Bliar ally says Tories are best for NHS

One of the architects of Labour’s NHS reforms is to become a key adviser to the Conservatives because the labour Government has “lost the plot” on improving patient care.

Professor David Kerr, a renowned oncologist who led efforts to cut waiting and give hospitals greater independence, said that the Tories now offered the best chance for the NHS, which had been driven into a “whirl of thoughtless tick-box exercises”.

Professor Kerr, a lifelong Labour supporter who campaigned with Tony Blair in the 2001 general election, told The Times that the key principles of giving patients a better choice of health services and a better understanding of how they were performing had been “driven into the sand”.

“To say that we have run out of steam, I would say definitely, definitely yes,” Professor Kerr said. “We have got lost in the blizzard of increasingly irrelevant targets. The position now is disenfranchising, dull and disconnected. That is the clinical reality.”

The doctor, a professor of cancer medicine at the University of Oxford, was a frequent visitor to Downing Street as Labour drew up its reform agenda in Mr Blair’s first and second terms. 

Before 1997 he conducted the first national audit of cancer services — identifying delays that allowed “patients’ cancers go from curable to incurable while they sat and waited”.

Under Labour he worked on ways to improve access as chair of the national Cancer Services Collaborative and became a founding commissioner of the Commission for Health Improvement, the first regulator to assess NHS clinical performance.

He was also one of the main drivers of the foundation trust scheme, offering the best hospitals the chance to become more independent, hold greater responsibility for their budgets and make clinicians more engaged in service improvement. A knife-edge Commons division on foundation status was won by 17 votes after Professor Kerr wrote to all MPs underlining the advantages that it would bring.

In 2005 he was given the task of developing a 20-year plan for the future of the NHS in his native Scotland, known as the Kerr Report.

Professor Kerr said that he felt “for the first time in [his] life” that the Tories offered the health service a better future. He said that the Conservative priority of getting NHS data out to patients in an understandable form, allowing them to choose the highest standard of service best suited to them, was a mission that disappeared with the departure of Mr Blair.

“[The Tories] are more committed to the NHS that we love and understand as free at the point of access and offering universal care. Only that degree of certainty would convince me to go and work for them.”

Professor Kerr would not be drawn on whether he had been a member of the Labour Party, but said that currently he was not a member of any political party.

He said that he hoped to push through the ideas of choice and the empowered patient, encouraging the NHS to make more high-quality information publicly available. “People need to be able to understand how their hospital is improving,” he said.

Another focus will be to allow patients to ask clinicians key questions about care standards without compromising the doctor/patient relationship.

“I firmly believe for the first time in my life that we have a Conservative leadership that is committed to the future of the health service. If I didn’t believe that I wouldn’t be there.”

On informed choice for patients, he said that under the Government “the whole big idea ended up in the foothills of dodgy websites. No one was really engaging with it.”

He identified the loss of momentum “around when the transition happened”, with things “starting to lose the plot” under Patricia Hewitt as Health Secretary, then Alan Johnson, “who is good on many fronts, but was more interested in keeping the NHS out of the headlines”.

Andrew Lansley, the Conservative health spokesman, said of Professor Kerr: “His expertise and knowledge will be crucial in helping us to create a NHS which has patients at its centre. That a key architect of the Blairite health reforms is now working with the Conservatives shows that under David Cameron’s leadership we have truly become the party of the NHS.”

From:

http://www.timesonline.co.uk/tol/news/politics/article7041772.ece

How labour government squanders £300 billions with PFI schemes

On the face of it, PFI schemes does not sound like a good deal- decide what you want, find someone to supply it, then sign a contract that binds you into a legal straitjacket for decades, during which you pay them 37 times what the item is worth.

Such a deal makes even less financial sense in a country still struggling to escape the effects of the worst slump since the Great Depression. Yet this is what the labour Government's promotion of private finance initiatives (PFIs) to pay for public services has foisted on the taxpayer.

The taxpayer is, in effect, locked into making enormous annual payments for 667 school, hospital and other public-sector programmes with a capital value, or price, of around £55bn. The good news is that more than £37bn has been paid. 

But the overall bill for the contracts is more than £262bn, and this will not be fully paid off until 2047.

And that is not all. With a fresh catalogue of further projects valued at £11bn – in capital costs alone – currently under negotiation, Britain's liability for PFI projects since 1997 could exceed £300bn.

The PFI – the brainchild of the former Conservative chancellor Norman Lamont – was seized upon by Tony Blair in 1997, when he swept into power with a New Labour government determined to show that it could be the party of business. The Government committed itself to keeping the proportion of public debt to gross national product (GNP) below 40 per cent. Financing investment through PFI – with costs kept off the balance sheet – was seen as a way of achieving this, and led Alan Milburn, then health minister, to declare that PFI was "the only game in town".

PFI works on the principle of private firms building various forms of infrastructure – whether roads or bridges, schools, hospitals or prisons – then charging the public sector for using them over lengthy contracts that can run for more than 30 years.

But it has left a legacy of debt that will last a generation, according to unions who have slammed what they say is a credit-card approach to buying-in essential services. Calling for an end to the use of PFI to pay for public sector projects, Brian Strutton, the GMB's national secretary for public services, said: "PFI is building up a legacy of high-interest debt that will last for decades. The public is paying over the odds on PFI projects, with debt ratios in most areas at over 500 per cent. This is like paying for schools and hospitals by credit card."

Jean Shaoul, professor of public accountability at Manchester Business School, said: "They've mortgaged the future in the most profligate way... we have a government that acts in the interests of a financial oligarchy. Using the private sector as an intermediary to raise finance to build hospitals and to run them is extremely expensive and far more expensive than if the Government were to do it itself."

A case in point is the Norfolk and Norwich University Hospital, where the PFI consortium made tens of millions on a deal described by the Commons' Public Accounts Committee as "the unacceptable face of capitalism".

Firms have also made millions in profit by putting up the money for IT programmes that have become so expensive the Government now frowns on PFI being used to fund them. To take only one case: payments for the Crown Prosecution Service's Compass IT system come to £670m over the 10 years of the contract, 37 times the £18m capital value.

And the nature of PFI deals means that payments still have to be made even if the project is abandoned. Balmoral High School in Belfast closed six years after it was built, when pupil numbers halved. However, the Northern Ireland Department of Education owes the contractor £370,000 a year for the next 18 years.

Making changes to PFI-funded buildings and projects can cause costs to spiral. A 2008 National Audit Office report found that £180m a year is paid out for contractual amendments. And it highlighted extortionate charges for routine maintenance – such as £302 for an electric socket to be fitted, £47 for a key, and almost £500 to fit a lock.

Peter Dixon, chief executive of University College London Hospital – which pays some £43m in PFI charges a year – says that inflation is a real fear. "If we run into a bout of inflation, because all these payments are index-linked, then we are in trouble, all of us."

He described the arrangement as "expensive and inflexible", but added: "For the past 12 years the only way you were going to get a brand new hospital was by the PFI route... people knew they weren't cost effective but it was the only way they could get funding."

But a Treasury spokesman said: "PFI has a good record of delivering to time and budget, and represents good value for money over the whole life costing by telling us what it will cost to build and manage our assets."

Contracting out: Familiar faces with PFI connections

Alan Milburn MP
He famously described PFIs as the "only game in town" during a stint as health minister, and is now a director of Diaverum Healthcare – a company that is contracted to run the kidney dialysis unit at the PFI-funded Burnley General Hospital.

Quentin Davies MP
The Defence minister is a former director (he resigned in 2008) of Vinci UK and Vinci SA – firms involved in PFI projects with a total capital value of £223m which will cost £933m over the terms of their contracts.

John Reid MP
The former home secretary is (since November 2009) a paid consultant to G4S UK and Ireland. G4S is involved in PFIs, mainly in prisons, with a total capital value of £330m; they will end up costing £3.6bn.

Steven Norris
Once Conservative Transport minister under John Major, he is now the chairman of Jarvis, a major PFI player which has a number of contracts, worth £721m, with government. The total capital value of PFI programmes funded by Jarvis comes to £175m.

Adam Ingram MP
A defence minister for six years under Tony Blair, he now gets paid more than £50,000 a year as a consultant to Electronic Data Systems – an MoD contractor responsible for the PFI-funded Tafmis IT system which cost £171m over its 10-year contract.

Patricia Hewitt MP
During her tenure as health secretary, BT won IT contracts from the NHS. The former minister is now a director of BT Group and was paid £59,475 for 140 hours' work over the past six months – a rate of £424 an hour.

PFI initiatives - the Lords' inquiry

The continuing flaws in the PFI option have been exposed in evidence to a House of Lords inquiry into the system.

A consultant, T Martin Blaiklock, said the Government had used the PFI option "like a credit card". He added: "It allows payments, which would normally be due to be paid today, to be paid at some future date. The key is to know when to use it, for what, and for how much."

The British Medical Association said: "PFI appears to be an unnecessarily costly and short-sighted means of building new hospitals."

But the Confederation of British Industry claimed that PFIs had helped to deliver a broad range of modern projects with "high-quality services and maintenance activities".

It added: "Without this long-term investment, the UK would not have the infrastructure required to support our economy, nor the public services that are needed."

The soaring cost to taxpayers

Queen Mary's Hospital, Roehampton Cost £73.5m to build, but will cost taxpayers in excess of £340m by 2034.

John Radcliffe hospital, Oxford Taxpayers will have to pay back £832m for key developments at a hospital which cost £134m to build.

Queen Elizabeth Hospital, Greenwich Trust is locked into a PFI deal costing £9m a year more than if it had borrowed money from the Government. Last year it admitted its PFI contract is "underfunded" by £8m to £10m a year, and it was also carrying debts of £65m.

Norfolk and Norwich University Hospital The 953-bed hospital will cost not £229m, as announced in 1998, but £16bn, including PFI charges, staff and equipment. Rent costs are £800m until the end of the contract in 2037.

Paddington Health Scheme £900m super-hospital abandoned in 2007; costs rose £300m to £894m and finish date slipped to 2013.

Leicester hospitals Pathway Project Costs up from £711m to £921m; scrapped in 2007.

University College London Hospital PFI project, rose from £120m to £430m or so in the three years prior to signing off on the deal.

From:

http://www.independent.co.uk/news/uk/politics/iiosi-special-investigation-how-government-squanders-billions-1877276.html

NHS paid doctor £375 an hour

NHS spending on agency workers has risen sharply in the past financial year in spite of attempts to control such expenditure, according to figures issued by the Conservatives.

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.

From:

http://www.ft.com/cms/s/0/ed1bd7c2-f4e1-11de-9cba-00144feab49a.html

Jack Straw wants legal heroin as Health Sec's son is charged for cocaine possession

Jack Straw, the Justice Secretary, has called for the NHS to give out heroin on prescription to addicts where other forms of treatment have failed whilst the former health secretary Patricia Hewitt’s 21-year old son Nicholas has been charged with possessing cocaine.

Justice secretary Jack Straw has called for imaginative solutions to tackling to the problems of drug addiction

He called for “imaginative” solutions to hard-drug abuse and said there could be “huge benefits” to issuing the drug to chronic addicts.

At the moment addicts can be prescribed heroin substitutes designed to wean them off the drug, but the idea of prescribing the drug itself is aimed at keeping long-term addicts away from drug dealers and crime.

“For the most problematic heroin users it may be the best means of reducing the harm they do themselves, and of stamping out the crime and disorder they inflict on the community," said Mr Straw.

The Justice Secretary is the first cabinet minister to get involved in the debate following the results of a pilot scheme involving 127 heroin addicts in three cities, published last week.

The trial, which involved users injecting themselves under medical supervision in London, Brighton and Darlington, showed that crimes committed by addicts who had been prescribed heroin dropped by two thirds after six months.

Mr Straw said prescription heroin was “no magic bullet” but claimed it could reduce the £15 billion a year cost of the abuse of hard drugs.

The trials were set up in 2002 by David Blunkett, the then home secretary, but Mr Straw is the first cabinet minister to endorse prescribing the drug.

Harry Shapiro of Drugscope, which represents 800 drug projects, said: "It's important to do everything possible to discourage Britain's 300,000 problem drug users from injecting their drugs, and we should allow injecting heroin users to be provided with foil as part of a harm-reduction programme."

From:
http://www.telegraph.co.uk/Jack-Straw-calls-for-heroin-on-prescription

Meanwhile, Nicholas Hewitt Birtles, a sales rep, was arrested when police raided a car parked near his home in Camden, north London, on Saturday evening, Scotland Yard said.

Officers observed three men sitting inside the vehicle parked in Camden Square and went to investigate at about 7.45pm.

They searched the car and allegedly recovered a small amount of white powder, arresting two of the occupants while the third was allowed to go.

The pair were taken to a nearby police station for questioning.

Mr Hewitt Birtles, whose father is Judge William Birtles, was later charged with possessing cocaine while the other man, who has not been named, was released on bail while tests are carried out on the powder.

The former Cabinet minister’s son was released on Sunday but ordered to appear in court next week. His friend is to answer police bail next month.

Australian-born Miss Hewitt, who served as Trade and Industry Secretary before moving to the Department of Health, left the Government in 2007 and is stepping down as an MP at the next election.

A Scotland Yard spokesman said: “Nicholas Hewitt Birtles, a sales representative of NW1, is bailed to appear before Highbury Corner Magistrates’ Court on Sept 30 charged with possession of a class A drug, namely cocaine, on Saturday Sept 19 at Camden Square.

From:
http://www.telegraph.co.uk/Patricia-Hewitts-son-Nicholas-charged-with-cocaine-possession

Health Direct has long question the "logic" of labour's drugs policy.

On August 02, 2006 we posted: Risks of taking drugs compared- Scientific review of dangers of drugtaking- Drugs, the real deal

Health Direct reproduced the first ranking based upon scientific evidence of harm to both individuals and society. It was devised by government advisers - then ignored by ministers because of its controversial findings. The analysis was carried out by David Nutt, a senior member of the Advisory Council on the Misuse of Drugs, and Colin Blakemore, the chief executive of the Medical Research Council. Copies of the report have been submitted to the Home Office, which has failed to act on the conclusions.

Labour U turn on NICE's cancer drugs postcode lottery killing policy

The rule preventing NHS patients from "topping up" their treatment is cruel and vindictive. Under just axed guidelines, anyone paying for drugs with their own money may be deprived of any further free health care.

This is a crude form of blackmail by the state provider that may have been understandable 60 years ago when the NHS was finding its feet but has no place in a modern healthcare system. It is to the credit of Alan Johnson, the Health Secretary, that he has finally acted to remove this barrier to patient choice.

Allowing a co-payment system to develop in healthcare is, however, more than just a humane decision that will allow seriously ill people to purchase life-saving drugs that may be too expensive for the NHS to prescribe. It is also a fundamental step towards diversifying healthcare in a way that will allow a better-funded and more patient-friendly system.

Health insurance companies will now start marketing policies for top-up payments only, as a supplement - not an alternative - to NHS provision, an attractive option to people who cannot afford full private health insurance.

That will help remove the barrier between state and private provision that has proved so restrictive, while opening up new revenue streams. A hybrid, public/private system could then emerge, without sacrificing the cardinal NHS principle that treatment remains free at the point of delivery to all who need it.

From:
http://www.telegraph.co.uk/opinion/main.jhtml?xml=/opinion/2008/11/05/dl0502.xml

Health Direct points out that there is now a three tier NHS service. The top level is private health insurance for NHS services. The middle tier is part payment for drugs and services. With the base rate being access for patients only if whitehall edicts allow doctors to prescribe certain life saving drugs.

Top-up insurance is still essentially a means test - and works contrary to the concept of universal access on equal terms to the NHS at all points of contact.

There is no reward here for those who already self-provide, nor any consideration of what those seeking to claim contribute to our taxes, or to the costs of the NHS.

This is a bit like thanking the person, who has decided to refrain from beating you over the head with a baseball bat.

The magic formula, top up insurance- is routine in France. The plan does not call for genius; rather, its absence calls for rebuke.

I have just one question about this, Alan Johnson is claiming credit for changing this particular rule, but which minister was it who allowed the rule to be set in the first place- Health Direct suspects the bean counter Patricia Hewitt?

Private companies get access to millions of NHS medical records

The confidential medical records of millions of NHS patients could be handed over to private companies under controversial plans being drawn up by labour ministers.

Patients' postcodes, medical conditions and treatments - and in some circumstances, their names - could be passed on to third parties without their consent.

The labour Government is considering giving firms access to a massive computer database which will contain the records of almost every man, woman and child in England.

The information is a goldmine for private companies, who could use it for medical research or for helping them to sell products to the NHS.

But privacy campaigners say they are "horrified" by the proposals which could see patients' postcodes, medical conditions and treatments - and in some circumstances, their names - passed on to third parties without their consent.

The database, part of a long-delayed scheme to give NHS staff access to computerised medical records, will hold details of almost all visits by patients to hospitals and GPs.

The plans have been dogged by controversy. Last week. ministers gave in to pressure from privacy campaigners and agreed that medics will have to gain the consent of patients before opening their computer records. Yet patients will have almost no control over the same information being passed on to companies and other bodies outside the NHS.

The Department of Health says most records passed onto third parties would be made anonymous, but admits that identifiable data - which could include patient names - could also be handed on if it was deemed to be more useful.

Security experts said the scheme would "hoover up" vast quantities of confidential data which could easily be traced back to individuals, whether or not names and addresses or other personal details were removed.

Ross Anderson, Professor of Security Engineering at Cambridge University, said: "We have had a lot of debate about patients being able to opt out of the national scheme for patient records, but meanwhile the Government have pulled a fast one. There are no limits set on the way this data can be used; this database will hoover up all the personal medical data on every person, and it can be used for whatever the Secretary of State says it can be used for."

Prof Anderson suggested the creation of one large database would also make it easier for different parts of the state to use confidential health data for other purposes, with social workers, courts and police able to access medical files more easily.

Helen Wilkinson, a former NHS manager who founded The Big Opt-Out, a campaign against the national care records scheme, said she was "horrified" by the latest development and planning a major publicity launch to warn people of the threat it posed to their privacy and security.

She said: "We are talking about a hugely valuable commodity which will be worth a fortune to the pharmaceutical industry, and to all the companies which make their profits from the health service."

Joyce Robins, from patient pressure group Patient Concern, said patients would be left "entirely at the mercy" of those operating the scheme.

"We have no idea where this information will end up, and we have no control over it. Even when the data is anonymised, it will be easy to trace back to individuals because the nature of medical data is that it reveals a lot about a person. We have seen an endless succession of data losses and breaches, and there is little to reassure anyone that this information would be secure."

The Government public consultation on secondary uses of NHS data, which began without publicity on Wednesday, has been outsourced to a private company called Tribal, which holds contracts to organise the planning of NHS services.

Its managing director Matthew Swindells was until recently chief information officer of the DoH, and before that adviser to then health secretary Patricia Hewitt.

A spokesman for Connecting for Health, the government agency which oversees the patients records scheme, said that while "in theory" anonymised data could be used to trace an individual, researchers would be more likely to examine records in batches of hundreds of thousands at a time. He described the matter of whether information should stay within the health service, or ever go outside for research - to academic researchers or pharmaceutical companies - as a "valid question" on which the consultation sought public opinion.

The agency's chief operating officer, Professor Michael Thick, said patients would be able to be removed from the so callled "secondary use" database if they made an application under the Data Protection Act. Under the proposed system, third parties would need to request information from the central database, and fulfil requirements set by data custodians and ethics committees.

From:
Private-companies-could-get-access-to-millions-of-NHS-medical-records.html

Health Direct points out that labour government records have shown themselves to be as watertight as a rusty bucket.

Now labour are openly proposing that your health details will be accessible to many.

Medical records are personal and private to the individuals concerned, having been given in trust to their medical adviser.

The assumption that medical records can be widely disseminated represents a breach of this trust and would be totally unethical.

If you also don't want your medical details to be widely available, sign up at the Big Opt Out at http://www.nhsconfidentiality.org/
now!

Labour ministers ignored junior doctor recruitment warnings

Thousands of junior doctors had their careers thrown into chaos last summer because of "inept" decisions at the highest levels, according to a report by MPs.

Warnings over a new recruitment system and possible job shortages were ignored by the Department of Health, says the Commons health committee.

The labour government's failure to restrict the access of overseas doctors to training posts in Britain was also "inexcusable", it says.

The report also singles out Sir Liam Donaldson, the Chief Medical Officer for England, saying that confidence in his abilities among the medical profession has been "seriously damaged" by the debacle.

Doctors' groups said the report was a "damning indictment" of the Government's failure to listen to warnings from the medical profession.

Thousands of junior doctors found themselves in limbo last year when a combination of factors, including a new computerised recruitment process, left their search for jobs in disarray.

Hundreds marched in protest, which prompted an apology from Patricia Hewitt, the former health secretary.

From:
http://www.telegraph.co.uk/news/1936349/Ministers-%27ignored%27--junior-doctor-warnings.html

Pressure to reveal ex-ministers' outside pay

Pressure is mounting on the authorities at Westminster to overhaul the rules that allow MPs and peers to avoid disclosure of earnings from outside interests.

The "revolving doors" between parliament and business have come under increased scrutiny in recent weeks with former ministers such as Patricia Hewitt, former health secretary, taking lucrative outside jobs.

About 30 former Labour ministers - and scores of MPs and peers - have won posts in the private sector in the past two years but only a handful declare their remuneration.

Lord Warner, the former health minister, is now chairman of UK HealthGateway, a health business; Richard Caborn has joined Amec; Ian McCartney is at Fluor Corporation; John Reid, former home secretary, is at Celtic Football Club, and Denis MacShane is at United Utilities.

Almost half of these are still sitting MPs, such as Ms Hewitt, who has taken jobs at BT, Cinven and Alliance Boots.

Paul Flynn, Labour MP and member of the Commons public administration committee, has called for a ban on former ministers taking jobs in industries related to their former roles.

Although the appointments are vetted by parliament's advisory committee on business appointments, the group has only ever prevented one MP and two civil servants from taking up their new roles.

Many individuals do not say how much money they are earning from their extracurricular activities.

MPs have only to say how much they earn from directorships and other jobs if they are "providing services in their capacity as an MP", according to the House authorities.

Peers, who have a separate register of interests, have to disclose only how much they earn from "advice in relation to parliamentary matters".

However, Sir Alistair Graham, former chairman of the Committee on Standards in Public Life, said parliamentarians should disclose all their interests in detail.

"If you're playing an active role in politics, speaking in debates or trying to amend legislation, people should be able to see what your interests are and do you have a private - as opposed to public - interest in legislation," he told the Financial Times.

Among those who do not disclose their earnings is Lord Cunningham, the former Labour "cabinet enforcer", who is a partner at two political and public policy consultancies. He refused to comment.

Lord Truscott, who has just taken a job as a consultant to Gavin Anderson, the public relations group, said there was no reason why he should declare his pay because he advised the company and not its clients.

Many MPs and peers have enjoyed earlier careers in professions such as law, which they want to resume in later life.

But Adam Ingram, former defence minister, said it was hard to disentangle whether or not a politician had won a job because of his or her political contacts and experience.

Mr Ingram has just taken a £48,000-a-year job at a company called Signpoint Secure.

He said he was surprised by the lack of disclosure by other peers and MPs. "Some MPs do it in a way that they don't disclose what they're earning," said Mr Ingram.

There was nothing wrong with MPs having outside interests, he said. But there was a lack of transparency in both the Commons and Lords.

"My view is that all of that has to change," he said.

Norman Lamb, MP for North Norfolk, said peers should not have to disclose income from their business interests where these had no relationship with politics.

But it should be a "matter for public interest" where MPs and peers had work that could draw on their political experience.

"I think we are moving into a new era where transparency has become the order of the day," said Mr Lamb.

"You shouldn't have a situation where people are simply appointed and can use their position to earn money through contacts they have had in government - the whole system is unattractive and unsustainable," he added.

Mr Lamb has complained to the authorities about Lord Cunningham's failure to disclose his clients or remuneration on the register of interests.

Lord Woolf, chairman of the sub-committee on lords' interests, is carrying out a preliminary investigation, which may lead to an inquiry by the committee.

However, one MP voiced the attitude of many of his contemporaries when he told the FT: "I don't see why we should have to tell the whole world how much money people are making from jobs which may have nothing to do with their parliamentary roles."

http://www.ft.com/cms/s/0/54a9a00c-fad6-11dc-aa46-000077b07658.html

Health Direct asks the question of the last shameless MP vulture- would any of these incompetent, lying MPs have been offered these roles in the private sector if they did not have the experience of being elected an MP and then running government departments? If the answer is no- then tax payers have the right to know how much these MPs are supplementing their tax payers income.

GPs win legal fight over pensions cap

Patricia Hewitt acted unlawfully when health secretary by capping the pensions of family doctors after they earned more from a new contract than expected, the High Court has ruled.

GPs retiring between 2004 and 2006 had their pensions capped after earnings from the new contract rocketed and ministers argued they had to cap pensions to protect the taxpayer.

However, Lord Justice Mitting yesterday ruled that ministers had no power to impose the limit, which was an attempt "to renegotiate an arrangement that had already been determined".

Dr Hamish Meldrum, chairman of the British Medical Association's council, said: "We are delighted that the BMA has been vindicated in its decision to challenge the government."

Doctors looked to the government to honour the deal, he said. The BMA said the cap had so far affected about 3,000 retiring GPs who had lost around £3,000 a year in pension. But the health department said the estimated long-term saving from the cap was £600m.

Mr Justice Mitting awarded the BMA its costs but gave Alan Johnson, the current health secretary, leave to appeal.

Lawyers for the health department argued the scale of the increases risked diverting resources from patients and were "indefensible".

Ministers acted after GPs performed far better than expected under a new performance-related contract, with average earnings comfortably clearing £100,000. Ministers were also angered GPs took more of their practice earnings as profit in the early years of the contract.

However, Dr Meldrum said there was "a very important principle at stake, which is that when the government makes agreements it should stick to them".

From:
http://www.ft.com/cms/s/0/45ac7808-f168-11dc-a91a-0000779fd2ac.html

Health Direct points out that labour's attempt to claw back funds from doctors is a direct result of their incompetent renegotiation of GPs contracts in 2006.

Patricia Hewitt cashes in on health post

Patricia Hewitt, the former health secretary who left the government six months ago, has been offered jobs with at least five companies with links to the health sector.

The disclosure has led to renewed calls for more stringent rules to stop politicians from cashing in too quickly on their time in office.

Hewitt, who resigned in June, has been inundated with consultancy jobs since leaving the Department of Health. She is set to be the latest in a series of health ministers and senior officials to move into the private sector.

Lord Warner and Alan Milburn, both former health ministers, have also benefited, moving to healthcare jobs soon after leaving office. Liz Kendall, Hewitt’s former special adviser, is now a healthcare consultant to a number of organisations, including private sector companies.

Hewitt, who was health secretary from May 2005 but stood down when Gordon Brown took over as prime minister, is expected to take up her roles in the new year.

Warner’s jobs, revealed this month, include advisory roles for Xansa, a technology company in Reading, Berkshire, that has a partnership with the Department of Health to provide finance services to National Health Service bodies, and Byotrol, an antimicrobial company that sells products to the NHS.

Warner also has an advisory role with DLA Piper, which advised ministers on the NHS’s £12 billion IT programme. Warner was responsible for this while a health minister.

The move into consultancy will raise fresh questions about whether companies are gaining a strategic advantage by hiring ministers with recent experience of the highest levels of government.

Norman Lamb, the Liberal Democrat health spokesman, said: “There is a question about whether they could exploit their continuing links with the government. We need a far greater cordon sanitaire to prevent any suspicions.”

Hewitt confirmed that she had received a number of offers and was likely to decide which ones to take up after Christmas. She said: “I haven’t taken up any appointments and I will only do so after I have had the advice from the Advisory Committee [on Business Appointments].”

This committee vets private sector roles for former ministers to ensure there is no conflict of interest. It often imposes a cooling-off period before such job offers can be taken up.

From:
http://www.timesonline.co.uk/tol/news/politics/article3056703.ece

Considering Hewitt's inept performance as a labour government minister, Health Direct is surprised to learn that any company would consider touching her with a ten foot pole.

Health Direct wonders if the companies that are offering Hewitt the chance of gravy are either stupid, given her demonstrable lack of any ability, or hope to gain some advantage from employing a labour politician-I wonder what it could be ?

Ms Hewitt does however confirm a diagnosis of complete cynicism and a sickness in the body politic which will take many years to heal.

Foundation trusts increase cash as patient care declines

Foundation trusts, a flagship of the labour government’s National Health Service reforms, are building a growing cash mountain that they appear unable or unwilling to invest in improved services. The sums involved are up by more than £300m from about £1bn at the end of the last financial year to £1.32bn in the first three months of this year.

Much of the money is concentrated in a minority of the 67 foundation trusts, and some of it appears to reflect prepayment for work not yet done.

The surplus exceeds the £1bn being forecast for the rest of the NHS. Foundation trusts account for only about a third of acute and mental health spending.

Some of the cash is simply working capital but a significant part of it could be invested in new or improved services.

Reporting the first quarter results, Monitor, the foundation trust regulator, said their financial strength put foundation trusts “in a good position to invest in reshaping services for the benefit of their communities”.

But they were reluctant to do so yet because it was not clear what primary care trusts – the chief commissioners of care for patients – wanted to buy.

“There is an increasingly urgent need for clear indications from commissioners about their healthcare purchasing intentions,” said Bill Moyes, Monitor’s chairman. Without certainty about long-term requirements, trust boards were reluctant to invest.

The lack of clarity, he said, is “having an impact on the timing of significant investment decisions”.

But while Monitor says the lack of investment is not all the fault of foundation trusts, it also takes them to task for not using some of the money to invest in better environments for patients and ensuring they hit healthcare targets.

Twenty-two of the 67 are behind targets for the reduction of hospital-acquired infections, and some are behind on other government targets. A significant number are failing to make progress, having forecast in their annual plans that they would.

With the judgement of foundation trusts’ performance relying on a degree of self-certification, Mr Moyes warned that Monitor would put independent review teams into hospitals where boards appeared to make overly optimistic progress predictions.

The Foundation Trust Network – the body that represents foundation trusts – said it would be “concerned” if that “marked a move away from its role as a risk-based regulator towards direct performance management”.

From:
http://www.ft.com/cms/s/0/e351a596-68a2-11dc-b475-0000779fd2ac.html

The revelation from Monitor that fudged financial fiddling is still rife in the NHS reminds Health Direct of our posting on Patricia Hewitt's distorted financial observation.

On June 07, 2007 Health Direct posted: NHS figures show 510m Pound annual surplus as the NHS apparently made a small surplus in 2006/07, figures unveiled by Health Secretary Patricia Hewitt showed.

The NHS recorded a surplus of £510 million, the data showed. However, 22% of NHS organisations are still in debt and unable to balance their books. The gross deficit of the NHS stood at £911 million, down from £1.3 billion in 2005/06.

To offset the deficit and create the surplus, regional health bosses have been building up cash reserves.

They took millions of pounds from primary care trust (PCT) budgets and held back £450 million from training and public health budgets.

Dr Jonathan Fielden, chairman of the British Medical Association's Consultants' Committee, said: "While the NHS may be in credit today, the journey to balance the books has wreaked havoc on the NHS and is a return to boom and bust health economics.

Professor Janet Finch, chair of the Universities UK health and social care policy committee, said: "On the face of it, today's announcement is good news. But take a closer look at the Strategic Health Authorities' 'strategic reserves' and they seem to consist of funds from the education and training budgets. If things continue in this way, it will be a disaster for patient care and health service morale. "

Labour voting areas get most PFI NHS cash

Questions have been raised about hospital building projects as it emerged 85p out of every £1 spent has been invested in Labour areas. Many hospital build projects have been funded through PFI. Official figures showed that of the 47 hospitals built since 1997, 33 served areas represented by a Labour MP. That compares to 10 in Tory and two in Liberal Democrat territories.

The Tories and Lib Dems questioned the motives behind the spending, but ministers said "patient need, not party politics" was the determining factor.

Of the remaining two, one was in the Respect party's sole seat of Bethnal Green and Bow, and the final one serves several different constituencies in Avon and Wiltshire.

Overall, the capital value of the projects - almost all undertaken through the public finance initiative whereby a private company builds a hospital and then collects "rent" from the NHS for around 30 years - was around £4.1bn. Of this, nearly £3.5bn was allocated in Labour constituencies.

Labour currently holds 353 of the 646 seats in the Commons, compared to the Tories' 198 and the Liberal Democrats' 63.

Shadow Health Secretary Andrew Lansley, who obtained the data by tabling questions in the House of Commons, questioned the motives - especially as ministers were wanting to shift care away from hospitals and into the community.
He said: "Patients in Conservative and Lib Dem areas will be wondering why it is patients in Labour areas [that] benefit from virtually all the spending Labour is committing to building new hospitals which are, apparently, unnecessary."

And Liberal Democrat health spokesman Norman Lamb said: "The case for new hospitals should be based entirely on medical need and including any political considerations would be quite outrageous. This analysis raises serious questions that the government needs to answer."

From:
http://news.bbc.co.uk/1/hi/health/6547703.stm

Health Direct is appalled at the biased NHS funding allocations that Labour ministers have been directing to their own constituencies and is one of the greatest scandals of Tony "purer than pure" Blair's time in office.

On Nov 22, 2006 Health Direct posted: Hewitt defends NHS cash for Labour voting areas when Patricia Hewitt sparked new controversy over NHS funding last night after insisting that it was "absolutely right" that spending per head on health care was at least 35 per cent higher in many Labour areas than wealthier Tory ones.

The Health Secretary told MPs that people in more prosperous areas had the "good fortune" to be in better health and as a result needed less allocated for their care.

Asked by a Tory member of the health select committee, Mike Penning, if it was fair that people in her Labour constituency of Leicester West received £1,300 per head in NHS spending, compared with £960 in his Hemel Hempstead seat, she replied: "I am satisfied that funding allocations are fair. I believe that reflects the very real differences in health areas, in the prevalence of disease between our two constituencies.

Mr Penning said Miss Hewitt had given "the most complacent, arrogant and patronising evidence I have ever heard." He added: "She gets nearly £400 per head more than I do for the NHS because my constituents aren't as sick. It is the most ridiculous thing I have ever heard."

Hewitt's home births promise is premature, warn Tories

Labour's promise that healthy women who choose to can have their babies at home was undermined yesterday by fears of a shortage of midwives and lack of funds. Patricia Hewitt, the Health Secretary, announced that from 2009 all women would be able to choose where they had their baby - in hospital, in a midwife-led unit or at home. But the Conservatives said there was "no substance" behind the plans and the Royal College of Midwives (RCM) said that the plan would need an extra 3,000 midwives.

Only about two per cent of the 600,000 babies born each year in England are home births but it is estimated that 10 per cent of women could safely have babies at home.

The Royal College of Midwives says only one in five women is currently given the option of a home birth.

Ms Hewitt said it would be up to NHS trusts to decide on staffing levels, although there would be another 1,000 midwives graduating from training by 2009.

She admitted no money was being earmarked for maternity services, which currently receive £1.7 billion a year.

She said the NHS needed to make maternity care more of a priority. While the maternity budget has been rising in recent years, the overall proportion of NHS funds spent on it has fallen.

Ms Hewitt denied that maternity support workers would be used as substitutes for midwives.

Andrew Lansley, the shadow health secretary, said he did not believe that the government would be able to deliver on its promises.

Research by the Tories shows that 43 maternity units are threatened with closure this year. "There is no evidence to support the planned closures and there is no evidence that Patricia Hewitt has substance behind this announcement about home births," Mr Lansley said.

The RCM said the service, which has the equivalent of 19,000 full-time midwives, would need another 1,000 by 2009 and a further 2,000 by 2012.

Dame Karlene Davis, president of the RCM, told the BBC's Breakfast programme: "It is an ambitious plan and the RCM supports it wholeheartedly because we believe that the quality of service the Government is aiming for is exactly what the women of England should have.

"We are obviously concerned that there will need to be enough midwives to make it happen."

From:
http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2007/04/04/nbirth04.xml

Health Direct is disgusted at the brass neck of Patricia Hewitt's latest spin/lies. With no new money and labour cutbacks to existing maternity services her latest "promise" is as much welcome as a fart in a space suit.

On March 27, 2007 Health Direct posted in NHS crisis is forcing cuts to maternity care, charity warns when support for pregnant women is being cut because of the NHS's financial troubles, a healthcare charity has warned.

The National Childbirth Trust (NCT) says it is receiving "increasing reports" that NHS antenatal classes, breastfeeding services and postnatal visits are being cancelled.

NHS antenatal classes have been cut or suspended in at least 10 areas in England and Wales, according to the NCT. These are Romsey in Hampshire; Worcestershire; Newham in London; Watford; Gwent in south Wales; south-west Kent; Nottinghamshire; Gloucestershire; Hemel Hempstead in Hertfordshire; and Wiltshire.

Health Direct points out that while the number of births rose from 563,744 in 2001 to 613,029 last year, the number of midwives dropped. In 2005 there were 24,808 midwives, 36 fewer than the previous year.

Midwife cuts
— Trusts are cutting budgets for midwifery training, in some cases by 75 per cent or completely
— Many midwifery units now depend on charitable donations to fund training
— Two thirds of midwifery managers say that their department is understaffed
— Thirty-eight per cent say that they have suffered budget cuts
— Twenty-seven per cent say that their Primary Care Trusts froze recruitment in 2005-06. A fifth say the freeze has not been lifted
— There were 24,808 midwives in NHS England, in 2005
— Since 2001, the annual number of births has risen by 49,285 to 613,029

On 10 Jan 07 Health Direct posted that Maternity wards are having their cash cut amid boom in birthrate, say midwives when the NHS is responding to a boom in the birthrate by cutting spending on maternity services, the Royal College of Midwives said after a survey of more than 100 heads of midwifery in hospital trusts across Britain.

It found that two thirds of maternity units were understaffed and most were trying to save money by employing fewer qualified midwives and taking on maternity support workers instead.

Hewitt U turn and apology for Doctors' MMC chaos

Health Secretary Patricia Hewitt has apologised to junior doctors over the continuing recruitment crisis. A new online system for selecting doctors for training posts has been heavily criticised for failing to select the best candidates. Ms Hewitt said the scheme had caused "terrible anxiety" for junior doctors which shouldn't have happened. The government has now offered doctors one interview but the British Medical Association said it was "unacceptable".

Speaking on BBC Radio 4's Today programme, Ms Hewitt said she regretted the failures in implementation of the Modernising Medical Careers (MMC) reforms. "The new system of MMC I think everybody supports but the actual implementation in this first year of transition was nowhere near what it should have been."

But she still didn't accept that there were faults with the system. even though she said "The shortlisting process didn't work. We are in the process of sorting it out and we are now guaranteeing every junior doctor an interview for the speciality of their choice."

The head of MMC, Professor Alan Crockard, resigned at the weekend over the chaos caused by the introduction of the Medical Training Application Service.

"We really don't want highly qualified medical staff to be forced to leave the NHS, but if they can't complete their training in this country, it could be their only option." Dr Jo Hilborne
BMA Junior Doctors Committee.

It was designed to speed up the process for placing doctors in specialist jobs, but a catalogue of complaints have emerged. Doctors say the forms are badly worded, do not ask pertinent questions, do not allow them to set out relevant qualifications and experience, and have no facility for attaching a CV.

The result, they say, is that the best candidates are not being selected for the right jobs and has left thousands without any interview at all.

Junior doctors abandoned talks with the government's review group, saying it was "unacceptable" for more than 11,000 doctors who offered two or more interviews to now settle for just one.

Dr Tom Dolphin, deputy chairman of the British Medical Association's Junior Doctors Committee, said: "It's long overdue, but at last the government is acknowledging the huge anxiety that this shambles of a system has created.

"However, an apology isn't enough. We need a way out of this mess for the 32,000 junior doctors who currently don't know if they have posts to go to in August."

'Fewer jobs available'

A BMA analysis has suggested that 18,518 specialist training posts are available under the new system - not 22,000-23,000 indicated by the government.

It is warning that large numbers of doctors will have no training post in August.

Dr Jo Hilborne, chairman of the BMA Junior Doctors Committee, said: "Not only has the government failed to design a fair recruitment process, they've also misled everyone on the number of jobs available.

"Even if the application system improves, thousands of doctors are going to find themselves without a training post in August.

"We really don't want highly qualified medical staff to be forced to leave the NHS, but if they can't complete their training in this country, it could be their only option."

From:
http://news.bbc.co.uk/1/hi/health/6521095.stm

Health Direct first warned over a year ago (6 Mar 06) that the MMC's computerised application was in meltdon in Junior Doctors' new IT MMC MTAS recruitment system is a disaster.

As it has therefore taken the labour govt a year to wake up to the IT disaster that it created, how can we be confident that it will be sorted quickly?

About as likely as John "not fit for purpose" Reid's recent spin about sending text messages to illegal immigrants asking them to kindly leave the country. How can anyone have any confidence when the labour govt doesn't know how many people there are, what their names and addresses are let alone their correct phone numbers. Pathetic.

The depth of feeling at labour's incompetence was highlighted by Health Direct on March 19, 2007 in Junior doctors recruitment MMC- this is a fight we cannot afford to lose when some 12,000 people took part in Saturday's march through central London.

That represents more than one in three junior doctors in Britain. Consider that another one in three or four was working or asleep between nightshifts, and that most doctors have not been on a march before, and you will understand the scale of the anger.

The disastrous overhaul of the way in which junior doctors are selected and trained to become consultants is the most serious threat to the patient care and the health service that we have witnessed, and the ramifications are frightening in scope.

Earlier on March 08, 2007 Health Direct posted : Labour climb down over junior doctor fiasco MMC MTAS IT system

The Labour govt backed down yesterday and agreed to an immediate review of a flawed selection system that has left thousands of able young doctors without the prospect of a job and many threatening to leave the NHS. The independent review will start today and may recommend changes to the system before the current interview round has been completed.

Patricia Hewitt, the Health Secretary, has come under increasing pressure from within the medical profession to review the new, online system, the selection methods and the questions candidates had to answer. In some hospitals half of junior doctors did not even get interviews for posts at the next level of their training.

Hewitt U turn as hospital trusts to be free of RBA rule

An accounting rule that has plunged more than two dozen hospital trusts into an irrecoverable financial position is to be ditched, Patricia Hewitt, the health secretary, announced yesterday. Now "absolutely confident" that the National Health Service would record a small surplus at the end of this financial year, Ms Hewitt said it could now use part of the £450m contingency reserve that strategic health authorities had built up to find the £179m needed to end a rule that the health department had long accepted was "unsustainable".

Under resource accounting, a trust that overspends not only has to pay that money back the next year, but has to do so after the same amount is knocked off its budget.

The "double whammy" rule had affected 28 NHS trusts, "making it impossible for them, in some cases, to get out of debt", Ms Hewitt said.

The accounting rule will still apply to primary care trusts as they are chiefly purchasers, not trading bodies like hospitals.

Some of the 28 trusts will now record a small surplus. Others, however, including Hinchingbrooke, the Queen Elizabeth in Woolwich, Whipps Cross and Mid-Yorkshire, will still be left with deficits not caused by the accounting rule that range from £12m to £21m. These will still have to be paid off over time.

Ms Hewitt told the Financial Times there remained "a small number" of hospitals - thought to be between 15 and 20 - with financial positions so serious that they were unlikely on their own to recover.

With the first takeover of an NHS hospital by a foundation trust expected to be formally approved this week, further foundation trust takeovers "may well be the solution in some cases", she said, "but it won't be the solution in every case."

One surprise is that detailed work has shown the "double whammy" effect on hospitals - which has been inconsistently applied across the NHS - is smaller than original estimates that it would cost £500m to £600m to remove.

Ms Hewitt said the ending of the rule was the final part of a big set of financial reforms that would make the NHS finances "much more transparent" and "much fairer" in future.

They would end a trend that had seen healthier but overspending parts of the country being subsidised by other parts, chiefly in the north and Midlands, that had bigger health problems but which had, nonetheless, tended to break even or make surpluses, she said.

From:
http://www.ft.com/cms/s/26d60290-dcca-11db-a21d-000b5df10621.html

The inequity of Resource Accounting and Budgeting (RAB) was highlighted by Health Direct on Dec 14, 2006 in Unsustainable NHS resource account and budgeting (RAB) rules to stay- Hewitt insists when the health department postponed a decision to scrap a set of accounting rules- that have plunged some NHS trusts into potentially irrecoverable financial deficit.

The NHS Confederation, which represents health authorities and trusts, said yesterday that it was disappointed at the decision which came despite the health department accepting that the application of the rules to individual NHS trusts "will become increasingly unsustainable".

Under resource accounting and budgeting, not only does an overspend have to be paid back but the same amount is knocked off the budget for the succeeding year. As a result a £10m overspend on a £100m budget has to be paid back from a budget that has been reduced to £90m.

The refusal of Hewitt to halt the Resource Account and Budgetting farce nails once and for all the lie that the NHS cutbacks are part of a process by Labour ministers to improve the NHS's services.

These accounting cutbacks are the purely the result of Brown and Milburn's incompetent stitch up in 2002 when they tried to agree a new funding process for the NHS.

Health Direct praises NHS workers' blogs as thousands of NHS staff protest over job cuts

In respect to the national day of action on Saturday that was called in support of the NHS and to protest against cuts in both patient care and staff jobs, Health Direct praises four blogs written by NHS staff. Random Acts Of Reality by Tom Reynolds an E.M.T working for the London Ambulance Service; NHS Blog Doctor by Dr John Crippen, Life in the NHS by Julie and Nee Naw by Mark Myers.

Thousands of health workers have been holding marches and rallies to protest about cuts to NHS jobs and services, and below-inflation pay increases.

Demonstrations took place in a number of towns and cities, including London, Manchester, Preston, Bristol, Birmingham, Sheffield and Belfast. TUC general secretary Brendan Barber - who spoke in Sheffield - said there was "real concern" about NHS policies. The events were co-ordinated by NHS Together, an alliance of unions and NHS staff organisations.

Random Acts Of Reality, a Blog based in London, England, written by an E.M.T working for the London Ambulance Service. Also, number one search result for "Womble porn". All names have be changed to protect the guilty. This Blog was previously known as "Why I Hate Humanity" but the antipsychotic medication seems to have kicked in.

Pay 'Rise'
by Tom Reynolds on Thu 01 Mar 2007 06:19 PM GMT

Expletive Deleted.

Isn't it nice to be valued by the government? Pay rises below the rate of inflation which are also staggered which effectively means that my standard of living is set to go down.

Crap conditions, increasing demands, moronic running of the NHS and increased expectations with no increase of resources. Lies from the government who took money away from the ambulance service that made it's (worthless) targets.

A screwing over of our new members of staff giving them barely liveable wages for years. An expectation to work harder, an expectation to increase our scope of practice and all this leading to increased danger to staff.

http://randomreality.blogware.com/blog/_archives/2007/3/1/2773493.html

Dr John Crippen's diary The trials and tribulations, the pleasures and pitfalls of family medicine in the modern British National Health Service.

Dr Crippen is angry. He has worked for over 20 years in the NHS. He watches and weeps as the Health Service, slowly but inexorably, is destroyed.

He takes a sad, sometimes humorous, sometimes cynical, look at the health care from the inside

http://nhsblogdoc.blogspot.com/

The more I listen to Patricia Hewitt, and her health care "truths", the more I feel trapped in an Orwellian vision of the future.

A horrifying report from yesterday's Independent on Sunday.

Record numbers of women are being harmed or dying as a direct result of childbirth in what doctors are labelling as “a crisis” in maternity care.

* 391 women have died in childbirth in the last three years, a 21% increase on the previous comparable period.
* The UK now has one of the highest maternal mortality rates in Europe, with 13 deaths per 100,000.
* 17676 women have suffered physical harm on labour wards in the last three years – harm such as perforated bowels, necessitation temporary colostomies.
* Maternity medical negligence claims are costing the NHS £1 billion a year

It is all due to lack of resources and, as Dr Crippen never tires of saying, dumbing down.
* Midwives are doing work for which they are not trained; work that should be done by doctors.
* Health care assistants are doing work for which they are not trained; work that should be done my midwives.

How is the government dealing with this?

The Independent quotes the Department of Health as saying:

“Giving birth is safer than it has ever been.”

Patricia Hewitt said last year that the NHS had had its “best year ever”. This year, she has promised to “balance the books”; to get the NHS finances out of deficit.

"I'm not planning on failure"

In typical fashion, Ms Hewitt last year declared that she would "take personal responsibility" if she failed to balance the NHS books by this April, the end of the financial year.

Think about that last statement. She says she will "take personal responsibility". She is the Secretary of State for Health. She is responsible for the NHS.

And precisely how is she going to balance the books?

by closing maternity units
by sacking young hospital doctors who are training in obstetrics
by sacking midwives

How many more deaths do there have to be before Paricia Hewitt is sacked?

Life in the NHS Julie has been a nurse for more than 25 years (yes really), and for the last 5 have managed a training and education department of a Primary Care Trust in the United Kingdom.

Married, have a teenage son and am also studying for a post graduate degree. Not surprisingly I am sometimes unsure of my own sanity!

I was amused to hear that the government is now suggesting round the clock surgery to clear waiting times. The very idea of getting your routine hernia repair, or hip replacement at midnight sounds bizarre beyond belief.

We have PCTs who are bankrupt telling NHS Trusts not to operate on their patients before April and suddenly it is a good idea to operate in the dead of night. How much would it cost your average cash strapped hospital to run services in this way, and how many doctors would be left to cover the day time hours?

Puts a new perspective on ‘day’ cases which would be come ‘night’ ones and if the hospital was in London would save money for all by avoiding congestion charges! Maybe the idea has mileage after-all?
February 19th, 2007
http://lifeinthenhs.wordpress.com/tag/news-and-current-affairs-general/

Nee Naw - Blog by Mark Myers a Dispatcher in the London Ambulance Service's Control Room

About This Blog
If you were to walk into London Ambulance’s control room and peer down into the call taking area (otherwise known as “the pit”), you might see a young green-clad man ferociously scribbling notes on the back of a rejected annual leave slip between calls.

That man is me, and those notes form the basis of this blog. Since I started work in Central Ambulance Control (or Nee Naw Control, as it shall henceforth be known), I have kept a diary my most memorable calls, from delivering babies in pub toilets to soothing hungover teenagers, via the inevitable embarrassing sexual accident.

I have now decided that the time has come to release that diary on to the Internet for public consumption.

Weeding Out The Snifflers
Posted in Ambulances by Mark Myers on the February 13th, 2007

When it gets busy, the dispatch desks spend a lot of time calling back our lower priority calls “apologising” for delays and hoping that the callers will get the message that they shouldn’t be calling us and should be calling a GP/taxi/etc instead.

We are not allowed to refuse people an ambulance but we are allowed to warn them of long delays and generally coax them into deciding to cancel and deal with the problem more appropriately. We are on rather shaky ground doing this, but since the Telephone Advice people stopped using TAS and started using a new system called PSIAM we have no option.

Gone are the days of the No Send Policy — using PSIAM, Telephone Advice are forced to make us send out ambulances for any person who insists on one. As you can tell, I am not a fan. I fear for us dispatchers, because one day, in an effort to weed out an inappropriate call, we are going end up coaxing someone who is seriously ill but mistriaged as low priority to make their own way to hospital, and the papers will get hold of it, and all hell will break lose.

It shouldn’t fall on us to do this; Telephone Advice should be given their old system back, which worked perfectly well in getting rid of the time wasters and identifying the seriously ill people who had erroneously been triaged as low priority.

Anyway, despite these worries, I felt reasonably confident in calling back a thirty-year old man whose symptoms were given as “runny nose, cough, slight fever, headache, for two days”.

“Hello sir,” I began. “This is the London Ambulance Service here. I’m ringing to apologise for the delay. All our vehicles are busy dealing with other emergencies” (I emphasised the word “emergencies”.) “How are you feeling?”

“I have a cold!” grumbled the man, as if that much had not been obvious.

“I see,” I said. “And has anything changed since you called? Have you done anything for your… cold?”

“No!” said the man. “Nothing has changed, and I have had it for TWO DAYS! I went to the hospital yesterday, and they did NOTHING! They told me to take paracetamol and sent me home. They were not able to cure me!”

“Well, sir,” I said. “That’s the thing about the common cold — there is no cure. If you’re sure that’s what it is, then you just have to wait for it to go away.”

The man tsked and muttered something about the state of the NHS, and then cancelled the ambulance, which was good, because we needed five vehicles for an 80mph RTA on a 30mph road, and wouldn’t have had one for him for hours.

I think a lot of our inappropriate callers share the underlying beliefs of this caller, which is that if you are ill or injured and feeling lousy, you shouldn’t have to put up with it, and that someone from the medical profession will always be able to come along and wave a magic wand, which will make you feel better.

It just doesn’t occur to people to go to bed and take some time out and wait for whatever is wrong with them to go away. Everything has to be fixed instantly, and if it can’t be, it is always someone’s fault.

More trusts expect deficits as NHS spending cuts bite

Patricia Hewitt's job as secretary of state for health looked safer yesterday as the National Health Service forecast a tiny overall surplus for the current financial year despite more trusts projecting a bigger gross deficit than last year.

The health secretary has said she will take personal responsibility for the NHS achieving financial balance this year. Yesterday the health department published figures suggesting that by the end of next month there will be a £13m surplus in England on a £75bn turnover.

35 per cent of organisations - 2 percentage points up on last year - are forecasting a gross deficit that almost exactly matches last year's £1.3bn.

Those deficits are off-set by surpluses elsewhere and a £450m contingency reserve. But strategic health authorities are also holding back more than £1.1bn top-sliced from the budgets of primary care trusts.

A minority of NHS organisations remain in deep financial trouble. Around 30, or 8 per cent, are forecasting deficits of more than 5 per cent of turnover, with some projecting 10 per cent. In one or two cases, the deficit will be 30 per cent or more.

But the underlying performance of the whole system, including foundation trusts, shows it is running at a small in-year surplus after allowing for a £450m reserve created for this year, and once the £700m of previous overspends dealt with this year, are knocked off.

David Nicholson, the NHS chief executive, said the figures showed the health service would be "on a sound financial footing" for next year.

Some £700m will go back into the budget, on top of an increase of about £7bn in cash spending, with some of the top-sliced money being returned to primary care trusts.

The improvement, however, has come at a price. Around a quarter of primary care trusts are setting minimum waiting times for patients or otherwise slowing treatment, at least until the start of the new financial year.

Hundreds of millions of pounds have been taken from training and other budgets. Some organisations are pushing orders for supplies and planned developments into April and beyond - the start of the new financial year.

Mr Nicholson acknowledged that patients had been affected. But he said the service was still treating more people, and training cuts would be restored next year.

However, Andrew Lansley, the Conservative health spokesman, said "the surplus they have generated is a sham". More organisations were saddled with worse deficits than last year, he said, adding that "Patricia Hewitt's skin is being saved only by savage cuts to centrally held budgets".

The NHS Confederation argued that half the overspend was in just 6 per cent of organisations. It urged the health department to end the "double whammy" caused by a set of accounting rules it said were being applied inappropriately to some hospitals, causing them to enter an inescapable spiral of debt.

From:
http://www.ft.com/cms/s/3f56e594-c151-11db-bf18-000b5df10621.html

The delusions of the Alice in Wonderland were reported by Health Direct blog on Feb09, 07 when in Bed closures are a healthy sign for the NHS, says Patricia Hewitt

Patricia Hewitt, the Health Secretary, was criticised for claiming bed closures were a sign of "success" as new figures showed NHS trusts will end the year more than £1 billion in the red.

The scale of the health service's financial crisis emerged as Miss Hewitt delivered a presentation to the Cabinet on NHS "reconfiguration" — plans which will lead to the closure of dozens of maternity units, casualty departments and community hospitals.

Andrew Lansley, the shadow health secretary, said Miss Hewitt's remarks would be greeted with incredulity at a time when many trusts were struggling to cope with huge deficits.

"The Health Secretary is living on a fantasy planet, far removed from the reality of the front line cuts that are having a daily adverse impact on NHS staff and patients," he said.

"Despite this year's savage job losses, bed cuts and service closures, the NHS organisations providing front-line care are no less in the red than they were last year."

The Patients Association said it did not see bed closures as a sign of success.
As Health Direct wrote on 3 Jan 07- in NHS hospitals told to delay operations to ease health service's debt underfunding.

Health Direct warned that the New Year has only just begun but it is clear that the next three months are not a good time to become ill as the NHS can not cope with Labour's underfunding of the health services as patients in some parts of the National Health Service are for the first time facing minimum waits to be seen and treated as managers attempt to balance their books. Suffolk, Hertfordshire, North Yorkshire and Kingston are all imposing various forms of minimum wait, with some primary care trust chiefs saying their organisations may follow suit as the NHS battles to recover from last year's £536m plus overspend.