Hundreds of foreign doctors working in Britain have not been checked for language skills or competency, according to figures out today.
Despite widespread outrage over the case of a German doctor with poor English whose mistake led to the death of a pensioner, less than one in four foreign doctors is currently being properly verified, according to a Freedom of Information (FOI) request.

The investigation by Pulse, a newspaper for GPs, also found many NHS trusts in England have no accurate record of whether or not a doctor has been checked.

Dr Daniel Ubani killed David Gray, 70, by giving him 10 times the normal dose of diamorphine on his first-out-of-hours shift in Britain in 2008. He later admitted never having heard of the drug.

In February a coroner found that Dr Ubani was “incompetent” and ruled that Mr Gray had been killed unlawfully.

Dr Ubani was struck off by the General Medical Council in June but he still practises in Germany.

His poor English meant he was refused work by the NHS in West Yorkshire but was later accepted in Cornwall and then Cambridgeshire, where Mr Gray lived.

Today’s survey of more than 100 primary care trusts (PCTs) shows hundreds of foreign doctors are included on “performers’ lists” without having been fully checked.

Out of 152 PCTs in England, 108 responded to questions following an FOI request.

Of 35 that gave information about language checks, only 23 per cent of non-UK EU doctors on their performers’ lists had undergone such tests. More than 300 had not.

And of 20 PCTs able to provide details about tests on clinical competence, just 17 per cent of doctors trained on the continent had undergone such assessments.

More than two thirds of trusts that responded (74 of 108) admitted they did not collect data on whether doctors had been checked, including NHS Cambridgeshire.

Mr Gray’s son Dr Stuart Gray, himself a GP, said he was “horrified” by the results of the survey.

“To be honest I don’t know what more it takes to get changes made,” he lamented. “It’s only a matter of time before there’s another death.”

He believed compliance with such checks would have stopped Dr Ubani practising in Britain and hence saved his father’s life.

Niall Dickson, chief executive of the General Medical Council, said: “The Pulse survey appears to show worrying failings in the system of employer checks, which could put patients at risk.

“Both the Government and the GMC have reminded PCTs of their responsibility to ensure the doctors they employ, or contract with, are fit for purpose; this includes making sure they can communicate effectively.”

However, the GMC believes its hands are tied by European rules which prevent it from directly checking the language skills and clinical competence of foreign trained doctors.

Professor Steve Field, chairman of the Royal College of GPs, who co-wrote a recent Government-commissioned report that was highly critical of out-of-hours care, said: “We’ve given PCTs a wake-up call and it’s disgraceful they still aren’t taking the issue seriously.

“The performers’ list simply hasn’t worked in providing safety for patients.”

Richard Hoey, editor of Pulse, said: “PCTs work in a difficult financial environment, and some of the criticism they get is unfair.

“But in this case they are shirking on the cost of testing an average of just 10 doctors each, and risking a far greater cost in human life.”

A spokesman for the Department of Health said: “Under European law healthcare regulators such as the General Medical Council cannot systematically test the language knowledge of European Economic Area migrants at the point of registration.

“United Kingdom domestic law supports the EU directive on mutual recognition of proof of qualifications in this respect.

“However, employers and those contracting with healthcare workers can, and indeed should, verify the language knowledge of any person they appoint to ensure that they can undertake the duties being asked of them.”

She added that PCTs had “a legal duty” to ensure that doctors were fit to provide services, and that Europe-trained doctors could be subjected to language tests. However, she said there was no requirement stipulating such a test.

From: http://www.telegraph.co.uk/Hundreds-of-foreign-doctors-not-checked

The National Health Service (NHS) is the only major area of Whitehall spending in which there will be a rise in real terms. However, an increase of just 0.1 per cent a year will be dwarfed by the rise in the cost of drugs, an ageing population, the cost of reorganisations and inflation.

The cuts:
Technically the NHS has been given an increase in funding but this is less than half a per cent over four years.

£1bn will be diverted from the NHS to social care to help cut emergency readmissions to hospitals.

Psychological therapies will be boosted for those with mental health problems.

A new cancer drug fund for medicines that have been turned down by Nice worth up to £200m a year.

Three new hospitals were given the go ahead including Epsom and St Helier, West Cumberland and the Royal Oldham.

However the extension of free prescriptions to people with long-term conditions will be stalled.

One to one nursing care for cancer patients and a pledge under the previous government to have cancer tests conducted within one week will also be postponed.

The number of quangos will be cut from 18 to 10 by 2014 and the administration costs will be reduced by a third.

Radiographers will examine some x-rays as well as take them in order to save £7.9m of consultant radiologists’ time.

What it means:

Although an increase in funding sounds generous compared to the other departments it is nowhere near enough to keep pace with inflation in the NHS or the increase in demand for healthcare as the population ages and new treatments are developed.

The NHS has already been planning to make £20bn worth of savings over the next four years and it is not yet clear if this will have to be increased in light of the CSR settlement.

The Chancellor said the NHS spent £102bn this year but this is £5bn lower than what was planned for in the 2007 spending round, raising the question of where that money has gone.

Thousands of jobs in the NHS are already earmarked for cuts as primary care trusts and strategic health authorities are to be abolished as part of the coalition’s reforms and it is feared that some hospitals may seek to cut frontline jobs as well.

Experts have warned that plans to give GPs greater control over the NHS budget and the reorganisation this will take will cost between £2bn and £3bn.

What is the department’s budget?

£109.4bn

How well does the department perform?

Waiting times for patients needing treatment in hospital reduced dramatically under Labour, following the introduction of many targets. But with them came an expanding bureaucracy. The number of managers rose by 84 per cent in a decade, while nurse numbers grew by just 24 per cent.

Recent scandals such as that at Stafford Hospital, where patients suffered appalling and basic failings, illustrated the dangers of prioritising finances and targets over care.

Britain’s record in funding drugs for many serious diseases – especially cancer – compares poorly with the rest of Europe, and survival rates are worse than in other countries.

While growth in spending on the NHS in the past decade was at a record level, most of the money went on pay. GP pay rose by nearly 50 per cent in a decade, to an average of £106,000.

Had any savings already been identified?

The Government says more than £1 billion will be saved by halving the size of NHS bureaucracy in four years. 150 primary care trusts and 10 health authorities will be scrapped. However, redundancy payouts to get rid of so many managers will be expensive. Quangos such as the Health Protection Agency will be culled. Funding for a £75 million public campaign against obesity and drinking is to be stopped, with food and drinks companies asked to foot the bill.

From: http://www.telegraph.co.uk/Spending-Review-What-it-means-for-the-National-Health-Service-NHS-Department-of-Health

The Summary Care Record IT program  is to go ahead, but its content will be limited to core information with an opt out form will be included in patient information packs.

The Department of Health has published the results of two simultaneous reviews of the SCR, covering the content of the record and the information patients receive before their record is uploaded.

The reviews were set up by the coalition government this summer, following concerns about patients’ awareness of the SCR and the kind of information added to it. This had led to the suspension of further patient information programmes.

The review of the content of the record, led by NHS medical director Sir Bruce Keogh, concluded that the core record should only contain a patient’s demographic details, medications, allergies and adverse reactions, and that these should continue to be copied from the GP’s medical record.

The review group said the DH should only consider expanding the content of the record “when we have built trust in the system and when patients request that we should do so.”

Sir Bruce said: “In an advanced national health system, it is reasonable for citizens to expect that when they arrive in accident and emergency or require treatment out of hours, the clinicians treating them have access to enough basic medical information to prevent anyone making wrong or even dangerous decisions.”

The separate Patient Information and Preference Review group, led by national director of patient and public affairs Joan Saddler, concluded that an opt-out form should be included in the patient information packs, and that these should also be simplified.

It said services such as HealthSpace should also continue to provide access to SCRs.

Almost 30m patients have already received information about the SCR but the review concluded that there should be no requirement to send another letter to those patients.

However, it said but there should be awareness raising campaigns at local, regional and national levels to ensure patients realise that an SCR is being created for them unless they choose to opt out.

Health minister Simon Burns said he was pleased that a consensus had emerged about the importance of the SCR in supporting safe patient care, so long as the content of the record was limited to core information.

He added: “Coupled with improvements to communication with patients which reinforce their right to opt out, we believe this draws a line under the controversies that the SCR has generated up to now.

“We see this review as having taking a significant step towards the goal of patients owning their records and using them to share decision-making with healthcare professionals.”

A BMA spokesperson said: “We welcome the progress that has been made towards an emergency electronic record that supports urgent care, yet recognises many of the understandable concerns of patients and clinicians.

“Much will depend on the way the amended scheme is put into practice, and the BMA looks forward to continuing our work with government on its implementation. It is essential that patients have genuine control over who has access to their records, and when changes are made to them.”

The review groups concluded that patients should play a key role in deciding the evolution of the record and that new arrangements should be introduced to define responsibility for decisions about the introduction of any new content to the record.

They said the principle should be that any change to the scope of the record should be driven by citizens and patients with appropriate advice from professional bodies and in line with the IT capability.

Saddler said the availability of core information when patients need care was essential if patients were to be at the heart of care but it should also be easy for patients to opt-out.

She added:”Patients must be the ones who decide if any additional information should be included in their SCR, supported by appropriate professionals. This is the only way we will build trust in the SCR and its use.”

The SCR Content Review group said standards should be defined to support a patient’s wish to add information to their SCR such as end of life preferences, a care plan for patients with long term conditions or the inclusion of a patient’s significant medical history.

The review groups, which between them took evidence from almost 50 bodies, said it had heard strong opinions that the use of smartcards was not universal within GP practices which had implications for accurate updating of the SCR.

The reviews said use of smartcards was outside their remit but recommended that further options were investigated to mitigate the risk of practices not using smartcards.

The review group on Patient information and Preferences also recommended that the outer envelope that patients receive should have clear emphasis that the information contained in the envelope is about “Your health records, you need to make a choice.”

John Heyworth, president of the College of Emergency Medicine, said the college welcomed the decision to proceed with the SCR.

He added: “Clinicians working in emergency departments are currently often deprived of key background and patient information, particularly during the initial phase of time critical treatment and this may significantly compromise the quality and safety of care provided.

“Immediate access to such records will lead to better and safer care for our emergency patients.”

The review’s conclusions were backed by a range of bodies including the Patients’ Assocation, The Royal College of Nursing, Asthma UK and Sue Ryder Care.

From: http://www.e-health-insider.com/summary_care_record_given_go-ahead

Newborn babies could die or suffer brain damage because hospitals are facing shortages of vital drugs, a senior doctor says.
Hospitals are having difficulties obtaining drugs that boost lung growth in unborn babies who doctors know will be born prematurely.

At least 20,000 babies a year in the UK who are born before they have reached 34 weeks’ gestation routinely receive the drugs, called corticosteroids. They can prevent babies from dying or suffering brain damage through a lack of oxygen.

The shortages are revealed by Dr Susan Bewley, a consultant obstetrician at St Thomas’ hospital in London, who specialises in foetal medicine.

Writing in the magazine HealthWatch, she discloses that in the past two years the NHS has had trouble getting regular supplies of two main drugs used to promote lung development in unborn children.

“These two corticosteroids, dexamethasone and betamethasone, improve foetal lung maturity when babies are at high chance of premature delivery,” writes Bewley. “Corticosteroids do save life and prevent handicapping brain haemorrhage in premature infants.”

They are given to the baby’s mother in two injections 12-24 hours apart to prevent the infant from suffering a condition called respiratory distress syndrome.

The highly respected Cochrane Library, global experts in establishing which medical treatments are effective, concluded that “this treatment results in fewer babies dying and fewer common serious neurological and abdominal problems … that affect babies born very early”.

According to Professor Sabaratnam Arulkumaran, the recent past president of the Royal College of Obstetricians and Gynaecologists, the drugs are cheap and highly effective. They are given to unborn babies under 34 weeks whose mothers have already started having early contractions.

He has raised concerns with the Department of Health (DoH) about the supply problems, which are thought to result from manufacturing issues and the fall of sterling against the euro.

Bewley relates experiencing several shortages of the drugs in the past two years. No infant was harmed as she was able to use other drugs. But, she warns, problems look likely to continue. “The risk is that patients will not receive effective, timely medication and be endangered as a consequence.”

The shortages may mean rationing, with doctors and midwives forced to decide which patients need the drugs most, Bewley believes. Hospitals should agree to lend each other spare supplies, she says.

Andy Cole, the chief executive of Bliss, the sick baby charity, said access to the drugs was vital. “These lifesaving drugs have been crucial in helping to drive up survival rates for many premature babies since the late 1980s,” he said. “They are an established and essential part of care for a preterm pregnancy. Availability should be made to any expectant mother, whenever and wherever they are needed, to ensure the very best outcome for her vulnerable baby.”

The health department acknowledged that hospitals had experienced difficulties getting the drugs, but said things were back to normal. “In the cases of dexamethasone and betamethasone injections, the recent supply problems have occurred due to manufacturing problems,” said a spokeswoman.

“The DH has worked with both the MHRA [Medicines and Healthcare products Regulatory Agency] and the manufacturers to help resolve the manufacturing issues and minimise disruption to patients. Both betamethasone and dexamethasone injection are now available as normal. The department continues to monitor the situation and is in close contact with the companies involved.”

A spokeswoman for the Royal Pharmaceutical Society, which represents pharmacists, said betamethasone had been “in short supply for some time” and “the shortage is a manufacturing issue”. Hospitals unable to get betamethasone had been ordering extra supplies of dexamethasone, which performs the same function, causing some shortages of that drug too, she said.

From: http://www.guardian.co.uk/premature-babies-corticosteroids-shortage

The NHS spends up to £86m a year on thousands of websites that are difficult to find, confusing for patients and which do not meet their needs, according to research commissioned for a Department of Health report.
Research for the NHS Digital Communications Review, conducted by communications agency Precedent and leaked to the Health Service Journal, found 2,873 nhs.uk websites that were in use and more than 1,000 other nhs.uk sites that were no longer active. A total of 287,300 web pages were accessible and Google listed 56 million pages within the nhs.uk domain.

The researchers concluded that the public would appreciate fewer contact points online but the digital communications review said there was not sufficiently strong evidence that there were too many NHS domains.

Instead the review said there was a need for a digital brand strategy with standards for all NHS sites. It said a central information role was “sound in principle but its adoption requires a general acceptance that it is the role of the centre to perform this organising function.”

EHI understands that the researchers suggested that the NHS may be spending too little on too many websites rather than too much.

The Precedent researchers said that two of most recognised health service websites, NHS Choices and NHS Direct, were often competing for attention and although NHS Choices focuses on health information and local service data and NHS Direct offers online diagnostic tools the differences in content between the two was not clear to patients.

They added: “NHS Choices and NHS Direct are both established as national sites with similarities of positioning, brand and audience. This confuses users about the ‘definitive’ access point for NHS information and the roles of each site.”

Research for the review also concluded that GP practices websites were also the weakest of the health service’s online offerings.

It added: “GP surgeries have by far and away the poorest sites, in that they have the largest percentage of problems identified. GP sites failed to provide the means to allow interaction with users.”

The researchers found that overall the NHS was failing to meet patients’ needs for online functionality such as online appointment booking, repeat prescription requesting, test result reporting and contact via email. Only 50.3% of sites included email addresses. “The NHS is not making itself easy to do business with,” the report said.

The research is also critical of the accessibility of websites and said that vulnerable members of the public were not been catered for with 30% of sites exhibiting at least one “notable deficit in standards” which might cover poor quality content, lack of NHS branding, poor navigation or out of date content.

The researchers said it was very difficult to estimate the cost to the NHS of the websites with responses to information on usage and cost received from only 188 out of 4,121 sites. However it estimated that the cost of running the sites “could be as high as £86m per year” and said costs could be higher as those figures did not include set up costs.

The digital review, however, said no broad conclusions could be drawn about value for money “given the relatively low cost of establishing and operating small, focused websites.”

The researchers claimed the public “struggled to locate the NHS online with a Google search” when searching on health-related terms and said the scale and depth of information on offer was daunting to many. It said patients also often ended up going to information offered by Wikipaedia, the charity sector and websites such as NetDoctor and PatientUK rather than the NHS.

The researchers said interviews with users revealed that the public wanted to see “one NHS” online which would tally with their perception that they were receiving care from “one NHS”.

The Department of Health said the white paper had outlined the government’s plan to being about an NHS information revolution to give people access to comprehensive, trustworthy and easy to understand information. Information on how this will be achieved is to be set out in the DH’s information strategy, due to be published in the autumn.

From: http://www.e-health-insider.com/nhs_%C3%82%C2%A386m_website_spend_confusing

An investigation found that 320 hospital, ambulance and health authority chiefs are paid more than David Cameron’s annual salary of £142,500.
The report comes as the health service faces cuts to frontline services to reduce the deficit. Of those 58 are paid more than £200,000 a year. Financial experts described the salaries as “unsustainable”.

The number of high-earners has increased 50-fold since Labour came to power in 1997. Prior to that only six NHS officials were paid more than John Major, who then earned a salary of £101,557.

The highest paid was Ian Miller, Interim Director of Finance and Investment for South East Coast Strategic Health Authority, who earned £310,000 for nine months work from April 2009 to January 2010.

His salary – which would be £400,000 per year – would pay for up to 14 nurses.

Meanwhile Ron Kerr, Chief Executive of Guys and St Thomas’ NHS Foundation Trust, earns the second-highest amount with £270,000.

Some health executives also receive additional bonuses such as leased luxury cars that cost more than a nurses salary of £20,000 a year.

The survey looked at 172 acute hospital trusts, 11 ambulance trusts and the ten regional strategic health authorities.

In total 734 staff earned more than £100,000 per year according to available records.

Matthew Elliott, chief executive of the TaxPayers Alliance, said: “It’s shocking that pay in some parts of the NHS has now reached these stratospheric new heights. It simply isn’t sustainable.”

Anthony Marsh, chief executive of West Midlands Ambulance Service NHS Trust, earns £232,000 – more than 14 times the salary of some ambulance drivers.

Pay does not appear to be linked to performance. Martin Yeates, former chief of Mid Staffordshire NHS Trusts, which runs Stafford hospital where 400 died due to inadequate care, earned up to £160,000 a year before he left.

Meanwhile the Department of Health said it was “committed to cutting NHS management costs” and planned to reduce them by 46 per cent in the next three to four years.

From: http://www.telegraph.co.uk/More-than-300-NHS-executives-have-a-larger-salary-than-the-prime-minister

Ministers are considering ‘privatising’ an NHS agency that provides 50,000 nurses and other workers to the health service.
An advert has been placed for private sector investment in NHS Professionals, a company owned by the Department of Health, which provides bank staff to fill shifts in the health service.

Unions criticised the plan saying it was privatisation and that NHS Professionals was set up to stop the NHS being ripped off by private agencies charging large sums for staff to work unfilled shifts.

NHS Professionals has 50,000 staff on its books who cover around two million shifts in 77 organisations around England.

Karen Jennings, head of health at Unison, said: “The whole reason that NHS Professionals was set up, was because private agencies were ripping off hospitals by charging them outrageous fees for recruiting or finding staff for shifts. It makes no sense at all to bring back private companies who will want their slice of the action in return.

“This proposal is purely about Tory plans to promote privatisation and hive off parts of the NHS to private companies, regardless of the consequences on patient care.”

A Department of Health spokesman said: “This is about exploring ways that the commercial skills of the independent sector can make NHS Professionals Ltd a more efficient business and save the NHS money.

“NHS Professionals Ltd is a business, not a public service, and like any business it must ensure its services are as efficient and effective as possible. We want to discuss options with potential independent sector investors that could help to achieve this, and ultimately improve services outcomes for patients.”

It comes as the Royal Berkshire Hospital Trust announced up to 600 jobs will be cut to make £60 million worth of savings in the next few years, pledging that frontline staff would not be affected.

The Royal College of Nursing said last month that thousands of NHS jobs were being cut despite Government promises to protect frontline services.

The nurses’ group said it was aware of almost 10,000 posts lost through recruitment freezes, redundancies and people not replaced when they retired, or which face cuts in the future.

From http://www.telegraph.co.uk/Ministers-accused-of-privatising-NHS-nursing-agency

International travel and medical tourism helped the spread of drug resistant bacteria that could lead to the end of antibiotics, scientists have warned.
A new gene, NDM-1 (New Delhi metallo—lactamase), emerged which allows bacteria to be highly resistant to almost all antibiotics, the scientists said.

NDM-1 spread in India, Pakistan, and Bangladesh.  But it was also found in 37 patients from the UK, who travelled to India or Pakistan for medical procedures including cosmetic surgery, according to an article published in The Lancet.

“The potential of NDM-1 to be a worldwide public health problem is great, and co-ordinated international surveillance is needed,” Timothy Walsh of Cardiff University and his international colleagues wrote.

The gene was mostly found in E Coli, a common cause of urinary tract infections and pneumonia, which is highly resistant to antibiotics.

The authors said it could be easily copied and transferred between different bacteria, suggesting “an alarming potential to spread and diversify among bacterial populations”.

The paper said several of the UK patients had travelled to India or Pakistan for surgical procedures within the past year.

They wrote: “India also provides cosmetic surgery for other Europeans and Americans, and it is likely NDM-1 will spread worldwide.”

Study co-author Dr David Livermore, director of antibiotic resistance monitoring at the Health Protection Agency, said: “The findings of this paper show that resistance to one of the major groups of antibiotics, the carbapenems, is widespread in India.

“This is important because carbapenems were often the last ‘good’ antibiotics active against bacteria that already were resistant to more standard drugs.

“We have now also identified bacteria with this type of resistance – NDM – in around 50 patients in the UK.  Most, not all, had previously travelled to the Indian subcontinent, and many had received hospital treatment there.”

“International travel gives a great potential for spread of resistant bacteria between countries.  Few antibiotics remain active against these bacteria. Their spread underscores the need for good infection control in hospitals both in the UK And overseas, and the need for new antibiotic development.”

A Department of Health spokesman said: “We are working with the Health Protection Agency on this issue. The HPA alerted the NHS in January and July last year to be vigilant about these bacteria and take appropriate action where necessary.

“Hospitals need to ensure they continue to provide good infection control to prevent any spread, consider whether patients have recently been treated abroad and send samples to HPA for testing.

“So far there has only been a small number of cases in UK hospital patients. The HPA is continuing to monitor the situation and we are investigating ways of encouraging the development of new antibiotics with our European colleagues.”

From: http://www.independent.co.uk/new-superbug-spreads-to-uk-hospitals

The Department of Health has spent almost £500 million on management consultants, including deals with firms which have hired senior Labour figures and high ranking civil servants.The disclosure of more than 100 contracts worth a total of £470 million last night engulfed the labour Government in accusations of “cronyism”.

Among those recruited by the favoured firms are a former health minister, an ex-adviser to the health secretary and a senior Whitehall official responsible for encouraging private sector involvement in the NHS.

Doctors’ and nurses’ leaders expressed concern over the use of resources which could have paid for more than 60,000 hip operations, or the annual salary of 22,000 nurses.

Critics also said the revelations indicated that the “revolving door” between the labour Government and its favourite consultant firms was spinning ever more quickly, with former senior politicians, officials and advisers linked to companies profiting directly from the policies they had introduced.

Lord Warner, a Labour peer, who was a health minister until December 2006, now acts as an adviser to PA Consulting group, which received £4.9 million from the Department of Health (DoH) in 2007/8.

Until last December he also advised Deloitte, which received almost £3 million in the same year.

Since resigning as a minister in 2006, the peer has also registered interests working for six other health care, technology and IT firms.

Matthew Swindells, policy adviser to then health secretary Patricia Hewitt between 2005 and 2007, who was earning £195,000 at the DoH, is now group managing director for health at Tribal, which earned more than £2 million from the department in 2007/8.

KPMG, the finance firm, secured £4.9 million in the same year. Last month the firm announced the appointment of Mark Britnell, currently on gardening leave from his £235,000 role as DoH director general for commissioning.

The civil servant was responsible for a policy to encourage more private sector involvement in the health service. He drew up plans which allowed a shortlist of firms – including KMPG – preferential access to lucrative NHS contracts.

Under rules intended to reduce conflicts of interests, Mr Britnell has been told that he cannot lobby the Government for his first nine months in his new job.

Other figures to have crossed from Government to private sector firms which won the management consultancy contracts include Sir Michael Barber, who was Tony Blair’s chief adviser on delivery – focusing on education and health – from 2001 to 2005.

Since September 2005 Sir Michael has been a partner at McKinsey, which was paid £9 million for management consultancy services to the DoH in 2007/8.

Lord Birt, the former BBC director general, was Tony Blair’s strategy adviser from 2000 to 2005. In 2006 he was appointed as an adviser to Capgemini UK, the British arm of the global outsourcing giant.

The DoH figures show that Capgemini UK was paid £3.2 million in 2007/8 for management consultancy to the DoH and the agency running the NHS IT programme.

Information released under the Freedom of Information Act discloses for the first time the details of 111 management consultancy contracts held by the DoH and two of its central agencies.

In total, the DoH, its IT programme Connecting for Health and the NHS Purchasing and Supplies Agency spent £470 million on management consultants in the three years from 2005/6 to 2007/8.

It came after the department had made hundreds of its own staff redundant via an “efficiency programme” intended to save money.

The spending came in addition to an estimated £350 million spent annually on consultants by 150 primary care trusts. Research has shown consultants in the NHS earning up to £2,000 a day for project work.

Matthew Sinclair, from the TaxPayers’ Alliance, said: “It is particularly alarming that many of these management consultants are political cronies or have only recently finished working for the Department of Health.”

Dr Mark Porter, deputy chairman of the BMA’s consultants committee, said: “These consultants aren’t just taking money from the front line, they are often drawing up policies which in themselves damage patient care.”

Dr Peter Carter, general secretary of the Royal College of Nursing, said: “We are unable to find any evidence about whether this represents good value.”

Andrew Lansley, the health secretary, said: “This lays bare the hypocrisy of Labour’s claims to have cut back on Government administration costs.”

PA Consulting group said Lord Warner’s advisory work for them did not relate to any contracts held with the DoH. Deloitte said the peer’s role as a strategic adviser ran from March to December last year.

Lord Warner said he only began advising PA Consulting in Autumn 2008, and was no longer advising four of the eight companies he has worked for since stepping down as a minister.

He added: “Provided people leave a decent period after they are in office before they take up such posts – which I did – provided they clear it with the Advisory Committee on Business Appointments, which I did, and provided they register the interest in a public document – which again I did, I don’t think it is right to stop people who were involved in Government forever from working elsewhere. I would defend to the death the right to have a free flow of labour.”

From: http://www.telegraph.co.uk/Millions-spent-on-NHS-management-consultants-with-Labour-links

The coalition Government ignored scientific advice on the questionable value of homeopathy by continuing to allow the NHS to fund homeopathic treatment despite there being next to no evidence that it works.
Last week, health ministers refused calls from the House of Commons science and technology committee to stop the NHS funding homeopathic treatment on the grounds that such a ban would limit patient choice and contradict the Government’s stated aim of devolving more power to the Primary Care Trusts (PCTs) of the NHS.

However, the Government’s own chief scientific adviser, Sir John Beddington, said that he had spoken informally to coalition ministers about his grave concerns about homeopathy and the Department of Health’s policy of allowing it to be prescribed under the NHS.

“I remain of the view that the evidence of efficacy and the scientific evidence base of homeopathy is highly questionable. It is vitally important that the public can make informed choices on their use of homeopathy, so the evidence base must be freely available in an easily-accessible format,” Sir John said.

The Government does not know how many PCTs prescribe homeopathic treatment or how much it costs but the total annual funding is believed to run into millions of pounds.

Earlier this year, the Commons’ science committee recommended that the NHS should stop funding homeopathy on the grounds that it is a waste of money and it gives patients the false impression that such treatment works.

“When the NHS funds homeopathy, it endorses it. Since the NHS Constitution explicitly gives people the right to expect that decision on the funding of drugs and treatments are made ‘following proper consideration of the evidence’, patients may reasonably form the view that homeopathy is an evidence-based treatment,” the select committee’s report said.

In its response to the report, the Government said that it will keep the position on NHS funding under review. “However, we believe that providing appropriate information for patients should ensure that they form their own views regarding homeopathy as an evidence-based treatment,” it said.

Scientists point out, however, that if patients are told clearly that there is no credible evidence to support homeopathic treatments, this may undermine the only benefit that homeopathy is likely to provide, namely the well-established “placebo effect” where someone feels and gets better because they believe a treatment is working.

“Doctors are not allowed to prescribe an honest placebo, even if they think that is the best they can do for the patient. But they are allowed to prescribe a dishonest placebo by referring the patient to a homeopath,” said Professor David Colquhoun, a pharmacologist at University College London.

“Certainly you may feel better after the pill, because you were getting better anyway, or because of the placebo effect. That can’t justify your doctor giving a pill that contains nothing whatsoever,” Professor Colquhoun said.

“If there is no evidence that homeopathy works beyond the placebo effect, why does the Government pay for it? The answer given to that is ‘patient choice’. I dare say the patient would cheer up if the NHS paid for a bottle of Chanel No 5,” he said.

Professor Edzard Ernst, a specialist in complementary medicine at the Peninsula Medical School in Exeter, said: “If the Government is serious about putting patient choice over evidence, it not only displays a profound misunderstanding of both these issues but should then also give cream cakes to diabetics and cigarettes to someone with a lung disease.”

Evan Harris, a former Liberal Democrat MP who sat on the science select committee when it carried out its inquiry, said that the decision to continue NHS funding homeopathy by the Government is not a good start for the health secretary Andrew Lansley.

“How does the Government justify allowing treatments that do not work to be provided by the NHS in the name of choice, when it allows medicines which do work to be banned from NHS use?” Dr Harris said.

From:  http://www.independent.co.uk/government-ignored-our-advice-on-homeopathic-remedies-say-experts