Measles cases triple with no backup vaccine stocks

Parents are being urged to give their children the measles, mumps and rubella jab before the start of the new school year after an unprecedented surge of measles cases was recorded over the summer holidays.

Experts fear that hundreds of thousands of children returning to school as early as next week may cause the highly infectious disease to spread.

Despite this the labour Government has ordered no extra stocks of the MMR vaccine and doctors may run out if they face a sudden rise in demand, The Times has learnt.

The Health Protection Agency (HPA) said that the number of confirmed cases of measles in children had more than trebled over recent months and was far higher than would normally be expected for this time of year.

By June 10 only 136 cases of measles had been confirmed. But just over 11 weeks later this number has risen to 480, with new cases being detected every day, the HPA said. This compares with 756 cases recorded during the whole of 2006 – the highest year on record.

Measles, which can be life threatening or cause severe disabilities, is most common among children aged 1 to 4 who have not been immunised, but can strike older children and adults, too.

It was difficult to explain the large increase this year, the HPA said, but parents not vaccinating their children and a lower uptake of a second MMR “booster” dose are thought to be key factors.

The triple vaccine has proved highly controversial in recent years over unfounded concerns that it may be linked to autism. The study that first sparked fears about its safety is currently being scrutinised in a hearing by the General Medical Council, the medical watchdog. Andrew Wakefield and two co-authors of his research are currently appearing before the GMC on charges of serious professional misconduct.

MMR coverage began to drop in the late 1990s, though uptake is rising slowly again. The latest figures show that 88 per cent of British children begin school having had one dose of MMR.

The latest data, for January to March 2007, showed particularly high numbers of measles cases in London and southeast England, East Anglia and Yorkshire and Humberside.

Mary Ramsay, a consultant epidemiologist at the HPA, said yesterday: “We’ve been very worried because the cases have stayed up over the summer holidays. This means it is crucial that children are fully immunised with two doses of MMR before they return to school.”

In previous decades, measles could cause an average of 20 deaths a year. Officials are nervous that the numbers could creep up again after gaps in vaccination coverage. “Although the numbers are still small, compared to the history of measles, we’re always worried about measles because very rarely it can kill,” Dr Ramsay added. “We hadn’t had any deaths from measles since the early 1990s, but unfortunately we had one death last year and we don’t want any more.

“Measles is a highly infectious and dangerous illness and, as there is increased close contact in schools, it can spread easily.”

Along with buying school uniforms and other preparations, “parents should think about adding the MMR vaccine to their back to school ‘to do’ list”, she added. “It is never too late to get vaccinated.”

But Laurence Buckman, chairman of the British Medical Association’s GPs’ committee, said that many doctors had not been warned to prepare for a sudden demand and could run out of supplies. “GPs will only have ordered as much vaccine as they would typically use at this time of year, so there may not be enough to satisfy a surge in demand,” he said.

“Doctors and nurses will do their best, but at this short notice, they will not be able to run any extra clinics on the weekend and when they run out of supplies there is not much they can do.”

Doctors’ surgeries at Hackney, East London, are dealing with the effect of reduced levels of vaccination, with more than 120 measles cases in the past three months. Most of those were in children under 5 who had not been immunised.

Michael Fitzpatrick, a GP in the borough, said that he was disappointed but not surprised by the latest figures: “Scepticism about the MMR vaccine results in outbreaks of measles like this,” he said. “This was inevitable and I think the only surprise is this hasn’t happened earlier, and on a bigger scale.”


How the Dept of Health and the government is going to clear up this sorry mess is not clear without extra vaccine stocks.

On June 19, 2006 Health Direct posted: Measles- how a spurious health MMR scare brought an old killer back as health chiefs last week reported the worst outbreaks of measles across Britain in 20 years, slow progress was being made in bringing to justice the doctor who sparked the MMR scare.

At the high court in London, lawyers for the General Medical Council (GMC) gave the first public hearing to disciplinary charges against Andrew Wakefield, whose scientific paper published eight years ago caused millions to shun the vaccination for fear that their children might contract autism.

As health chiefs revealed last week, Britain is now in the grip of what has every sign of becoming a measles epidemic. In March the first child in 14 years was killed by the virus. Clusters of infections, such as in Surrey and Yorkshire, have propelled the number of confirmed cases this year to 449, the largest number since the MMR jab was introduced in 1988.

The current preventable measles crisis is a disaster waiting to happen. On June 16, 2006 Health Direct posted: Scare over MMR vaccine safety causes cases of Mumps to soar

With the immunisation rates falling to around 50 per cent in Westminster and other parts of London Scare over MMR vaccine safety causes cases of Mumps to soar as immunisation postcode lottery grows one would think that the GMC would be moving faster than it is to clear up this sorry mess.

UNICEF blasts labours breastfeeding nanny state

The long term health of mothers and babies is being put at risk by UK hospitals that have failed to introduce pro-breastfeeding policies, the United Nations says. UNICEF, the UN children’s fund, today releases a report showing that four out of 10 maternity hospitals have not implemented guidance from the National Institute for Curbing Expenditure (NICE) that was published a year ago.

Breastfeeding protects babies from a range of illnesses and saves the NHS millions of pounds a year, says Unicef. Breastfeeding also lowers a mother’s risk of breast cancer, ovarian cancer, hip fractures and low bone density.

Bottle-feeding puts babies at greater risk of gastrointestinal and respiratory infections and other illnesses, yet UK breastfeeding rates are among the lowest in Europe.

NICE recommended that all maternity trusts should adopt the Unicef Baby Friendly programme, which focuses on giving mothers information so they can choose whether or not to breastfeed, and ensuring they have support to do so.

It is intended to be non-judgmental and women who elect to bottle feed will be helped to do it safely and well.

Unicef accredits hospitals that reach an acceptable standard. But some hospitals say budget cuts mean they cannot afford to train staff.

Unicef points out, however, that NICE predicted cost savings for hospitals after three years of the initiative, because of reduced childhood illness.

Some hospitals have seen a transformation in attitudes after adopting the Baby Friendly policies. The Pennines acute trust has seen its breastfeeding rate rise from 29% in 1994 to 65%.

“In 1994 women knew about formula milk but had no knowledge about breastfeeding,” said Val Finigan, infant feeding coordinator for the trust. “We gave them information to enable them to make an informed decision.” The other priority was to train staff at all levels to help women with whichever type of feeding they chose.

Unicef has this week written to all hospital chief executives, reminding them of the Nice guidance.


Health Direct is amazed that with even such a parsimonious organisation as the National Institute for Health and Clinical Excellence (NICE) proclaiming the benefits of breastfeeding that UNICEF’s guidelines are not being followed .

Is this yet another case of the labour govt cow-towing to it’s big business friends?

Nurses dont report abuse of the elderly

More than half of nurses would not report the abuse of an elderly person in their care, according to a survey published today. The poll of NHS and private sector nurses, conducted for Help the Aged, found that a lack of training, heavy workloads and fear of confrontation or of upsetting the victim all prevent nurses taking action.

The findings come amid growing evidence that elder abuse is a widespread problem in families, care homes and hospitals. A study by the National Centre for Social Research and Kings College London suggested that 342,000 older people living in private households are subject to some form of mistreatment every year in the UK.

A report by the parliamentary joint committee on human rights this month highlighted significant levels of abuse and neglect suffered by older people in care homes and hospitals.

Its latest study, based on 848 responses from readers of Nursing Standard and Nursing Older people, found that 58% of nurses would not report abuse of an older person because they fear having got it wrong.

The poll revealed that 68% of nurses felt a lack of training in how to deal with elder abuse was a barrier to them providing decent care.


On June 22, 2006 Health Direct posted: Minister wants Dignity debate for caring for the elderly
when the new care services minister Ivan Lewis said that he wanted to make dignity of older people one of his top priorities.

Speaking at a session on the out of hospitals white paper, he said: ‘I want to make dignity an important theme in my time as a minister. ‘This is not a gimmick; just another initiative. It
should be at the heart of what we are doing.

As Health Direct also mused: Classic Labour tactic this. Ivan Lewis’s caring, sharing labour government announces a laudable new spin policy for caring for the elderly and frail. Brilliant

He then lambasts everybody else for not delivering his policy- when it’s his own fault because the Labour govt has not put a single new penny of money into the pot to pay for the new initiative.

Where is the money to pay for the extra nurses that you want to police your dignity policy, Mr Lewis?

NHS deaths could be halved say doctors as 10,000 die needlessly every year

More than 10,000 people are dying needlessly each year after being denied intensive care treatment, according to senior doctors. They have written to the Health Secretary Alan Johnson, warning that many patients are dying after routine surgery because of a failure to identify them as high risk cases.

The result is that they are not monitored closely enough, causing at least 20,000 deaths each year. But consultants say that figure could be halved if high-risk cases were properly identified and transferred to intensive care.

They say the number of critical care beds devoted to post operative patients should be tripled from the 30,000 currently provided, while 50 per cent of patients should receive extra care. Britain has 0.6 critical care beds per 10,000 population compared to 4.4 per 10,000 in the US.

Shadow health secretary Andrew Lansley said: “This is a really critical issue for this country. We have chronically poor levels of intensive care compared with elsewhere.”

In the letter to Mr Johnson, seen by this newspaper, 17 eminent anaesthetists demand an overhaul of NHS surgical practices, warning that four times as many patients die in Britain after surgery as in the United States.

The doctors say the health service has failed to introduce simple tests to identify high-risk patients and challenge the health secretary as to why technology proven to cut deaths is used in a fraction of NHS operations.

One of the co-signatories, David Bennett, Emeritus Professor of Intensive Care Medicine at St George’s Hospital in London, said: “There are at least 20,000 patients dying after surgery across the UK – that is a very conservative estimate.

“We think we could halve the numbers dying, and save at least 10,000 lives a year, if patients were given the right support. This is a political decision. There aren’t many interventions that could have such a dramatic effect.”

Increased use of intensive care, combined with better monitoring, could save money by cutting patients’ time in hospital and preventing emergency re-admissions, he said.

Prof Bennett said that most hospitals had failed to invest in equipment such as fitness bikes, which help to assess the patient’s health prior to surgery, and blood-flow monitors, which maintain fluid levels and cardiac output during an operation.

Despite backing from NHS rationing body the National Institute for Curbing Expenditure (NICE), blood flow monitors are used on less than 10 per cent of patients.

Dr Bruce Taylor, honorary secretary of The Intensive Care Society said more patients should be monitored by intensive care before they became seriously ill. But he said there was “no slack at all in the existing system” to take on more patients without a substantial rise in funds.


On March 12, 2007 Health Direct posted: Medical errors- new campaign aims to reduce deaths and costs when a safety drive was launched by the labour government’s health watchdog in the face of “alarming” figures on the harm patients suffer in hospital and elsewhere.

Various studies, some using US data, estimate that there is a one in 300 chance of a hospital patient dying as a result of medical error.

One in 10 is estimated to suffer harm, of whom a third suffer serious harm, while studies suggest that 600 errors are made a day in primary care with more than one in 10 prescriptions containing errors.

And again on 4 Nov 05 Health Direct posted: NHS accidents cost £2bn and up to 34,000 lives finds National Audit Office (NAO) when according to a report by the National Audit Office, around a half of incidents in which NHS hospital patients are unintentionally harmed could have been avoided, if lessons from previous incidents had been learned.

Whilst reporting has improved at the local level, at the national level progress on developing a national reporting and learning system has been slower than envisaged in the Department of Health’s 2001 strategy “Building a safer NHS for patients”.

UK stroke treatment is worst in Europe

The UK has the worst outcome for strokes in western Europe despite spending the same amount or more on care as other countries, a leading article in the British Medical Journal warned.

Hugh Markus, professor of neurology at St George’s university and medical school, said three different studies had put the UK at the bottom among several other western European countries.

The problem appears to lie in the way services are organised, with strokes seen as a “Cinderella” subject that falls between neurology and geriatric medicine, Prof Markus said.

Instead it needs to be treated as “a condition that requires emergency action”.

Clot-busting drugs can now be given to patients whose stroke is due to a blocked blood vessel rather than a broken one.

To do that, however, rapid 24-hour access to specialised expertise and imaging equipment is needed to determine the type of stroke. The drugs have to be given within three hours to have most effect and can harm a patient whose stroke is due to bleeding.

“It is unlikely that every acute hospital will be able to provide such a service,” Prof Markus said, and alternative strategies that include regional centres and the use of telemedicine are needed, as in Germany and America.

“In many European countries,” Prof Markus added, brain imaging “is performed on admission to the accident and emergency department, while in the UK many units struggle to provide it within 24 hours.”

A National Audit Office report in 2005 calculated that 550 deaths could be avoided a year, and 1,700 patients would recover fully rather than being disabled, if ­services were better organised.

A stroke strategy is apparently due to be published by the health department in the next few months.

The limited data available, Prof Markus said, “show that European countries with better outcomes focus resources more heavily on the acute aspects of care”.

“The vast majority of the cost of in-hospital stroke care in the UK is for nursing and hospital overheads, with the cost of investigations and medical care being very low.”

At present less than 1 per cent of patients eligible for clot-busting drugs get them in the UK, against 20 to 30 per cent in many European countries and North ­America and Australia.


It is nearly two years since MPs in the National Audit Office pointed out that hundreds of UK citizens are dying needlessly and over a year since Health Direct posted on July 12, 2006- Stroke patients dying needlessly from Labour’s health failures

Since then new Prime minster- same lack of compassion and urgency.

Stroke patients are needlessly dying or suffering more serious disablement because not enough priority is given to stroke services, according to a report by the Commons Public Accounts committee.

The report found that stroke is not treated as a medical emergency, brain scans for patients are often delayed and a significant proportion of stroke patients are not treated on specialist units.

The MPs found:
* Stroke is not treated as a medical emergency in the same way as a suspected heart attack, though the shorter the time between the stroke and the treatment, the greater the chance of reducing damage to brain tissue.
* Brain scans for many stroke patients are being delayed, though a scan is vital for determining appropriate treatment.
* A significant proportion of stroke patients are not being treated on a specialist stroke unit, despite evidence that this is the most clinically effective model for acute care.
* There is considerable variation between hospitals as to what a specialised stroke service entails.
* Public awareness of the symptoms and impact of stroke, and how strokes can be prevented, is very low.
* There are insufficient nursing, therapist and other specialist staff with expertise in stroke care across the primary and secondary healthcare sectors, and there is scope to improve training for the existing stroke workforce in the National Health Service (for example, by training stroke consultants to interpret brain scan results).
* The carers of stroke survivors, and stroke survivors living on their own, are often not accessing the social and care services they need.
* There is low awareness on the part of members of the public and general practitioners about the fact that a transient ischaemic attack (‘mini stroke’) is a strong indication of increased risk of major stroke, and requires immediate investigation and treatment.

Labour red tape shake up costs NHS 140 million Pounds

The reorganisation of strategic health authorities (SHAs) in England has seen the NHS pay out more than £80m in redundancy costs, Health Direct and the BBC has learned. More than 700 staff lost their jobs in last year’s shake-up, which saw the number of SHAs reduced from 28 to 10. The cost of the average redundancy package for senior managers was more than £350,000.

“These are the kind of costs that result from endless reorganisations. Not one penny contributes to the health of patients.” claimed Andrew Lansley, shadow health secretary

The BBC obtained the figures from the 10 SHAs using the Freedom of Information Act.

Twenty-eight SHAs were set up in 2002 by the labour govt to supervise local health services in England. Their job was to coordinate care and deliver government policy.

But three years later ministers announced £250m had to be cut from red tape and four years after they were created the regional bodies were merged into 10.

Some 764 people were made redundant or took early retirement at a cost of £82.89m. That included 61 senior managers. Their redundancy packages cost an average of £358,355.

But the Liberal Democrats say the true cost of the changes must include the reorganisation of primary care trusts, which were reduced from over 300 to 152 last year.

They claim that the cost of those mergers could be as high as £60m, making a total bill for the changes of more than £140m.

Liberal Democrat health spokesman Norman Lamb said: “This is the price we’re paying for botched reforms. The government rushed into ill thought out reform…when the system didn’t work they changed it.”


Health Direct posted on 20 Jul 07 NHS manager’s lottery payout is nearly £1m – An NHS manager has been given a redundancy package worth almost £1 million in what was described as “a lottery win rather than a payout”.

David Johnson, the former head of a regional strategic health authority, was one of about 70 staff who left the organisation when it was abolished as part of a restructuring programme.

Robert Goodwill, the Tory MP, condemned the settlement awarded to Mr Johnson. He said: “Most people will look at this and say this is a lottery win rather than a payout.”

Mr Goodwill, who represents Scarborough and Whitby, in North Yorks, said he understood Mr Johnson was entitled to the payout under the terms of his contract. But he criticised the contract itself and the multiple reorganisations of the NHS that lead to high-profile job losses.

Mr Goodwill said: “How do I explain these payouts to people who can’t get their Alzheimer’s disease drugs, or they can’t get drugs for conditions causing blindness?”

Given the current climate of tony’s cronies- Health Direct asks if there any relationship between David Johnson the NHS lottery winner and Alan Johnson the new NHS boss?

New nurses left jobless by labours NHS budget squeeze

Thousands of newly qualified nurses are facing unemployment because of labour’s NHS hospital cutbacks, with vacancies at their lowest for 10 years. New National Health Service figures have revealed how difficult it is for nurses, physiotherapists, scientists and doctors to find jobs.

The highest vacancy rate was among consultants, with 1.2 per cent of jobs empty compared with 0.4 in trainee nursing. There are currently 5,000 newly qualified nurses who cannot find a job and half of the 2,413 newly qualified physiotherapists have not found permanent posts.

More than 20,000 jobs have been cut in recent years as managers struggle to bring NHS finances back into balance.

Vacancy rates across the medical professions have dropped, showing the boom and bust nature of current workforce planning in the health service.

Places at medical school and nursing colleges were expanded and the NHS has now almost reached a point where it is self-sufficient in staff.

But experts are predicting shortages again in the medium to long-term because large numbers of nurses, GPs and consultants are nearing retirement age. In the meantime, newly qualified staff are struggling to find work and many are considering retraining or working abroad.

Dr Peter Carter, the general secretary of the Royal College of Nursing, said: “This is not a ‘good news’ story for nurses.

”Vacancy rates appear to have reached their lowest levels for years but we fear that has been achieved only by widespread freezing and deleting of posts by NHS trusts desperate to balance the books.

“Thousands of newly qualified nurses – costing taxpayers millions of pounds to train – cannot find jobs this year yet at the same time the workload on the wards and in the community remains high.

“It’s time for the Government to put in place a long-term workforce strategy that prevents the feast or famine characteristic of the NHS job market in recent years.”

The NHS Vacancy Survey also found that:
– In March 2007 there were 1,695 vacancies for qualified nurses and 391 for trainees.
– There were 364 consultant posts available and 73 jobs for other doctors in non-training posts.
– The vacancy rate for GPs has dropped from 2.4 per cent in March 2005 to 0.8 per cent this year.
– There were just 63 vacancies for physiotherapists in March this year compared with 464 in 2005.
– The highest vacancy rates are in the South East Coast area, followed by the North East, with the lowest in the West Midlands.


Health Direct points out that Labour’s complete and utter incompetence in attempting to “save the NHS” is exposed by these latest figures. It’s a waste of taxpayers money for us to subsidise medical training and then throw the highly skilled new staff out onto the dole queues.

On March 22, 07 Health Direct posted: MPs expose lack of control over NHS billions

A devastating insight into financial mismanagement at all levels of the NHS- from Labour ministers down to hospital bureaucrats- is provided by a committee of MPs. The report by the all party Public Accounts Committee exposes how billions of pounds of taxpayers’ money is being poured into a health system with inadequate financial controls and low levels of accounting expertise.

The MPs conclude that NHS structures are so inadequate that the Department of Health has no idea what the effect of last year’s total deficit of £570 million is having on patient care.

In no less than one in three NHS organisations, auditors had raised concerns “about the financial management capabilities of general management”.

The committee said that while the Department of Health had no “overall picture” of the effect of deficits on services to patients, it was clear they were adversely affecting the level and quality of care.

Dr Peter Carter, the general secretary of the Royal College of Nurses, said it was very disturbing that the department had no clue about the effect of deficits on services and jobs. “It’s time for the Government to come clean.

Ministers need their advisers to tell them just how damaging the deficits crisis has become and acknowledge the Government’s responsibility to work with front line staff to find a long term solution.”

Cancer survival rates- UK patients are losing out

Cancer survival in the UK is still below the European average, despite recent improvements, a report says. Survival rates in lung, breast, prostate and colorectal cancer were lower in the UK compared with everywhere except eastern Europe.

The Eurocare studies of 23 countries looked at the outcome of 2.7m new cases between 1995 and 1999. Government cancer “tsar” Mike Richards said poor results in the UK had been due to delays spotting the disease.

The studies, published in the Lancet Oncology journal, are the largest international projects to compare the survival of patients from 11 different cancers. They reveal wide differences in death rates from both rare and common types of cancer.

“Our concerns illustrate the considerable challenges that now face the UK government if it is to make the NHS work efficiently and effectively” Editorial, Lancet Oncology

The best performers are Nordic countries such as Sweden and Norway and central European countries.

Ranked just beneath them are south European countries, and lower still is the UK, followed by Eastern European countries.

While death rates have fallen in the UK, they have also fallen in the rest of Europe.

Some eastern European countries almost matched the UK’s performance despite spending less than a third of the UK’s health budget per head of population.

Overall, for men Sweden had the best survival rates with 60% of cancer patients alive five years after diagnosis, compared to between 40% and 50% among the UK countries.

For women, Sweden and Iceland were top on 62% with Wales, England and Northern Ireland just below the European average of 56%, while Scotland was among the worse on 48%

Delayed diagnosis

An editorial in the Lancet Oncology questioned whether the NHS Cancer Plan, launched to tackle poor survival rates in the UK, was working.

“Eurocare is an important indicator of oncology provision in Europe, giving insight into healthcare effectiveness and the improvements needed. Our concerns illustrate the considerable challenges that now face the UK government if it is to make the NHS work efficiently and effectively.”

Professor Richards conceded that while some of the data from European countries could be flawed, this was unlikely to account for all of the differences between countries.

“The findings show that many more lives could be saved if the outcomes in all countries were brought up to the standards of the best countries.”

He added: “The poor results from the UK were attributable mainly to patients having more advanced disease at diagnosis than patients in other European countries.”

‘Must ensure access’

The NHS Cancer Plan was launched in 2000, and promised an increase in specialist staff and equipment to tackle the delays in diagnosing and treating cancer.

Strict targets on the waiting times for scans and appointments were set.

Professor Richard Sullivan, Cancer Research UK’s director of clinical programmes, said “Cancer is still not being diagnosed early enough in all cases. And we need to ensure that patients have access to the best surgery, radiotherapy and other treatments. This study shows that cancer is certainly not a ‘ticked box’. We need a sustained effort to beat the disease.”


Health Direct readers will not be surprised by the latest shocking news on cancer survival rates in the UK. On Aug 09, 06 we posted: Postcode lottery for cancer, hearts and mental health King’s Fund reports

Wide variations in NHS spending may be denying patients fair access to drugs and treatment, a study says. The King’s Fund think tank found that some English trusts spent four times as much on certain diseases than others. The research, compiled from government data from 2003-4 to 2004-5, also showed mental health got the most cash, followed by heart disease and cancer.

Researchers also analysed overall spending on particular disease groups. The greatest proportion – over £7bn – was spent on mental health, with heart disease absorbing nearly £6bn and cancer just over £3.5bn.

As long as the Labour govt continues to use the National Institute fro Curbing Expenditure to block the use of new cancer drugs like Herceptin then UK patients will contiue to die unnecessarily.

On 4 Apr o6 Health Direct posted: Cancer: There are life-saving drugs. So why can’t we have them?

Thousands of cancer sufferers are being denied life-saving drugs because of delays and bureaucracy in making them available on the NHS. The hold-ups are a matter of life and death for desperate people who have been diagnosed with cancer of the breast, colon or lung, or with a brain tumour.

Doctors are furious that drugs such as Avastin, which is used to treat colon cancer, and Cetuximab, a treatment for head and neck cancers, are being blocked by the National Institute for Curbing Expenditure (NICE), a labour government created quango set up to decide which drugs should be routinely prescribed on the NHS.

But backlogs mean that Nice is taking up to two years to make its decisions. That means drugs such as Avastin, which have been officially licensed and approved for use, are currently denied to NHS patients although well-off people can obtain them privately. In some cases, patients are being told they face a three year wait if they want to obtain these life-saving treatments free.

Cancer charities, MPs and leading specialists are warning that this is creating a two-tier system where only those with money, and the well informed, can afford the drugs, which cost many thousands of pounds.

They also condemn the postcode lottery over prescribing of cancer drugs, which means that some people are turned down for treatment but others are successful in proving that their case is “exceptional”, depending on what part of the country they live in.

GPs given ultimatum to open at night and weekends

Having disastrously fouled up the GPs’ service contract last year the Dept of Heath is now aggressively bullying GPs to work weekends again. Family doctors have been warned that unless they agree to open at evenings and on Saturdays, private companies will be contracted to take over their practices.

A letter sent to local NHS organisations has ordered them to improve surgeries’ responsiveness to the public, along with people’s access to and choice of GP services. This includes the option of seeking alternative providers, including private companies, instead of GPs.

Health Direct and the Times understands that the letter, from Mark Britnell, Director of Commissioning at the Department of Health, was altered before being sent to tone down references to “competitive tendering” – which would include offering GP contracts to private sector companies.

But doctors’ leaders said that the final draft sent to health trusts remained “very aggressively worded” and a clear sign of a labour government mission to bring more private practice into the NHS.

Changes to GPs’ contracts, introduced by the Department of Health in 2004 to relieve some of their work pressures, allowed doctors to opt out of providing night and weekend care. About 90 per cent took up the option, leaving it to Primary Care Trusts to employ private firms, groups of independent doctors and other health staff to provide cover.

Gordon Stalinist Brown promised to address problems with access to GPs on the eve of becoming Prime Minister. His stance was backed by the Confederation of British Industry, which found that 3.5 million working days were lost last year, at a cost of £1 billion by people taking time off to see their GPs.

Leading medical insurance firms have also reported a dramatic rise in the number of complaints against doctors connected to care at evenings and weekends.

The letter, which is seen as a sign of Labour’s willingness for a head-on clash with GPs, threatens to use the GPs’ contract to favour those doctors who provide longer opening hours, and to create new practices using private companies in areas where there are too few GPs.

Mr Britnell’s letter tells PCTs to come up with plans to persuade GPs “to respond to the needs and expectations of their patients, for instance by opening practices for longer periods” and suggesting that PCTs make “full use of existing contractual arrangements and other mechanisms to ensure more locally responsive services”. This replaced the original reference to competitive tendering.

Mr Britnell adds: “We expect PCTs and practices to be able to demonstrate tangible improvements for patients by December 2007”.

The letter has infuriated the British Medical Association, which says that the Government’s own surveys show patients to be content with the services offered by their family doctors.

Dr Laurence Buckman, who chairs the BMA’s GP Committee, said: “It is a very aggressively worded letter which I don’t think can be interpreted in any other way but as giving primary care to the private sector. PCTs are being told that their performance will be judged on how well they do this.

Has anybody asked the public if that is what they want? Has anybody worked out what it will cost?”

Dr Buckman confirmed that an early draft of the letter made clear that trusts would be backed if they sought tenders from the private sector to replace GPs who were failing to provide easier access for patients. This threat was implicit, rather than explicit, in the version finally sent.

The letter followed a Government survey of GPs services, which cost £12 million and found that almost all patients were satisfied with their GPs. The survey found that fewer than one in 10 people want their GP surgery to open on weekday evenings or weekends, and that 84 per cent of people were satisfied with existing hours.


Or is this another example of a Labour health Secretary saying one thing one moment and doing something else?

On July 26 07 Helath Direct posted: Johnson blocks new wave of private health clinics

The health secretary, Alan Johnson, yesterday vetoed plans for a third wave of independent sector treatment centres to compete with NHS hospitals.

In a break with Tony Bliar’s drive to expose the health service to the challenge of market forces, Mr Johnson said local NHS commissioners should adopt a more pragmatic approach to treating patients on the waiting list for tests and operations in England.

He will allow them to buy extra capacity from the private sector if they need it to meet targets on waiting times, and can show it provides value for the taxpayer.

But he told the Commons health committee: “There will be no need for another national independent-sector procurement … There will not be a third wave.”

Cameron promises a bare knuckle fight to save NHS District Hospital services

David Cameron the Conservative leader, attempted to regain the political initiative today by promising a “bare knuckle fight” with the Government to save local NHS hospitals from closure.

Amid speculation that Gordon Brown is planning an early election, Mr Cameron sought to reassert his centre-ground credentials by claiming that labour Ministers are attempting to close district hospitals.

“The basic point here is we believe the district general hospital is an absolutely key part of the NHS,” the Tory leader said.

“People have put money into the NHS, they’ve paid increased taxes and they want to see their district general hospital improve. People simply do not understand why maternity units and accident and emergency units are being shut down when actually accident and emergency admissions are up and births are up.”

He added: “The labour government’s new health minister, Sir Ara Darzi, has said ’the days of the district general hospital are over’.

“That’s why I say the Government can expect a bare knuckle fight with us over the next few weeks and months about saving district general hospitals as a key part of the local NHS.”

Mr Cameron made his remarks ahead of a trip to Sussex this afternoon where he was due to visit a hospital.

“What people will see in the run-up to the next election is that all the problems the country faces today – whether it’s NHS closures, family and social breakdown, whether it’s a weak pension system, whether it’s the stealth taxes they are having to pay that are making the cost of living so hard to meet – they can trace all of those decisions back to Gordon Brown sitting at a desk in Number 11 Downing Street as Chancellor,” he said.

Speaking later, a Department of Health spokesman said that the Tory leader had quoted Lord Darzi out of context.