Patients' medical records go online without consent

Patients’ confidential medical records are being placed on the controversial NHS database (NPfIT) without their knowledge, doctors’ leaders have warned.

At present 1.29 million people have had their details placed on the system. A further 8.9 million records are due to be added by June.

Those who do not wish to have their details on the £11 billion computer system are supposed to be able to opt out by informing health authorities.

But doctors have accused the Government of rushing the project through, meaning that patients have had their details uploaded to the database before they have had a chance to object.

The scheme, one of the largest of its kind in the world, will eventually hold the private records of more than 50 million patients.

But it has been dogged by accusations that the private information held on it will not be safe from hackers.

The British Medical Association claims that records have been placed on the system without patients’ knowledge or consent.

It follows allegations that the Government wanted to complete the project before the Conservatives had a chance to cancel it.

In a letter to ministers published today, the BMA urges the Government to suspend the scheme.

Hamish Meldrum, its chairman, writes: "The breakneck speed with which this programme is being implemented is of huge concern.

"Patients’ right to opt out is crucial, and it is extremely alarming that records are apparently being created without them being aware of it.

"If the process continues to be rushed, not only will the rights of patients be damaged, but the limited confidence of the public and the medical profession

in NHS IT will be further eroded."

At present 1.29 million people have had their details placed on the system. A further 8.9 million records are due to be added by June. By the end of next

year, the NHS hopes to have more than 50 million uploaded.

The "summary" records contain basic medical information including illnesses, vaccination history, and could include medication patients have been given. Ages

and addresses are also included.

Patients are supposed to be notified by letter at least 12 weeks before their details go live on the system and given the chance to opt out.

The BMA says that letters have gone to the wrong addresses and that many patients have been unsure what they mean.

Doctors point out that there has been no national advertising programme to explain the scheme, as has been the case with other government initiatives.

The BMA also criticises the fact that the information packs do not include the form which allows patients to opt out. It can only be obtained via the internet or by calling a helpline.

Katherine Murphy, of the Patients Association, said: "The Health Service should not put in place bureaucratic obstacles to patient choice because they are worried about what patients might choose to do."

Norman Lamb, the Liberal Democrat health spokesman, said: "The Government needs to end its obsession with massive central databases. The NHS IT scheme has been a disastrous waste of money and the national programme should be abandoned."

From:

http://www.telegraph.co.uk/Patients-medical-records-go-online-without-consent

Health Direct was warning of labour's duplicity, for example on Dec 16, 2009's post- Your medical confidentiality under threat again

Despite labour's promises to the contrary- their track record on snooping databases is appalling.

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

Health Direct strongly recommends that you use the opt-out letter which was developed by with TheBigOptOut at http://www.nhsconfidentiality.org/optoutletter

and send it of NOW!

Government to clamp down on health tourists

A new clampdown on health tourism by foreigners who visit Britain for NHS treatment was announced by ministers.

Compulsory health insurance for visitors, refusal of treatment to failed asylum seekers who do not co-operate with the authorities, and a ban on entry for foreigners who have outstanding debts for previous NHS treatment are among measures proposed.

The Department of Health said the measures could save between £6m and £20m over five years. Emergency treatment and treatment for infectious diseases would remain free for all. 

The measures were condemned by human rights organisations but received a qualified welcome from the British Medical Association, which has previously refused to countenance the denial of treatment to patients in need.

A spokesman said: "The BMA appreciates that the NHS does not have infinite resources and that there is a need to restrict services to patients who are eligible to receive them."

"However, we will seek assurances from the Department of Health that, where there is genuine clinical need, doctors will have the discretion to provide treatment, irrespective of an individual's immigration status."

From:

http://www.independent.co.uk/government-to-clamp-down-on-health-tourists

Labour delays free hospital car parking again.

Andy Burnham has outlined more proposals to phase out hospital parking charges for in-patients and some out-patients which he says have caused "great resentment".

Mr Burnham origonally announced plans to phase out charges for in patients in September.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

UK health groups look abroad to fight MRSA superbugs

UK companies developing products that fight MRSA hospital superbugs are complaining that there are few opportunities in their domestic markets, and focusing their sales efforts overseas.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Government departments waste £4m on website redesigns

Labour government departments have spent £4 million of public money revamping their existing websites over the past two and a half years.

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

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

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

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

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

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

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

What departments said they spent on redesigns since June 2007:

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

From:

http://www.telegraph.co.uk/Government-departments-spend-4m-on-website-redesigns

Nanny state libel laws gag doctor over drug risks

General Electric, one of the world’s biggest corporations, is using the London libel courts to gag a senior radiologist after he raised the alarm over the potentially fatal risks of one of its drugs.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Labour's nanny state failing poor children as child obesity trends show class divide is growing

A widening class gap is likely to be seen in the coming years in childhood obesity, new research suggests.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Number of NHS staff at record high

Employment in the National Health Service jumped by another 23,000 jobs to a record high in the third quarter of this year, in spite of the squeeze to come on spending under the next government.

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

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

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

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

Furthermore, some of this recruitment will have been taking place before people had fully woken up to the scale of the problem to come. We think the decline in the number of jobs advertised, however, is significant.”

The increase, however, leaves the NHS across the UK employing 1,601,000 people, according to the Office for National Statistics: 400,000 more than when Labour took office. The growth follows a study in England by McKinsey, which said the NHS might need to shed 10 per cent of its workforce to keep the books in balance.

The bigger the workforce when the money starts to run out in 2011, the greater the efficiency gains that will be needed if it is not to shrink in the face of a real-terms freeze in spending.

The NHS in England has 5.5 per cent revenue growth for this year and next. However, David Nicholson, NHS chief executive, has ruled that at least 2 per cent of next year’s money must be spent on capital and other projects to transform the way care is delivered in subsequent years.

The rise in staff numbers was the driver for an overall rise of 23,000 in public sector employment in the third quarter of this year to 6.093m. Local government shed 3,000 jobs and public corporations employed 5,000 fewer people.

Civil service employment rose 4,000, driven chiefly by a rise of 7,000 in the numbers employed by Jobcentre Plus to deal with rising unemployment.

From:

http://www.ft.com/cms/s/0/87df4c06-ea9e-11de-a9f5-00144feab49a.html?nclick_check=1

NHS hospitals face four year spending squeeze after labour's cuts

NHS hospitals are to face a four year spending squeeze in an attempt to drive up their productivity.

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

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

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

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

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

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

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

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

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

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

From:

http://www.ft.com/cms/s/0/947c7940-e592-11de-81b4-00144feab49a.html

New drugs available on NHS before NICE appraisal

Patients with rare diseases are to get innovative new drugs on the NHS before they have been through NICE under a new pilot scheme.

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

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

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

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

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

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

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

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

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

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

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

From:

http://www.telegraph.co.uk/New-drugs-available-on-NHS-before-Nice-appraisal.html

Rich list reveals 80 NHS chiefs paid more than Gordon Brown

At least 350 NHS executives in hospitals and primary care trusts were paid more than £150,000 last year, according to new research.

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

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

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

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

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

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

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

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

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

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

From:

http://www.timesonline.co.uk/tol/news/uk/article6943540.ece

Turmoil over NHS records scheme as labour cuts NPfIT to save cash

The world’s biggest civilian IT project was thrown into turmoil yesterday after Alistair Darling, the labour chancellor, implied that it was going to be scrapped.

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

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

A senior health department official, meanwhile, said bluntly span that “the chancellor mis-spoke” in saying the project to create an electronic medical record would be scrapped.

Details of which elements would go were not clear on Sunday night. But the government would face compensation claims of many hundreds of millions of pounds if it cancelled the programme. Fujitsu, an IT provider, is already in mediation with the health department over its £700m compensation claim after it was fired last year.

Ahead of Wednesday’s pre-Budget report, Gordon Brown will on Monday announce that the government has found another £3bn of “efficiency savings” – in practice, many of them cuts – since the Budget.

In a change of rhetoric, Mr Brown is expected to argue these savings are an “element of our efforts to reduce the [£175bn] deficit”, not just a means of protecting frontline services.

Some 123 quangos will go – including the Foreign Office advisory committee on wine purchasing – with the courts inspectorate merged into an existing inspectorate and several health bodies merged with NICE, the National Institute for Curbing Expenditure.

Full details of quango mergers and abolitions will not be spelt out until next year’s Budget, but they are expected to save an estimated £500m.

Central government’s use of consultants will be halved and the marketing budget cut by 25 per cent, saving £650m. Better use of text messaging and online services should save £665m – for example by reducing missed hospital appointments – according to government estimates.

Many of the proposals, which the prime minister will present as “streamlining government”, mirror those from the Tories, who have promised to slash the use of consultants to cut council tax. They also propose reducing by 24,000 the 80,000 civil servants employed in policymaking, inspection and regulation, and grant assessment over the next Parliament.

The FDA, the top civil servants union, condemned the planned cut in civil service numbers as “crude electioneering” and “irresponsible” just months ahead of a general election.

Mr Darling’s apparent scrapping of the NHS electronic record programme excited both the Conservatives and the Liberal Democrats, the latter calling for it to be “abandoned in its entirety” and Andrew Lansley, the Tory health spokesman, describing it as “another government IT procurement disaster”.

From:

http://www.ft.com/cms/s/0/71d29630-e2a5-11de-b028-00144feab49a.html?nclick_check=1

12 NHS hospitals at centre of safety scandal

The true scandal of NHS hospitals failing to comply with basic safety standards is revealed. 

Research that ranks every general hospital in England against a range of safety measures has named 12 NHS hospital trusts judged to be "significantly underperforming".

This is despite the fact that last month the Care Quality Commission, the health service regulator, judged overall care at eight of the trusts to be good or excellent. Today's study by Dr Foster, an NHS partner organisation that collates and analyses healthcare data, also highlights 27 trusts with unusually high death rates. Almost 5,000 more patients in their care died in the past year than was expected.

Revelations of such widespread safety failings will send shockwaves through the NHS, already reeling from scandals at two trusts last week. Poor nursing care, filthy wards and hundreds of unnecessary deaths were exposed at Basildon and Thurrock University NHS Hospitals Foundation Trust, and the chair of the NHS trust in Colchester was fired.

Now the new data proves that key safety failings are occurring in 11 more hospital trusts across England. They include Scarborough and North East Yorkshire Healthcare Trust, South London Healthcare Trust, Weston Area Health Trust, Hereford Hospitals Trust, Lewisham Hospital Trust and University Hospitals Coventry and Warwickshire Trust. Eighteen were found to have death rates the same or higher than at Colchester. Ministers want to know why seven in particular have had persistently high death rates over five years.

The Department of Health yesterday ordered the CQC to investigate if any other trusts needed urgent attention. The CQC said it was "monitoring closely a number of other trusts", but had no evidence there was another case in England where it would take action of the kind taken at Basildon.

John Black, president of the Royal College of Surgeons, last night told the Observer that patient safety had been neglected by hospitals too busy meeting NHS-imposed financial targets: "Too many hospitals are too concerned with meeting financial targets at the expense of clinical standards, and we are seeing patients suffering as a consequence."

Today's research exposes systemic failures in large parts of the NHS during the last financial year and finds:
¦ 39% of trusts failing to investigate unexpected deaths or cases of serious harm on their wards.
¦ At least 209 incidents in which "foreign objects", such as swabs and drill-bits, were left inside patients after surgery.
¦ At least 82 cases in which medical staff operated on the wrong part of the patient's body.

It finds that 5,024 people died after being admitted for "low-risk" conditions such as asthma or appendicitis, of whom 848 were under 65. A proportion of those deaths will be linked to safety errors.

The Conservatives reacted by promising a complete overhaul of the regulation system, which rated Basildon "good" only weeks ago. Andrew Lansley, the shadow health secretary, said: "Labour's failed health inspection regime is more interested in targets than patients." 

He also questioned the timing of the Basildon announcement. Officials knew of the hospital's failings weeks ago but decided to publicise them last Thursday, just days before the Dr Foster research was due to be published in the Observer.

The study paints a picture of large variations in the hospital standardised mortality ratio, a measure used by Dr Foster. The measure, which was used last week by Monitor, the regulator for NHS foundation trusts, looks at the likelihood of individual patients dying, given their underlying condition, age and economic background, then compares that to the actual number of deaths.

Cynthia Bower, the CQC's chief executive, said improvements had been made, but added: "The NHS cannot stand still on safety. It must be able to look the public in the eye and say safety is top priority for the leadership of every NHS trust in the country – no ifs and no buts."

Roger Taylor, from Dr Foster, responded: "We have used the most credible available data to assess patient safety. CQC ratings are not designed to just assess patient safety and instead use broader indicators, including measures of effectiveness and patient experience. The hospital guide is focused on patient safety, and mortality ratios are used alongside other indicators."

From:

http://www.guardian.co.uk/society/2009/nov/29/nhs-hospitals-safety-report

Nanny state wants NHS to provide free marriage guidance

Couples are to be offered marriage guidance counselling for free on the NHS, in a move which has drawn strong condemnation from patients and doctors' groups.

Couples with relationship problems will be offered free sessions for up to six months, as part of a £270 million programme to increase the provision of "talking therapies" for the public, Andy Burnham, the health secretary, announced.

Doctors and patients' groups said they were "horrified" by the use of NHS resources for relationship advice when patients with cancer and dementia were being denied treatment they desperately needed.

Currently, most people seeking help from services like Relate pay between £45 and £60 per session, meaning the free counselling packages will be worth around £1,000 per couple.

The NHS is expected to have to pay existing marriage guidance services, and newly-trained counsellors to provide the therapy.

Doctors and patients groups last night attacked the recommendation, contained in guidance by the National Institute for Health and Clinical Excellence (NICE). NICE has repeatedly come under fire for decisions to reject life-extending drugs for cancer and treatment to reduce symptoms of dementia.

On Thursday, NICE was accused by charities of "condemning patients" to an early death by rejecting the use of Nexavar, a drug which can extend the lives of liver cancer, arguing that its £9 million annual cost – £3,000 a month per patient – could not be justified.

Nick James, professor of clinical oncology at the Cancer Research UK Institute for Cancer Studies said: "I am horrified, in particular because of the way these decisions are taken without public debate.

"I think most people would say treatment for those who are sick with cancer should be top of our list, and I would really question whether these kinds of efforts to preserve marriages are a matter for the state."

NICE has previously restricted the use of drugs to limit the effects of Alzheimer's, costing £2 a day, while provoking further controversy in May when it ruled in favour of alternative therapies like acupuncture for back pain, despite admitting there was little evidence they worked.

Michael Summers, Vice-President of the Patients Association, urged NICE and the Government to "get their priorities right". If we had the luxury of untold sums of money, maybe we would think about paying for couples counselling," he said.

"As things stand, people are still waiting for urgent treatment, being denied drugs for cancer, and dementia, and it seems inappropriate at the very least to start using public money in this way".

From:

http://www.telegraph.co.uk/health/healthnews/NHS-will-provide-free-marriage-guidance

The evidence in favour of Prof Nutt- Financial Times Editorial

The UK government published a policy document committing itself to independent scientific advice in all departments, with an introduction by the prime minister proclaiming the “international respect” earned by the UK for “its thorough and professional approach to the use of evidence”. Only two days later Alan Johnson, home secretary, put that respect in jeopardy with an act of political clumsiness.

He sacked Professor David Nutt, a renowned neuropharmacologist, as chairman of the government’s Advisory Council on the Misuse of Drugs for insisting publicly that last year’s upgrade of cannabis to a Class B drug was not justified by the evidence. 

Two members of the council quit immediately in protest, more are threatening to follow – and the great and good of British science have lined up to attack the home secretary.

If Mr Johnson had thought through the consequences of his action, he would surely have consulted Lord Drayson, the science minister, and John Beddington, government chief scientist. They would have warned him of the outcry and dismay that Prof Nutt’s dismissal would cause.

At stake is not just the future of the ACMD, an important body that has helped to formulate drugs policy for more than 30 years, but as many as 80 other scientific councils and committees across government. These advise on everything from food and nutrition to climate change, and they depend on the unpaid part-time service of hundreds of scientists (mainly working in universities because industry researchers are often ignored for having alleged conflicts of interest). 

The volunteers may turn away from the system if they cannot express contrary views in public or if they see advice being rejected without good reason or even courtesy. Across the Atlantic, that sort of treatment gave George W. Bush’s administration a bad reputation with US scientists.

Indeed the row has implications beyond what most people would think of as science. Ultimately it is about the relationship between evidence and policy. 

Democratic governments always say they want to make “evidence-based policy”. The danger is that, when this does not suit them, they search for “policy-based evidence” – in other words picking out what supports their planned course of action and rejecting what does not. Saddam Hussein’s “weapons of mass destruction” are a prime example.

Of course scientific advice is not sacrosanct. Governments have the right to over-ride the evidence for broader policy reasons – but only if they do so openly and without gagging their advisers.

Mr Johnson is unlikely to pay a high political price for the Nutt affair, because the Conservative opposition, to its shame, supports the professor’s sacking. Chris Grayling, shadow home secretary, wants to outdo Mr Johnson in his hard line on illegal drugs, whatever the evidence. Only the Liberal Democrats are prepared to take a broader (and wiser) view of the need to encourage experts to give governments independent advice.

From:

http://www.ft.com/cms/s/0/379cbe88-c7e7-11de-8ba8-00144feab49a.html

Labour's drug policy up in smoke as scientists resign from drugs Council

Five scientists have now resigned from the labour Government's drugs advisory body Advisory Council on the Misuse of Drugs (ACMD) in the wake of the sacking of Professor David Nutt, its chairman.

An ACMD insider said that the three members to quit were Dr Campbell, a former head of worldwide discovery at the drugs company Pfizer and a former President of the Royal Society of Chemistry; Dr Marsden, a research psychologist at the Institute of Psychiatry; and Mr Ragan, a pharmaceutical and biotechnology industry consultant. None of the three was available for comment.

The departures of Dr Campbell and Mr Ragan would be particularly damaging as this would leave the council without representation from the pharmaceutical industry, which is required by law. Professor Walker’s resignation had already left the council without a pharmacist, another required discipline.





The Home Office has confirmed the ACMD, which is down to 25 members, must have at least 20 members to function, and that six key positions must be filled for the advisory group to function.

Professor Nutt said “I’m not surprised. The way I have been treated was reprehensible, and I’m pleased to have the support of these other council members.”

The trio quit the Advisory Council on the Misuse of Drugs following a crunch meeting with Alan Johnson, the Home Secretary, who earlier this month told Prof Nutt to step down after criticising Government policy.

The meeting had been called because members of the advisory body wanted reassurances from the Home Secretary that they could continue in "good conscience" and that their advice would be respected.

The row erupted after Prof Nutt said the dangers of alcohol and tobacco were more serious than those posed by Ecstasy and LSD and criticised the decision to reclassify cannabis as class B, against ACMD advice.

Prior to the news that three more had gone, Mr Johnson said he had told the body that their views will be given "due weight" in future.

He said he stood by the decision to remove his chief drugs adviser but wanted to improve relations but was "very sorry" to lose Marion Walker and Dr Les King, who quit earlier this month.

Mr Johnson said: "I understand why the Advisory Council on the Misuse of Drugs were concerned about this.

"Their major concern – and the reason why two very good people who I'm very sorry to lose – was because they felt Prof Nutt was being dismissed for his views. I reassured them that was not the case."

He added: "There is a duty I think to accept that politicians make the final decision.

Mr Johnson said a joint code between Government and scientists, proposed by the Royal Society, was being considered by Prime Minister Gordon Brown and the Government's chief scientific adviser.

Chris Grayling, the shadow home secretary, said: "Whilst we backed the original decision, by now I would have expected the Home Secretary to be able to sit down with other members of the Council and rebuild confidence and stability in what they are doing. Quite clearly he has failed to do that.”

In a joint statement released by the Home Office, the meeting was described as "very constructive" but made no mention of any impending resignations.

Evan Harris, the Liberal Democrat science spokesman, said: “The latest resignations represent a deepening in the crisis of confidence of scientists in the Government — in particular, in the Home Secretary. That they come after Alan Johnson met the ACMD demonstrates that he just doesn’t get it when it comes to the importance of respecting the academic freedom and integrity of independent, unpaid, science advisers.

Ministers are entitled to their own opinions, but not to their own facts. The cost of the failure of the Home Secretary to understand the lessons of the BSE Inquiry will be poor policy — unless the Prime Minister acts decisively to bring the Home Office and rest of Government into line with established good practice.

“By clumsily and unfairly sacking David Nutt, Alan Johnson has been rewarded with five resignations in protest. That takes a certain kind of ineptitude.”

Health Direct has complied this post from:

http://www.telegraph.co.uk/health/healthnews/6470090/Three-more-drug-advisers-quit-over-David-Nutt-sacking.html

http://www.timesonline.co.uk/tol/news/politics/article6911558.ece

Surge in patients going private on NHS

More patients are choosing private hospitals for their NHS treatment, latest figures from the Department of Health show, as labour's much vaunted "choice" agenda finally takes off.

Almost 100,000 individual patients have now chosen the private sector for diagnostics and waiting list operations, paid for by the NHS, since the option was first offered.

The great bulk have done so during the past year.

The rise in NHS patients has thrown something of a lifeline to private hospitals, which have seen the number of patients willing to pay for treatment out of their own pocket - as opposed to via insurance - fall in the recession. There are also indications that the private health insurance market is stagnant or falling for the same reason.

Since April last year, NHS patients have been able to choose any private hospital willing to take them at NHS prices, and almost all private hospitals are registered to participate in the scheme.

Over 18 months, and after a very slow start, the numbers doing so have quadrupled from 2,100 a month in April 2008 to 8,400 this August. The business is now worth £200m a year to the private sector, and rising, according to Bob Ricketts, director of system management at the Department of Health.

These numbers are on top of NHS patients being treated in independent sector treatment centres, and those treated where primary care trusts or NHS hospitals buy operations from the private sector in order to hit NHS waiting time promises.

All NHS business is now understood to account for more than 20 per cent of the income of some private hospital groups, and more than a third of the income for Ramsay Health Care business, which runs a chain of independent sector treatment centres.

William Laing, chief executive of the analysts Laing and Buisson at whose conference Mr Ricketts disclosed the new figures, said: "This is great news for the private hospital groups because they can turn the tap on and off at will for NHS patients. If and when self-pay revives, they can run down their NHS work."

Despite the rise in patients choosing the private sector, it still accounts for only a fraction of all NHS waiting list surgery- less than the potential 15 per cent that ministers once indicated was possible. 

Asking whether the big squeeze to come on NHS spending is likely to mean fewer opportunities for the private sector or more, Mr Ricketts said: "Probably more".

Dramatic changes in the way care is delivered will be needed to secure efficiencies and quality improvements as the NHS seeks savings of £20bn, he said - and an innovative private sector, prepared to invest, could play a big part. He played down the likely impact of statements from Andy Burnham, the health secretary, that NHS organisations are now the service's "preferred provider".

From:

http://www.ft.com/cms/s/0/4728bd8a-c1ce-11de-b86b-00144feab49a.html?nclick_check=1

Sacked – for telling the truth about drugs

Labour fires top adviser Prof Nutt for challenging its hardline policy on cannabis and ecstasy.

The labour Government's drugs tsar was sacked for stating his view that cannabis, ecstasy and LSD were less harmful than the legal drugs tobacco and alcohol.

The Home Secretary Alan Johnson asked Professor David Nutt to resign as chairman of the Advisory Council on the Misuse of Drugs (ACMD), saying he had "lost confidence" in his ability to give impartial advice.

But Professor Nutt, who is head of psychopharmacology at the University of Bristol, retaliated, accusing the Government of "misleading" the pubic in its messages about drugs and of "Luddite" tendencies.

He was backed by other senior scientists and politicians.

Colin Blakemore, professor of neuroscience at Oxford University and former chief executive of the Medical Research Council, said: "The Government cannot expect the experts who serve on its independent committees not to voice their concern if the advice they give is rejected even before it is published. "I worry that the dismissal of Professor Nutt will discourage academic and clinical experts from offering their knowledge and time to help the Government in the future."

Richard Garside, director of the Centre for Crime and Justice Studies at King's College London, where Professor Nutt made his comments, said: "I'm dismayed that the Home Secretary appears to believe that political calculation trumps honest and informed scientific opinion. The message is that, when it comes to the Home Office's relationship with the research community, honest researchers should be seen but not heard." He added it was "a bad day for science and for the cause of evidence-informed policy making".

Professor Nutt had become a thorn in the side of ministers with his criticisms of drugs policy. He clashed with former home secretary Jacqui Smith when he suggested ecstasy, which causes 30 deaths a year, was less dangerous than horse-riding, which causes 100 deaths a year. He also argued that, to prevent one episode of schizophrenia linked to cannabis use, it would be necessary to "stop 5,000 men aged 20 to 25 from ever using" the drug.

Most drugs experts believe his analysis is right. But ministers did not want to hear the truth or at least to be reminded of it repeatedly. 

The Home Secretary asked him to consider his position after a recent lecture in which attacked what he called the "artificial" separation of alcohol and tobacco from other, illegal, drugs. Last night Professor Nutt said he stood by his comments. "My view is policy should be based on evidence. It's a bit odd to make policy that goes in the face of evidence. The danger is they are misleading us. The scientific evidence is there: it's in all the reports we published. Our judgements about the classification of drugs like cannabis and ecstasy have been based on a great deal of very detailed scientific appraisal.

"Gordon Brown makes completely irrational statements about cannabis being 'lethal', which it is not. I'm not prepared to mislead the public about the harmfulness of drugs like cannabis and ecstasy. I think most scientists will see this as an example of the Luddite attitude of governments towards science."

He repeated his view that cannabis was "not that harmful" and that parents should be more worried about alcohol.

"The greatest concern to parents should be that their children do not get completely off their heads with alcohol because it can kill them ... and it leads them to do things which are very dangerous, such as to kill themselves or others in cars, get into fights, get raped, and engage in other activities which they regret subsequently. My view is that, if you want to reduce the harm to society from drugs, alcohol is the drug to target at present."

In a recent broadside, Professor Nutt accused Jacqui Smith, who oversaw the reclassification of cannabis from Class C to Class B, of "distorting and devaluing" scientific research. He said her decision to reclassify cannabis as a "precautionary step" sent mixed messages and undermined public faith in government science.

"I think we have to accept young people like to experiment – with drugs and other potentially harmful activities – and what we should be doing in all of this is to protect them from harm. We therefore have to provide more accurate and credible information. If you think that scaring kids will stop them using, you are probably wrong."

The Home Office said Mr Johnson had written to Professor Nutt expressing "surprise and disappointment" over his remarks. Mr Johnson said in the letter that Professor Nutt had gone beyond providing evidence to "lobbying" for changes to policy. He said: "As Home Secretary it is for me to make decisions, having received advice from the [Council] ... It is important that the Government's messages on drugs are clear and as an adviser you do nothing to undermine the public understanding of them ... I am afraid the manner in which you have acted runs contrary to your responsibilities."

The shadow Home Secretary Chris Grayling said: "This was an inevitable decision after his latest ill-judged contribution to the debate, but it is a sign of lack of focus at the Home Office that it didn't act sooner, given that he has done this before."

But Phil Willis, chairman of the Science and Technology Select Committee, said: "I am writing immediately to the Home Secretary to ask for clarification as to why Sir David Nutt has been relieved of duties as chair of the Advisory Council on Misuse of Drugs at a time when independent scientific advice to Government is essential. It is disturbing if an independent scientist should be removed for reporting sound scientific advice."

Claudia Rubin from Release – a national centre of expertise on drugs and drugs law – said the expert should not have been penalised. "It's a real shame and a real indictment of the Government's refusal to take any proper advice on this subject," she said.

From:

http://www.independent.co.uk/life-style/health-and-families/health-news/sacked-ndash-for-telling-the-truth-about-drugs-1812255.html

Health Direct notes that it is hard not to suspect that Professor Nutt's real crime in the eyes of the labour Government was not his interference in politics but the fact that his words embarrassed ministers.

But why now? Health Direct posted on August 02, 2006 Prof Nutt's orginal research Risks of taking drugs compared- Scientific review of dangers of drugtaking- Drugs, the real deal

Health Direct reproduces 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.

Since then Prof Nutt was promoted by labour to be chairman of the govt's Advisory Council for the Misuse of Drugs. So his research and opinions were in the public domain- and presumably approved of when he was promoted. Ergo, why the fuss now? He's not saying anything new. Just common sense.

Patients to be able to choose GP in new labour spin

Patients will be allowed to register with the GP of their choice within the next year, Andy Burnham , the health secretary, announced.

The scrapping of existing GP catchment areas would allow commuters to register with a family doctor near work, or choose another practice locally, outside the catchment area of their primary care trust.

"I want to open up real choice in primary care," Mr Burnham said in a speech to the King's Fund health think-tank. Patients should be able to choose a practice "based on their needs, not by lines on a map" or by postcode.

Wider choice of GP is already Conservative policy and, according to the British Medical Association, this will be the fourth attempt by Labour to widen the choice of a family doctor, with previous efforts foundering over the cost and complexity of what appears a simple change.

Dr Laurence Buckman, chairman of the British Medical Association's GP committee, said: "Most GPs would be comfortable with flexible boundaries."

But "major logistical barriers would need to be overcome for a patient to be able to register with practices a long way from home", he warned.

The issue of home visits would need to be sorted out, Dr Buckman said. But a bigger problem was that patients came with an amount of money attached to them, which funded hospital and community as well as GP services. Without some compensation system, big movements of young, fit patients, whose fees help subsidise sicker and older patients, could hit funding formulas for rural and suburban services.

"Practices in rural and suburban areas could lose significant numbers of young, healthy patients, destabilising their funding and threatening their viability," Dr Buckman said.

"Meanwhile, city centre practices would be inundated with requests for appointments at lunchtimes and evenings, which would effectively limit patient choice." Dr Buckman said the problems "are not insurmountable". But they needed "a lot of careful thought" and could prove costly to solve.

Mr Burnham appears determined to do that. Dual registration - allowing patients to register both with a practice near work and one at home - has been raised in the past, but ruled out because of the cost.

From:

http://www.ft.com/cms/s/0/09770f8e-a3ea-11de-9fed-00144feabdc0.html

Health Direct wonders quite where the funding will come from for the new paperpushers that will be needed to balance the doctors' surgery budgets- as well as transferring patients' data as the much promised NPfIT white elephant is still years away from completion.

Labour to cut £20bn off NHS budget

The National Health Service will have to find savings of £15bn ($24bn) to £20bn, Andy Burnham, the labour health secretary, has acknowledged.

Hospitals are to get their first indication in the autumn of just how far and fast they will have to cut costs to help achieve that. His acknowledgement of  the scale of the challenge comes as Gordon Brown and Alistair Darling, prime minister and chancellor, have begun a series of meetings with cabinet ministers to discuss priorities and potential candidates for cuts in the run-up to the pre-Budget report in the autumn.

Labour Government insiders played down suggestions that the autumn statement would be a mini spending review, setting out departmental spending limits beyond March 2011.

But after the prime minister’s use of the “c” word this week, promising to “cut unnecessary programmes and cut lower priority budgets”, the chancellor is likely to offer some totemic sacrifices in the pre-Budget report, while possibly spelling out areas likely to be protected from the worst of the squeeze.

It is already clear that the capital intensive areas of transport and housing are set to take a hammering given previously announced plans to halve capital spending from this year’s level.

“They will almost certainly be amongst the hardest hit,” said Robert Chote, director of the Institute for Fiscal Studies.

Health is likely to be relatively protected, not least because the Conservatives are promising some real terms growth. That, however, will still leave the NHS having to make massive savings in the face of rising demand from medical advances and an ageing population, which together with pay and price inflation tend to outstrip economic growth.

Mr Burnham indicated this week that he would like to set out an “overall spending settlement” for the NHS in the autumn, while acknowledging that is a matter for the chancellor.

But whether that happens or not, he told the King’s Fund health think-tank, he will take the unprecedented step of spelling out the prices the NHS is likely to pay hospitals for treatment over the next four years.

That “will set out the scale of the efficiency and productivity challenge year on year, building up over time, with the most demanding savings coming later,” he said. In turn, he said, that “will begin the process of showing how we realise [the] challenge of finding £15bn to £20bn of savings” up until 2014.

Nigel Edwards, head of policy for the NHS Confederation, which itself has calculated that the NHS needs to make up to £15bn of savings by 2015, said: “This is the first ministerial acknowledgement that I have seen of the scale of the challenge.

“The good news is that it has been publicly acknowledged, and we welcome that realism. The bad news is that it is at least as bad as we thought”. 

"The price schedule, or tariff, covers about 70 per cent of hospital activity, which itself accounts for only some 40 per cent of the NHS budget. So spelling that out will give an indication but not a firm projection of likely level of NHS spending.

From:

http://www.ft.com/cms/s/0/b56a59c6-a486-11de-92d4-00144feabdc0.html?nclick_check=1

The new CRB check nanny state paranoia won’t stop another Soham

"I helped to catch Ian Huntley and I know these new stupid rules would not have prevented his crimes." Health Direct reproduces the article below by Chris Stevenson who is a retired detective chief superintendent. 

In 2002 I was a senior detective with Cambridgeshire police. That August two ten year old girls disappeared, and I took over the investigation. Two days later I set up the surveillance operation that led to the arrest of Ian Huntley and Maxine Carr a few hours later.

Huntley has not been a free man since. He was convicted of the murders of Holly Wells and Jessica Chapman in December 2003.

Last weekend my actions came back to haunt me. My wife and I went to Benson, Oxfordshire, to celebrate the birthday of my nine-year-old grandson. We went off to see him play as goalkeeper for his village under-10s football team. Mum and dad, sisters, uncles and both grandparents were there to cheer him on.

One of my hobbies is photography, so I took my camera to take a few “action shots” of my grandson. Ten minutes later I was approached by the manager, who said: “Can I ask you not to take photographs, it’s against the regulations. You have to get permission in writing from every parent of every child.”

I felt humbled. I am now a suspected paedophile — along, I fear, with millions of other parents and grandparents. 

I looked at the pictures I had taken. They were of my grandson making saves as his team came under pressure. I am sure he would have liked to look back on them in the future. Who knows, he may be England’s goalkeeper at a future World Cup, although it’s a remote chance. I deleted the photographs.

The furore that has gripped the nation since the Soham murders has made us all paranoid. Is this in children’s interests? The latest “regulations” will require us to be checked by the Criminal Records Bureau if we give lifts to children going to Scouts or similar activities.

Commentators constantly refer to Huntley and the events in Soham as the reason for this. I am sure Sir Michael Bichard, who chaired the inquiry into the murders, did not intend such a wave of recrimination over one case. Yes, changes were necessary: Huntley lived a charmed life in Humberside, where he was investigated for a number of crimes. He was charged with rape, but after he spent a week in custody the case was dropped for lack of evidence.

As a result of poor intelligence, Huntley was appointed a school caretaker in Soham. Did that give him access to children? Yes, hundreds. Did he abuse them? No. In fact he reported to the headteacher that several teenage girls had made inappropriate comments. 

What Huntley did to Holly and Jessica was as bad as it gets, but did he come into contact with them through being a caretaker? Not exactly — he was caretaker of Soham Village College, a school for the over-11s. The two girls attended St Andrew’s Junior School. Different building, different caretaker. Huntley had contact with them because Carr was employed at St Andrew’s as a classroom assistant. 

She worked in a class with Holly and Jessica, who both liked her. Holly’s mother sent Carr a box of chocolates on the last day of term to say thank you for helping her daughter.

The girls were sorry when Carr was not given a permanent job. This was what led them to Huntley.

Out for a ramble around Soham on the Sunday evening, they stopped outside Huntley and Carr’s house to ask after Carr. Huntley told the media that they were sorry she hadn’t got the job.

Tragically, she was away, visiting her family in Grimsby. It was the first time they had been apart overnight since their relationship started. Huntley was in a bad mood as Carr had told him she was going to her second party in successive nights. He was alone. Somehow he conned the girls into the house and they were never seen alive again.

Did he achieve this because he was a caretaker? He could have been in any occupation, lorry driver, architect, anything, and lived with a woman that the two girls knew and trusted. And were right to, as I am convinced that Carr would never have done anything to hurt them.

How do we prevent such chance encounters happening? We can’t. No amount of legislation, record keeping or checking could prevent this type of crime completely. Thankfully it is extremely rare. Children are far more likely to be killed by a family member or on the roads.

Only recently a young girl was murdered by her mother’s partner. There is a suggestion that she had been sexually abused. He then hanged himself. The girl’s mother described him as loving, caring and the last person she would expect to do anything like that. We await the inquest, when it will be asked if the killings could have been prevented. I doubt that the answer will be yes.

We are subjecting our whole community to paranoia. On Friday a BBC journalist announced on breakfast television that “a million children are being abused”.

Where do these figures come from? How do we know? Are we feeding the paranoia that stops a grandfather taking a picture of his nine-year-old grandson playing football? Surely this cannot continue. Someone needs to put things back on an even keel.

Chris Stevenson is a retired detective chief superintendent

From:
http://www.timesonline.co.uk/tol/comment/columnists/guest_contributors/article6834362.ece

Swine flu- nanny state criticises naughty professionals who refuse vaccine putting patients at risk

Doctors and nurses are potentially putting patients at risk if they refuse the swine flu vaccine, labour's nanny state has warned.

Nanny state officials said that NHS staff had a duty to take the jab, to ensure they did not pass on the virus to those who were already sick. Even though the vaccine has not met their own NICE drug guidelines.

The warning follows a spate of surveys which suggest that many healthcare workers will refuse the vaccine, despite being on the labour Government's “priority list”.

Up to half of GPs and one in three nurses say that they do not plan to take the vaccine, some because of concerns over safety.

Vivienne Parry, a member of the Joint Committee on Vaccination and Immunisation, (JCVI) who advise ministers on vaccines, said that health professionals should protect “vulnerable patients” from the virus.

She said: “This (protection) aspect does not seem to feature at all in medical staff responses about flu vaccination, which is extremely concerning.

“Indeed the word ‘patient’ hardly seems to figure at all in responses in this and other surveys of healthcare workers, even though 75 per cent of deaths from swine flu are in those with serious underlying medical conditions who are in regular contact with healthcare workers.”

Prof David Salisbury, the nanny states's Department of Health director of immunisation, told GP magazine, which carried out the poll, that frontline health workers had a “duty” to have the vaccine.

“They have a duty to their patients not to infect their patients and they have a duty to their families,” he said.

More than two thirds of GPs who told Pulse magazine that they would turn down the jab believe that it has not undergone enough tests.

Doctors have been warned to look out for possible signs of Guillain Barre Syndrome, a rare neurological condition, which can cause paralysis and even death.

A vaccine used against flu in America in 1976 caused a number of cases of the condition.

However, the World Health Organisation (WHO) insists that the production of vaccines has become much safer since then.

Human trials are currently underway and will be scrutinised by the regulatory authorities before the vaccines will be licensed for use, probably in October.

Earlier this month a poll of almost 1,500 Nursing Times readers revealed that one in three said that they would not have the swine flu vaccine.

Uptake of the seasonal flu vaccine among NHS staff has been traditionally low, and just 16 per cent of all those employed by the health service took the vaccine last year.

Another study published online by the British Medical Journal shows that half of 8,500 healthcare workers in Hong Kong say that they would refuse a swine flu vaccine, because of safety concerns and worries that it would not work very well.

Researchers said that the figures were surprisingly low given the impact the SARS (Severe Acute Respiratory Syndrome) virus had on the area.

However, some experts insisted that the polls did not prove that NHS staff were “irresponsible” or had serious concerns about the safety of the vaccine.

Prof Robert Dingwall, Director of the Institute for Science and Society at the University of Nottingham, said that it was important not to blow the apparent reluctance of healthcare workers to have the vaccine “out of proportion”.

He said: “(These polls) identify a communication challenge for those managing the pandemic but they are not evidence of a crisis of confidence in the vaccine or of professional irresponsibility by health workers."

From:
http://www.telegraph.co.uk/Swine-flu-Doctors-who-refuse-vaccine-putting-patients-at-risk

NHS health debate is more heat than light

There are moments when politics and healthcare collide and all that is generated is heat. With absolutely no light.

As opponents turn their fire on to President Obama’s health plan, a gross mischaracterisation of Britain’s tax funded National Health Service has become the weapon of choice to attack it.

In response British politicians from Gordon Brown, the prime minister, downward have resorted to all of the 140 characters available on Twitter to defend it – implying that all is beautiful in the British NHS, and the US system with its 47m uninsured, its monumental costs, and its ability to bankrupt individuals is the approach that is “evil” – to use Sarah Palin’s description of the UK’s NHS.

This is a debate being driven by blind prejudice on both sides. For a start, what Mr Obama is proposing is not a British NHS. There is no proposal that a government backed insurer would run hospitals, as is still largely the case in the UK.

Second, half of the mighty 17 per cent of gross doemstic product that the US spends on health care – roughly double the level in the UK – is already funded by tax dollars through Medicare, Medicaid and the Veterans Health Administration, which incidentally does run medical facilities and provides some of the best health care in the US.

Third some of the charges levelled against the NHS are plumb wrong. That Teddy Kennedy would not get treatment for his brain tumour in the UK. That the NHS indulges in forced euthanasia. That people over the age of 59 do not get coronary artery by-passes.

The fractious British political classes have united in defence of the UK’s healthcare system after it has become a byword for the failings of universal, state-funded provision among the US Republican right.

Gordon Brown, prime minister, and David Cameron, leader of the Conservative opposition party, have both declared their commitment to the National Health Service.

The US right has used the NHS as an example of the potential pitfalls facing President Barack Obama as he tries to push through a healthcare reform bill.

Some Republicans have ridiculed it as a bureaucratic and “Orwellian” system that often denies care to the elderly – with Sarah Palin, the former Republican presidential candidate, decrying it as “evil”.

But in Britain, where since 1948 all citizens have enjoyed free healthcare from birth to death, the attacks are widely seen as wrong and insulting.

Some are true. The UK does have a lower dialysis rate for kidney disease than the US. Some of its cancer survival figures look appreciably worse and quite probably are worse: “probably” for a bunch of reasons, which include comparability of the data and the fact that five-year survival figures are by definition what was happening then, not what is happening now.

The NHS does indeed have waiting lists for non-emergency surgery, although after a doubling in spending in real terms over the past decade they are much shorter than they were. And, in contrast to the impression of “socialised medicine” held by some in the US, people can by-pass those queues by going private.

About 10 per cent of the population has some sort of private insurance, paid for indivdually or by their employers. The proportion has barely shifted over a decade, implying at least some sort of satisfaction among Brits at what they get.

In response to the worst of the UK performance, Brits can also pluck selective statistics from the US showing it has much poorer overall results for diabetes and a bunch of other chronic conditions where Britain’s primary care physicians treat patients well in the community, reducing complications and avoding costly hospital care.

A balanced view of the two systems might go like this. The US has some of the very best medicine in the world, particularly hi-tech medicine, notably in its leading academic health centres, and it has more of it than in the UK.

But study after study shows that overall the highest level of health spending in the world does not deliver anything like the best results.

A recent study, for example, looked at deaths in those aged under 75 that are amenable to treatment – for example, infections, cancers, diabetes, heart and vascular disease.

Overall, the US had the worst record among 19 industrialised countries, and the rate at which those deaths had been declining had slowed over the previous five years against the declines seen in other countries.

The US record was worse than that not just of the UK, but for example Portugal and Ireland. Martin McKee, of the London School of Hygiene and Tropical Medicine, one of the study’s authors, says: “If the US performed as well as the top three countries in the study” – France, Japan and Australia – “there would have been 101,000 fewer deaths per year.” There would also have been tens of thousands fewer in the UK if it had done the same.

Both systems have their strengths and weaknesses. But rather than presenting a caricature of the NHS, US opponents of reform might ask why. The US spends half as much again as almost any other country on healthcare, yet it still gets overall results that are nowhere near the best. One contributory reason, although only one, is the quality of care received by the uninsured. And that should be the real focus of the debate.

From:
http://www.ft.com/cms/s/0/4cecb8e4-88d9-11de-b50f-00144feabdc0.html?nclick_check=1