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

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.

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 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

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.

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

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

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

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

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

More than eight thousand breaches of Labour’s pledge to “virtually eliminate” mixed wards were reported in just half of England’s Strategic Health Authorities in the first quarter of this year, new figures show.

If the same level existed across the rest of the country it would mean there were more than 16,000 breaches in three months, equating to 64,000 cases a year.

Andrew Lansley, the Health Secretary, announced yesterday that the “indignity” of men and women sharing accommodation would be abolished, almost 15 years after Tony Blair made the same promise.

But men and women may still have to share wards, provided the hospital ensures that male and female patients sleep in separate areas and have their own washing facilities.

Labour committed in two manifestos to provide separate accommodation for men and women, except where it was in the interests of the patient not to do so.

They later decided to divide wards into same-sex “bays”, meaning same-sex accommodation could include men and women sleeping in separate partitions of the same ward.

But the new figures reveal that one in ten patients is still admitted to a mixed ward, while a third have to share bathrooms with members of the opposite sex.

The information suggests data is not being recorded consistently across the country and NHS organisations are continuing to place patients in mixed sex accommodation for “operational reasons”, the government claimed.

Under new steps announced by Mr Lansley, NHS organisations can be held accountable for failing to guarantee same-sex accommodation where there is no clinical justification.

From next January, any breaches of the guarantee will be reported regularly and commissioners will sanction NHS bodies which admit failing to meet the pledge.

For the first time the reports will be made publicly available, meaning patients receiving elective treatment can choose to avoid the worst-performing hospitals.

Mr Lansley told BBC Radio 4′s PM programme: “It should be more than an expectation, it should be a requirement that patients who are admitted should be admitted to single-sex accommodation.

“Patients should be in single-sex accommodation, meaning that all of their period that they are admitted they should be in a bed or a bay which only consists of people of the same sex.

“And they should be able to come and go, for example to all their washing and toilet facilities, without having to pass through a part of the ward or another ward where there might be people of a different sex… so to that extent they would have the kind of privacy and dignity people have a right to expect.”

He added: “Patients should not suffer the indignity of being cared for in mixed sex accommodation. I am determined to put an end to this practice, where it is not clinically justified.

“In the future, NHS organisations will have clear standards, spelling out when they should report a breach. Where NHS organisations fail to meet this standard, we will let the public know they have failed and we will strengthen the fines which may apply.”

Chief Nursing Officer Christine Beasley added: “Protecting the privacy and dignity of patients by eliminating mixed sex accommodation must be a priority for the NHS.

“Driving this change will be the publishing of statistics on mixed sex accommodation breaches by NHS trusts. This measure will allow patients to make better informed decisions about their care.”

From: http://www.telegraph.co.uk/Thousands-of-patients-still-forced-to-stay-in-mixed-sex-wards

This despite a misleading announcement from the Department of Health that uploads to the Summary Care Record (SCR) aka Snoopers Charter are ‘on hold’.

In just the last few days, the medical press has reported that:

• NHS East Riding of Yorkshire began sending out notification letters to patients the day before election day;

• GP practices in Hastings, East Sussex have uploaded records over the past 2-3 weeks, despite patients complaining they hadn’t received a notification letter;

• At least 9 other Primary Care Trusts are working towards upload, and practice managers – not GPs – may already have given the go-ahead for upload at some practices in South West Essex.

Clearly, whatever deal was agreed between the British Medical Association and the NHS, there is no effective barrier to upload. And CfH is desperate to create a ‘critical mass’ of records, which it thinks will make the system impossible to scrap.

Health Direct warns that you need to act quickly.

30 million ‘Patient Information Packs’ were sent out in the run-up to the general election. No-one knows how many failed to reach their intended target. Both parties that now form the new government pledged to scrap the Care Records system but, every day that uploads continue, people’s medical confidentiality is being put at risk.

Please take a few minutes now or today to write to your new MP, urging him or her to call for an immediate halt to Summary Care Record uploads. POWER2010 has very kindly built an online letter-writing tool to help
you do this: http://www.power2010.org.uk/Halt

On the subject of the Nanny State’s Snoopers Charters- Home Information Packs (HIPs) were announced in the Queen’s Speech in November 2003, so were plans for a national ID scheme. The introduction of HIPs was subject to delays and plans were scaled back – just like the ID scheme.

In 2009 HIPS were finally issued and so were ID cards. The scrapping of HIPs was a manifesto pledge by the Conservatives and the Liberal Democrats, so was scrapping ID cards.

Yesterday Eric Pickles MP, the new Communities Secretary announced that “HIPs are history” and “laid an Order suspending HIPs with immediate effect” (pending primary legislation for a permanent abolition).

Meanwhile ID cards are still being issued and the UK Identity and Passport website states: “Until Parliament agrees otherwise, identity cards remain valid and as such can still be used as an identity document and for travel within Europe.” Alas we still await a Pickles style announcement from the Home Office.  See http://www.communities.gov.uk/news/corporate/1591777

Despite pledges from Labour and the Conservatives to protect front line services, there is evidence that their promises may have come too late.

A list of cuts has already been identified – including job losses, banning certain operations, closing casualty departments, downgrading maternity services and reducing the number of junior doctors. But these have been mostly quietly ignored by the three main parties.

The Conservatives pledged to stop all closures until they could be reviewed but, with billions of pounds of savings needed to cope with growing demand, cuts and closures are almost inevitable.

David Cameron emphasised that he was personally in favour of the NHS, after his experiences with his disabled son Ivan, who died last year, to combat arguments that the health service was not safe in Tory hands. The party manifesto contained promises about dentistry and round-the-clock GP services which appear too expensive in the current climate.

Both the major parties were accused of chasing the “fear of cancer” vote. The Tories said they would fund cancer drugs turned down by Nice, the health rationing watchdog, but did not mention drugs for other illnesses such as arthritis or dementia.

Labour said cancer patients would see a specialist and have test results back within a week. The party was criticised for unveiling its manifesto at a new hospital in Birmingham. It is against the rules to use NHS premises for election events.

But Labour pointed out that the hospital was still in the hands of the private finance initiative organisation – a policy which means the NHS will be repaying billions of pounds for new hospitals for decades.

Nick Clegg refused to ring-fence NHS spending given the size of the national debt.

The Liberal Democrat campaign focused on cutting waste on managers, scrapping regional strategic health authorities and pledging more power to communities to direct the health service locally.

From: http://www.telegraph.co.uk/General-Election-2010-cuts-inevitable-as-NHS-must-make-savings

Peter Carter, the general secretary of the Royal College of Nursing (RCN), also said he was in favour of “drug consumption rooms” to enable addicts to take drugs safely under medical supervision, and to cut rates of drug-related crime.Nurses gathering at the RCN’s annual congress in Bournemouth had earlier discussed providing heroin to addicts where other attempts at treatment have failed.

Results of pilot studies in London, Brighton and Darlington suggest that allowing users to inject themselves with the Class A drug under medical supervision can cut local crime rates by two thirds over six months.

Aberdeen has been considered as a potential future pilot location in Scotland.

But some experts are concerned at the prospect of providing legitimate “shooting galleries” in publically-funded clinics, despite the increasing use of methadone, the heroin-subsitute, and a lack of abstinence-based programmes.

Amid controversy over how to treat chronic drug users, members of the RCN, the country’s largest nursing union, discussed the possibility of providing heroin on the NHS today but did not hold a vote for or against the move.

Speaking in a personal capacity after the debate, Dr Carter, the former head of Central and North West London Mental Health NHS Trust, said that he believed in providing drugs, needle exchanges and locations for users to inject substances safely.

“The fact is heroin is very addictive,” he said. “People who are addicted so often resort to crime, to steal to buy the heroin. It obviates the need for them to steal.

“It might take a few years but I think people will understand that if you are going to get people off heroin then in the initial stages we have to have proper heroin prescribing services.” Dr Carter added that more research was needed into consumption rooms, which have been tested in Sydney and Amsterdam.

Experts found the programme stopped users injecting in school playgrounds and stairwells.

“Critics say you are encouraging drug addiction but the reality is that these people are addicts and they are going to do it anyway,” he added.

Radical proposals for the most chronic drug users were first advocated in 2002 by the then Home Secretary David Blunkett. The gave rise to pilot programmes in England in which users inject themselves with pharmaceutical diamorphine imported from Switzerland, under medical supervision.

From:
http://www.timesonline.co.uk/tol/news/uk/health/article7108342.ece

David Smith, deputy commissioner at the ICO told the Infosec security conference the NHS had highlighted 287 breaches to it in the period.

That accounts for more than 30% of the total number reported.

The NHS – the UK’s largest employer with 1.7m staff – has only started the process of rolling out digital patient records.

Most of the breaches (113) were the result of stolen data or hardware, followed by 82 cases of lost data or hardware.

Mr Smith said the problems were not confined to the public sector and that results could be skewed because the public sector has a culture of reporting all breaches whereas not all private sector firms did.

Richard Vautrey, the deputy chair of the British Medical Association’s GPs committee thinks the number of breaches reflect the size and complexity of the NHS as well as its culture of openness.

“So many people have access to data and often human error is to blame. There is an increased attempt to be open and honest about what happens to data,” he said.

He added that he was not aware of a specific case where a data breach had affected patient privacy or care.

“We need to keep their breaches in perspective,” he said.

As part of its plans to digitise patient records, the NHS is asking patients if they want their data stored on national databases. It is important that people are given the chance to opt out, said Mr Vautrey.

Currently the reporting procedure for data breaches in the UK is voluntary although the ICO is “moving towards” a compulsory system.

In April the ICO introduced fines of up to £500,000 for serious data breaches.

The European Union’s Telecoms Package requires telecom firms to report data breaches and Mr Smith said he expected this requirement to expand beyond telcos.

Data encryption firm PGP welcomed the tough new approach to data security.

“Finally the ICO, which has long demanded greater powers, will be able to severely punish those in serious breach of the Data Protection Act. For too long, organisations have continued to ignore the warning signs – risking both the privacy of their customers and the reputations of their brands,” said Jamie Cowper, European marketing director at PGP.

He anticipates “severe fines” for the next private sector company to be involved in a serious data breach although he does not imagine the ICO will pursue the NHS.

PGP calculated that data breaches cost companies, on average, £67 per piece of data lost.

From:

http://news.bbc.co.uk/1/hi/technology/10089066.stm

Health Direct asks- given that the NHS has the worst record of data security and that labour politicans have already sent 250,000 political letters to cancer sufferers- are you CERTAIN that your medical records will be safe on the Snoopers Charter database? If not OPT OUT NOW- whilst you still can!

A postcode lottery means hundreds of people are missing out on life-prolonging care

Now figures obtained under the Freedom of Information Act show that a cancer patient’s chances of overruling health authorities who deny them access to drugs depends on where they live.

Some NHS trusts, such as Torbay in Devon and Salford in Manchester, granted all appeals while in others, such as Kingston in southwest London, only 7% were granted. In about one-third of trusts, fewer than half of the requests for drugs that can cost thousands of pounds a month were approved.

Access to cancer drugs has become an election issue, with the Conservatives saying they will ensure the National Health Service directs £200m more into supplying new drugs. The money will come from what the health service would otherwise have had to pay to meet Labour’s hike in National Insurance, which the Tories have said they would partially reverse.

The drugs concerned have all been approved by the labour government’s National Institute for Curbing Expenditure (Nice). However, each of 152 primary care trusts (PCTs) in England is allowed to use its own interpretation of Nice’s regulations.

In some cases patients who have already had two courses of chemotherapy are not allowed the drugs; in other cases they must have tried cheaper alternatives before being eligible. Those who do not meet the conditions must appeal to an “exceptional case” panel.

Widespread variation in attitudes between health trusts emerged in research to be published in Health Insurance magazine. It asked how many “exceptional-case funding requests” for cancer were received by trusts in 2009.

It named five drugs, including Rituxan for leukaemia; Tarceva for lung cancer treatment and Revamid for blood cancer.

All such appeals were granted by 17 healthcare trusts, with the areas benefiting ranging from Walsall and Manchester, to Torbay and Suffolk. However, Kingston and Northamptonshire refused most of the appeals made to them.

Forty one of 122 primary care trusts that responded granted fewer than half requests. The figures present an incomplete picture because some trusts may prescribe medicines without the need for patients to appeal. Critics, however, say they still show unacceptably wide variations in practice.

Specialists also complain that the NHS trust officials who decide whether or not to grant the appeals are rarely experts in the disease, so they help to create the wide discrepancies.

Karol Sikora, a cancer specialist at Hammersmith hospital, west London, said his department has a wallchart that marks both sympathetic and unhelpful PCTs. “You find yourself talking to office temps and all sorts of unlikely people who are apparently making these life-or-death decisions,” said Sikora.

Doctors describe “mirthful laughter” as the equivalent of “internal jogging” because it can lower blood pressure, stress and boost the immune system much like moderate exercise.

A number of volunteers asked to watch just 20 minutes of comedies and stand up routines saw a dramatic drop in stress hormones, blood pressure and cholesterol.

That means that the “laughercise” could be a way to reduce heart disease and diabetes. It is especially important to the elderly who may find it hard to perform more physical activities.

Dr Lee Berk, from Loma Linda University, California, who led the study, said that emotions and behaviour had a physical impact on the body.

He concluded “that the body’s response to repetitive laughter is similar to the effect of repetitive exercise”.

“As the old biblical wisdom states, it may indeed be true that laughter is a good medicine,” he said.

Dr Berk, who has been studying the effects of laughter for more than two decades, said that the high you get from a giggling fit was similar to the endorphin rush from exercise.

He has shown how it can reduce your risk of a heart attack and diabetes and generally regulate the body’s vital functions.

It is also an important way to de-stress after a day’s work, he believes.

In the mid-1990s, Dr Berk found that laughter increases the number of natural killer cells in cancer patients. Natural killer cells are the body’s way of fighting tumours.

For the latest study he had 14 volunteers watch either a stressful 20 minute clip of the war film Saving Private Ryan or an extract from a comedy or stand up routine.

Blood samples taken afterwards showed the reduction in stress hormones and increase in immune T cells for those who watched the comedy. Blood pressure testing showed it was down too with this group.

In 1997, Dr Berk performed experiments with diabetic heart patients. One group watched a television comedy each day for one year, another did not.

The difference in outcomes was stunning. At the end of the year, the comedy viewing group required less blood-pressure medication.

Eight per cent of the comedy viewers had another heart attack, compared with 42 per cent of those who did not regularly view it.

An earlier study also showed that watching just half an hour of comedy a day slashes levels of stress hormones and compounds linked to heart disease.

Levels of compounds linked to hardening of the arteries and other cardiac problems had also dropped, while levels of ‘good’ cholesterol – thought to protect against heart disease – rose.

An earlier study by Dr Berk also showed that the mere anticipation of a good laugh can benefit health.

The expectation of watching a comedy video was enough to raise levels of feel-good endorphins and boost amounts of a hormone that helps our immune system fight infection.

The findings were presented at the Experimental Biology conference.

From:

http://www.telegraph.co.uk/Laughter-really-is-the-best-medicine-as-doctors-find-it-can-be-as-healthy-as-exercise

The move emerged after the party had been criticised for delivering campaign leaflets on the party’s cancer policy to 250,000 women, some of whom had the disease.

The postcards, produced by Tangent, which works for the Labour Party, said that the Tories would scrap a Labour guarantee that patients would see a cancer specialist within two weeks.

One of those who received the latest communication, a doctor, has complained that senior Labour figures are trying to pressure her into publicly backing the party against her will.

Labour is trying to organise a round robin letter from senior figures in the NHS saying that only Labour can be trusted to look after the health service.

The Twickenham GP, whose name has been withheld for fear of retribution, contacted the Conservatives in fury at the attempt to make her sign a petition.

The GP expressed concern that Amy Fowler, a development officer for the Labour Party, obtained her work e-mail address, which she claimed is not publicly available.

The petition that the doctor was being asked to sign, which is likely to have been forwarded to a newspaper, committed members of the health service to explicitly backing Labour.

It says: “We are a group of clinicians, staff and campaigners working in and with the NHS. Every day, every week, we see first-hand the quality of care which the NHS gives to patients when they need it most. At this election we are backing Labour as the party of the NHS which will do the most to improve it for all patients.

“There is more to do to improve the NHS, but it is this Labour Government which has shown commitment to the NHS by investing in more doctors, nurses, more services and new hospitals and GP practices. It is Labour who are making the tough decisions that will allow our NHS to be protected in the future from spending cuts which would harm patient care. And only Labour are prepared to put patients first, for example with guarantees to rapid access to cancer specialists and cancer tests.

“For these reasons we believe only Labour can be trusted to protect and improve our NHS at this election.” The e-mail came from Martin Rathfelder, from the Socialist Health Association, but was signed by Ms Fowler.

The GP said: “[This was] totally unsolicited by me. I have never been to any socialist events and would not mix my personal views with work. He says he got it from a list of trainers which is possible. I feel this is an absolute abuse of a publicly funded service. Don’t know anyone who would have nominated me.”

She added: “I am angry that they have e-mailed me at my work e-mail address and would very much like to know how they have obtained confidential NHS e-mail addresses. You might be interested to investigate a. where they obtained these addresses [and] b. whether it is appropriate to use the addresses in this party political way. Needless to say I do not support the petition!”

Paul Beresford, the Tory MP who represents the doctor, said: “This is a grossly unfair attempt by the Labour Party to draw NHS clinicians into political campaigning. They feel under threat of blacklisting if they do not sign up.” Andrew Lansley, the Shadow Health Secretary, said: “The Labour Party need to explain how they have received these NHS e-mail addresses. If they are using the NHS private e-mail system to reach NHS staff for party political campaigning it is an abuse.

“We know from recent research that NHS staff support the Conservatives and not Labour because we are now more trusted to improve the NHS.”

Mr Lansley has written to Andy Burnham, the Health Secretary, to demand that he apologises for the cancer postcards. He said: “Cancer sufferers across the country have condemned Labour’s scaremongering breast cancer leaflets, but still Gordon Brown and Andy Burnham refuse to apologise.”

When asked where he got the address, Mr Rathfelder replied that he obtained it “from a list of training practices”. However the GP said “I still feel it is an abuse of the NHS.”

From: http://www.timesonline.co.uk/tol/news/politics/article7095225.ece

Personalised cards addressed to sufferers by name warn that a Labour guarantee to see a cancer specialist within two weeks would be scrapped by the Tories. Labour claims the Conservatives would also do away with the right to be treated within 18 weeks.

The offending mailshot
Cancer patients who received the personalised cards, sent with a message from a breast cancer survivor praising her treatment under Labour, said they were “disgusted and shocked”, and feared that the party may have had access to confidential health data.

Labour sources deny that the party has used any confidential information. However, the sources admit that, in line with other political parties, it uses socio-demographic research that is commercially and publicly available.

The postal campaign started last month before the general election was called. This is the first election in which parties have been able to use internet databases and digital printing to personalise their mailshots.

Labour has sent out 250,000 “cancer” postcards, each addressed to an individual, asking: “Are the Tories a change you can afford?” Many of those receiving the cards have undergone cancer scans or treatment within the past five years.

- In the Labour constituency of Sherwood, Nottinghamshire, two of a group of eight women friends received the breast cancer card. They are the only two to have undergone cancer treatment. One of them, Phyllis Delik, 80, described it as “callous” and “despicable”. The second woman, Shirley Foreman, 58, who received the card a fortnight after undergoing surgery, said: “It is bad taste after what I have been through.”

- In the marginal east London constituency of Poplar and Limehouse, the card was sent to a 44-year-old television producer who had a potentially cancerous lump that turned out to be a cyst. She appeared to be the only person who received the mailshot among 50 neighbours. She said: “It’s crude and insensitive.”

- A card was sent to a woman who has died of breast cancer. Her 33-year-old husband was so upset that he sent a message to the Facebook page of Diane Dwelly, the woman whose case is featured in the mailshot, accusing her of being a pawn for the Labour party.

This weekend Dwelly, 48, from Rugby, admitted she had “probably been used by Labour”. She believed her photograph had been taken for use in a magazine for the National Health Service, not as part of Labour’s election campaign.

The cards are being distributed by Ravensworth, part of Tangent Communications, which has won accounts sending out mail for the Department of Health and Cancer Research UK.

Tangent claims that it specialises in “highly targeted marketing”.

The cancer cards are part of a wider postal campaign targeting various groups. Others are aimed at parents whose children attend Sure Start centres, pensioners and the owners of small businesses.

Labour has so far sent out 600,000 cards. It plans to distribute 4.5m during the election campaign.

Janet Arslan, 40, a graphic designer who also lives in the Sherwood constituency, said: “When I received the breast cancer card at first I thought it was from the hospital.

“I did not think Labour would be that crass to deliberately target a terminal cancer patient like me.”

Damian Bentley, managing director of Tangent, said: “Our company does a lot for the Labour party but I don’t work on that side of the business.”

He failed to respond to a list of questions on how the addresses of the cancer victims were obtained.

Emilie Oldknow, 29, the Labour candidate in Sherwood, worked for the NHS before she became the regional organiser of the East Midlands Labour party. She is the fiancée of Jonathan Ashworth, Gordon Brown’s deputy political secretary and a member of his “kitchen cabinet”.

Oldknow has denied all knowledge of the cards.

“I had not seen the mailshot before and it wasn’t sent out by my campaign,” she said.

In an email to Arslan’s mother, she said her details had been “obtained from the electoral register, which is available to political parties”.

Experian, the data management company, confirmed that both Labour and the Conservatives use its Mosaic database, which divides voters into 67 groups. The databases can use anonymised hospital statistics, including postcodes and the diagnoses of patients, to identify the likely addresses of those with particular illnesses.

It cannot identify potential breast cancer sufferers because the disease affects adult women of all ages and backgrounds.

Andrew Lansley, the shadow health secretary, said: “For Labour’s campaign to deliberately distress or scare sufferers from breast cancer is shameful. Because we are going to increase the NHS budget in real terms and cut bureaucracy and waste, we will have the capacity to ensure that cancer patients are seen sooner than they are at the moment and to meet the quality standards that they expect.”

From: http://www.timesonline.co.uk/tol/news/politics/article7094308.ece

Health Direct doubts labour spin about this approach being a “one off” as they have given themselves the right to snoop on all of your medical data- as well as their nightsoilmen at the Deptament of Health.

Highlighting once again the need for you to opt out of their expense white elephant that is the NPfIT propgram.

Private companies get access to millions of NHS medical records

September 29, 2008 By: Dr Search- Principal Consultant at the Search Clinic

The confidential medical records of millions of NHS patients could be handed over to private companies under controversial plans being drawn up by labour ministers.

Patients’ postcodes, medical conditions and treatments – and in some circumstances, their names – could be passed on to third parties without their consent.

http://www.healthdirect.co.uk/2008/09/private-companies-get-access-to-millions-of-nhs-medical-records.html

CSC, which holds the contract for two-thirds of England, missed the deadline to get the Lorenzo electronic medical record product up and running at the Morecambe Bay NHS Trust’s hospitals.

CSC originally said the system would go live almost two years ago, in June 2008.

The failure is the latest crisis for the much-troubled programme which is running at least four or five years late.

CSC and BT, which covers London, had each been given a deadline to get new systems running smoothly in a big, acute, hospital, with the Department of Health warning last year that it would “look at alternative approaches” if that failed to happen.

BT has since installed a system at Kingston Hospital to the health department’s satisfaction. Christine Connelly, the department’s chief information officer, said it now needs to go through a due process under its contract with CSC which could yet see a new deadline set and met.

But if progress is not made, she told the Financial Times, the department has the option of cancelling CSC’s contract to install the systems in acute hospitals and letting hospitals choose from other suppliers.

Morecambe Bay, she said, remained keen to continue and under the contract CSC has to be given time to propose a fresh deadline for deployment, with the programme then assessing the credibility of that and whether to agree it.

“We have to walk through this step by step,” Ms Connelly said. “In a contract as large and complex as this we cannot just set a deadline and say that’s it. We have to act responsibly and not expose the department and the taxpayer to risk.”

But, she warned bluntly, “we cannot wait for ever”.

CSC has contracts worth about £3.3bn to install hospital, community, mental health and GP systems, with the latter elements progressing much better.

But Ms Connelly said if CSC’s plan was not credible the NHS had the option of cancelling the acute hospital part of the deal, thought to be worth around £1bn. CSC did not respond to attempts to contact it last night.

BT, having hit its deadline, has agreed a contract variation, signed yesterday, which the department said would save the NHS £112m, or about 12 per cent of the contract value, as part of the £600m savings the health service is seeking on the programme as a whole.

As part of the deal, BT is now signed up to install much fewer full systems in London, with about half the hospitals likely to add clinical systems to their existing IT arrangements, rather than replacing everything, Ms Connelly said.

Allowing hospitals to choose other suppliers is already starting to happen in the south of England, although the first contracts for that have yet to be signed. That should start to take place from May this year, she said.

From: http://www.ft.com/cms/s/0/6a9f7ee2-3d26-11df-b81b-00144feabdc0.html

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

Gordon Brown described Labour’s proposal for an NHS-style universal scheme as “bold and ambitious,” despite postponing the plan until the election after next.

Andy Burnham, the Health Secretary, defended the delay, saying: “Rome wasn’t built in a day” as he unveiled a White Paper setting out the staged introduction of improved care for the elderly

MPs last week voted through the first part of the proposals, a law to provide free personal care in the home for 400,000 people with the “greatest needs”.

If Labour is elected, Mr Burnham said, this would be followed in 2014 by the provision of free nursing care for those in residential accommodation for more than two years.

Questions were raised immediately, however, over how ministers would meet the scheme’s £800 million price tag, after it emerged that most of the costs would be met from “efficiencies”.

The Conservatives also pointed out that care home residents would still be required to pick up their own accommodation costs, such as utilities and housing fees, which average £14,000 a year.

Labour had originally hoped to fight the forthcoming general election on a radical pledge to establish a comprehensive National Care Service, paid for by elderly people from a range of methods including an inheritance levy.

The plans were shelved at the last minute amid Tory accusations that the party was planning a “death tax,” leading to Cabinet fears that the proposal would prove unpopular at the ballot box.

Instead, Mr Burnham announced that a commission to be established during the next Parliament would seek a “consensus” on funding for a comprehensive, compulsory National Care Service “based in need rather than the ability to pay,” which would then be put to voters in the election expected in around 2015.

The Health Secretary confirmed that the “death tax” option remained on the table for the review, which would follow an earlier Royal Commission, chaired by Lord Sutherland, which concluded in 1999 and which the labour Government failed to act on.

Charities immediately criticised the delay – and questioned how the labour Government proposed to meet the costs of their more modest residential care plans when councils were already being ordered to make massive cutbacks.

Steve Barnett, chief executive of the NHS Confederation, said: “We have significant concerns about the further delays in implementing a long-term solution.”

Dot Gibson, general secretary of the National Pensioners’ Coalition, added: “Social care in Britain has been in crisis for decades, but many older people and their families will not be able to wait until 2016 before they get any help.”

The over-50s group Saga warned that elderly people had been left: “Waiting for God – and for care funding.”

Emma Soames, Saga spokesman, said: “We’re disappointed by the delay, lack of detail and any figures. Overall, it seems like a lot of waiting just to be told that they are going to a Royal Commission – which they could easily ignore as they did with long term care in1999 – to draw up proposals for a change in the system for 2015.”

Opposition politicians also criticised the delay. Andrew Lansley, the shadow health secretary, said: “The Government is in complete retreat and they have ended up with not a White Paper but frankly a train crash.

“We seem to have arrived at the point where Andy Burnham is saying he wants everyone to have free care but he doesn’t know how to pay for it.

“The death tax is alive and kicking – despite their attempts to bury it in the small print of policy in the hope people won’t notice. The simple fact remains that if Labour win the election, they’d introduce plans for a death tax to pay for care.”

Norman Lamb, the Liberal Democrat health spokesman, added: “After 13 years in power spent ducking social care reform, we probably shouldn’t be surprised that Labour has once again hit it into the long grass.

“A White Paper without any commitment to substantial change in the next Parliament is barely worth the paper it is written on. We’re now being offered a series of piecemeal reforms that have not been properly thought through or costed.”

From:
Government plans for-elderly care branded a train crash

The College of Emergency Medicine says the target, at English hospitals, puts staff under “incredible pressure”.

It says it supports having a target in principle, but that doctors sometimes need time to make the right decision.

The government says safety and good quality care should always take priority over targets.

The NHS target in England to deal with patients in A&E within four hours has been highly controversial. Critics say it forces clinical staff to put deadlines before quality of care.

The chairman of the College of Emergency Medicine, Dr John Heyworth, says the target has helped to make emergency care a priority for the NHS. But he says staff are being forced to meet it at almost any cost.

“We’ve had nurses reduced to tears. We’ve had very senior consultants in emergency medicine threatened with a disciplinary process.
 
Patient safety and good quality care should always take priority over administrative targets where a doctor believes that is necessary
Department of Health spokeswoman

“This is an outrageous misuse of the standard.

“It’s not what the clinicians are in the emergency departments for. But it’s representative of the immense pressure being put on chief executives and all managers downwards from there to comply with the target.”

The four-hour target is just one of a range of centrally imposed standards, most of them designed to speed up treatment.

They have been used in other parts of the UK but have been much more heavily enforced in England.

Politicians now dislike the language of centrally-imposed targets in the NHS.

The Conservatives and Liberal Democrats say they will scrap them. Labour now prefers to talk about “standards”, “entitlements” and “guarantees”. The issue promises to be an important dividing line in the general election.

Professor Julian Le Grand, who was senior policy adviser to Tony Blair between 2003 and 2005, says many patients did benefit from targets – but he recalls that the then-PM was troubled by complaints from doctors about the targets regime.
 
“I remember sitting in a meeting once where the prime minister said ‘do we have to just keep beating up on the consultants – in A&E for instance – endlessly to achieve this? Or is there some way we can think of building in incentives within the system so that we’ll get these quality improvements on their own, without always having to crack the whip?’”

That led to a shift towards encouraging more patient choice and competition between hospitals, rather than relying on targets to improve standards.

The trust’s director, Dr Jennifer Dixon, says they are a potent way of achieving quick results.

“I think there’s widespread consensus that targets have resulted in immediate benefits, for example in reduction in waiting times.

“It’s highly unlikely that those other reforms could have had that impact so quickly and so precisely on the waiting times. So it’s really ministerial “diktat” almost that’s produced the goods.”

The Department of Health said that, in England at the beginning of 2003, almost a quarter of patients spent more than four hours in Accident and Emergency. It argued that since then there has been a “revolution in patient care”, reducing that figure to less than 2%.

A spokeswoman said: “The funding for hospitals has risen dramatically and targets are minimum standards which taxpayers have a right to expect from NHS hospitals.

“Patient safety and good quality care should always take priority over administrative targets where a doctor believes that is necessary.

“Despite his concerns over the four-hour standard, Dr John Heyworth from the College of Emergency Medicine said he had nothing against targets in principle. But he said he wanted a more sophisticated measure that accounts for quality of care, as well as speed.

From: http://news.bbc.co.uk/1/hi/health/8580761.stm

The Advisory Council on the Misuse of Drugs was asked last year to report on the dangers of the substance, which is also known by its street name “miaow miaow”.

But drugs charities said that the report had been “extremely” delayed by the departure of Professor David Nutt, the ACMD chairman, who was sacked by Alan Johnson, the Home Secretary, last October for criticising the Government’s cannabis policy.

The report, which is now due on March 29, is expected to recommend a ban on mephedrone which can currently be bought legally as plant fertiliser.

Niamh Eastwood of Release, the drugs law charity, said: “There are a number of things that have been delayed in relation to the sacking and I think this report was delayed by about eight weeks.

“Our position is that scientists should be able to express their opinions without fear of being sacked, and the labour Government’s decision to sack Professor Nutt did a lot of damage to the ACMD.”

The ACMD wrote to the Government promising to report on the dangers of mephedrone last September, before Professor Nutt was sacked.

In a letter dated December 22 2009, Les Iverson, Prof Nutt’s successor as chairman of the panel, said he still planned to report to the Government “at the earliest possible opportunity” despite “the difficulties of the last two months”.

Pressure on the Government to outlaw mephedrone has intensified after headteachers called for action on the dangerous drug which has been linked to the deaths of four people.

Louis Wainwright and Nicholas Smith, both 19, took mephedrone – a legal stimulant sold as plant food – before collapsing. The substance can be bought on the internet for £4 and is known on the street as “miaow miaow”.

There have been two previous deaths in Britain linked to the drug which is illegal in other European countries including Norway, Germany and Finland.

Headteachers this morning joined calls for the Government to consider outlawing the substance.

Mick Brooks, general secretary of the National Association of Head Teachers, told the BBC: “This drug clearly has the same inherent dangers as any Class A drug and I think serious consideration should be given to banning it.

“The problem with that is that you then criminalise the people who take it, so we need to think very carefully about what we do, but act with some speed.”

Dr David Wood, consultant clinical toxicologist at Guys and St Thomas’s hospital, said the dangers of the drug were clear.

“We know that it’s a stimulant drug similar to cocaine, amphetamine or MDMA,” he told Radio 4’s Today Programme.

“We’re already seeing patients coming in with significant acute effects like agitation, anxiety, fast heart rates and high blood pressure. There have been reports of patients having seizures and fits like epileptic fits.”

Dr Wood said the drug is also similar to the active component of Khat, the hallucinogenic plant leaf chewed by members of some Somalian communities.

Police are questioning three people over the deaths of the two teenagers who died after taking the drug this week.

On Monday, police were called to Mr Wainwright’s home in the village of Winteringham, where he was pronounced dead.

They were later called to a remote farmhouse in Winterton, the home of Mr Smith, a promising chef who worked at the Winteringham Fields restaurant. Mr Smith’s father Tony, a retired fireman, said his son was not a “druggie”.

Detectives fear the teenagers were killed by a contaminated batch of mephedrone. They have warned anyone with the group or at the same venues who had taken the drug recently to go to a hospital.

Their alleged supplier is under arrest in hospital and a woman was admitted for examination. Two men have been arrested on suspicion of supplying controlled drugs.

From:
http://www.telegraph.co.uk/news/newstopics/politics/lawandorder/7463675/Efforts-to-ban-mephedrone-delayed-by-sacking-of-top-drugs-adviser.html