Joachim Boldt is at the centre of a criminal investigation amid allegations that he may have forged up to 90 crucial studies on the treatment. He has been stripped of his professorship and sacked from a German hospital following allegations about his research into drugs known as colloids.

Experts described Mr Boldt’s alleged forgeries as possibly the biggest medical research scandal since Andrew Wakefield was struck off last year for falsely claiming to have proved a link between the MMR vaccine and autism.

Guidelines for British anaesthetists regarding colloids – used to boost blood volume in patients undergoing surgery – are being revised after it emerged that four of the key studies on which they were based are to be formally retracted.

Mr Boldt, 57, was regarded as a leading specialist in intravenous fluid management, and his work was published widely in British medical journals.

He claimed to have proved that colloids were as safe as other, similar treatments despite earlier studies showing them to be more dangerous. Mr Boldt’s alleged forgeries date back up to a decade.

The Consensus Guidelines on Intravenous Fluid Therapy, published by six British medical groups including the Association of Surgeons and the Intensive Care Society, were being withdrawn last night. Prof John MacFie, president of the Association of Surgeons, suggested that some British patients could have been put in danger. He said he would urge other medics to abandon colloids.

“We have withdrawn the guidelines from our website and we will need to rewrite the article,” he added. “The profession I represent does not want to be to be associated with potentially fraudulent research.

“Some people are comparing this to the Andrew Wakefield scandal. What Wakefield did had terrible implications on children’s lives, and the principle of this is the same.” As chief anaesthetist at Ludwigshafen Hospital in the Rhineland, Mr Boldt was the leading advocate of colloids, which are now commonly used across Europe.

He published dozens of papers “proving” their benefits and contradicting studies which suggested they could increase the risk of death in surgery and cause kidney failure, severe blood loss and heart failure.

German medical authorities are scrutinising 92 of his key publications and a criminal investigation is under way into allegations that he forged documents, tested drugs on patients without their consent and fraudulently claimed payments for operations he had never performed.

Mr Boldt received funding from manufacturers of hydroxyethyl starch (HES) – the colloid he most strongly advocated – including B. Braun, Baxter and Fresenius Kabi.

He was frequently paid to speak at international medical conferences where he hailed HES as “the holy grail” of fluid drugs.

HES and other colloids are up to 10 times more expensive than the alternative fluid management drugs, crystalloids, which some experts believe are safer as they contain smaller molecules and are more easily absorbed.

Mr Boldt was sacked from Ludwigshafen Hospital last November. It has established an investigating commission to review 29 of the 92 papers which have been identified as “highly suspected” of containing forged or distorted data. The others will be examined if serious evidence of forgery is found.

Prof Eike Martin, head of the investigating commission, told The Telegraph: “At first we thought that all the studies were 100 per cent invented, but now we have found a huge amount of clinical data from trials that were conducted.

“Our suspicion is that the trials are not reported accurately in the papers. Prof Boldt was an advocate for colloids and that was the conclusion of his studies, but the data he published is different from the original data we have seen.”

Prof Martin said investigators examining one study, which purported to show that HES caused less inflammation than another fluid management drug, had found that the original data contradicted the conclusion.

The editors in chief of a consortium of medical journals which published Mr Boldt’s work are also reviewing the 92 publications.

Sources close to the investigation said that the editors would announce the formal retraction of 89 papers next month.

Rhineland state prosecutors are investigating Mr Boldt over allegations that he forged the signatures of his alleged “co-authors” on his studies, conducted drugs trials without official approval and claimed money for operations that he never performed. Police raided his home and his offices at the hospital in December and seized paperwork and computers.

Lothar Liebig, the state’s director of public prosecutions, said: “Boldt published certain studies about medical drugs in order to get them accepted.

“There there is a strong suspicion that he deliberately failed to obtain the approval of the institutional review board in Ludwigshafen, which is a criminal offence.”

Other medical research has contradicted Mr Boldt’s findings.

Research by Dr Gill Schierhout and Dr Ian Roberts of University College London found in 1998 that the use of colloids during surgery increased the risk of death by four percentage points – equivalent to four extra deaths in every 100 patients.

A review published 10 years later by Konrad Reinhart and Christiane Hartog of Friedrich Schiller University in Jena, Germany cited two large-scale clinical trials which found that HES could prevent the blood from clotting, which can cause heavy bleeding. Other studies have shown that some colloids can result in complications including heart and kidney failure, fluid entering the lungs and anaphylactic shock.

Suspicion first fell on Mr Boldt in October when readers of an article that he had published in the US journal Anesthesia and Analgesia, about the benefits of HES in bypass surgery, noticed that the pattern shown by his data was “too perfect to be believed”.

Dr Rupert Pearse, a senior lecturer in intensive care medicine at Barts and the London School of Medicine, and co-author of the British guidelines on fluid drugs, said last night: “I specifically remember looking at a paper of his last year and being surprised at how lucky he had been with his results.

“For me, it shakes the world I work in and makes me feel less confident in it, and if I were a member of the public I would feel the same.”

From: http://www.telegraph.co.uk/Millions-of-surgery-patients-at-risk-in-drug-research-fraud-scandal

Official figures show that, under Private Finance Initiative (PFI) schemes, British taxpayers are committed to pay £229 billion for new hospitals, schools and other projects with a capital value of just £56 billion.

Several contracts are due to run for 60 years, documents released under freedom of information requests show, meaning taxpayers will be paying for the projects for generations to come.

Private contractors who agreed PFI deals with the Government are set to make billions of pounds in profit, with some due to see returns of up to 71 per cent.

In a series of reports, UK media lines disclose the heavy costs and administrative burdens caused by PFIs. The deals are a way of building large public projects using private finance, which were relied upon by the Labour government. The disclosures will lend weight to MPs calling on PFI companies to refund a share of their profits to the taxpayer.

The PFI deals include:
• A hospital which charged £52,000 for a job that cost £750. Demolishing a shelter for smokers resulted in the PFI contractor charging £2,600 a year for the additional work .
• A hospital in Bromley, south London, which will cost the NHS £1.2billion, more than 10 times what it is worth.
• An empty school which will cost taxpayers £370,000 a year until 2027. Another school had to pay £302 for a socket, five times the cost of the equipment it wanted to plug in.
• Military dog kennels which would have ended up costing more per night than a room in the Park Lane Hilton, London. The deal to replace facilities at the Defence Animal Centre in Melton Mowbray resulted in the sacking of the contractor and the scrapping of the contract.
Under a PFI, a private contractor builds a school, hospital or other asset, then owns it for typically between 25 and 35 years, effectively renting it to the taxpayer for that time. In exchange, the contractor has responsibility for maintenance.

Treasury papers suggest that payments on PFI contracts already signed run until 2048. The Daily Telegraph (a UK daily broadsheet) has uncovered deals, signed in the late 1990s, which include special clauses meaning that they last for up to six decades.

So a 21 year-old leaving university this year will pay taxes for the PFI until they are almost 70.

By then, some of the facilities will have been obsolete for years. Political pressure on the PFIs, introduced by John Major but greatly expanded when Gordon Brown was chancellor, was mounting last night after The Telegraph established the scale of profit-making by some of those involved.

An almost unknown City company, Innisfree, with only 14 staff, is the largest single player in the PFI market, owning or co-owning 269 PFI schools and 28 hospitals.

According to accounts filed at Companies House, Innisfree’s profit margin was 53 per cent last year. A successful FTSE 100 company makes margins of around 6 per cent. David Metter, the founder and chief executive of Innisfree, owns almost three-quarters of the company and collected pay and dividends of £8.6 million last year.

Jesse Norman, the Conservative MP for Hereford has been quoted as saying that Innisfree have made money like it is going out of style, and that a tiny number of individuals have made more money for less work than any other group of people he can think of. Innisfree said its directors were at a conference abroad yesterday and unable to comment, although there is no suggestion that Innisfree has done anything improper or illegal.

Mr Norman heads a new cross-party group of MPs demanding that Innisfree and other PFI beneficiaries return a portion of their profits to the taxpayer, saying that it’s scandal.

Labour’s last health secretary, Andy Burnham, who was in charge of 221 PFI projects, admitted last year that mistakes were made. Innisfree co-owns the Princess Royal University Hospital in Bromley, opened in 2003, which cost an estimated £118million to build and equip according to Treasury figures.

However, Treasury calculations indicate the NHS will have paid Innisfree and its PFI partners a total of £1,210 million for the hospital over the 35-year life of the contract, but this does include support services. The National Audit Office says the deal will produce a return for the PFI contractors of around 70 per cent.

From: http://www.telegraph.co.uk/Private-Finance-Initiative-hospitals-will-bring-taxpayers-60-years-of-pain

The NHS has received more than 1,000 complaints about Implanon, a device that had been hailed as the future of family planning.

The procedure involves injecting a plastic implant under a woman’s skin, which releases the “pill” hormone progesterone, guarding against pregnancy for up to three years.

The procedure is regularly given to under-16s who are not deemed responsible enough to remember to take oral contraceptives on a daily basis.

Figures obtained by Channel 4 News show that 584 women who had the hormone-filled tube inserted into their arms have reported unwanted pregnancies to the Medicines and Healthcare Regulatory Agency.

There have been a total of 1,607 complaints about scarring and other problems associated with the device, the majority made by doctors and nurses who claimed it was difficult to insert properly and could not be checked afterwards. In the most serious cases, NHS Trusts have offered settlements to seven women totalling nearly £200,000.

Some women who took Implanon terminated pregnancies and suffered the breakdown of relationships.

One woman, named as Lara, said her marriage collapsed due to the stress. “I don’t want kids at this time. It really disturbed me,” she said.

MSD, which manufactured the implant, said it was replacing Implanon with a new contractive implant named Nexplanon.

In a statement, it added that the active ingredient would remain the same but, unlike Implanon, the new implant would show up on X-rays and CAT scans. The applicator has been modified, the company said.

It added that a training programme was available for health professionals involved in fitting the devices.

Family planning clinics in England have reported rapidly increased use of contraceptive implants, from 16,000 women in 2005 to nearly 82,000 in 2010. Implanon, which cost £90 per treatment, was more than 99 per cent effective.

A spokesman for the MHRA said: “The reports we received from health care professionals and consumers played a strong role in the update of the device.”

From: http://www.telegraph.co.uk/Women-win-200000-payout-over-pill-implant-pregnancies

The rise has been fuelled by growing dissatisfaction over the treatment of the elderly in hospitals, according to The Patients’ Association, which has launched a campign to improve NHS care for older people.

The charity wants matrons appointed within hospitals whose sole role is to look after elderly patients and ensure they are treated with dignity.

It is calling for fundamental change to the complaints system and the creation of an independent complaints body.

At present people must complain to the hospitals they feel have failed them.

The campaign would have met with the approval of their former president Claire Rayner who died in October.

She promised to haunt David Cameron if he failed to improve the NHS.

Her widower Des said: “Let the haunting begin.”

The charity campaign also aims to raise £100,000 to boost its dedicated helpline which helps NHS patients to submit complaints.

According to the NHS Information Centre 101,077 people made written complaints to hospitals compared with 89,139 in 2008/09.

From: http://www.telegraph.co.uk/Complaints-to-NHS-top-100000-for-the-first-time

The quantitative study by Raft, which interviewed 50 older people, people on low incomes and those with a learning disability from Bolton, Salford, Bury and Manchester, found that although few people had heard of NHS Choices and Easyhealth, participants were positive about the services when they were demonstrated to them.

However, some felt NHS Choices in particular was aimed at people that were newly diagnosed and could not help those who had had a condition for many years.

Others said that fear of health information, puts them off searching for health information “as a computer can’t reassure you if you’re frightened.”

In relation to HealthSpace, again, few participants had heard of the service including those in Bolton and Bury which are early adopters for the summary care record.

The reaction was mixed and found that it was “clear that most people would only wish to used certain functions of the website” such as the calendar function to help them remember hospitals appointments and the communicator.

Several added that they saw no advantage of seeing a record of medications or allergies when they already knew that they had them.

The report concludes that there is a high degree of trust in the information from the NHS websites which could usefully be used to promote the websites for effectively.

“Most people felt that leaflets and posters in GP surgeries and hospitals clinics would be suitable. Several people suggested the idea of TV advertising.”

The study also aimed to address those who had never accessed the internet, which amounts to 9.2 million people across England. It found that those who would consider learning wanted to do it as possible to home as possible in such as at home, community group they attended, GP surgery or hospital clinic.

Another finding was that although many people did not have access to computers or did not know how to use them, family members were able access the websites and provide the information.

The report recommends that “By promoting NHS websites to all computer uses, we can indirectly improve access to electronic health information for those people who do not use a computer.”

Marlene Winfield OBE, director for patient and public at CfH said: “This report is already helping CfH in the design and delivery of its products and services.

“It will we hope, contribute to the wider digital inclusion discussions taking place as a result of the current health whitepaper and the information strategy consultation that followed it.”

From: http://www.e-health-insider.com/major_nhs_public_websites_unheard_of

Across England the cost of specials to the NHS has risen from £57m to £160.5m in just four years.

A saving of nearly £72m could be made if all specials were limited to £75 an item, according to internal NHS sources.

The problem has also been recognised in Scotland and Wales, but the relevant NHS departments were unable to provide figures.

Using Freedom of Information legislation, the BBC has obtained data that shows that the NHS in Coventry has paid anything from £50 to £1,556 for the same medicine, a blood pressure drug called Captopril Liquid Special 25mg/5mls.

That is just one example in one city.

Stephen Jones, chief executive of Coventry Primary Care Trust, said: “It concerns me because of the level of variation. I don’t understand it. I am not sure that when we dig down into it it is fully justifiable.”

The price inflation is possible when chemists do not buy directly from a specials manufacturer, but via a wholesaler. The wholesaler adds his costs to the price.

However high the rise in costs, when the chemist submits the prescription, the NHS has to pay because there is no price tariff for unlicensed specials.

Brian Hebron, head of pharmacy at Sandwell and West Birmingham NHS Trust, said: “When we have received these large mark ups, we have asked the NHS Counter Fraud Office to look at it, but they have told us that it is within the law.”

Although chemists cannot benefit directly from the price on the prescription, they can receive a “special discount” or cash back at a later date.

Pam Kaur, who runs Vantage Chemist in Coventry, shops around for specials and records some of the lowest prices.

She said she has been offered up to 40% discount or money back by wholesalers who are trying to attract business in the past.

“I think that pharmacy is based around ethics. For me in my pharmacy, it is important to get good value for money for the NHS.”

She buys directly from manufacturers. One such manufacturer, Nova Laboratories in Leicester, said the average price for its specials is about £40, but it varies from a few pounds to about £100 for the vast majority of products.

For the period October 2008 to November 2009, the pharmacy with the highest average cost for specials in Coventry was A & M Pharmacies run by Ashwin Hindocha.

His charges for specials were on average 475% higher than Pam Kaur’s.

As well as the £1,556 charge for Captopril, he has submitted a prescription charge of £997 for Omeprazole which can cost as little as £50.

When questioned regarding these charges, Mr Hindocha said that he was disgusted, but that he only found out recently about the high prices.

He said that he runs a busy chemist, but has since taken steps to reduce the costs.

When asked further about being on the Local Pharmaceutical Committee when the problem with specials was discussed at a meeting he attended in 2007, his solicitor, Noel Wardle, stated that Mr Hindocha had acted in accordance with the drug tariff.

He said: “To a large extent the price claimed is set by specials manufacturers and suppliers.

“It would be impossible for pharmacists to shop around for the lowest price and other factors may be more important such as speed of service, quality, reliability.”

One of Mr Hindocha’s suppliers is Camrx, whose managing director is Rajni Hindocha, Mr Hindocha’s brother.

The company was also used by two more of the chemists that submitted the highest prices in Coventry.

In 2008 Camrx offered chemists a 51% discount through a manufacturer, Quantum Specials.

Quantum Specials has denied having anything to do with the discount.

In fact, Quantum Specials wrote to Camrx in November last year, saying customers and NHS primary trusts had made it aware of the high prices Camrx was charging which did not reflect the prices that Camrx was paying Quantum Specials for the medicines.

Quantum Specials said that it did not want to be associated with this practice and that if Camrx did not agree to stop within seven days, then it would stop supplying drugs to Camrx.

However, Camrx said Quantum Specials was aware of, and approved, the deal.

Through a statement from his solicitor, Rajni Hindocha denied any wrongdoing.

It said: “Mr Hindocha has been unable to locate any invoices for Omeprazole or Captopril for the amounts stated.

“The system is complex. Neither Campdale Pharmaceuticals nor Camrx colluded with any pharmacist to inflate the cost of specials medicinal products which were supplied.”

In the absence of government rules, the NHS is trying to tackle the high prices in other ways.

Hospitals have the right to substitute cheaper drugs which do the same job, so by using a dissolvable tablet instead of a liquid, they can save hundreds of pounds on each item.

Mr Hebron, of the Sandwell and West Birmingham NHS Trust, said: “I think it is outrageous because if I can find ways around having to spend that kind of money on products, then there ought to be a system that prevents the taxpayer having to fund that sort of mark up.”

Claire Parker, assistant director of pharmaceuticals at Sandwell Primary Care Trust, has seen her specials drugs bill go up from £40,000 a month to £100,000 a month in a year.

She believes that the answer is for the Department of Health to set a limit on the price of specials as it has done for other drugs.

She said: “There’s nothing that we can specifically do in primary care and I believe that they are looking at setting a national tariff, but we need it done quickly so that we can control prices.”

A Department of Health spokesperson said: “We recognise the system needs to be reformed.

“The department is working with the Pharmaceutical Services Negotiating Committee (PSNC) on proposals for new payment arrangements for these products.”

From: http://www.bbc.co.uk/news/uk-england-11376557

But the exodus, added to new European regulations limiting the hours of doctors, caused unfilled vacancies.

Attempts to recruit scores of Indian doctors foundered on a disagreement between government departments.

“We pulled the plug on overseas recruitment far too quickly,” said Professor Derek Gallen, who is postgraduate dean of medical training for Wales.

“We didn’t realise what the implications of that action would be two, three or four years down the line,” he added.

The Welsh Deanery is one of four medical training schools across the UK which has been recruiting in India over this year.

The other deaneries involved cover the Severn area, the West Midlands and Northern Ireland. In total, they plan to take more than 100 junior doctors over to the NHS.

The deaneries are looking to recruit in areas such as paediatrics, obstetrics, gynaecology, anaesthesia, as well as accident and emergency.

The need for junior doctors is most acute outside the big metropolitan areas.

The European Working Time Directive, which was fully introduced into the NHS last August, limits doctors to working no more than 48 hours per week and has left gaps on rotas.

Some district general hospitals have had trouble attracting enough staff to cope with the changes leading, in some cases, to services being cut.

In May, the Victoria Hospital in Kirkcaldy had to close its accident and emergency department overnight for a week due to a shortage of junior doctors.

At Erne hospital in Enniskillen, its obstetric and gynecology service had to be suspended for several weeks for the same reason.

The shortage of junior doctors means hospitals are struggling to fill vacancies, and having to devise their own initiatives to recruit doctors wherever they can find them.

From: http://news.bbc.co.uk/1/hi/health/10202803.stm

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

But fewer patients are dying or coming to seriuos harm as a result of medical errors in England, the National Patient Safety Agency (NPSA) said.
The figures show that 473,162 incidents were reported between April and September last year, compared with 379,345 in the same period in 2008.

The agency said that the year-on-year rise of nearly 25 per cent was positive because increased reporting meant that lessons could be learnt and patterns identified.

The number of incidents which resulted in death across England has decreased from 1,856 to 1,160. Cases that resulted in severe harm to the patient also fell from 3,643 to 2,412.

However, campaigners say that the level of avoidable mistakes is still unacceptably high.

The most commonly reported incidents were accidents involving patients, such as slips, trips and falls, which accounted for nearly 155,000 reports, a third of the total.

But there were nearly 51,000 cases of medication errors— such as administering the wrong type or dose of drug— and a similar number of delayed or wrong site procedures.

Under a new system of NHS regulation that began last month, hospitals and health authorities could face fines or possible closure if they fail to report anonymised details of “serious incidents” to the NPSA.

However, they are not obliged by law to provide details of such events to injured patients or their next of kin.

The campaign group Action Against Medical Accidents (AvMA) has renewed calls for a legal duty of candour to apply to all trusts, to ensure patients and relatives are given full details if they are harmed.

Peter Walsh, chief executive of AvMA, said: “How can people have faith in a system that puts collecting data before being open with patients?

“We are not saying that the labour Government intended to legitimise cover-ups of medical accidents, but that is the effect.

“One would have thought that recent scandals such as Mid Staffordshire Hospital would have underlined the need to tackle the culture of cover-up and denial.”

Six unidentified trusts in England — two hospital trusts, three primary care organisations and an ambulance trust — did not submit enough data on incidents to be counted in the latest reporting period, the NPSA said.

But Suzette Woodward, the NPSA’s director of patient safety, said that overall the latest figures were “extremely positive”.

“[They] provide real evidence of an improved patient safety culture in the NHS with a decrease in the severity of incidents reported and a corresponding, real increase in the number of patient safety incidents reported to the NPSA.

“This trend is extremely positive and goes to show just how seriously frontline services view reporting and, more importantly, learning from incidents.”

Katherine Murphy, director of the Patients Association, said: “We welcome the increased reporting, but it is appalling that after constant pressure and now even plans to make reporting mandatory, that some organisations are still not reporting incidents sufficiently.

“Patient safety is supposed to be a priority and yet some trusts don’t even seem able to comply with basic recommendations about reporting.

“It raises the question of whether the managers at those organisations really are committed to patient safety.”

From: http://www.timesonline.co.uk/tol/life_and_style/health/article7073966.ece

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

NHS managers, under pressure to cut costs, are implementing the changes despite warnings about poor security in some offshore centres.

The Sunday Times has identified seven primary care trusts in northeast London, serving more than 1.5m people, that have begun to send patient details overseas. The databases are administered by about 200 workers in Pune, western India.

Although companies handling the records in India said security was “paramount”, there is a risk of patients being identified if the NHS numbers are matched with anonymised clinical notes carrying NHS numbers, already being sent to India by more than 30 trusts.

Typically, a set of clinical notes will be based on a consultant’s findings during a session with a patient, which he will read into a voice recorder during or after the appointment.

The recording is then transferred to a computer and sent to India, where it is transcribed. One source involved in processing the information said patient names can crop up during the appointment and may then inadvertently be included with the clinical data.

Workers in India are also producing letters for patients with appointments for cervical smear tests and breast screenings.

Pilot schemes for NHS offshore transcription services began more than four years ago and have rapidly expanded. The Royal Free hospital in London, the Derby hospitals trust and the Newham University hospital trust are among those sending clinical notes overseas.

Labour ministers have been anxious to allay concerns about the confidentiality of patient information since the launch of a £12 billion scheme to computerise health records.

In January 2007 Caroline Flint, then health minister, told parliament the project would “expressly preclude the transfer of patient information outside the United Kingdom”.

Trusts, however, believe they may send patient information outside the UK if it does not come under the electronic records project.

John Hemming, the Liberal Democrat MP for Birmingham Yardley and an expert on IT projects, said: “Given the government’s track record of losing data in this country, it is worrying that data are being sent overseas. Every transfer of information adds to the risk of it being lost.”

The possible risks of transferring patient data overseas were exposed last year when undercover reporters from ITV1’s Tonight programme were able to buy health records from a private hospital in London, processed in India. The sellers claimed to have access to thousands of UK medical records.

The transfer of primary care trust records is being handled by NHS Shared Business Services, a joint venture between the Department of Health and the IT company Steria.

From: http://www.timesonline.co.uk/tol/life_and_style/health/article7086816.ece

Health Direct urges you to opt out of labour’s snoopers charter- whilst you still can!

The number of reported mistakes a t the 138 fertility clinics in England and Wales nearly doubled in the year to April 2009, rising to 334 from 182 the previous year. One leading patient safety expert has now warned that blunders which have occurred as record numbers of women seek treatment, may be “systemic”.

The increase comes as one clinic, IVF Wales, is at the centre of a fresh scandal after losing the last two remaining embryos it had frozen for one of its patients. It is the second time in less than 12 months that a mix up at the centre, based at University Hospital of Wales in Cardiff, has left patients devastated.

The Cardiff-based couple has had their eight-year quest to have a baby put on hold as a result of the blunder, which followed an initial, unsuccessful course of IVF. The pair, identified only as Clare and Gareth, are suing Cardiff and Vale University Health Board, which last year paid out a five-figure sum in compensation for negligence after another mix up.

Guy Forster, a solicitor at the law firm Irwin Mitchell who is representing the couple, said the incident raised questions about the Government’s IVF watchdog, the Human Fertilisation and Embryology Authority.

“This raises concerns about the HFEA’s ability to regulate the IVF industry properly. I think it should be doing a lot more to follow up when an incident occurs, especially at a clinic with a poor track record,” he said, adding: “These problems appear to be on the rise.”

An official review last year found that the HFEA was failing to punish badly run fertility clinics by not using the “full range of sanctions” at its disposal. Professor Brian Toft, a patient safety expert at Coventry University, said: “If the HFEA fails to clamp down when something has gone wrong then things will continue to go wrong.”

He said the rise in reported incidents, uncovered by BBC Radio 5 Live, implied clinics were not learning from their mistakes, adding: “I have been told there are not enough qualified staff doing the work. HFEA do not make any recommendations for staffing levels per number of patients. If you have a lot of patients and not enough staff, this could account for an increase in errors. This problem may well be systemic.”

Professor Sammy Lee, an IVF expert, said the watchdog must ensure clinics comply with regulations. “They need to obtain staff that have experience of enforcement and are able to make sure that regulations are put into place,” he said.

An HFEA spokesman played down the increase in blunders, which he said was partly due to new rules requiring clinics to include incidents when patients suffered from ovarian hyperstimulation syndrome (OHSS). “The number of reported incidents has increased as the sector has responded positively to the opportunity to share lessons learned from incidents which have been reviewed and investigated,” the HFEA added in a statement.

From: http://www.independent.co.uk/errors-at-ivf-fertility-clinics-double-in-just-one-year

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!

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