Dismantling Labour’s disastrous £12 billion NHS IT programme may cost taxpayers more than keeping it going.Ministers announced on Thursday that they will speed up the scrapping of the National Programme for IT (NPfIT)  after a review concluded “there can be no confidence that the programme has delivered or can be delivered as originally conceived”.

It confirmed earlier reports that the central part of the scheme, allowing NHS staff across England to access any patient’s details, was unworkable while costs had increases and deadlines were missed.

The governance board of the programme will now be scrapped, and local trusts will be given the freedom to develop their own versions of the electronic care record rather than having the rules dictated by Whitehall. A new Cabinet Office oversight committee will monitor future IT investment to ensure money is not wasted.

But many trusts across England have large contracts with private suppliers to supply their care record systems, and their cancellation could leave taxpayers even more out of pocket.

The Department of Health’s own chief information officer, Christine Connelly, told MPs on the Public Accounts Committee in May that a £3bn deal with CSC to deliver systems in the north, midlands and east of England would cost more to get out of than to keep going.

She said: “Potentially, if you ask me about the absolute maximum, we could be exposed to a higher cost than the cost to complete the contract as it stands today.”

A decision will be made on the future of the contract later in the autumn.

However the Cabinet Office’s Major Projects Authority said that some parts of the £12.7bn programme had worked and would be retained, including the NHSmail email system and the Choose and Book process of arranging hospital referrals.

Andrew Lansley, the Health Secretary, said: “Labour’s NHS IT Programme let down the NHS and wasted taxpayers’ money by imposing a top-down IT system on the local NHS, which didn’t fit their needs.

“We will be moving to an innovative new system driven by local decision-making. This is the only way to make sure we get value for money from IT systems that better meet the needs of a modernised NHS.”

Roger Goss, co-director of the pressure group Patient Concern said: “Thank goodness politicians have decided to stop money being poured into a huge bottomless pit. Now we must pray that they don’t sanction pouring it into endless incompatible regional pits.”

From: http://www.telegraph.co.uk/Dismantling-NHS-computer-scheme-could-cost-more-money

Patient care is under threat at more than 60 NHS hospitals which are “on the brink of financial collapse” because of costly private finance initiative schemes the Health Secretary warns.Andrew Lansley says he has been contacted by 22 health service trusts which claim their “clinical and financial stability” is being undermined by the costs of the contracts, which the Labour government used extensively to fund public sector projects.

The trusts in jeopardy include Barts and the London, Oxford Radcliffe, North Bristol, St Helens and Knowsley, and Portsmouth.

Between them the trusts run more than 60 hospitals which care for 12 million patients.

There is already evidence that waiting lists for non–urgent operations have begun to rise as hospitals delay treatment to save money. Adding to this are growing fears over the impact of the financial crisis on care this winter.

Under the PFI deals, a private contractor builds a hospital or school. It owns the building for up to 35 years, and during this period the public sector must pay interest and repay the cost of construction, as well as paying the contractor to maintain the building.

However, the total cost of the deals is often far more than the value of the assets. As a result, Mr Lansley says, the 22 trusts “cannot afford” to pay for their schemes, which in total are worth more than £5.4billion, because the required payments have risen sharply in the wake of the recession.

Mr Lansley said: “Over the last year, we’ve been working to expose the mess Labour left us with, and the truth is that some hospitals have been landed with PFI deals they simply cannot afford.

“Like the economy, Labour has brought some parts of the NHS to the brink of financial collapse. Tough solutions may be needed for these problems, but we’ll help the NHS overcome them. We will not make the sick pay for Labour’s debt crisis.”

He said hospitals would not be allowed to collapse financially.

“There are many hospitals that are well run, do not have a legacy of debt and do have projects which are perfectly sustainable. My point is that we have looked since the election and are working together with individual trusts to arrive at a place where they are financially, and in terms of the quality of their services, sustainable for the future. We can only do that if we work closely with them,” he said.

“This is about making very clear that we are not only working on unsustainable PFIs, but also working with legacy debt that the NHS has been left with, working on the IT programmes which were on an unsustainable scale of contractual commitments that didn’t meet the need of the NHS’s customers.

“Across the board, we have to tackle Labour’s legacy of poor value formoney and debt.”

Over the next few weeks, Department of Health officials and executives at the 22 trusts will develop detailed plans for dealing with the crisis. Their proposals are expected to include significant cost–cutting and the renegotiation of PFI contracts.

Money will also be moved from NHS trusts that are in better financial shape to cover the debt costs at those that are struggling. However, officials are braced for the need to use Whitehall funds to bail out some hospitals.

Among the trusts which have contacted Mr Lansley to inform him of their severe financial problems are several London institutions, including South London Healthcare, Barking, Havering and Redbridge, and North Middlesex.

Outside the capital, other trusts to have approached the health department include Wye Valley, Worcester Acute Hospitals, Mid Yorkshire, and Walsall.

After the general election last year, Mr Lansley ordered officials to establish why some NHS hospitals were under–performing. The health department is assessing the financial position of every hospital. It is understood that the PFI costs have emerged as a leading factor in poor patient care in some areas.

The Health Secretary decided to disclose the list of hospitals in difficulty and is expected to announce the rescue plans for each trust next month.

Taxpayers are having to pay more than £200 billion for schools, hospitals and other projects whose capital value is little more than £50 billion.

In one example, a hospital in Bromley, south east London, will ultimately cost the NHS £1.2 billion, more than 10 times what it is worth. Another hospital was charged £52,000 for maintenance that cost £750. The annual cost of the schemes is almost £400 for each household.

The public payments for PFI deals are typically linked to inflation and therefore the cost to taxpayers has increased by up to a third since the beginning of the credit crisis, according to the National Audit Office. Last month, MPs on the Treasury select committee effectively called for a moratorium on new PFI projects, which it said were “like a drug” as the costs were not apparent at the outset.

George Osborne, the Chancellor, has tightened the rules on the deals.

Earlier this year, John Healey, the shadow health secretary, admitted in an interview that Labour ministers had failed when negotiating the multi–million pound schemes for hospitals.

“There is definitely a case for saying we were poor at PFI, poor at negotiating PFI contracts at the outset,” he said.

Companies who run PFI schemes boast profit margins of up to 71 per cent on the projects, but have come under growing pressure from MPs and ministers to return some of their “windfall profits”.

From: http://www.telegraph.co.uk/NHS-hospitals-crippled-by-PFI-scheme

Clinical negligence claims against the National Health Service have increased by almost a third over the past year, with an extra £100 million paid out to victims of medical blunders.Nearly 9,000 patients claimed for damages after allegedly suffering at the hands of doctors or nurses, figures from the NHS Litigation Authority show.

It paid out £863m to victims of accidents in hospitals and clinics, up from £787m the year before, after settling 5,398 cases.

But a quarter of this was spent on legal costs, with £200m going to claimants’ lawyers under the system whereby so-called “ambulance chasers” can charge up to £900 an hour to pursue claims.

The litigation authority’s annual report is scathing about the current regime, which it claims is driving the “rapid growth in claims numbers” rather than any increase in mistakes by NHS staff.

Under the “no-win, no-fee” system set up by Labour so poorer people could have access to justice, known as Conditional Fee Arrangements, claimants do not have to pay for lawyers upfront. But if they win cases, the lawyers can claim big “success fees” from the defendant.

Steve Walker, chief executive of the NHS Litigation Authority , said: “We believe very strongly that a regime which allows success fees and the recoverability of After the Event (ATE) insurance premiums makes litigation so profitable that solicitors and so-called ‘claims farmers’ are drawn into the market thereby fuelling the rise in claims volumes we have experienced.”

However he added that the body is “delighted” that the Ministry of Justice is acting on the Jackson review of civil litigation costs, which recommended that success fees and ATE premiums should not be recoverable in no-win, no-fee cases.

At the same time the Government hopes to save millions every year by scrapping Legal Aid in cases of alleged malpractice.

The litigation authority’s report shows that in total it recorded 12,142 claims against NHS trusts in 2010-11 but expects only 4 per cent to go to court, as most will either be settled beforehand or dropped.

Of these, 8,655 were clinical claims, up from 6,652 the previous year, and 4,346 were non-clinical, up from 4,074.A further 22,364 claims were still open at the end of the financial year.

The authority – funded partly by trusts and partly by the Department of Health directly – paid out £729m under its main clinical scheme and a further £134m under claims relating to incidents that took place before 1995.

This was an increase on £651m under the current scheme and £136m under the old schemes recorded in 2009-10.

A further £47.9m was paid out in non-clinical cases.

However these figures do not only include compensation paid to patients, staff and members of the public but legal costs as well.

The costs claimed by claimant lawyers continue to be significantly higher than those incurred on our behalf by our panel defence solicitors. This continues to be a major concern.

“The availability of Conditional Fee Agreements (CFAs) and the continued increase in their use by claimants in clinical negligence claims has also meant that claimants’ costs are almost invariably disproportionate, often significantly, to the amount of damages paid, particularly in low-value claims.

“In the 5,398 clinical negligence claims closed by us with a damages payment in 2010/11, we paid over £257m in total legal costs, of which almost £200m (76 per cent of the total costs expenditure) was paid to claimant lawyers.”

From: http://www.telegraph.co.uk/30-rise-in-negligence-claims-against-NHS

The Department of Health should consider abandoning the disastrous £12 billion NPfIT project to computerise all patients’ medical records according to a powerful group of MPs.The integrated electronic care records system was a central part of Labour’s £12 billion National Programme for IT (NPfIT).

The Public Accounts Committee says that although £2.7bn of taxpayers’ money has already gone on the scheme, it is unclear what the benefits have been and so ministers should think about whether the rest of the cash could be better spent elsewhere.

Although the intention was to create a single network that would allow NHS staff across England to access any patients’ details, the report says this will not happen now and the country has been left with a “patchwork” of costly and fragmented IT systems whose future is uncertain because of reforms to the health service.

The chief executive of the NHS, Sir David Nicholson, also comes in for criticism for failing to oversee the project properly while civil servants provided “late, inconsistent and contradictory” information to the MPs’ inquiry.

Margaret Hodge, the committee’s chairman, said: “The Department of Health is not going to achieve its original aim of a fully integrated care records system across the NHS. Trying to create a one-size-fits-all system in the NHS was a massive risk and has proven to be unworkable.

“The Department has been unable to demonstrate what benefits have been delivered from the £2.7 billion spent on the project so far.

“It should now urgently review whether it is worth continuing with the remaining elements of the care records system. The £4.3 billion which the Department expects to spend might be better used to buy systems that are proven to work, that are good value for money and which deliver demonstrable benefits to the NHS.”

The integrated electronic care records system was a central part of Labour’s £11bn National Programme for IT in the NHS, which was set up in 2002 and faced repeated criticism since then over its cost and technical problems, most recently from the National Audit Office.

In the report the MPs say the intention to allow rapid sharing of patients’ records was “worthwhile” but the Department of Health has been unable to make it work.

They claim that creating a single system was always a “massive risk” especially as clinicians were not asked for suggestions on its operation.

In the north, midlands and east of England just 10 of 166 trusts have received only a basic system, while no mental health body has received one. Dozens of different interim and local schemes have been devised, at greater cost.

Whitehall officials are said to lack “basic management information” on the number of systems built and their cost, even though there is a body overseeing the whole project with 1,300 staff that has spent £820million.

Sir David Nicholson was accused by the committee of having “lacked the capacity to meet his responsibilities fully” as Senior Responsible Owner for the scheme, leading to “increasing costs and delays”.

The Department of Health is now trying to renegotiate some contracts and is working on a slimmed-down “menu of modules” that hospitals can choose for their patient records systems, but there is no guarantee the systems will work with each other.

In addition, the Strategic Health Authorities responsible for delivery of the programme are being scrapped and there is “considerable uncertainty” over how the new NHS bodies will adopt the IT systems and how much it will cost them.

Andrew Lansley, the Health Secretary, said: “This is yet more evidence that Labour’s botched approach to IT in the NHS failed taxpayers and failed patients. Their one-size-fits-all IT programme has once again been found unworkable.

“This Government is taking action where Labour failed. Already, we have reduced expenditure on Labour’s costly IT schemes by £1.3 billion. We are making sure that systems are not imposed on the NHS from the centre which organisations do not want. And we will shortly announce our plans for even stronger action to deliver value for money for taxpayers and the NHS.”

From: http://www.telegraph.co.uk/NHS-should-consider-abandoning-7bn-IT-project.html

Killer quango NICE- The National Institute for Curbing Expenditure has launched a new online money saving tool – NICE Pathways – that pulls together connected National Health Service guidance into one easy-to-use resource.
For the first time, doctors and commissioners will be able to view and navigate all of NICE’s separate sets of recommendations that relate to a single care pathway in a user-friendly electronic flow chart, as part of a bid to improve the use of its evidence across the nation.

The postnatal care pathway, for example, covers everything from the baby’s first 24 hours up until the first two – eight weeks after birth, providing an immediately accessible overview of all recommended care, as well as links to other products such as the Institute’s Quality Standards and implementation tools.

Launching the new tool at NICE’s 11th annual conference in Birmingham, Gillian Leng, the Institute’s deputy chief executive, said that 18 care pathways have already been completed and that the target is to have 60 on the site by the end of the year.

“NICE Pathways will provide a useful starting point for users new to a topic, while giving specialists confidence that they are up to date with everything NICE has recommended,” she said.

The move comes under a wider plan to improve the digital format of its guidance, which, in future, is likely to remain a crucial element of the new system of value-based pricing for new medicines planned by the government for 2014.

While NICE’s exact role going forward is yet to be defined, in his address to the conference health minister Earl Howe stressed that the Institute – which is to be re-established under primary legislation – will continue to provide independent advice to clinicians, and be a source of advice on cost effectiveness.

From: http://www.pharmatimes.com/NICE_unveils_new_digital_guidance_tool_at_annual_conference

Health Direct notes the use of the phrase “a source of advice on cost effectiveness” as it evokes the memory of labour’s spin- the type of phraseology that labour used to use for cost cutting.

Councils are planning a sharp rise in care home fees to counter Government cuts and a rapidly aging population.
Almost nine out of 10 local authorities confirmed proposals to charge more for residential accommodation to plug a huge budget shortfall, figures show.

Other councils are planning to shut centres altogether or dramatically tighten up the eligibility for places over coming years.

The disclosure will fuel warnings over a crisis in care for the elderly.

It follows warnings last year that growing numbers of pensioners are being forced to sell their homes to cover expensive care home fees amid spiralling costs.

Emily Thornberry, the shadow care services minister, who obtained the latest figures, said the Government was failing to protect social care. Miss Thornberry’s office surveyed 50 councils providing care services.

Almost all said they were being forced to make sweeping changes to residential accommodation because of a combination of cuts and increasing pressure on services.

Some 88 per cent confirmed plans to increase care charges. A quarter of these were pegging increases to inflation, but others were introducing new and additional charges, raising or abolishing the maximum contribution from users or making other increases.

Almost two-thirds of councils said they were being forced to close care homes or day centres to save money.

Many confirmed plans to close homes in the next two years, while others said money was being saved by putting more emphasis on providing services in residents’ own homes.

A previous survey carried out by the Care and Support Alliance, whose members including more than 40 leading charities, has found that 23 per cent of disabled and older people have already seen their services cut.

Many said they can no longer afford essentials such as food and heating as a result of having to pay for care, while more than half said their health had suffered after support was reduced.

Paul Burstow, Minister of State for Care Services, said: “Under Labour social care was always the poor relation. Under the Coalition social care is receiving a £2bn spending boost including an unprecedented transfer of funds from the NHS to support integration.

“In 13 years Labour failed to reform the way we fund social care. Labour’s survey results are the product of that failure. Without the Coalition’s decision to priorities social care Labour’s legacy of underfunding would have been even greater.

“We are determined to put in place a lasting and fair settlement to the funding question. This Government has acted quickly to set up the Dilnot Commission on funding.”

From: http://www.telegraph.co.uk/health/Councils-planning-sharp-rise-in-care-home-fees

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

It is “absolutely essential” that the coalition government improves how it communicates risk and uncertainty to the public and the media, say MPs, reporting on Ministers’ handling of the H1N1 (swine flu) pandemic.
On July 16, 2009, when Chief Medical Officer Sir Liam Donaldson held a press briefing that led to media reports suggesting that in a “worst-case scenario” 65,000 people in the UK could die from swine flu, the number of deaths at that time actually stood at around 30 and, by the time the pandemic was over in April 2010, had reached 460 in total, says a report published today by the House of Commons Science and Technology Committee on the use of scientific advice and evidence in emergencies.

The “reasonable worst-case scenario” of around 65,000 deaths communicated by the government was useful for emergency responders such as the NHS but led to sensationalised media reporting, say the MPs, who suggest that it would be better for the government to establish a “most probable scenario” with the public. Improvements in how risk and uncertainty are presented to the public and media are “absolutely essential for allaying fears,” they add.

It is equally – if not more – important for central government to communicate effectively with emergency responders, say the Committee members, who had been told by the British Medical Association (BMA) that doctors had felt “overwhelmed” by the volume of information about the swine flu pandemic issued by various bodies, including government, and that key advice had been lost within the large quantity of emails received, which often duplicated information.

The Committee suggests instead that a single portal of information should be set up for every emergency along the lines of flu.gov in the US, for use by the public as well as emergency responders. This should be the primary source of all information, linking to other websites as necessary.

The swine flu pandemic was also the first emergency in the UK for which a Scientific Advisory Group for Emergencies (SAGE) was convened to advise the government, and the MPs have concerns about the operations of such groups. Their report finds that SAGEs  “tended towards an unnecessarily secretive way of working, thus closing doors to the wider scientific community, and did not appear to adhere to any published guidance or code of conduct.”

A SAGE “should not be given carte blanche to operate however it pleases simply because an emergency is occurring,” say the MPs, and they call on the government to provide greater clarification as to the codes, principles and guidance which cover the operations of such groups. “The Government Office for Science should take responsibility for ensuring that all future SAGEs operate in a more organised, transparent and accessible manner and adhere to a published code – existing or new,” they add.

Experience with the swine flu pandemic also points to the need for a better international mechanism for data-sharing, particularly for raw epidemiological data, say the MPs, and they suggest that the UK should propose the formation of an international working group within the World Health Organisation (WHO) to discuss how epidemiological data can be shared effectively between countries in the run-up to a new pandemic.

As well as the H1N1 pandemic, the Committee also examined the role played by scientific advice and evidence in the government’s handling of the April 2010 volcanic ash disruption, space weather and cyber attacks. The experience has, they say, left them with the impression that “while science is used effectively to aid the response to emergencies, the government’s attitude to scientific advice is that it is something to reach for once an emergency happens, not a key factor for consideration from the start of the planning process.”

“This is not trivial,” the MPs stress, concluding: “we urge the government to do better at embedding scientific advice and an evidence-based approach in risk assessment and policy processes before emergencies occur.”

From: http://www.pharmatimes.com/Swine_flu_govt_communication_led_to_sensationalised_reporting_say_MPs

The number of cancer patients being admitted to hospital through accident and emergency has doubled in less than a decade amid claims they are being “abandoned” after receiving treatment.
Such admissions are meant to be “the exception” but the number has increased from 70,000 in 2000/01 to 140,000 in 2008/09, according to the National Audit Office (NAO).

Macmillan Cancer Support said that showed too many patients were not being cared for properly after being given treatment like chemotherapy and radiotherapy.

According to the NAO’s report, which examines how well the NHS has managed to deliver the last government’s five year Cancer Reform Strategy so far, waiting times have fallen and the number of days cancer patients spend in hospital has dropped.

The strategy, launched in 2007, was meant to make NHS cancer services “among the best in the world” by 2012.

But the NAO report said there was “limited assurance” as to whether the £6.3 billion spent on cancer care annually was money well spent, because such poor information linking spend and outcomes was available.

In particular it illuminated problems caring for cancer outpatients.

Ciaran Devane, chief executive of Macmillan Cancer Support, said: “English cancer services have improved but there is still an incredibly long way to go for the UK to be a world leader.”

She warned: “The NHS won’t be able to support the growing number of cancer patients unless it seriously ups its game.

“The whole NHS needs to realise that cancer is a long term condition for many. If the NHS does not provide appropriate services after patients leave hospital, they can expect to see a massive increase in costs as cancer patients are forced to use emergency services.

“Abandoning cancer patients after treatment is no longer acceptable, nor does it make any financial sense.”

The previous government had pledged to cut the total number of emergency cancer admissions – not just via A&E but also for example by doctors making emergency referrals – but instead the number has been rising steadily.

It has risen from 231,000 in 2000/01 to 300,000 in 2008/09. However, the rate of annual increase has almost halved. Four in five have an existing diagnosis.

Karen Taylor, from the NAO, said there was “poor understanding” of the issue while primary care trusts “don’t appear to be aware of it’s extent”.

Mike Hobday, head of policy at Macmillan, said the reason was clear.

“The traditional NHS approach at the end of cancer treatment has been to say, ‘Go away, you are cured.’ ”

But he explained: “While treatment is in most cases extremely good, people with cancer have ongoing problems. Chemotherapy is toxic – you can’t do it without impacting people’s health.

“Patients aren’t being given the support to manage themselves, so they turn up at A&E.”

A “small investment” in things like better information and dedicated helplines for cancer patients would reap large savings by lowering emergency admissions, he predicted.

With growing numbers of cancer survivors and stretched budgets “the NHS has to do this smarter”, he said.

Dr Jodie Moffatt of Cancer Research UK said the increase could partly be explained by the tripling of cancer patients receiving chemotherapy since 2000. The government was trying to tackle the problem, she argued.

Paul Burstow, the Health Minister responsible for care services, said: “This report is a damning indictment of Labour’s failure to deliver on their promises to improve the quality of cancer care.

“The shocking levels of emergency admissions are the legacy of Labour’s obsession with hitting targets instead of helping patients.

“Under Labour, NHS spending rose to European levels of funding, but they have failed to deliver European levels of quality cancer care. If the NHS was performing at the level of the best in Europe, an extra 10,000 lives could be saved each year.”

Jo Webber, deputy director of policy at the NHS Confederation, which represents health trusts, said: “It is difficult to attribute a rise in emergency re-admissions to any one factor.

“Commissioning appropriate after-care services and providing patients with access to specialist services and home support services all play their part in bringing numbers of re-admissions down.

“Providing patients with access to quality treatment in or close to home, as well as information on local support services, is just as important as the early detection and treatment of the disease when planning an effective cancer strategy.”

From: http://www.telegraph.co.uk/Cancer-patients-abandoned-after-treatment

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