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Health lottery launched to raise £50 million

September 27, 2011 By: Dr Search- Principal Consultant at the Search Clinic Category: Health, Health Direct, Health Websites, Healthcare, NHS, NHS Cash Shortages, National Health Service, Uncategorized, postcode lottery

A new health lottery is launched today with the aim of generating up to £50 million a year for health causes.Health lottery launched to raise £50 millionThe Health Lottery – run by Northern & Shell, which owns Channel 5 and Express newspapers – offers a £100,000 top prize for matching five numbers from 50.

The launch was hosted by television presenter Eamonn Holmes, who will also front the live draw to be shown on ITV1 and Channel 5 each Saturday from October 8.

He said: “It’s such a great idea, I am really excited about being part of something that not only makes people smile every week, but also has the ability to change lives in the longer term.

“In these difficult economic times, the Health Lottery will inject a sizeable amount of new money into that local network, and the projects that are supported will help people live longer, healthier lives.”

Twenty pence from tickets, which cost £1, will go towards health-related good causes.

Matching three numbers wins £50 and four numbers £500.

No matter how many people win, everyone will get the advertised prize, the Health Lottery said.

John Hume, chief executive of the People’s Health Trust, said: “We will be working directly with communities to identify practical and sustainable ways in which funding from the Health Lottery can have real impacts on health and well-being in communities experiencing significant disadvantages.”

Martin Hall, chief executive of the Health Lottery said: “The Health Lottery game is a fresh new alternative which has one single good cause at its heart – health.

“We will be offering people the opportunity to win a life-changing amount of money while at the same time contributing to tackling real health issues in their own communities.

“It is an exciting new launch which will benefit every community in Great Britain.”

But the launch attracted criticism from Sir Stephen Bubb, of the Association of Chief Executives of Voluntary Organisations, who dubbed it a “disgraceful new development”.

He wrote on his blog: “He (Northern & Shell owner Richard Desmond) intends to only give 20p in the pound to health, whereas the National Lottery is giving 28p to good causes.

“So if people switch to Desmond from the National Lottery charities will lose out.”

Health Direct also notes that the marketing and admin charges are higher for the new lottery than the national Camelot lottery.

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NHS Hospitals failing to report serious safety incidents

September 19, 2011 By: Dr Search- Principal Consultant at the Search Clinic Category: Accident & Emergencies, Doctors, Health, Health Professionals, Healthcare, NHS, NHS Deaths, National Health Service, Uncategorized, red tape

NHS Hospitals are breaking the law by failing to report incidents that result in severe harm to patients a charity has warned.NHS Hospitals are breaking the law by failing to report incidents that result in severe harm to patients a charity has warned.Peter Walsh, chief executive of the charity Action Against Medical Accidents (AvMA), said many were failing to own up to such incidents despite a law that had been in force since April 2010, requiring them to do so.

He was commenting on National Patient Safety Agency (NPSA) figures, showing an 8.5 per cent increase in the total number of reported incidents in the NHS in England, between April to September 2010 and October to March 2011.

The vast majority of such incidents result in “no harm” (69 per cent), “low harm” (24), or “moderate harm” (six).

However, one per cent result in “death or severe harm”. Since April 2010, health trusts have had to report these incidents.

Between the two most recent six-monthly periods for which data are available, the number of such reported incidents rose by 13 per cent – from 4,358 to 5,012.

While significant, Mr Walsh believed if all trusts were reporting as they should, the rise would be larger still.

He said: “Given that there was a new set of rules that came in, in April 2010, that made it a statutory requirement for trusts to report incidents that cause severe harm or death, we would have expected a bigger increase.

“So we think some trusts might be holding back on reporting incidents that caused severe harm.”

He added: “We think work is needed looking at why trusts do not seem to be reporting at a rate we would expect.”

Individual cases that were known through clinical negligence claims should be checked back, to see if trusts had reported them to the NPSA, he recommended.

A spokesman for the NPSA said that overall new figures reflected an improving culture of reporting incidents in NHS trusts.

Sarndrah Horsfall, chief executive of the NPSA, said: “Identifying patient safety incidents and ensuring they are reported and analysed is at the heart of reducing risk in healthcare.

“NHS organisations should use the data and review the tools, guidance and support available to them. This will ensure patient safety incidents continue to be reported and learned from, strengthening the patient safety culture across all levels of the NHS.”

From:  http://www.telegraph.co.uk/Hospitals-failing-to-report-serious-safety-incidents

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Patients left at risk by health quango’s focus on red tape

September 16, 2011 By: Dr Search- Principal Consultant at the Search Clinic Category: Doctors, Health, Health Websites, Healthcare, NHS, National Health Service, Preventable Crisis, Quangoes, Uncategorized, red tape

Patients have been left at risk as the country’s main health watchdog quango carried out 70 per cent fewer inspections in order to focus on bureaucracy MPs find.Patients left at risk by health quango's focus on red tapeThe Care Quality Commission was guilty of a “significant distortion” in its priorities as it concentrated on red tape rather than checking that hospitals and care homes were safe, according to the Health Select Committee.

The situation was made worse by the fact that almost 300 posts were unfilled at the regulator and it failed to make Government understand the difficulties it was facing in adding dentists to the professions it monitors.

A damning report accuses the CQC of responding “woefully” to a whistleblower who uncovered abuse of people with learning disabilities at a private hospital, and of only offering “out of date and unhelpful” information to the public.

The MPs also call on the watchdog to focus on the broader culture at hospitals and care homes, rather than individual failings in treatment, to make sure that complaints are not being suppressed.

Stephen Dorrell, the Health Secretary under John Major who now chairs the select committee, said: “In its review of the CQC, the Committee concluded that the organisation’s priorities became distorted by a statutory deadline for the registration of dentists and that this distortion led directly to a drop of 70 per cent in inspection activity during the second half of 2010-11 compared with the same period in the previous year.

“The primary causes of this distortion, which resulted in increased risk to patients, were the unrealistic statutory obligations imposed on the CQC.”

Rosie Cooper, a Labour member of the committee, said: “I was really disappointed that the CQC allowed itself to get trapped in the regulatory profess and that restricted its ability to carry out inspections, which left vulnerable people at risk.”

The CQC, which has a budget of more than £160 million, was formed in 2009 in a merger of three separate watchdogs for healthcare, mental health and social care, and set about registering thousands of NHS hospitals and care homes.

But it missed its target of registering 8,000 dentists by April because of its complex process and the deadline for putting GP practices on its books has been postponed for a year so it can catch up.

As a result of this focus on administration, the select committee says that CQC inspections to see if patients are being looked after safely fell by 70 per cent, from 6,840 between October 2009 and March 2010 to 2,008 in the following six months.

Meanwhile its number of job vacancies rose from 148 in June 2010 to 297 a year later, “a further cause for concern”, almost half of whom were the inspectors and registration assessors it needed the most.

The MPs said the watchdog should have argued its case to Government more persuasively and far sooner.

Caseloads for the CQC’s inspectors have risen from 50 to 62 organisations over the past year, and so many assessments are mere “box-ticking” exercises carried out from its offices.

After a nurse contacted the CQC to complain about abuse at Winterbourne View, its response was “woefully inadequate”. Calls from whistleblowers elsewhere increased after the scandal was exposed by Panorama but this could be “only the tip of the iceberg”.

The CQC has a website where patients and relatives can read reports on hospitals and care homes but in many cases they are “several years old” and contain “limited” information.

The MPs say that inspectors should visit hospitals and nursing homes every year and speak to staff, patients and visitors to get a true picture of the quality of care being provided, rather than just relying on easily met targets.

From: http://www.telegraph.co.uk/Patients-left-at-risk-by-watchdogs-focus-on-red-tape

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Chocolate is as good for you as exercise according to new research

September 15, 2011 By: Dr Search- Principal Consultant at the Search Clinic Category: Doctors, Exercise, Health, Health Professionals, Health Websites, Uncategorized

Scientists found that small amounts of dark chocolate may improve health in a similar way to exercise.Chocolate is as good for you as exercise according to new researchThe researchers focused on the mitochondria, the tiny powerhouses in cells that generate energy, and discovered that a plant compound found in chocolate, called epicatechin, appeared to stimulate  the same muscle response as vigorous activity.

Dr Moh Malek, from Wayne State University in Detroit, who led the US study on mice, said: ”Mitochondria produce energy which is used by the cells in the body. More mitochondria mean more energy is  produced the more work can be performed.

”Aerobic exercise, such as running or cycling, is known to increase the number of mitochondria in muscle cells. Our study has found that epicatechin seems to bring about the same response –  particularly in the heart and skeletal muscles.”

A specific type of epicatechin from cocoa was given to mice twice a day for 15 days.

At the same time, the animals underwent 30 minutes of treadmill training each day.

Researchers found that mice only fed epicatechin had the same exercise performance as those running on the treadmill.

The findings were published today in the Journal of Physiology.

The scientists hope their research will lead to better ways of combating age-related muscle wasting.

”The number of mitochondria decreases in skeletal muscle as we age, and this affects us physically in terms of both muscle energy production and endurance,” said Dr Malek. ”Applying what we know  about epicatechin’s ability to boost mitochondria numbers may provide an approach to reduce the effects of muscle ageing.”

Middle aged mice who both exercised and ate epicatechin showed an even greater benefit.

”It appears epicatechin treatment combined with exercised could be a viable means to offset muscle ageing,” said Dr Malek.

He added: ”At the moment it would be a leap of faith to say the same effects would be seen in humans. But it is something we hope to identify in future studies.”

From:  http://www.telegraph.co.uk/Chocolate-as-good-for-you-as-exercise

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NHS hospitals needed £200 million in bailouts and loans

August 22, 2011 By: Dr Search- Principal Consultant at the Search Clinic Category: Health, Health Direct, Health Professionals, NHS, NHS Cash Shortages, National Health Service, Uncategorized, red tape

England’s NHS hospitals needed at least £200 million in bailouts and loans as they struggled to balance their books while also meeting tough savings targets, according to a spending watchdog.NHS hospitals needed £200 million in bailouts and loansThe Audit Commission said nine NHS trusts “failed to achieve financial balance” and many more applied for extra funding from managers and the Government, although overall performance “continues to be good”.

Health bodies spent £289m on redundancy payments but the number of staff employed in hospitals actually rose by almost 8,000.

Dozens were found at fault with the “value for money” they offer and a fifth of all NHS bodies failed to meet their savings targets despite cutting back on staff and the number of patients they treat.

The Audit Commission, the public spending watchdog that is being scrapped, warned that health service providers face even tougher times ahead as savings become harder to find and Government spending increases dry up.

Andy McKeon, managing director for health at the Audit Commission, said: “It is impressive that the NHS overall performed so well financially last year, even if some organisations struggled.

“But there is no room for complacency. Tighter funding, and the need to continue to improve services and implement reforms, will make the next three years much tougher.  NHS organisations will need to make a determined effort to find further recurrent savings while continuing to deliver high quality services.”

The watchdog looked at the 2010-11 accounts for Primary Care Trusts, which pay for treatment; hospitals not including the semi-independent Foundation Trusts; and the regional Strategic Health Authorities.

It found that they were running a £1.5 billion surplus and had actually underspent by £272 millon on the £2.95 billion in capital expenditure they were given by the Department of Health, twice as much as recorded the previous year.

But seven hospitals and two PCTs failed to break even, one fewer than in 2009-10, with the biggest deficit of £41m recorded by South London Healthcare NHS Trust.

At least 16 NHS organisations needed additional financial support from PCTs which is never paid back “thereby obscuring their real financial health”.

Managers gave out £90 million to hospitals, while the Department of Health issued loans totalling £34 million to four hospitals and also gave £76 million to two trusts which did not even have enough money to pay back loans.

Ministers want to cut management costs by 45 per cent at SHAs and PCTs, which are being restructured, and they did let 5,713 people go with average pay-offs of £40,000 each.

But the headcount at hospitals actually rose by 7,616 and only fell by 27 in the 10 SHAs.

The Audit Commission did not find any NHS body’s accounts were not “true and fair”, but it did issue “qualified Value For Money conclusions” for 27 hospitals and 18 PCTs, suggesting they had problems with “financial resilience” or “economy, efficiency and effectiveness”.

The Audit Commission warns next year will be “a more financially challenging year” as there will be no “significant real-terms increase” in the central budget, so trusts will require “determined effort and strong leadership”.

From:  http://www.telegraph.co.uk/NHS-hospitals-needed-200m-in-bailouts-and-loans

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Labour own goal on postcode lottery claims

July 25, 2011 By: Dr Search- Principal Consultant at the Search Clinic Category: Conservatives, Health, Health Direct, Uncategorized, postcode lottery

Deprived areas in England will lose out to affluent parts of the country under health spending reforms Labour has claimed- despite repeatedly creating those same postcode lotteries when they were in power.
Labour own goal on postcode lottery claimsChanges to funding formulas means poor health rates will be given less consideration when cash is allocated, the party said.

It suggested areas like Manchester and the London borough of Tower Hamlets would lose out to parts of the wealthy south east, such as Surrey and Hampshire.

Labour based the claims on an assessment of funding reforms by public health bodies in Manchester.

But the government has disputed the allegations and claimed Labour’s figures were misleading.

Department of Health officials said primary care budgets in Surrey and Tower Hamlets would go up by a similar amount this year.

The Conservatives claimed every area would have suffered health funding cuts under Labour.

A Conservative party spokesman said: “This is yet another own goal from Labour. If they had won the last election, the NHS would now be being cut by £28 billion across the country. Every area would have seen spending on the NHS cut – as it is in Labour-run Wales.

“This Government is increasing spending on the NHS in real terms over this parliament, and every region of the country will receive more money as a result of this investment.”

Health Direct has repeatedly tracked Labour’s proud boast when it was in power of creating postcode lotteries based on it’s voting constituencies:

Friday, April 13, 2007 Labour voting areas get most PFI NHS cash
http://www.healthdirect.co.uk/2007/04/labour-voting-areas-get-most-pfi-nhs.html

Wednesday, November 22, 2006 Hewitt defends NHS cash for Labour voting areas
http://www.healthdirect.co.uk/2006/11/hewitt-defends-nhs-cash-for-labour.html

Tuesday, October 24, 2006 NHS cuts twice as likely in Tory and Lib Dem areas
http://www.healthdirect.co.uk/2006/10/nhs-cuts-twice-as-likely-in-tory-and.html

Monday, September 25, 2006 NHS closures rigged in Labour voting constituencies
http://www.healthdirect.co.uk/2006/09/nhs-closures-rigged-in-labour-voting.html

Friday, September 15, 2006 Labour accused over hospital cuts in marginal constituencies
http://www.healthdirect.co.uk/2006/09/labour-accused-over-hospital-cuts-in.html

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IVF drugs may be linked to genetic defects discovered in embryos

July 08, 2011 By: Dr Search- Principal Consultant at the Search Clinic Category: Doctors, Drugs, GPs, Health, Health Professionals, Private Healthcare, Uncategorized, maternity, postcode lottery

Drugs used to stimulate the ovaries of older women undergoing IVF treatment may be causing genetic defects in the embryo which have until now gone undetected.
IVF drugs may be linked to genetic defects discovered in embryosScientists have discovered abnormalities in the chromosomes of eggs from women over 35 years of age who had been treated with synthetic hormones to stimulate their ovaries prior to IVF.

The researchers said they were surprised to find the chromosome defects which appeared to have occurred during the second stage of the specialised process of cell division that leads to the creation of the human egg cell.

Chromosome defects in eggs were previously considered to have resulted in the first stage of cell division, which occurs when a woman was herself a foetus in the womb. Finding them during the second stage, which occurs at ovulation, therefore suggests they may have resulted from the hyperstimulation of the ovaries during IVF treatment.

The defects included abnormal variations from the usual number of 23 pairs of chromosomes. Three copies of chromosome 21 instead of the normal two, for instance, leads to babies with Down’s syndrome. As women get older it becomes increasingly difficult for them to produce enough viable eggs for IVF treatment. It is common practice for older women to have their ovaries stimulated with stronger doses of drugs than is the case for younger women.

The results of the study are to be presented at a fertility conference in Stockholm this week but the scientists behind the research said that they wanted to reassure older women considering IVF treatment. They said further work needs to be done fully to explain the findings and there is no evidence to suggest that IVF babies of older women are at any higher risk of birth defects than babies conceived naturally by women of the same age.

“We found that some IVF eggs have up to seven chromosome abnormalities. This suggests the possibility that ovarian stimulation during the treatment may have caused some of these defects,” said Professor Alan Handyside, director of the London Bridge Fertility, Gynaecology and Genetics Centre, who led the study.

“These defects are unexpected and it may be that this is just an undiscovered aspect of biology. At the moment all we can say is that this is part of the natural process as women get older.”

The study, which will be presented at the European Society of Human Reproduction and Embryology, analysed more than 100 egg cells from 34 couples undergoing IVF treatment. The average maternal age was 40.

Scientists screened the chromosomes of the eggs and structures known as “polar bodies” that result from a type of cell division known as meiosis. Meiosis is a specialised form of division that results in eggs with half the normal complement of chromosomes – crucial to ensuring that the fertilised egg has the full complement of 46 chromosomes when it fuses with a sperm cell.

The first stage of meiosis occurs when the woman’s ovary is developing in the foetus before birth, when the dividing chromosomes are held together by a kind of cellular “glue” ready for the second stage of division at ovulation.

However, when the ovary of an older women is stimulated with synthetic hormones it is possible that this dislodges the glue prematurely. This might result in abnormal numbers of chromosomes to segregate into the resulting egg cell.

“Our evidence demonstrates that, following IVF, there are multiple chromosome errors in meiotic divisions, suggesting more premature separation of single chromosomes resulting in more random segregation,” Professor Hanyside said.

Stuart Lavery, a consultant gynaecologist at Hammersmith Hospital in London, said “This provides evidence that there is a problem, but it does not prove that it’s treatment related,” Mr Lavery said.

The most important conclusion to be reached from this research isn’t so much the “why” but that the screening process for eggs to be used in IVF must be improved.

It is possible to screen the chromosomes of so-called First Polar Body eggs, at least as part of research. This paper stresses the importance of also screening Second Polar Body eggs, those that have been fertilised.

Doing so will, we can now see, allow us to better identify eggs that have developed abnormalities that result in conditions like Down’s Syndrome.

The issue of whether drugs used to stimulate ovulation are having a role is two-fold. Are the drugs damaging the eggs or simply releasing those that would otherwise be discarded naturally because of abnormalities? Or it could be the drugs have no role at all? We don’t know.

One intriguing point is that if the drugs are a factor we would have anticipated having seen more cases of Down’s Syndrome among older mothers. They may be there but we haven’t detected any such increased risk yet – it means we need to research the possibility.

From:  http://www.independent.co.uk/ivf-drugs-may-be-linked-to-genetic-defects-discovered-in-embryos

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Drugs treatment policy for England doomed to failure

June 27, 2011 By: Dr Search- Principal Consultant at the Search Clinic Category: Conservatives, Drugs, Health, Health Direct, Health Websites, Healthcare, NHS, NHS Waste, National Health Service, Risk of Drugs, Uncategorized, red tape

Government policies for treating drug addicts in England are flawed and “doomed to failure”, a think tank says.
Drugs treatment policy for England doomed to failureThe Centre for Policy Studies says rehabilitation is a better use of the £3.6bn now spent on treating users with drug substitutes like methadone and keeping them on benefits each year.

But it says plans to reward groups which treat addicts so they can return to work are open to manipulation.

The Department of Health said it aimed to get users “off drugs for good”.

The coalition government wants to change the way drug addiction is tackled, with more people with problems diverted away from prison and into treatment as part of what it calls a “rehabilitation revolution”.

Part of this involves rewarding treatment providers who show addicts have improved their health and employment prospects.

A report from the right-of-centre think tank, which has links to the Conservative Party, says these payment by results schemes were being run by the very organisations “responsible for the current failure of policy”.

It says the current annual cost of maintaining treatment for 320,000 problem drug users is made up of £1.7bn in benefits, £1.2bn for looking after their children and £730m for prescribing the heroin substitute methadone.

Kathy Gyngell, Centre of Policy Studies: “The Department of Health has been paying 153,000 people to be on methadone”

The think tank calls for “a real transfer of power from large distant organisations to small innovative providers” for rehabilitation.

It says such units have a better chance of getting addicts off drugs completely, adding: “There is one simple measure of success: That of six months abstinence from drugs.”

According to the report’s author Kathy Gyngell, chairwoman of the prisons and addictions policy forum at the CPS, prescribing methadone to addicts delays their recovery.

She told the BBC: “The state is subsidising people to be any number of years on methadone, which has turned out not to be a cheap option and will only subsidise the tiniest proportion – 2% – to go into a rehabilitation unit that would actually free them from dependency and allow them to live their life.”

A Department of Health spokesman said: “The 2010 Drug Strategy is fundamentally different from those that have gone before.

“Instead of focusing primarily on reducing the harms caused by drug misuse, our approach will be to go much further and offer every support for people to choose recovery as an achievable way out of dependence.”

He added: “Work is under way to support local recovery systems tailored to the needs of communities, many of which are already showing positive results.”

From: http://www.bbc.co.uk/news/uk-13826759

Health Direct has for a long time noted the costly failure that is the current policy on drugs. On August 02, 2006 in Risks of taking drugs compared- Scientific review of dangers of drugtaking- Drugs, the real deal

we reproduced the first ranking based upon scientific evidence of harm to both individuals and society.

It was devised by government advisers – then ignored by ministers because of its controversial findings.

The analysis was carried out by David Nutt, the then senior member of the Advisory Council on the Misuse of Drugs, and Colin Blakemore, the chief executive of the Medical Research Council.
http://www.healthdirect.co.uk/2006/08/risks-of-taking-drugs-compared.html

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Organ donor register passes 18 million pledges

June 24, 2011 By: Dr Search- Principal Consultant at the Search Clinic Category: Doctors, Health, Health Professionals, Health Websites, NHS, National Health Service, Uncategorized, Waiting Times

The number of people registered as organ donors in the UK has reached “staggering” levels, according to the NHS Blood and Transplant.
Organ donor register passes 18 million pledgesA record 18 million – nearly one out of every three – people now say they are willing to donate their organs.

But the organisation said even more people needed to register.

Although nearly 30% of the UK population have registered their willingness to help others live in the event of their death, Black and Asian people had to wait three times longer for a transplant, because of a shortage of donors in those communities.

Sally Johnson, director of organ donation and transplantation, said the number of people on the register represented “a fantastic achievement”.

But she added: “Getting people to sign up to the register is only half the battle.

“In order to see that their wishes are carried out in the event of their deaths, it is essential that those who want to become donors discuss donation with family and friends.”

People in Scotland are the most likely to donate, 37% are on the register. The South West of England isn’t far behind with 35% of people signing up.

In 2010, more than 1,000 people donated their organs, and 2,700 organs were transplanted, across the UK.

However, 10,000 people are still on a waiting list for transplants.

To add your name to the NHS Organ Donor Register, please ring 0300 123 23 23 or visit www.organdonation.nhs.uk.

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Cameron’s five pledges for NHS future

June 06, 2011 By: Dr Search- Principal Consultant at the Search Clinic Category: Conservatives, Doctors, GPs, Health, Health Direct, Health Professionals, Healthcare, NHS, NHS Cash Shortages, National Health Service, Nurses, Out of hours, Private Healthcare, Uncategorized, Waiting Times

David Cameron will commit to “five guarantees” on the future of the National Health Service in a speech designed to reassure critics of his controversial health reforms.Cameron's five pledges for NHS futureThe Prime Minister will promise to keep waiting lists low, maintain spending, not to privatise the NHS, to keep care integrated and to remain committed to the “national” part of the health service.

Such is the concern in Downing Street at the damage the issue of NHS reform is causing the Government, that Mr Cameron will put his reputation on the line with a personal pledge to protect its core values. It represents his boldest attempt yet to assuage criticism from his Liberal Democrat Coalition partners and from many health professionals over the impact of the reforms.

In his speech, the Prime Minister will admit that he is willing to act on their concerns after listening to the “profession and patients” during a two-month exercise which was held after Mr Cameron called for a “pause” in the Health Bill’s passage.

His “five guarantees” are designed to show the Prime Minister is committed to the NHS, and “he is hearing what is being said”, according to one source. Mr Cameron’s promise on integrated care is designed to ensure patients receive continuity of treatment, without having to explain their condition from scratch each time to different doctors.

It also means that nurses and hospital professionals will retain a role in commissioning services, and that not everything is transferred to GPs.

His commitment to the “national” part of the NHS represents a pledge to keep it as a universal service, free at the point of use. But Mr Cameron will also say that “no change” is not an option.

He will echo the words of Andrew Lansley, the Health Secretary, who wrote in last week’s Daily Telegraph about the threat to the NHS if it does not reform. He warned of a £20 billion a year funding black hole without reform.

Despite ring fencing health spending, Mr Cameron is expected to make clear that NHS services will be threatened unless there is reform because of the rising costs of drugs and an increasing elderly population.

Mr Cameron is likely to say that the Coalition’s reforms will see the NHS working better. He will point out that in Europe there are health systems which work more effectively.

The speech comes as ministers prepare to rewrite much of the Health Bill. At present the plans involve abolishing two tiers of NHS management and handing control of a £60 billion-a-year budget to groups led by GPs, who can choose to buy treatment for patients from local state-run hospitals or private providers.

This week, the Royal College of Nursing is expected to renew its call for nurses to have a key role on the GP commissioning boards. Mr Lansley will not commit to such a plan until he has heard from the Future Forum, which is reporting back on possible changes to the Bill.

Tomorrow, Mr Lansley, who has been subject to rumours that he is about to resign or be sacked over the issue, faces MPs in the Commons. He will defend the reforms, although he is prepared to see them substantially watered down. However, Labour will seize on stories circulating that Cabinet colleagues had suggested he would not last the year in his post.

Downing Street polling has painted a stark picture of the problems Mr Cameron faces over the NHS and Mr Lansley’s presentation of the plans over the past 12 months is being blamed.

Last week Stephen Dorrell, who was health secretary in John Major’s government, added to speculation that he will replace Mr Lansley. Asked on BBC’s Question Time about whether he would do a better job, he said: “I am going to plead the Fifth Amendment.”

From:
http://www.telegraph.co.uk/David-Cameron-puts-reputation-on-the-line-with-five-pledges-on-the-future-of-the-NHS

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