical illness insurance. You buy it or you dont it depends on what value you put on it.

Maybe it is about time that people started to take more responsibility for their own health. The current government think it is a dirty word, but perhaps people should ASPIRE, to be in a better position when benefiting from healthcare; rather than aspiring to own a car they cannot afford or sinking 20 pints and smoking 40 fags that weekend.

It is these people, with skewed notions of aspiration i.e. to appear wealthier and more important that they actually (just like a celebrity) are who will ensure the demise of the NHS, not the ones who have chosen to invest in their health!

Gordon Brown is always battering on about choice, why not put your money where your mouth is then Gordo, give people the choice!

Polyclinics threaten 600 GP practices, say Tories

More than 600 GP practices are under threat because of labour Government plans for "super surgeries" despite overwhelming public opposition to the proposals, according to the Tories.

Hundreds of family doctor surgeries across England have been identified by local health Trusts as being in the same catchment area as proposed new polyclinics.

The Conservatives have compiled the list of practices across the country, named in plans for polyclinics drawn up by Primary Care Trusts, which they say could be killed off by the scheme.

They said the list showed practices which could be forced to shut because they would lose patients to the new clinics if they went ahead and warned that the final figure is likely to be much higher as many Trusts are still compiling plans.

Doctors who found their name on the list would now be "even more concerned than they were already" about the possibility of closure, the British Medical Association (BMA) said.

But the labour Government insisted that there was no suggestion in the documents that any of the practices had been earmarked for closure.

Recently, more than 1.2 million patients signed a petition protesting against plans for polyclinics, which was delivered to Gordon Brown.

Doctors' leaders argue that the new surgeries will destroy the relationship between patients and their GP family doctor and force them to travel much further to see a doctor.

GPs are also worried that polyclinics could "cream off" younger, healthier patients who help to subsidise their practices to treat those with more complex medical problems.

But ministers insist that the clinics, which could house up to 25 GPs as well as extra services such as dentistry and minor surgery and will open during evenings and weekends, will provide a "world class" service.

The Tory research reveals that 608 practices in almost half of all Primary Care Trusts outside London -where ministers insist that the "GP led health centres" will be in addition to existing services - have already been listed as close to proposed new clinics.

If this were replicated across the rest of the country including the capital as many as 1,700 practices could be under threat.

The Tories said the implication was that polyclinics would threaten the viability of the practices listed, even if not all of them would be forced to shut.

Andrew Lansley, the Conservative health spokesman, said: "The Government needs to explain why these GP surgeries are being named if it's not because polyclinics pose a threat to the local doctor.

"It adds to the huge weight of evidence now building up that polyclinics are not the additional services as Gordon Brown has claimed. Patients and family doctors are right to be worried about losing a valued local service. It's time Labour faced up to their concerns and called a halt to their unpopular polyclinics scheme."

A spokesman for the BMA said that the publication of the list would worry GPs already concerned that their practices could shut.

He said: "We have always had concerns about the viability of practices that are close to these polyclinics.

"It is inevitable that they will lose resources because of the new development, even if they are not actually dragged into it.

"Ben Bradshaw [the Health Minister] has said that some patients won't have to deregister with their GP to use this service, but that is not really the point.

"There is only one pot of money and if it is all going into polyclinics then GP surgeries will have to cut back on services and many could be forced to close."

He added: "GPs who find themselves on this list will be even more concerned than they were already."

An official spokesman for Mr Bradshaw said: "There is no suggestion from any of those PCTs that these surgeries are marked for closure."

Within London, where ministers insist plans for polyclinics differ from the rest of the country, around 100 practices have already been already earmarked for closure, to make way for the new surgeries.

From:
Polyclinics-threaten-600-GP-practices%2C-say-Tories.html

A million patients battle against polyclinics

More than one million patients have signed a petition protesting against plans to close hundreds of GP practices to make way for polyclinics.

The signatures, collected by the British Medical Association (BMA) in just three weeks as part of its "Support Your Surgery" campaign, was presented to Gordon Brown at Downing Street.

The BMA is concerned that the new clinics will destroy the relationship between patients and their family doctor

The labour government cannot afford to ignore the level of patient concern over polyclinics, which have been dubbed "supersurgeries", doctors' leaders will say.

Ministers insist that the centres, designed to house up to 25 GPs under one roof along with other services such as minor surgery, will provide a better service for patients.

But the BMA claims they will destroy the relationship between patients and their family doctor and lead to more private companies running surgeries.

Analysis by the Tories suggests that 1,700 of the 8,700 GP practices in England could have to shut under the plans.

Around 100 GP practices in just eight PCTs in London, the first part of the country to roll out the policy, have already been earmarked for closure to make way for polyclinics.

Doctors will protest against the plans at the BMA's Local Medical Committees annual conference today, entitled "standing up for General Practice".

Dr Laurence Buckman, chairman of the BMA's GPs Committee, will tell GPs at the meeting that the petition "will deliver a stark message to the Prime Minister" about the true level of patient concern.

Dr Buckman will also say: "My message to Gordon Brown is this: Whatever you think of GPs, take note of what your electorate thinks. Work with us to improve the service, not against us, and ignore at your peril the wishes of the most important people in the NHS – the patients."

He will tell GPs : "If the government won't listen to you, their doctors, then surely it will listen to the 1.2 million men and women who call for a halt to the plans to promote the use of commercial companies in general practice.

"Voters don't want funding to move from GP practices to commercial companies who are accountable primarily to shareholders rather than patients. They want to be treated as patients, not customers."

The petition calls on ministers to "continue to support our existing NHS GP surgeries" and "improve services to patients by further investment in existing GP surgeries".

But Neil Bentley, from the Confederation of British Industry (CBI), accused doctors' leaders of "ostrich-like denial" and said that the plans would extend opening hours and increase the range of services offered to patients.

From:
A-million-patients-battle-against-polyclinics.html

Doctors' anger at labour's cruelty to patients

The medical establishment is in revolt against Labour’s policy of denying National Health Service treatment to patients who pay privately for cancer medicines.

The outcry from eminent consultants and doctors’ leaders came as news emerged of two more patients whose NHS care was removed while they were dying of cancer.

Alan Johnson, the health secretary, faces opposition from the presidents of the Royal Society of Medicine and the Royal College of Surgeons, as well as British Medical Association consultants.

Baroness Ilora Finlay, president of the Royal Society of Medicine, said the issue went to the heart of the purpose of the health service.

“Can we justify spending billions of pounds on the relief of relatively minor conditions and deny patients with life-threatening disease the support of the NHS when they want to bridge the costs themselves?” she said.

Finlay’s intervention, in an article for The Sunday Times, comes after it emerged that a man dying of kidney cancer had to battle for NHS care because his family followed doctors’ advice to pay privately for a drug.

John Burrell, a retired financial adviser from the Isle of Wight, died last month aged 63. His daughter, Kate Tasquier, said: “The consultant told my dad he would be billed for all of his treatment such as blood tests and scans. My dad was so worried.”

Although she said the NHS eventually compromised on the fees, “he ended up being so scared that he was going to be billed for his care that he was scared to go into hospital and he delayed starting the treatment”.

It also emerged that Sandra Baker, a bowel cancer victim, died last year after being denied NHS treatment in her final months. When she paid £9,500 privately for drugs, she was hit with an extra bill of £16,000 for her treatment.

The Sunday Times revealed the case of Linda O’Boyle who died of cancer aged 64 after being denied NHS treatment because she paid for a drug. Bernard Ribeiro, president of the Royal College of Surgeons, and the annual consultants’ conference of the British Medical Association have also attacked the labour government’s block on NHS patients paying for additional drugs.

While Johnson insists cancer patients should not be allowed to pay for superior drugs because this would create a two-tier NHS, opposition parties have edged closer to supporting co-payments.

Norman Lamb, the Liberal Democrat health spokesman who is developing a new party policy on the issue, said: “When a clinician recommends a proposed treatment as having therapeutic value to the patient, it seems cruel and perverse to withdraw all NHS treatment if the patient follows that advice.”

Ribeiro said: “I would strongly oppose the denial of life-saving operations to patients based on decisions they had made about how they supplement their NHS care.”

Cancer specialists at one of the country’s largest hospitals have found a way around the ban. About 16 oncologists at University Hospital Birmingham NHS Foundation Trust write prescriptions for their patients to receive private cancer drugs at home.

Professor Nick James, one of the doctors, said: “There is no question of us turning away these patients. I believe that to do so is punitive and vindictive. We remain responsible for the NHS care of these patients.”

From:
http://www.timesonline.co.uk/tol/news/uk/health/article4087629.ece

Another question for Labour - how come these drugs are free in Scotland and that it's only Englsih patients who face this dilemma?

Polyclinics will not improve care, consultants tell BMA

Six out of 10 consultants say polyclinics will not improve patient care and 83 per cent fear privatisation of the NHS is detrimental to patient care and the service overall.

The survey, carried out by the British Medical Association, says that over half of respondents say they are prevented from innovating to improve patient care and seven in 10 lack adequate resources to support their work. The policy of patients having a choice over where to have treatment was supported by 69 per cent of respondents.

The BMA Central Consultants and Specialists Committee (CCSC) commissioned this survey on consultant opinion to gather information about consultant members’ views on labour government health policies, how changes are affecting consultants ability to care for their patients and to work to their full potential as trained professionals.

Consultant member views were gathered to ensure that members’ views were represented in future discussions on these issues. and to inform the BMA’s evidence to the review body on doctors’ and dentists’ remuneration (DDRB).

Key findings of the survey
* A total of 1,587 complete responses were received with an overall response rate of 31.7 per cent.

* Only 7 per cent of respondents remain on the pre-2003 contract.

* The average number of PAs included in the job plans of respondents on a full time contract was 11.3. 60 per cent of all respondents stated that the number of PAs accurately reflected the level of direct clinical care undertaken. The average number of SPAs included in the job plans of respondents on a full-time contract was 2.5. 55 per cent of all respondents stated that the number of SPAs did not adequately reflect the work involved.

* The average number of hours worked per week for respondents on a full time contract was 50.73 with almost one in five working more than 55 hours a week.

* There was overwhelming support for further change to the CEA scheme to improve its ability to reward excellence and general support for all awards being made available locally.

* 85 per cent of respondents indicated that there was a process in their Trust for consulting with consultants on contractual and human resource (HR) matters. This was for the most part via the Local Negotiating committee or through the job planning and appraisal process.

* There was overwhelming support for the view that consultants should be leaders and innovators in clinical practice. 52 per cent of respondents believed that consultants were actually prevented from innovation in support of patient care.

* Two thirds (66 per cent) reported that the numbers should be expanded in their departments, 31 per cent reported they should remain the same. 78 per cent of respondents reporting affordability as the reason for their response that consultant numbers should remain the same.

* 70 per cent of respondents reported that they did not have adequate resources to support them in their roles as consultants. Of those respondents who reported they did not have adequate resources 63 per cent of responses from respondents reported lack of secretarial support, 48 per cent reporting a lack of IT and a further 48 per cent a lack of managerial support.

* 60 per cent of respondents disagreed or strongly disagreed that polyclinics would improve the quality of patient care and almost two in five disagreed or strongly disagreed that polyclinics would improve patient access to treatment.

* 73 per cent of respondents reported that the direction of government policy to expand use of the private sector was detrimental to patients and the service as a whole. 83 per cent of respondents reported that privatisation of the NHS would be detrimental to patients and the service as a whole.

From:
http://www.bma.org.uk/ap.nsf/Content/Surveyconsultantopinion08

NHS at 60- MRSA superbug infections are patients biggest fear

NHS at 60- MRSA superbugs and fear of picking up a superbug infection is the public's main concern about NHS hospital care, a UK-wide BBC poll shows. Of the 1,040 people quizzed, 40% listed the risk of potentially deadly infections such as MRSA and Clostridium difficile as their top NHS concerns.

In a separate finding, 31% said they would consider avoiding NHS surgery for fear of getting an infection.


Despite the concerns raised by the survey, 82% of respondents said they were proud of the health service, with half claiming it was still the envy of the world.

The most widely-cited concern after infections was the wait people face for treatment.

Despite the NHS in England, Scotland, Wales and Northern Ireland making shorter waits a priority, one in four people still cited this as a concern.

In England, which is the furthest ahead in reducing waits, no-one should be waiting longer than 18 weeks by the end of the year.

One in 10 polled also said that both the lack of staff and mixed-sex accommodation was their biggest concern.

However, it is superbugs which dominate people's thoughts in the poll carried out by ICM Research for the BBC.

Just 33% of respondents said they were confident that the NHS would protect them from picking up an infection in hospital.

In contrast, 94% were confident that the NHS would provide good care in an emergency such as a car crash, and 86% were confident it would deliver a baby safely.

Ministers have made tackling bugs a priority, launching initiatives such as this year's £50m deep clean of wards.

Infection rates are even higher in Scotland, while in Wales and Northern Ireland they are slightly lower.

Dr Hamish Meldrum, chairman of the British Medical Association, said the findings on infection were of "huge concern".

He said: "We understand why people are so concerned about hospital-acquired infections and although infection rates are coming down, no-one can be happy with the levels that still exist.

"We owe it to patients to be able to prove to them that hospitals are a safe place to go to benefit from the help modern medicine can provide."

Professor John Appleby, chief economist of the independent think thank The King's Fund, said media coverage had fuelled fears about hospital infections.

A Department of Health spokeswoman said it had "come a long way in tackling infections, but any avoidable infection is one too many".

"We have introduced a raft of measures that we know will reduce infection and are already having an impact," she said.

From:
http://news.bbc.co.uk/1/hi/health/7475561.stm

NHS at 60- Labour no longer trusted on National Health Service

NHS at 60- On the eve of the NHS's sixtieth aniversary a new poll shows that Labour is no longer the party trusted to bring in the health reforms that are needed to safeguard the NHS for future generations.

Despite the billions Labour has poured into health, the YouGov poll shows that public satisfaction with the NHS is dropping. Barely one in five people believe the Labour party will deliver a better health service over the next ten years, the You Gov poll shows.

It comes on the day Gordon Brown is to publish Lord Darzi's package of reforms to overhaul the way the NHS is run.

The Prime Minister hopes the comprehensive review will transform Labour's fortunes and restore the party's reputation as guardians of the NHS on its 60th anniversary.

The results of the poll show he Tories have a clear lead on health policy with 31 per cent of people saying they would do a better job of running the health service, compared to 23 per cent who think Labour would deliver on the NHS.

The results of the latest poll confirm a shift in the political debate over health care, away from funding and towards improved management and organisation.

After years of above-inflation increases in health spending, most voters now believe the NHS has enough money. But they worry that the service has become bureaucratic and over-burdened with managers.

Sixty-nine per cent of people said reorganising the NHS is more important than spending more on it, up from 38 per cent in 1998. Only 24 per cent now want more spent on health, down from 59 per cent a decade ago.

Seventy-eight per cent of voters believe the NHS has too many managers.

And despite the billions Labour has poured into health, the new poll shows that public satisfaction with the NHS is dropping. In 1998, some 91 per cent of recent patients said they were happy with their treatment. That figure has now fallen to 81 per cent.

Some 44 per cent of people said they think "a great deal" of money is being wasted in the NHS. Another 38 per cent said a "fair amount" is wasted.

"David Cameron's unambiguous commitment to the National Health Service means a great deal to the public. They know that the NHS needs reform and that Labour have failed them on this crucial issue," said Andrew Lansley, the shadow health secretary.

"But they also know that Conservative reforms for healthcare will not threaten the security that comes with a health service available to all, based on need. This poll shows that the public, like staff across the NHS, are now willing and ready to trust the Conservatives with the stewardship of the NHS."

In the foreword to the Darzi report, the Prime Minister hails the document as the blueprint for a "once-in-a-generation" shake-up in the NHS.

The report will usher in the creation of "polyclinics" with several doctors and nurses to replace hundreds of GP surgeries in the biggest cities, despite opposition from patients and the

British Medical Association.

It also says that hospitals should publish death rates for dozens of conditions, allowing patients to make "informed choices" about where to get treatment.

Hospitals should offer more home births for mothers, and old and terminally-ill will get the right to chose to die at home instead of in hospital.

And a new NHS constitution will enshrine rights to confidentiality, control of patient records and a second medical opinion.

Mr Brown writes: "Lord Darzi's report is a tremendous opportunity to build an NHS which provides truly world-class services for all. It requires government to be serious about reform, committed to trusting front-line staff and ready to invest in new services and new ways of delivering services."

But Norman Lamb, the Liberal Democrat health spokesman said he feared the Darzi package would be vague and impractical. He said: "What does all this mean? Will patients be able to enforce their rights?"

And despite Mr Brown's bold claims for the review, there are doubts about whether Lord Darzi has been allowed to go far enough in drawing up his reform plans.

His report is not expect to deal with the controversial issue of "co-payment," where patients can pay extra to top-up NHS care with private provision. That omission has drawn accusations that the review is too limited to prepare the health service for the demands of the next century.

A separate opinion poll for Reform, a think-tank, has suggested that most doctors believe top-up payments should be introduced to the NHS.

The ComRes poll showed that 79 per cent of GPs believe patients should be able to top-up their NHS care with private treatment.

• YouGov polled 2,163 adults across Great Britain between June 23 and 25.

From:
Labour-no-longer-trusted-on-NHS-reforms.html

NHS NPfIT will be at least four years late

It will be at least 2014 - four years later than planned - before a single NHS electronic patient records NPfIT system is in place in England, say auditors.

The head of the National Audit Office, Tim Burr, said the challenge was "far greater than envisaged".

But an NAO report said the project was on budget and that staff thought it would improve patient care.

MP Edward Leigh, who chairs the Commons Public Accounts Committee, said further delays could damage public confidence.

The National Programme for IT in the NHS is one of the most ambitious computer projects ever undertaken - replacing hundreds of different computer systems spread across hospitals and GP practices with new, compatible versions that will allow NHS staff anywhere in England to access a patient's medical records.

However, the technical challenges involved have led to significant delays and some trusts, desperate to replace ageing systems in order to offer the labour government's "Choose and Book" service for patients, have been forced to install "interim" systems which will eventually have to be replaced again.

The NAO is responsible for the monitoring of public spending, and its latest report says the benefits are now starting to emerge.

It said that the fixed-price contracts used meant that their costs remained "broadly unchanged", despite the delays, but that it was likely to be 2014 or 2015 before every NHS trust was running the care records system.

Tim Burr, head of the NAO, said: "The challenge involved in delivering the National Programme for IT has proved to be far greater than envisaged at the start, with serious delays in delivering the new care records systems.

"Progress is being made, however, and financial savings and other benefits are beginning to emerge."

Doubts

Others are less convinced by these timescales.

Tony Collins, who has investigated the project for the magazine Computer Weekly, said it was possible that some trusts might not want to run the systems offered to them.

"Ministers are discovering that an IT-based scheme conceived at the centre cannot be imposed on a devolved NHS - a lesson that should have been learned from failures in the 1990s."

Dr Chaand Nagpaul of the British Medical Association, said: "It is clear from this report that the setting of unrealistic deadlines has been very damaging.

"Slipping deadlines for new IT systems and the premature release of systems that are not fit for purpose has been deeply frustrating for NHS staff leaving many doctors thoroughly disillusioned with the programme. "

The report will be considered by the Commons Public Accounts Committee next month.

Mr Leigh said that confidence in the project had been "damaged" by "unrealistic expectations".

"The current timetables for the care records system to be fully deployed by 2014-15 had better be realistic. The Department of Health cannot afford further knocks to the programme's reputation or our confidence in it."

From:
http://news.bbc.co.uk/1/hi/health/7403286.stm

More consultant radiologists needed to meet rising demand, say BMA doctors' leaders

Around 1,300 extra consultant radiologists are needed in England over the coming years if the NHS is to meet the increasing demand for emergency interventional treatments, diagnostic imaging and screening, the BMA warned.

Recent Department of Health projections on workforce show there is a need for a focused and planned expansion in consultant numbers to meet the increasing demand for radiological services.

Although government figures on diagnostic waiting times published show improvements in waiting, this level of activity cannot be sustained with the current workforce levels.

The demand for ultrasound, CT and MRI scans is increasing year on year, and with complex imaging now being required around the clock, more consultants are needed to ensure the service can be delivered more quickly and at the highest standard.

The Healthcare Commission’s report on its investigation into maternal deaths at Northwick Park Hospital recognised that there was a shortage of suitably trained interventional radiologists and recommended all obstetric units should have urgent access to this crucial emergency treatment at all times.

The Royal College of Radiologists (RCR) supports the need for consultant expansion. Dr Gill Markham, Vice-President of the RCR and Dean of the Faculty for Clinical Radiology, said: ‘Demand for scans and complex imaging is rising year on year and is set to increase even further in light of recent developments with extra patients being referred from the Government’s planned extension of the Breast programme and Colonic screening programme.

"We need a steady and sustained expansion in consultant numbers if we are to deliver this level of service to patients safely and to the high standards that patients deserve.”

The BMA recently launched a campaign to enhance the quality of care for patients by expanding consultant numbers across many specialities.

Dr Jonathan Fielden, chairman of the BMA’s consultants committee said: “Although waiting times for diagnostics seem to be improving; this progress cannot be sustained unless capacity is expanded to meet future rises in demand.

"Ad-hoc commissioning of poorly integrated private providers is not a long term solution. The NHS needs to build its own sustainable infrastructure to deliver for the longer term benefit of patients.

“Focused expansion of consultant numbers will not only help meet the extra demands on the NHS, but as medical leaders and innovators, this will enhance the development of local services and provision of teaching and research.”

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

Nanny state bans children with no MMR vaccinations

Labour's latest nanny state wheeze to cover up their MMR vaccinations fiasco is to ban children from starting school until they receive the MMR jab.

Parents will have to provide proof their offspring have had a full range of vaccinations when they put in applications for primary schools.

The plan, designed to increase the take-up of the measles, mumps and rubella triple jab, has been drawn up by Mary Creagh, the Labour MP in charge of the party’s health manifesto for the next general election.

“Parents need to protect their children and science gives them a way to do that,” said Creagh. “We need to get that message across.”

However, doctors’ leaders warned that the idea was “morally dubious”.

Dr Hamish Meldrum, chairman of the British Medical Association, said: “A Stalinist approach like this would be likely to backfire.”

Andrew Lansley, the shadow health secretary, accused Labour of “playing politics” with children’s lives.

Take-up of the MMR jab fell dramatically after research – now discredited – appeared to show a link between the triple vaccination and autism.

From:
http://www.timesonline.co.uk/tol/life_and_style/health/article3909515.ece

Health Direct finds the latest labour "thinking" plain incredible. The highest proportion of children who do not have the vaccine live in inner London, so labour's plans will compound the disadvantage that these children will endure.

NHS shake up to axe hospital services

Scores of hospital departments such as maternity units and cancer clinics will be closed or merged across the country under plans for a radical shake-up of the NHS.

Labour ministers are preparing for a summer of protest as residents campaign against proposals that could mean local hospitals losing specialist services to large regional centres.

In an attempt to head off the reaction that could mar the 60th anniversary of the NHS in July, Lord Darzi, the health minister, has pledged that patients would be involved in decisions and hospital units would not close before new ones opened.

Lord Darzi, a surgeon, said specialist services would be moved into larger regional centres only where there was evidence to prove that doing this would provide better care.

But critics argue that this will mean patients having to travel much farther for an operation or an appointment.

The plans, which appear to have been held back until after last week's local elections, will be released over the next four weeks by the nine Strategic Health Authorities in England.

They include setting a local target of reducing the four-hour wait in A&E to two hours, setting up dedicated trauma centres and better co-ordination of out of hours services.

However, in many cases, the changes – which result from Lord Darzi's continuing review of the NHS – will lead to services provided by cottage and district hospitals being moved out of the area.

He acknowledged that the plans would bring protest and said that in the past, officials were poor at communicating the reasons behind such changes.

Lord Darzi said that where care did not need to be provided in hospitals it could be moved into health centres, GP clinics and cottage hospitals closer to patient's homes.

He is convinced that when doctors have led previous changes and explained that they were not being carried out for financial reasons but in the interests of better care, the local community eventually agreed to the plans.

In an interview with The Telegraph, Lord Darzi said the plans were not about closing local hospitals or shutting down good services but were aimed at improving standards of NHS care.

"We need to be much more ambitious," he said. "We spend £110 billion a year on the NHS and we have to challenge ourselves in raising the clinical bar."

He said the challenges of an ageing population and increasing numbers of patients with long-term conditions such as asthma, diabetes and cancer meant changes were needed.

But campaigners and opposition MPs expressed concern. Residents and patients in Ipswich are already furious at proposals to move the head and neck cancer service from the local hospital to Norwich.

"Patients want to be treated in their local hospital safely," Katherine Murphy, of the Patients Association, said.

"To be admitted to a hospital 60 miles away from your home is not convenient. It is all very well having specialist centres around the country but it is not want the public want."

Andrew Lansley, the shadow health secretary, said: "We value our local NHS services and don't want to lose them. Labour seem completely out of touch with that feeling.

"The hints Lord Darzi has given today about his plans for the NHS sound extremely ominous.

"We already know about the huge upheaval and loss of local services there's likely to be in London; now we learn that something similar will happen in every single region.

"Lord Darzi is tripping over himself to say there isn't another big, top-down reorganisation of the NHS coming; unfortunately he has only heightened suspicion that that's exactly what this is."

Councillors will be able to raise objections with Alan Johnson, the Health Secretary. He can ask for an independent panel of experts for advice and where this has happened in the past, the verdict has usually been accepted.

Dr Hamish Meldrum, the chairman of the British Medical Association, said: "These principles are all positive – in fact they're impossible to disagree with. The problem is that the public and health-care staff have yet to see much evidence of them being delivered."

From:
http://www.telegraph.co.uk/news/uknews/1939162/NHS-shake-up-to-axe-hospital-services.html

Health Direct asks what became of joined up thinking and a green focus? By closing local health facilities- patients, relatives and friends will have to fork out more on brown's transport stealth taxes to travel further to visit the victims.

Nine NHS trusts admit scandalous security breaches as more personal data is lost

Nine more NHS trusts in England have admitted losing patient records in a fresh case of wholesale data loss by labour government services, Health Direct has learnt.

At least 168,000 patients have been affected by the b