Taxpayers are paying five per cent more per year for hospitals built under Labour’s Private Finance Initiative (PFI) because the debts are linked to inflation.Currently the combined debt for some 800 PFI projects, including 103 PFI hospitals in England, stands at about £300 billion, according to makers of the programme.

When a BBC Panorama programme contacted 85 hospital trusts with PFI deals, it found 80 of them said they were having to make increased payments due to inflation.

When most of the deals were set up, inflation was low and the outlook was for that to continue well into the future.

Most trusts decided not to protect their debts from rising inflation, against the advice of the Treasury.

By contrast, the companies building the hospitals insured themselves against losses due to inflation.

The PFI deals, under which companies build hospitals to be leased back by the NHS, typically run for 30 years.

Margaret Hodge, the Labour MP who now chairs the Public Accounts Committee, admitted to the programme: “We should have been much more transparent about the costs. I think we got the balance wrong.”

Richard Bacon, a Conservative member of the committee, said he thought taxpayers were being “ripped off”.

A spokesman for the Treasury said that protecting PFI debts against inflation was “not mandatory … because it is subject to individual authorities undertaking their own project assessments”.

He added said: “The Government has consistently expressed concerns about the misuse and costliness of PFI. That is why, less than two weeks ago, the Government launched a fundamental review of the PFI model, which will see the end of PFI as we know it.”

Cancer care on the NHS lags behind that in many other developed countries because Labour wasted billions of pounds on PFI schemes, bureaucracy and inflated salaries for managers.A report by the Organisation for Economic Co-operation and Development (OECD) has found that, despite record spending on health care, cancer survival rates in Britain are worse than in Slovenia and the Czech Republic.

Survival rates for breast cancer, prostate cancer and cervical cancer were below the average for the 34 developed countries in the study.

Mr Lansley lays the blame for the poor performance on the previous government’s failure to make sure that extra investment in the NHS reached the front line. He claims patient care was ignored in favour of increased salaries and botched computer systems.

Writing in The Daily Telegraph, Mr Lansley says: “Unfortunately this report shows how much work there is to do to deal with Labour’s legacy of neglect and mismanagement of our NHS.

“They hugely increased spending on the Health Service, but wasted much of it on managers, failed IT projects and unsustainable PFI projects.

“They failed to focus on what really matters – patients – which is why we still have some of the worst cancer outcomes amongst comparable countries.”

Under Labour, spending on the NHS trebled, reaching almost £100 billion in 2009, but money for treating cancer still lags behind much of the rest of the world.

A report by the Policy Exchange think tank last year found that England spent around 5.6 per cent of its health care budget on cancer care, compared with 7.7 per cent in France, 9.6 per cent in Germany and 9.2 per cent in America.

In September it emerged that private finance initiatives, introduced by Labour to fund capital projects, have left 60 NHS hospitals on the “brink of financial collapse”. Meanwhile, the pay of NHS chief executives has risen, with typical earnings now more than £150,000.

The OECD figures reveal that the best breast cancer survival rates were in the US, where 89.3 per cent of women were alive five years after being diagnosed. The average across all OECD countries was 83.5 per cent, while in the UK it was 81.3 per cent.

Survival rates for cervical cancer were worse. Norway topped the table with 78.2 per cent still alive after five years, compared with 58 per cent of women in the UK. There were also more hospital admissions for asthma and other lung conditions than the average and infant mortality was higher.

The report also showed that consultations by doctors have fallen, and were below he OECD average in 2009.

Katherine Murphy, the chief executive of the Patients Association, said: “The NHS provides some excellent care but it does fall down on many counts. We know from patients phoning our helpline that the quality of care that they have experienced can be very poor and sometimes it is downright neglectful.

“Rather than trying to tackle the issue of poor care, the Department of Health is demanding that the NHS makes £20 billion of efficiency savings while spending a million pounds a day on a reform plan that doctors, nurses, patients and NHS managers all say risks irrevocably damaging the NHS.”

From:  http://www.telegraph.co.uk/Cancer-cash-wasted-on-NHS-salaries

The last Labour government left taxpayers with a £60 billion PFI bill for the scores of new hospitals it built during its 13 years in power, new figures reveal.
They shine a fresh light on the profligacy of the party’s use of Private Finance Initiative (PFI) schemes.

Labour ministers only paid £5 billion of the £65 billion “spent” on building more than 100 hospitals between 1997 and 2010.

The rest of the money, some £60 billion, must still be repaid by the taxpayer – with some of the gigantic debt lasting for more than 30 years.

The highest profile case concerns Barts and the London NHS Trust project, signed by ministers 2006, which provided two new hospitals in the capital.

By the time the coalition took office four years later nothing at all had been repaid – leaving an outstanding bill of £5.3 billion.

Jesse Norman, the Conservative MP, accused Labour of “extraordinary hypocrisy”. Their PFI bill for hospitals will cost every working family in Britain £3,600, according to Mr Norman’s figures.

PFI schemes were started by the last Conservative government under John Major in the early 1990s. However, they mushroomed under Labour with Gordon Brown, as Chancellor, using them as a way of meeting his own public borrowing rules.

Under the schemes, instead of the government raising money upfront, a private company is given a lengthy contract to build a school or hospital and then provides related ‘services’ to the public sector.

The Government leases the building for the length of the contract before it goes back into public ownership.

Any change, however small, to the building or service provided can be charged at sky high rates, allowing the company to make a huge profit.

New analysis of official figures shows that Labour initiated PFI contracts to build 103 new hospitals between 1997 and 2010. The party proclaimed at the time of the last election it has been responsible for a “new generation” of hospitals in Britain.

The total “unitary charge” payments for these hospitals was £5.1 billion. However, many projects will not be fully paid off for more than two decades – with the last one not “completing” until 2048.

The total accumulated “unitary charge” payments for the hospitals will be £65.1 billion – meaning that only 7.8 of the total was actually paid for before Labour left office.

Costs have escalated because of rising fees and additional charges for maintenance, cleaning and catering.

According to official figures, the NHS currently pays back £1.25 billion each year – but this figure will increase until 2030 when it is expected to hit £2.3 billion.

The Barts and the London NHS Trust project, to develop Barts into a “centre of excellence” for cancer and cardiac treatment and to build a new hospital at The Royal London , was started in 2006 – but payments will not even commence until 2013-14 and will not be finished until 2048.

By that time, it will have cost £5.3 billion despite only having a “capital value” of £1 billion, according to the Treasury.

Poorly negotiated PFI contracts have already led to examples of waste including Queen Elizabeth Hospital in Woolwich having to have 64 visits a year from pest controllers even if there are no pests to control. When there are pests, the trust must pay for further visits.

In another example, officials at the Central Middlesex Hospital in north west London said that, on average, contractors charged it £210 to install an electric socket.

Senior Labour figures including Gordon Brown strongly defended using PFI schemes while in power but, more recently, leading shadow ministers have admitted errors.

John Healey, the shadow health secretary, said earlier this month: “There is definitely a case for saying we were poor at PFI, poor at negotiating PFI contracts from the outset.”

Andy Burnham, a former health secretary who is now shadow education secretary, said last year: “We made mistakes. I’m not defending every pen stroke of the PFI contracts we signed.”

Mr Norman, a member of the Treasury select committee, said: “This shows extraordinary hypocrisy. The last Government claimed to be investing in public services.”

“In fact their true investment was less than less than one tenth of what they claimed. Labour didn’t manage to pay for even one new PFI hospital on their watch.”

“Labour maxed out the nation’s credit card with a £60 billion bill for new hospitals, loading future generations with staggering debt repayments.”

“After bringing the country to the brink of bankruptcy, they now have no credible plan to clear up the mess they left us with.”

“Their approach – to spend less without making any reforms at all – would leave the NHS in crisis.”

From: http://www.telegraph.co.uk/Labour-left-taxpayer-60billion-bill-for-new-hospitals

Labour chair of public accounts committee laments ‘bad story of missed opportunities’ in tackling health inequality.
Labour’s stewardship of the NHS produced an alarming health gap that saw people living in the poorest neighbourhoods in England die almost two years before those in the rest of the country, in what the head of the public accounts committee today calls a “bad story of missed opportunities”.

Margaret Hodge, the Labour chair of the committee, said that despite the doubling of the NHS budget and rising prosperity levels there had been “lots of reports and inaction about health inequality”.

“New Labour came in in 1997 and announced it would put reducing health inequalities at the heart of tackling the root causes of ill-health. But it was unacceptable that health inequalities only became a NHS priority in 2006, and primary care trusts not required to report on it until 2007. It was too late.”

The committee’s report found that, as a result, the gap in life expectancy between the poorest areas and the national average grew by 7% for men and 14% for women, and Labour missed its own targets on public health. It says that the Department of Health did not have enough resources and lacked leadership and a “clear focus on health inequalities”.

“This was a bad story … of missed opportunities,” said Hodge, who said the premature mortality amounted to 3,335 excess deaths across the country. There were not enough family doctors in poor areas and no ideas to prevent public health problems rather than reacting to crises in, for example, obesity.

The report says two-thirds of the poorest places in the country still had “lower levels of GP coverage than the national average of 60 GPs per 100,000 population”. In the north-east, the report said, this dropped as low at 25 per 100,000.

Hodge, a minister in the last government, said Labour should have forced GPs in “single-handed practices” to band together in bigger practices in poorer areas, and paid new doctors more money to work in difficult areas. Single-handed practices make up 22% of all GP surgeries in poor areas.

“We should have drawn up new contracts, closed down single-GP practices and basically told them who to hire and how much to pay them,” she said, pointing out 10 of the 146 measures outlined in a doctor’s contract rewarded physicians for focusing on the neediest groups.

The committee’s response comes as the health secretary, Andrew Lansley, is preparing a white paper on public health to be published this month. The report says that at present around 4% of the NHS budget is spent on public health, although actual spending is not easy to identify. It calls on the government to develop “transparency and accountability for this [money]“.

Hodge said the committee had identified three public health prevention strategies – stopping smoking, high blood pressure and lowering cholesterol – which cost £24m out of a total budget of £3.9bn. “But it was not spent. We are too reluctant to spend on prevention in this country and end up spending billions on treatments.”

The government welcomed the report, saying it was committed to renegotiating doctors’ contracts so that disadvantaged areas could deal with their population’s health needs. “We’ve already set out proposals for how areas with the poorest health will be given money to help them be healthy, and public health budgets will be ringfenced,” said Anne Milton, the public health minister. “We need a new approach to improve the health of the poorest, fastest.”

From: http://www.guardian.co.uk/health-inequality-labour-margaret-hodge

Tens of thousands of NHS workers would be sacked, hospital units closed and patients denied treatments under labour’s secret plans for £20 billion of health cuts.

The sick would be urged to stay at home and email doctors rather than visit surgeries, while procedures such as hip replacements could be scrapped.

The plans have emerged as health chiefs draw up emergency budgets that cast doubt on pledges by Gordon Brown to protect “front line services” in the NHS.

Documents show that health chiefs are considering plans to begin sacking workers, cutting treatments and shutting wards across the country.

The proposals could lead to:
* 10 per cent of NHS staff being sacked in some areas.
* The loss of thousands of hospital beds.
* A reduction in the number of ambulance call-outs.
* Medical professionals being replaced by less qualified assistants.

The plans are contained in a series of internal NHS documents uncovered by The Daily Telegraph.

The final details of the plans are not due to be announced until the autumn, well after the country has gone to the polls for the general election.

The Conservatives and health campaigners said the public deserved to know the true extent of cuts at their local surgeries and hospitals before voting.

Last year all English health authorities were ordered by Sir David Nicholson, the NHS chief executive, to reconsider their plans after the recession forced the Government to freeze health spending from April next year.

This left a ”black hole’’ of up to £20 billion in health budgets up to 2014, prompting the drawing up of new proposals by the 10 strategic health authorities (SHAs).

They had until Friday to submit their plans to Andy Burnham, the Health Secretary. He is under pressure from the Treasury to show how money will be saved to help bring down Britain’s record £167 billion deficit.

In Wednesday’s Budget, Alistair Darling, the Chancellor, repeated that the £20 billion would come through “efficiency savings” and not key services.

Documents produced by several of the SHAs show how the cuts are, in fact, expected to fall on hospital services.

In the South East Coast region, which covers Surrey, Kent and Sussex, up to £1.6 billion must be saved.

A document marked “restricted” and circulated among SHA board members suggests 10,000 of the region’s 100,000 NHS workers may lose their jobs. “The new financial environment demands that the trend in workforce growth must be reversed,” it said, adding bosses must reduce employee numbers by 10 per cent “or further”.

The document said staffing in the acute sector, covering hospitals, “can be expected to decline faster and further” than elsewhere.

Job losses will be “starting in the coming year”, it states. Mr Brown has repeatedly promised Labour will not start making significant cuts to public spending until 2011. A spokesman for the South East Coast SHA said the document was a discussion paper and not a final plan.

In London, which faces £5 billion in cuts, documents show managers believe up to £2 billion can be saved from community care budgets, which cover GPs’ surgeries. This would include “changing how patients get in contact with and receive services, such as through greater use of the internet and email”.

An internal presentation by NHS Yorkshire and the Humber, which spans Sheffield, York, Hull and north Lincolnshire, made similar suggestions. The SHA, which is expected to make about £2 billion in cuts, proposed directing more patients to “teleservices such as NHS Direct”. Meanwhile, £450 million could be saved in London by banning clinical procedures “that have little or no benefit to those receiving them, for example some joint replacements”.

NHS North West, which oversees Greater Manchester and Liverpool, is expected to make about £2 billion savings. It is preparing to close an A&E unit in Rochdale during evenings before scrapping it altogether next year.

In the East region, covering Bedfordshire, Cambridgeshire, Essex, Hertfordshire, Norfolk and Suffolk, up to £2 billion is to be cut. The SHA proposes shifting services out of hospitals and making social workers take over some treatments. It is estimated that savings of about £2.4 billion will need to be made by NHS West Midlands, £2 billion in the South West, £1.3 billion in South Central, £1 billion in the North East and £800 million in the East Midlands.

All the Department of Health spokesman could say- as a way of confirmation: “We will be clear with trusts that they must not make short term cuts that harm patient care.”

From: http://www.telegraph.co.uk/health/healthnews/7529454/Hospital-wards-to-shut-in-secret-NHS-cuts.html