The NHS news advice,
spin and information on events in 2006
This
Health Direct weekly NHS news review is written in a contra blog-like
layout in advancing chronological order with the latest news at the
bottom of the page, however the overview links are in the usual date
format:
Choose
and Book- the supposed "brave new world"- 2 January 06
Most patients in England gained a historic new right this week - to
be treated in a private hospital at National Health Service expense.
The arrival of "patient
choice" - the right to choose, initially from at least four
hospitals, and by 2008 from any hospital prepared to meet NHS standards
and prices - is a symbolic moment in the Labour government's endeavour
to use market forces to drive up health service performance. Unfortunately
the IT
Choose and Book system that was supposed to underpin the whole process
has just been put back by a whole year.
The
Postcode lottery was revealed when a leading trust stopped the routine
procedure- Cardiac
catheter ablation that cured Tony Bliar of a heart murmur citing
it's financial deficit and the need to hit the government's six month
waiting list targets.
As
memories of the Christmas break recede in the distance, the financial
cost of Christmas for cancer sufferers was highlighted
Then
at the end of the week we had two stories analysing the chances of the
Labour govt meeting it's 18
week target for patient treatments. As Alan
Maynard, professor of health economics at York University said "What
these figures show,” he said “is that of the three elements
needed to get to an overall 18-week target, one (the outpatient wait)
is falling far too slowly, one (the wait for diagnostics) may well rise
before it falls, and the third (the time spent on the waiting list before
an operation)] is going in the wrong direction.
“Unless
something changes radically, the government is going to miss its target.”
Back to Health Direct's stories
headlines
Money
and IT dominate the week's health direct news- 9 January 06
In
it's desperation to get Doctors on it's side the Labour govt announced
a new 'bribe' to encourage GPs to take up practice-based
commissioning which will doom the whole policy to failure, according
to the leading pressure group for GP commissioning. However, the National
Association for Primary Care said the new nationally set financial incentive
will mean PBC will 'sink before it has even got going'.
The
Audit Commission then warned that the entire
health economy in Surrey and Sussex is at risk due to weak financial
management.
Not
to be outdone the Welsh health service suffered a huge embarrassment
when Jonathan
Osborne, an ENT consultant in North Wales, resigned as chairman of the
Welsh consultants' committee. He
highlighted the unprecedented cash shortage for hospitals in Wales.
Most NHS trusts are millions of pounds under funded and the news of
ward closures, non-availability of services, job cuts and stubbornly
high waiting lists are daily breakfast news to the people of Wales.
The
Scots had their own problems when hundreds of patients have been put
at risk after a computer glitch caused parts of their medical notes
to disappear and become attached to other patients' records. The errors
were caused by faulty software in the controversial
GPASS computer system used by more than 80% of GPs in Scotland.
Lastly,
a survey reveals a growing number of clinicians are worried about roll-out
of national IT systems. Support among the key target users of the world's
largest civil computer programme, the IT-based
modernisation of the NHS, has largely dissipated despite a major
communications drive in recent months, according to a new survey.
Only
1% of those who responded to the largest survey yet carried out into
the views of doctors on the national programme for IT in the NHS (NPfIT)
rated progress as "good" or "excellent". Back
to Health Direct's stories headlines
Embarrassing
warnings by Health Select Committee and experts views of the new Labour
health plans- 16 January 06
"Hugely
disruptive, appalled, extremely concerned, illogical, false economy
and flawed"- Health Select Committee's views of the new Labour
health plans The warnings are so damning that
we copied the House
of Commons Health Select Committee's conclusions and recommendations
on the Labour Government's new set of proposals for the NHS and health
care in the UK.
The
authoritive British Medical Journal published
a report highlighting staff
shortages in radiotherapy units across the UK which are leading
to long waits for cancer patients and may be reducing their survival
chances
Fertility
expert Lord
Winston expressed doubt that Labour's NHS reforms would deliver
more cash for services and spoke in favour of taking control of healthcare
away from politicians
A
report launched by sexual health charities showed an alarming lack of
local NHS planning to improve sexual health in England, despite considerable
central Government funding being made available to do so- with up to
half
of PCTs failing to mention plans to improve key STD areas such as
faster access to sexual health services.
A
leaked Treasury presentation revealed how the National
Health Service threatens the Labour government's other competing priorities
with its huge demand for cash. The spending review that concludes next
year will present Gordon Brown, whether he is prime minister or still
chancellor by then, with some very hard choices. Back
to Health Direct's stories headlines
The
effects of the health service funding crisis- 23 January 06
Patient
treatment is suffering as a result of labour govt under funding claims
a survey of chief executives of NHS trusts which also reveals the depth
of concern among healthcare professionals about the destabilising impact
of wide-ranging govt reforms. The spiraling cash crisis in the NHS has
already forced two
thirds of hospitals to close wards and will soon start directly
affecting patient care, health chiefs warn.
The
Royal College of Nursing also warned that health managers have been
freezing jobs, cancelling training and cutting up to 4,000 posts as
they struggle to reduce ballooning deficits that have swelled to £1.2bn
with operations cancelled, appointments deferred and wards closed,
With
all of the media attention currently focusing on the sex offenders lists
and the recruitment and use of pedophiles in our schools system, we
highlight the loopholes
in the health recruitment system for sex offenders that allows staff
to be employed in front-line children's services for up to six months
before their records are revealed but these do not cross-reference with
either the sex offenders register or local police information.
Eighty-four
per cent of health chief executives believe that the government
was trying to dodge its own culpability for the financial problems in
the NHS by blaming it on a small number of poorly performing trusts.
Alzheimer's
drugs to be available to NHS patients for
people with moderate dementia will continue to be available on the NHS
under revised plans unveiled by the treatment watchdog NICE. Back
to Health Direct's stories headlines
Health
Secretary Patricia Hewitt repeated her warnings that hospitals will
close- January 30
Patricia
Hewitt, the health secretary, called for the end of the "handout
culture" in the NHS this week and demanded that financial
management be put ahead of clinical objectives and that poor performers
will result in closures.
She also signaled that a swathe
of hospital closures and reconfigurations was necessary step to
get the National Health Service back into financial balance. The health
secretary's admission that big changes would be needed in the way services
were delivered in some parts of the country came as she announced she
was sending "turnaround teams" into the 18 NHS organisations
facing the greatest financial risks.
PFI
Hospital building schemes face major cuts as the NHS’s
£12bn hospital building programme in England faces a cut of up
to 40 per cent, according to leaked documents. Although the department
has repeatedly denied there is a review or moratorium on new PFI hospitals
under way, it has now admitted to a “reappraisal”
The former health secretary Frank
Dobson leads the opposition to plans for doctors' surgeries in supermarkets
warning the Labour Government that allowing Tesco to offer family doctor
style services could lead to the closure of GP surgeries.
Health
campaigners and doctors insisted that Labour's
NHS pledge 'needs more money' if it will work
in meeting its ambitious pledges to improve NHS services in the community.
Back to Health Direct's stories
headlines
Bliar
confirms his NHS health failures- 6 February 06
Tony
Bliar admits that billions of Pounds that he has poured into the NHS
have not made it the world class service he promised. He reveals that
the postcode lottery still affects the kind of treatment they get.
Tony
Bliar admits his NHS failures
The
latest figures for methicillin-resistant staphylococcus aureus (MRSA)
were released, revealling that the NHS is highly unlikely to achieve
the goal of cutting rates by 50 per cent within the next two years.
MRSA
still rising as hit squads go in to failing hospitals as
half of all hospitals in England are failing to control the MRSA superbug
in line with government targets in spite of a drive to improve awareness
and ward hygiene. These figures only cover the traditionally quiet summer
months- so worse is yet to come.
Lung
Cancer Patients' Charter set up to combat NHS bias-
Lung cancer is the UK's biggest cancer killer but sufferers
are still not getting the care and attention they deserve, campaigners
say with only 6% of cancer funds going to this disease. Patients who
want more done to combat the disease have drawn up a Lung Cancer Patients
Charter to set minimum standards for treatment.
Half
of elderly care homes give people the wrong drugs claims CSCI watchdog
The Commission for Social Care Inspection
(CSCI) found that thousands of elderly people in care homes are being
given the wrong medicine, someone else's medicine or doses that are
dangerous. Nearly half of all care homes in England fail to meet minimum
standards for managing medicines prescribed by GPs, says the independent
watchdog.
Lastly,
'over-performing' surgeons turn away non-emergency cases in the
latest NHS cash crisis. One of the Labour government's most successful
flagship hospitals has been forced to ban non-emergency surgery after
doctors cut long waiting lists by carrying out 'too many' operations.
Flagship
hospital halts operations in NHS cash crisis Back
to Health Direct's stories headlines
Bliar
breaks yet another promise- 13 February 06
The
move to bring back "Matron", a key policy in the Government's
reform of the NHS, has been dealt a blow by a hospital trust that is
considering axing half of its "modern matron" posts. Hospital
trusts to cut modern Matron jobs in cash crisis Under cost-cutting
plans to deal with a deficit of about £2 million, Peterborough
and Stamford Hospitals NHS Foundation Trust is considering losing 185
staff over two years, which it hopes will be absorbed in natural wastage.
The
tantalising prospect that Cancer care could be transformed within 20
years from a fatal disease to a manageable condition like diabetes,
experts was announced this week. Cancer-
we can control it but you can't afford it But the cost of
ensuring that cancer is no longer a death sentence could not be funded
under the current National Health Service, they will argue.
The
scandal of the week- Labour
breaks it's manifesto pledge as another promise goes up in smoke-
Tony Bliar has broken another manifesto promise as his MPs voted to
ban smoking in all pubs, restaurants, private clubs and most workplaces
across Britain by the summer of next year. Ironically, care homes and
hospitals will be exempt form the smoking ban.
The
number of people with sexually transmitted diseases has soared over
the past 10 years, creating a health crisis that threatens to overwhelm
the NHS. Cases of Syphilis have risen by 1,400 per cent over the past
10 years, from only 141 cases in 1995 to 2,254 in 2004. The
huge rise in STDs prompts calls for sex tests for all on high street
Another
reminder that Ministers need to be careful about the pace of reform
of the National Health Service came when Sir Michael Lyons, acting chairman
of the Audit Commission warned. "It would be very easy to say slow
it all down," Commission
warns Health ministers to keep careful watch on pace of reforms Sir
Michael said in an interview with the Financial Times as huge changes
are taking place in the way the NHS works. Organisations are reporting
deficits running into tens of millions of pounds with the service in
England likely to overspend this year by several hundred million. Back
to Health Direct's stories headlines
NICE's
primacy confirmed in Herceptin cancer drug High Court case- 20 February
06
A
mother fighting for the NHS to supply her with the Herceptin cancer
drug that could save her life
loses NHS Herceptin drug court case in the High Court. The
judge ruled that Swindon Primary Care Trust (PCT) had acted legally
in deciding that Ann Marie Rogers, 54, was not "an exceptional
case".
This
"win" for the bureaucrats confirms NICE's primacy as the main
road block in the development of new treatments and drugs for the NHS
aka Nice
Blight.
The
depth of the health changes and it's effect on front line health professionals
occurred when annoyed health staff have joined a new waiting list in
Wales where Welsh
Health Authority staff have to wait more than a year to get back pay-
which has arisen from the restructuring "Agenda for Change"
exercise.
Labour
Ministers are pursuing “meaningless
and unambitious” health targets that will fail to rid Scotland
of its reputation as the sick man of Europe, one of the country’s
leading economists has warned. Dr Andrew Walker, a health economist
at Glasgow University and a former NHS manager, has condemned as “useless”
eight of the Scottish executive’s 14 key health targets.
Doubts
are being raised about the
future of new PFI hospitals which are being built using private
money. Billions of pounds have been spent on PFI projects to date, but
many more are still in the pipeline. Are Labour's bad habits of moving
the goal posts in the middle of a game about to score a spectacular
own goal by Ministers making the future financing of the all of the
proposed new NHS capital building projects too risky for potential financiers?
This effectively stops the whole new NHS building programme.
The
number of deaths linked to the hospital superbug MRSA has risen by nearly
a quarter, in only 2 years. MRSA
deaths double under Labour- latest statistics report from The Office
for National Statistics data revealed that between 2003 and 2004 the
mentions of MRSA, on death certificates increased by 22% to 1,168. Since
Labour came to power in 1997 the number of deaths has more than doubled.
Back to Health Direct's stories
headlines
Health
Direct welcomes the Department of Health (DoH) to our blog- 27 February
06
This
was the week when we received official confirmation that the Department
of Health is activity monitoring our Health Direct blog. In case you
don't understand the health issues here's an analogy that football fans
up and down the land recognise only too clearly:
Your
team is languishing in the lower reaches of the division when amid great
fanfare and razzmatazz a new board of directors takes over promising
to save the club by buying several new players to propel the club towards
the playoffs.
To
placate the grumbling sell out crowds they also promise to rebuild the
stadium for the brave new world in a higher league.
Unfortunately
not all goes well and problems soon develop:
To
help pay for the ground improvements the cost of the season ticket is
doubled- and the board forgot to mention that the overall seating capacity
would be reduced.
As
the Board are such skinflints rather than finance the building of the
new stands from the ongoing cashflow and their own pockets they resort
to paying for the construction with their credit cards hoping to hide
their debts.
The
new foreign star striker scores a few goals but his goals per game productivity
ratio are less than the old carthorse who we’d had for the past
few seasons.
As
the new midfield generals- who were signed on long term contracts costing
astronomical weekly wages are so good the board worried that these new
players would show up the poorly performing existing players. Thus the
board decreed that henceforth all of our midfielders will play without
any bootlaces.
The
hard pressed new central defenders who were supposed to underpin the
whole team’s transformation don’t link up properly- and
one even managed to get himself suspended for a year.
The
new goalkeeper is useless at saving penalties. Whenever we give a penalty
away- which we seem to do with alarming frequency he can’t decide
whether to listen to the crowd, his managing director- or rely on his
own experience to save the spot kick.
Consequently
the goalie stands rooted to the line hoping that the ball will hit him-
which it never does as the kicker invariably flicks the ball around
him. Pleasing no one.
The
board keep promising to buy new players for the club but the contract
negotiations seem to take ages and the supporters have precious little
to show for all the media stories linking the club to fantastic new
world class wingers.
In
desperation, the board starts meddling in the team selection for games
and eventually sacks the new manager. Which results in an expensive
payoff.
All
the while cash is draining out of the club as it’s antiquated
administration and auditing systems utterly fail to control the club’s
resources.
As
a supporter- do you think that this board deserves your vote at the
next AGM?
I
don’t. And they won’t get my vote.
I
want to save my local club rather than see it being led by lying incompetents
and sink into a financial morass which may lead to it’s closure.
Forcing us to travel twenty miles to support the next football club.
How environmentally friendly and joined up thinking is that?
Please
think before you cast your vote
Other
health issues this week were:
The
black hole in public sector pensions is almost four times larger than
originally estimated, Whitehall accounts show as the unfunded
black hole in NHS pensions schemes grows to £26.8 billion. This
follows a change in the way the Government works out the cost of its
retirement schemes. Labour Government documents show that since last
year the amount of annual provision needed for public sector pensions
has risen from £24.2 billion to £81 billion. For the NHS
the Treasury figures disclosed that the provision for the NHS pension
schemes this year are some £26.8 billion, rather than the £7.8
billion in the previous year's figures.
The
National Health Service is heading for a record overspend at a time
of record growth, according to the latest returns from hospitals and
health authorities. Senior executives said yesterday the service in
England was heading NHS
overspend climbs to record £790m at the end of January
- up from the £620m that was forecast in only December.
A
report of a joint study by the Healthcare Commission, the National Audit
Office and the Audit Commission warns that "Without clearer leadership
from Departments there is a risk that the Labour Government's target
to halt the rise in obesity in children under 11 will not be met."
Obesity
reports Labour failure of leadership to keep its promise
The report investigates the strength and efficiency of that part of
the delivery chain that aims to reduce obesity in children between the
ages of 5 and 10.
Why
is NHS productivity falling- yet Labour claims it could be rising?
The Office for National Statistics started a fierce disagreement over
output and productivity in the National Health Service this week as
it launched a consultation into the issue. The ONS reported that different
techniques could show NHS productivity rose by 1.6 per cent a year between
1999 and 2004 or that it fell by 1.5 per cent a year. Official figures
show a decline of close to 1 per cent a year.
Speculation is mounting about the future of Sir Nigel Crisp, the National
Health Service chief executive and permanent secretary of the Department
of Health as ministers appear to lose confidence in him. Is
Sir Nigel Crisp- the NHS's CEO about to fry? As the health
service heads towards a record £790m overspend, Sir Nigel appears
to have lost much of the confidence of health ministers and the support
of his top tier of "field management" - many of the 28 chief
executives of the strategic health authorities. Back
to Health Direct's stories headlines
One
again we see the wheels coming off Labour's centralised NHS planning-
and their incompetence delivers chaos- 6 March 06.
Acute
and primary care trusts have been left unable to finalise their business
plans just a month before the start of the new financial year. Nineteen
foundation trust applications will be delayed. One chief executive said
he found it ‘incredible’ that the government ‘could
have got the tariff so wrong for the second time in a row’. DoH
in a ‘complete and utter cock-up’ over Payment by Results
(PbR) Health managers have reacted with disbelief
and fury after the Department of Health withdrew the national tariff
for Payment by Results (PbR) and admitted that the sums behind it did
not add up. Last week the DoH withdrew the tariff - due to go live in
April - admitting that ‘underlying errors in the calculation’
had been identified.
It
is an irony that many of the questions junior doctors must answer when
they fill in the new form to apply for hospital jobs relate to their
leadership skills and ability to work as part of a team as Junior
Doctors' new IT MMC recruitment system is a disaster. The
form is part of a new applications procedure, called Modernising Medical
Careers (MMC), which involves no human interaction whatsoever. Hospitals
are banned from holding interviews, having to rely instead upon a computer
"dating" system that supposedly matches the applicant to the
job.
Early signs that a big overspend in the National Health Service in England
is starting to affect patient care came with the waiting list figures
for January as NHS
overspending increases waiting times for patients. Although
the total list rose by only 7,600 in the month, up 1 per cent, the number
of patients waiting between three and five months for treatment has
jumped by 36,600- 25 per cent. In other words, while the number of patients
waiting has only risen slightly, the wait has increased.
The
Ministry of the bloomin' obvious blows £334m on PR- you know when
you’ve been quangoed. Nanny
state blows £334m on PR, spin and waffle. Government
advertising, once synonymous with serious matters of public safety,
is now campaigning to regulate the minutiae of daily life. A television
commercial warns of the risks of undercooking the Christmas turkey,
while a leaflet reminds holiday makers to keep out of the midday sun.
Next up is a poster campaign against dropping chewing gum in the street.
As
Health Direct suggested the previous week: Sir
Nigel Crisp carries the can as he collects his chips- and ennoblement
Tony Bliar was accused of trying to pass the buck for the NHS debt crisis
to civil servants after its chief executive was forced to resign and
take responsibility for this year's record overspending. Sir Nigel Crisp,
54, the Department of Health's top civil servant, stunned Whitehall
by announcing his resignation after reports of a breakdown in relations
with Patricia Hewitt, the Health Secretary.
Compulsory
redundancies in the NHS were announced yesterday, despite record investment
in the service as Wards
closed and staff cut as NHS cash crisis bites. Unions predicted
that more job cuts would follow after hospital trusts announced ward
closures, the cancellation of 24-hour care and staff redundancies. The
Royal Cornwall Hospital Trust, facing an £8.1 million shortfall,
said 300 staff would have to go and some departures would be compulsory.
Back to Health Direct's stories
headlines
Labour's
silence on it's NHS health failures- 13 March 06
The
new consultants' contract in Scotland cost almost NHS
staff contracts cost four times original estimates, Audit
Scotland found, with no clear evidence it has yet improved patient care.
The deal for hospital specialists was a UK-wide one and despite some
distinct features of the Scottish health service, National Health Service
auditors said there was no reason the picture should be any different
in England, Wales or Northern Ireland.
Half
of NHS hospitals 'failing MRSA targets' and are falling behind
the target to cut rates of the MRSA superbug by 50% by 2008, the Labour
Government said. The Department of Health said the NHS was still not
progressing fast enough in cutting rates of the killer infection.
A
suspicious silence is blasting out of Whitehall. We hear about the National
Health Service (NHS) in deepening financial crisis; we know its chief
executive has quit; we read the hospital wards are closing to save money
– but no minister is explaining why. Labour's
silence as NHS reform is dying of neglect Scanning
the headlines, it is reasonable to conclude that Tony Bliar’s
NHS “reform” programme is sinking – and that, soon,
someone will have to bring this sorry adventure to an end if financial
crisis is to be averted.
The
UK public is finally waking up to the disaster that Labour is creating
in the NHS as Public
pessimism about NHS grows sharply for Labours reforms. Public
perceptions of the National Health Service have become sharply more
pessimistic over the past three months, with an opinion poll showing
the highest level of voter disillusion with the sector in four years.
According to the latest results of the quarterly Deloitte/Ipsos MORI
delivery index, some 22 per cent of people said they expected the NHS
to get better over the next few years while 44 per cent expected it
to get worse.
NHS
care records IT roll-out raises patient safety fears The
first go-live in the South of England of a pivotal part of the NHS's
£6.2bn National Programme for IT (NPfIT) has caused significant
disruption at a hospital in Oxford and put the safety of patients at
potential risk, according to NHS documents. Nuffield Orthopaedic Centre
filed a "serious untoward incident" report with the government's
National Patient Safety Agency after the fraught implementation at the
hospital of a Care Records Service for sharing electronic records nationwide.
Back to Health Direct's stories
headlines
Labour
shows it's priority for the NHS is Brown's budget- 20 March 06
The
budget this week ignored the NHS- the sole mention being when brother
Brown decided to ignore his own pay review board’s recommendations
and capped the salary increases for nurses and doctors at 2%.
The
Labour lying spin machine keeps saying that they are adding an extra
£6 billion pounds of our tax payers money into the NHS this year.
However this line of “debate” completely ignores the fact
that thousands of NHS staff is being sacked because the trusts don’t
have the funds to pay them.
Either
patient care is going to suffer greatly. Or 9 years of Labour funding
has been wasted on huge amounts of bureaucracy and red tape. There may
be lots of paper pushers filling in Brown's endless forms, but voters
can see when wards and hospitals are being closing down.
Even
the NHS in Bliar’s own constituency announced this week that it
is cutting 700 jobs.
Sir
Jonathan Michael, a top NHS executive, who spoke at a healthcare symposium
at London's City University pointed out that the NPfIT
NHS plan is evolving but one-size-fits-all is a fundamental flaw in
the NHS's IT-driven modernisation. The flaw Michael sees in the National
Programme for IT (NPfIT) is its centralised, standardised approach at
a time when the health service is decentralising. The chief executive
of Guy's and St Thomas' NHS Foundation Trust, Michael wants IT support
for the specific ways people work in particular parts of his organisation,
such as the accident and emergency department.
Patricia
Hewitt puts her job on the line in defence of NHS reforms
and finances and pledged to press ahead with market-based reforms. The
reforms might seem to be going “too far and too fast”, she
said, but were “absolutely necessary” and “the only
route to safeguard the NHS”. Her pledge to press ahead came as
it emerged that hundreds of jobs are likely to be cut from NHS Direct,
the flagship telephone and web-based helpline as competition from others
for services it hoped to provide threaten to plunge it into a deficit
later this year.
So
it seems Patricia Hewitt is another lame duck Labour minister.
Thousands
of Dentistry practitioners are likely to reject the contract offered
by the government and quit the National Health Service to treat only
patients prepared to pay, according to a survey of NHS primary care
trusts meaning that 500,000
children are set to lose their NHS dental treatment in dentistry chaos.
The trusts, which provide GP and dental care locally, have admitted
that thousands of children will be hit. Some have already written to
patients warning them that from April 1 both adults and children will
be obliged to find another dentist unless they are prepared to pay for
treatment or buy insurance.
If
the National Health Service was listening to the Budget speech yesterday
it should have been quaking in its boots as Brown's
budget ignored the NHS- which slips down the waiting list. The
chancellor machine-gunned the House of Commons, not just with his usual
battery of statistics but with his priorities - ones he clearly sees
as shaping his inheritance when, as he hopes, he steps into the prime
minister's shoes.
Thousands
of health jobs go in NHS cash crisis with the ultimate irony as
NHS hospitals serving Tony Bliar's Sedgefield constituents announced
700 job losses yesterday, bringing the total cut over the past fortnight
to more than 4,000, according to figures compiled by the Guardian. Conservatives
accused the government of allowing the health service to sink under
financial pressures caused by ministers' mistakes. They forecast job
losses in England might top 15,000 as staff are made to pay for Labour
government errors.
Would
Nye Bevan approve of Labour's NHS chaos? Sixty years after
the national health service bill, a new white paper is needed to make
good recent damage. March 21 2006 was the 60th anniversary of the postwar
Labour government's white paper, the national health service bill. What
would a new white paper for the NHS today look like? We do not need
to reinvent the wheel. The weaknesses of the original NHS were serious
and they have been skillfully exploited in the drive to privatise it,
but the basic design was good; it deserved to be improved, not surrendered
to the ideologues of private enterprise. Back
to Health Direct's stories headlines
The
old, the mentally unwell and cancer patients lose out in budget cuts-
27 March 06
Madness-
Britain's mental health time bomb New
figures reveal one in five people will need treatment. Which is why
experts are calling £20m cuts in services 'cruel and insane'.
Health authorities are secretly cutting millions of pounds in funding
for psychiatric services, despite alarming new evidence of a crisis
affecting an estimated one in five people in Britain. In a move branded
"the real madness" by health experts, debt-ridden NHS trusts
are slashing budgets and cutting care for the mentally ill.
Doctors
opt to have private operations out of NHS Hospital
consultants are spurning the National Health Service by paying for medical
insurance so they can be treated privately if they become ill. A survey
of 500 consultants, commissioned by Bupa, the health insurer, found
that 41% of senior hospital doctors have invested in private health
cover.
Older
people are failed by deep rooted cultural attitudes in NHS
according to a new report by three independent watchdogs published.
It suggests that "deep-rooted cultural attitudes to ageing"
in local public services are hampering wider Government plans to improve
health, social care and local council services for older people. The
report has been produced jointly by the Healthcare Commission, the Audit
Commission and the Commission for Social Care Inspection.
A
national screening programme aimed at Bowel
cancer screening tests is to be cut in NHS cash crisis. The
tests could save more than 1,000 lives a year from bowel cancer. The
project, which would pick up the disease in patients before they developed
any symptoms, was due to be rolled out across the UK in two weeks time.
Bowel cancer is a major killer in Britain, and is diagnosed in 34,000
patients a year, claiming 16,000 lives annually.
Patient
care is suffering in NHS cash cuts as forcing
trusts to break even too quickly will compromise patient care, chief
executives have warned this week. Speaking in parliament in January,
health secretary Patricia Hewitt told MPs that actions to deliver organisational
turnaround will ‘never compromise patient care’. But chief
executives said they could not make the savings demanded of them for
2006-07 without an impact on the quality of care delivered.
One
CEO when asked whether a demand to break even would affect patient care,
he admitted ‘Of course it will. I cannot see how we can take a
sum like that out without it affecting services. It is about minimising
the impact on patient care."
The
saddest April Fool joke of all- D
Day for Dentists- 1,000 dentists expected to quit NHS in contract row.
Unfortunately, not an April Fool: an exodus of about 1,000 dentists
from the NHS in England was predicted last night by the chief executives
of primary care trusts, who take over untried and untested management
of the service from today. The NHS Confederation provided the first
hard evidence of how patients will be affected by a dentists' contract
that came into effect at midnight. Back
to Health Direct's stories headlines
Doctors
for Reform's report reviewing Labour failures and offers a solution
to the chaos- 3 April 06
Gordon
Brown to blame for NHS crisis- new poll finds. Gordon
Brown is being blamed for the financial crisis in the National Health
Service, which has resulted in hospitals laying off staff and closing
wards, according to a YouGov poll for The Daily Telegraph. His credentials
as prime minister-in-waiting are being undermined by a growing impression
that he is not spending enough on the health service, and his own personal
popularity ratings are falling.
Cancer:
There are life-saving drugs. So why can't we have them? Thousands
of cancer sufferers are being denied life-saving drugs because of delays
and bureaucracy in making them available on the NHS. The hold-ups are
a matter of life and death for desperate people who have been diagnosed
with cancer of the breast, colon or lung, or with a brain tumour.
Doctors
For Reform provide evidence of how the NHS is failing and unsustainable
under Labour's reforms "We
once believed the NHS was the finest healthcare system in the world.
Today few healthcare professionals would make that claim. Britain is
the world’s fourth largest economy. But it does not enjoy standards
of healthcare consistent with its status."
The
best international evidence on medical outcomes has been collected for
cancer patients. It shows that British cancer patients have a significantly
lower chance of survival after diagnosis than patients in other developed
countries as well as poorer access to cancer drugs.
On
other measures such as life expectancy, infant mortality, premature
mortality and cancer survival rates the UK continues to perform poorly
compared to other countries and there is a significant gap with the
best performing countries.
For
example the UK’s rate of infant mortality is roughly a quarter
higher than in France and Switzerland. The UK’s 5-year cancer
survival rates are amongst the worst in Europe and over 10 per cent
lower than France, Germany and Switzerland.
Waiting
lists, standing at just under one million, are far longer than in other
Continental countries such as France and Germany. Many patients’
conditions deteriorate further while on the waiting list. One study
has shown that 21 per cent of lung cancer patients became unsuitable
for curative treatment during the wait for their radiotherapy.
Despite
large spending increases and rises in the number of medical students,
numbers of medical staff in this country still remains below that of
other Continental countries. The latest figures show that the UK has
a third less practicing physicians per 1,000 population than France,
Germany or Switzerland and roughly half as many general practitioners
as France.
A
recent study found that while the total headcount number of midwives
had increased between 1994 and 2004 the number of actual number of midwife
hours worked had fallen by 14 per cent to the great detriment of mothers.
This
is likely to remain the case in the medium term. Noting that the number
of doctors cannot be raised as quickly as spending the OECD recently
stated: “When health spending reaches 9.5 per cent of GDP in 2007/08,
there will only be about 2.4 practising physicians per 1 000 population
(up from 1.9 in 1999), compared with currently 3.1 to 4.1 in Belgium,
Italy, Netherlands and Sweden, which have a comparable spending level
and 3.4 in Germany and France, which spend slightly more.”
There
are few indicators showing unambiguous improvements in outcomes over
and above trend improvements that were already apparent before the surge
in spending. For example, mortality rates from cancer and hear disease
have declined since 1999, but only at the same rate as the existing
trend.
Despite
the large increases in spending performance is still poor. One Department
of Health measure for average waiting times shows a 25 per cent increase
since 1999-00. The Royal College of Radiologists has shown that waiting
times for cancer treatment are “substantially worse” now
than in 1997. The current target – a wait of 2 months from referral
to first treatment – would be unacceptably long in most European
countries and result in litigation in the USA.
No healthcare system is perfect. But we have much to learn from other
countries.
Other
countries have both a diverse range of healthcare suppliers and mixed
funding systems, such as social insurance, which empower patients and
offer real choice to all, including the most disadvantaged in society.
In
Britain, nearly all resources for healthcare are collected through general
taxation. According to the Wanless Review, tax financing provides too
great an incentive for governments to limit spending, with the result
that the UK has under-invested in healthcare compared to other countries
over many years. Other countries have been able to spend more by raising
health funds from a variety of sources.
Switzerland is one
of the most attractive models of healthcare. With a wide choice of insurers
and providers, the Swiss enjoy a degree of choice unrivalled outside
the US. But as in Germany, efficiency is compromised as sickness funds
have to contract with all providers.
In
Switzerland, it is compulsory to pay for a basic insurance plan defined
by law. About 100 private insurers compete for customers, offering a
mandatory and comprehensive package which is set at the national level.
Community rating of the compulsory package means that everyone pays
the same premium in the same region with the same insurer, irrespective
of their own risk. Unlike France and Germany, employers do not make
contributions towards healthcare costs, which could be seen as advantageous
in Britain.
Around
one third of Swiss citizens receive premium subsidies and the poor have
virtually all the full premium paid for them, but the principle of payment
is regarded as important. Premiums vary with a wide range of deductibles,
co-payments and managed care options.
Around
three quarters of German citizens have mandatory insurance through a
statutory system of social insurance. Some groups such as the self-employed
are excluded and usually choose to purchase private insurance. High
income earners can choose between statutory insurance and private health
insurance.
The
social insurance benefits package is laid down by law. Citizens have
the right to choose their insurer and there are approximately 450 sickness
funds which are independent of government. Patients also have a choice
of provider. Half of all hospitals are non state-owned.
Treatment
capacity is high and waiting lists are virtually unheard of since competing
providers usually treat all patients. Germans enjoy high levels of healthcare
and outcomes. However the system contains elements which drive up costs,
for example the requirement for all insurers to contract with all willing
providers.
In
the absence of any other sane health funding proposal, I suggest learning
from the experts who work on the front lines of the National Health
Service. Their reports suggestion is to improve apon the Swiss and German
models as a fair and reasonable method of delivering the health facilities
and staff that are required by the public.
The
National Health Service is entering a period of "creative destruction"
when hospitals will need to close and services be reconfigured, the
former head of the Department of Health's strategy unit warned this
week. But Chris Ham, professor of health services management at Birmingham
University, said there were serious doubts about whether politicians
and health ministers "will be prepared to live with the consequences".
He said: "My guess is that they won't." The 2001 election
result in Kidderminster should be "engraved on politicians' minds",
Prof Ham said.
A
secret NHS plan to ration patient care with new review panels blocking
choice Patients
are being denied appointments with consultants in a systematic attempt
to ration care and save the NHS money. Leaked documents passed to The
Times show that while Labour ministers promise patients choice, a series
of barriers are being erected limiting GPs’ rights to refer people
to consultants.
Nanny
state expands as Folic acid is added to all bread The Food Standards
Agency in the UK is recommending the addition of the vitamin folic acid
to all flour and bread on sale in Britain within the next year. The
agency will recommend in principle that in future all brown and white
flour be fortified with folic acid. Wholemeal bread will not require
additional folic acid. Calcium, iron, thiamine and niacin are already
compulsory ingredients in white or brown flour. Back
to Health Direct's stories headlines
More NHS
cutbacks and closures as Bliar carries on regardless- 10 April 06
NHS
cutbacks and closures- 7,500 latest roll call review NHS
hospital job cuts that will run into more than 7,500 have been announced
in recent weeks as the NHS struggles to balance the books. Here is a
timetable of the latest cutbacks and redundancy announcements
Bliar
pushes health reforms amid cash crisis The
Labour government on Wednesday announced changes to the structure of
the NHS as Tony Blair and Patricia Hewitt brought together health chiefs
to discuss the cash crisis affecting the nation’s hospitals.
Landmark
High Court ruling in Herceptin patient's favour against "irrational
and unlawful" NICE guidelines A
breast cancer patient should have the drug Herceptin, according to a
landmark ruling from the Court of Appeal this morning. Ann Marie Rogers
of Swindon, Wilts, was appealing against an earlier High Court decision
upholding Swindon Primary Care Trust's refusal to fund Herceptin. The
Appeal Court ruling does not force local NHS bodies to fund the drug,
but it said it was irrational to treat one patient but not another.
Ms Rogers, 53, had said she faced a "death sentence" without
Herceptin.
Top
UK IT experts call for an audit of NHS (NPfIT) programme Leading
computer science experts are this week writing to parliament calling
for an independent audit of the NHS national programme for IT (NPfIT).
The signatories, 23 of the UK's top academics in computer-related sciences,
are concerned about the technical feasibility of a fully integrated
national programme. Their open letter to the House of Commons Health
Select Committee echoes a call last week by Computer Weekly and Health
Direct for an independent audit of the project.
Patricia
Hewitt has faced pressure from Labour MPs to step in and help debt-ridden
hospitals amid fears that 24,000
jobs are now at risk in the NHS claims new research
across the National Health Service. Alarm has grown among Labour's backbenchers
as they have witnessed nearly 7,000 job losses being announced by NHS
trusts across the country in the space of a few weeks. Figures published
today show that the number of posts axed by hospital managers could
eventually rise to nearly four times that figure. Back
to Health Direct's stories headlines
Centralist
IT NHS system is a recipe for "chaos and disaster"- 17 April
06
Anatomy
of a £15bn gamble- CfH's NHS IT busted flush The
new NHS computer system could be the biggest IT disaster in history,
warn experts. Inside a leading hospital in Oxford, expensive new computers
were humming away just before Christmas when disaster struck. The Nuffield
Orthopaedic Centre was at the forefront of a multi-billion-pound revolution
to modernise the entire computer system of the National Health Service
— and the screens had suddenly frozen.
The
scheme’s ambition and potential cost were staggering. Yet Bliar
gave it the go-ahead without public consultation. The government initially
allocated £2.3 billion for the project and boldly proclaimed that
electronic records for every patient in the country would be online
by the end of last year. The costs and the delays have been mounting
ever since- with the last quote being £6.2 billion.
“In the system they are building, errors can get spread and copied
across the network and nobody can do anything about it,” said
Ross Anderson, professor of security engineering at Cambridge University
and one of the 23 academics calling for an independent review of the
project. “What they are proposing is a recipe for chaos and disaster.”
Chief
execs should ‘take the rap’ if the elderly are failed on
dignity Chief
executives could face the sack if their trusts consistently fail to
treat their elderly patients with dignity, the national clinical director
for older people has said. Professor Ian Philip told HSJ he wanted to
see dignity breaches become as ‘totemic’ an issue for senior
managers as four-hour accident and emergency waits.
Dental
patients are having to use emergency dental services after their dentists
left the NHS One
in 10 of England's 21,000 dentists left the NHS at the start of April
after rejecting a new contract and local health bosses have struggled
to replace them, leaving patients to ring help-lines. Patients are then
told of dentists accepting NHS patients - in some areas this is a minority
- or diverted to services aimed at out-of-hours care.
Health
deficits are symptoms of a deeper failure Tony
Bliar once remarked that Labour's record spending increases and reform
were the last chance for the National Health Service. If they did not
work, the prime minister warned, waiting in the wings were politicians
who would dismantle the NHS. The reality is somewhat different. There
is no ideological difference between Labour and Conservative. The real
difference, in Rumsfeld- speak, is that Labour ministers know what they
don't know while the Conservatives don't know what they don't know.
Children's
hospitals warn of £22m funding crisis in PbR Four
children's hospitals have warned health ministers they will have to
cut specialist services because of miscalculations in the new Payments
by Results (PbR) system championed by Tony Bliar as part of his NHS
reforms. The shortfall will mean cuts in services with specialist surgical
procedures most at risk the trusts claim. Back
to Health Direct's stories headlines
RCN
nurses give health minister a black eye- 24 April 06
Angry
RCN nurses drown out health minister Infuriated
nurses stopped Patricia Hewitt in her tracks yesterday as they interrupted
her speech and demanded their voices be heard. The Health Secretary,
who was addressing the Royal College of Nursing conference in Bournemouth,
had been met by more than 2,000 stony faces, a sea of white and yellow
campaign T-shirts, and a welcome somewhere between cool and
Nurses
threaten to strike as Bliar warns of more NHS job cuts Nurses
and health workers threatened industrial action after Tony Bliar admitted
yesterday that the NHS faced a "challenging" year and more
job cuts. Nurses' leaders said they were considering a work-to-rule,
including stopping voluntary overtime, which could plunge heath care
into crisis. Dave Prentis, the general secretary of the biggest union,
Unison, promised support for industrial action to protect health service
jobs. He said: "We are being told that somehow jobs will disappear
or be left unfilled without patients and staff feeling the pain. What
utter nonsense."
RCN
warns of 13,000 NHS jobs cuts in cash crisis
Financial instability – the national picture: the NHS audit review
shows well over a quarter of NHS organisations in England (including
a third of Acute Trusts) have failed to break even at the end of the
financial year 04/05. For the financial year 05/06, RCN does not believe
that this is improving and estimates 27% of all NHS Trusts (and approximately
half of Foundation Trusts) will report an end of year deficit
Treatment
centre programme in disarray as contracts axed
The Department of
Health has been forced to scrap a large swathe of its second-wave independent
treatment centre programme nearly a year after it first invited private
sector healthcare organisations to bid for the lucrative contracts,
HSJ has learned. The ITC programme appeared in disarray this week as
it emerged that seven of the 24 local schemes - all part of the multi-million-pound
second- wave elective surgery contract - have been axed, with the rest
being delayed by up to a year
Labour
U-turn over ID card medical details
Identity cards are
to carry medical details, despite repeated Labour government assurances
that concerns about privacy meant it would not happen. A minister at
the Home Office disclosed it wants people to put personal health information
on the cards to give doctors information for emergencies. Back
to Health Direct's stories headlines
Labour's
financing "miscalculations" exposed as NHS staff count the
cost- 1 May 06
NHS
cutbacks and closures- Health Direct notes 11,525 NHS jobs are announced
Health Direct has
collated over 11,525 NHS job redundancy announcements in recent weeks.
Out
of hours GP shake up attacked as "shambolic" as £70
million is overspent The
shake-up of the out of hours health care system in England was "shambolic"
and led to longer waits and higher costs, a committee of MPs has said.
New providers are spending 22% more but are not meeting key targets,
the public accounts committee claimed. Fewer than 10% of primary care
trusts met targets on assessing patients within 20 minutes of an urgent
call the National Audit Office found.
PFI
profits from secondary market creates storm over unacceptable gains
Some of
the biggest operators in the private finance initiative were condemned
this week for making gains that are "unacceptable, even for an
early PFI deal" from the refinancing of Norfolk and Norwich hospital.
Even as that row erupted, the focus on how money is being made out of
PFI contracts is shifting to the newer secondary market in PFI - the
sale of the equity investments in them. Last month the National Audit
Office raised concerns about how transparent those deals are.
Watchdog
brands 60 per cent profits on PFI scheme as unacceptable Some
of Britain's biggest investors in the Private Finance Initiative were
yesterday condemned as "the unacceptable face of capitalism"
by parliament's public spending watchdog. John Laing, Innisfree, 3i,
Barclays Infrastructure and Serco were accused of taking gains "unacceptable
even for an early PFI deal" from a refinancing of the £158m
Norfolk and Norwich Hospital.
Health
Direct highlighted the PFI rip off on the Norwich hospital deal last
year on Monday 13 June as the National Audit Office
found that the PFI building company Octagon made a 60% return
on investment refinancing the Norfolk & Norwich PFI Hospital- PFI
hospital company makes 60% profit in 1 year
NHS
deficits "hit mental health" patients The
NHS is facing a deficit of at least £600m and the mental health
services are being unfairly hit by the deficits problem gripping the
NHS, MPs say. The Tories said over a half of the NHS trusts providing
mental health services have had to close wards despite none of them
running up a deficit.
NHS
pay deals add £7bn to black hole in public pensions
Overspending on National Health Service pay settlements has deepened
the black hole in the Labour Government's public sector pension plans
- by £7 billion. Taxpayers will have to cover the cost of the
enormous shortfall, caused by a Whitehall "miscalculation"
as the Labour Government last week admitted that the overspend on new
contracts for general practitioners, nurses, consultants and health
workers was £610 million. Back
to Health Direct's stories headlines
Labour
counts the cost of it's NHS failures at the local elections- 8 May 06
The
Kidderminster effect came back to haunt Labour with a vengeance at the
Local Elections. Voters
turn against Labour's NHS cutbacks and closures Local opposition
to NHS reorganisations provided the catalyst for single-issue party
candidates standing in last week’s local elections. GP Dr Jacqueline
Gunsell was elected to Kirklees council on the Save Huddersfield Health
Campaign ticket. She was one of three candidates standing in protest
at plans to move services from their local hospital in Halifax.
A
record 6 NHS hospital closures announced in one day in one county
Health Direct’s blog has been chronicling the sad demise of the
NHS for over two and half years, but until today we have yet to observe
the record of six NHS hospitals being closed in one day in only one county.
Massive cuts to health services across Gloucestershire will see 500 job
losses- many compulsory, community hospitals closed and maternity services
moved to help balance a £38 million deficit.
Given
the chaos and political mismanagement that the NHS currently is experiencing,
it is no surprise that few people are willing to pick up the poisoned
chalice as the Search
for new health chief goes overseas as UK candidates fail to shine The
search for a new chief executive for the financially beleaguered National
Health Service is to go overseas as the Department of Health struggles
to attract high quality applicants to top posts. In an indication that
they do not expect the search to be a short one, ministers have said
Sir Ian Carruthers, the acting NHS chief executive, will have his secondment
extended from July until the end of the year.
Scots
top heart death rate league in NHS postcode lottery Scottish
women are twice as likely to die from heart disease as those in south
west England, figures show. British Heart Foundation (BHF) data shows
Scots men and women still have the highest heart disease death rates
in the UK at 221 and 81 per 100,000. Rates for men are next highest
in north-west England at 210 and for women in Yorkshire at 72. The UK
average is 173 for men and 58 per 100,000 for women. Death rates have
fallen in every region of the UK.
Half
of all NHS hospitals can't afford to replace midwives More
than one in three hospitals are cutting budgets for maternity care as
the National Health Service financial crisis deepens. The cuts mean
that almost half of all health trusts are not replacing midwives who
leave the service, according to research by the Royal College of Midwives
(RCM). Meanwhile, one in four heads of midwifery have also been forced
to reduce home visits and 10 per cent are cutting back on home births,
despite NHS guidance that women should be allowed to opt for such a
procedure. Back
to Health Direct's stories headlines
European
court rules that Labour's waiting times targets are irrelevant- 15 May
06
NHS
told to fund treatment abroad in landmark court ruling UK
patients who are forced to wait longer than they should for NHS treatment
are entitled to reclaim the cost of being treated in Europe, a court
has ruled. The European Court of Justice said the NHS must refund costs
if patients waited longer than clinicians advised, even if waiting time
targets were met. The case, which centres on the definition of "undue
delay", could have a significant impact on the whole NHS.
Late
NHS payments shut down staff agencies Employment
agencies that supply staff to the National Health Service are going
bust because NHS trusts have put off paying them in their attempts to
deal with big overspends in the health service. At the same time, suppliers
of equipment and tests to the NHS say they are owed tens of millions
of pounds- which is the result of hospitals putting off paying bills
from the last financial year to this.
Doctors
warn that General Practices are bursting at the seams Three
quarters of GP practices responding to a BMA survey say their premises
are not suitable for anticipated future needs. The survey results, published
today describe how family doctors are prevented from expanding their
patient services by lack of space, coping instead with a daily round
of “hot desking”, room juggling and even using the coffee
room for immunisations.
Labour's
targets are triggering NHS staff bullying The
"target ethos" in the NHS is adding to a "survival of
the fittest" culture where bullying is common, doctors leaders
have warned. The British Medical Association says one in seven NHS workers
has been bullied by colleagues. The organisation is calling for "zero
tolerance" of bullying in the NHS.
Britain-
the sick heart of europe
Heart disease, the most preventable health threat facing Britain today,
is costing the economy £29bn a year. Rising rates of obesity,
an ageing population and the soaring prescription bills for heart drugs
such as statins mean that the bill is likely to rise in the future.
Back to Health Direct's stories
headlines
Hospitals
are getting dirtier claim patients- 22 May 06
NHS
hospitals are getting dirtier despite Labour's promises, claim patients
Fri
26 May- Standards of cleanliness in hospitals are falling despite
Labour Government promises to tackle dirty wards, a survey showed yesterday.
The annual NHS patients' survey found high levels of general satisfaction
with the health service. However, when more specific questions were
asked of the 80,000 people who took part a different picture emerged.
Only
52 per cent of the patients said their ward had been "very clean"
last year compared with 56 per cent in 2002. Less
than half - 46 per cent - described lavatories as "very clean"
compared with 51 per cent three years before.
Anna
Walker, the chief executive of the Labour Government watchdog, the Healthcare
Commission, which commissioned the survey, said " patients are
still sending a clear message that there is more work to do. Providing
patients with the right information, in the right format and at the
right time is crucial to their treatment and recovery, yet so many tell
us that they are not receiving this.''
Surgeon
used eBay to buy equipment- and has it confiscated by nanny
Thu
25 May- A surgeon has upset hospital bosses by ordering medical
equipment through the auction website eBay. Kevin Murray, a newly appointed
consultant at the James Paget Hospital in Gorleston, Norfolk, had been
asked to provide a list of the equipment he would need for his operating
theatre.
10,000
in 'breast cancer backlog'
Wed
24 May- About 10,000 women are now caught in a backlog for breast
screening in the Northern Health Board area, the BBC has learned. The
board said it was currently running 13 months behind schedule. It comes
after a consultant radiologist who worked at three NI hospitals was
suspended over concerns about his "clinical judgements".
DoH
orders £200m cuts to scheme to stay within Treasury guidelines
Tue
23 May- The Department of Health has | 
