Labour U turn on mixed sex hospital wards
The U-turn comes after more than a decade of Government promises, made at the 1997 election and repeated in 2001, to bring an end to male and female patients sharing facilities in NHS hospitals.
Figures reveal that 31 pc of NHS trusts admit to having fully mixed wards – without any form of partition
Patients’ charities have argued for years that mixed-sex wards are undignified, degrading and put women at risk of attack from male patients.
A number of female patients in recent years have been the victims of assault from men in mixed-sex wards.
Figures obtained by the Conservatives under Freedom of Information laws showed that nearly a third of hospitals are still treating men and women in the same wards.
This is almost double the amount stated in a report released in May by the Chief Nursing Officer.
Following inquiries by The Daily Telegraph, the Department of Health disclosed that eliminating mixed-sex wards is no longer an aim.
A DoH spokesman said: “We have to get away from this idea of single-sex wards. That is not what it is all about.
“Now we are in a situation where we are moving away from a set target on single-sex accommodation and moving towards the NHS locally taking privacy and dignity much more seriously.
“It is possible to envisage patient privacy and dignity with patients of different sexes on the same wards but with proper segregation.
“There are different ways of ensuring that. It’s not about targets. Now it’s much more about what the patient feels.”
The spokesman said a mixed ward divided into bays by fixed partitions – not necessarily fixed to the ceiling, but high enough that patients perceive they are in a separate room – counted as single-sex accommodation.
Patient groups and the Tories said the comments meant the Government was “walking away” from its manifesto commitment.
Andrew Lansley, the shadow health secretary, said: “After 10 years of failing to deliver, Labour now appear willing to betray the interests of patients by dropping their manifesto commitment to abolish mixed-sex wards as patients understand them.
“As recently as last May, Patricia Hewitt made it clear that what she meant by single-sex accommodation excluded partitioned bays.
“Now it seems the department are accepting the proposition that patients should be in mixed-sex accommodation with nothing but flimsy partitions between them.
“Tony Blair said it couldn’t be beyond the wit of Government to sort it out, but it is clearly beyond the competence of Labour.”
Catherine Murphy, of The Patients Association, said: “What patients, especially female patients, want is pretty simple. It is to be nursed and cared for on a ward where only patients of their sex are present.
“Even with bays, you still have a situation where you will have a member of the opposite sex around. Women, especially, feel very intimidated.
“We should not be in a situation in 2007 where we are having men and women sharing the same facilities. It’s another target the labour Government is trying to walk away from and drop.”
In May, Patricia Hewitt, the then Health Secretary, vowed there was more to be done to “meet our commitment to eliminate mixed-sex wards”.
Miss Hewitt stated two years ago that partitioned bays were “not good enough”.
Mervyn Kohler, of Help the Aged, said: “Going into hospital can be a fraught enough experience as it is, especially for older, more vulnerable patients, without being burdened with the worry and utter humiliation of undressing and bathing on a mixed sex ward.”
The Patients Association has taken increasing numbers of calls from patients and relatives who relate frightening stories of lack of privacy.
It heard from one woman who complained that a confused elderly man had tried repeatedly to get into bed with her.
In another case, the screen dividing a woman’s bed from male patients was a “simple partition that did not even reach the ceiling and finished with flimsy net curtains”.
Janet Street-Porter, the writer and broadcaster, spoke movingly last year of how her sister suffered the “hell” of a mixed-sex ward during her final days.
Patricia Balsom, 57, who died eight months after being diagnosed with lung and brain cancer, left a diary chronicling the failing of the NHS over the last three weeks of her life.
She said she was twice woken by a patient who was standing naked by his bed.
The figures obtained by the Conservatives showed 31 per cent of the trusts admitted still having fully mixed wards – without any form of partition and excluding intensive care, emergency and children’s wards.
Some 26 per cent of trusts reported washing facilities were not segregated on all wards, while 29 per cent said lavatories were not fully segregated.
Doctors quit dirty NHS for India
The director of one of India’s biggest private hospital chains said he was receiving five job applications a week from NHS doctors and that half his 3,000 consultants were from Britain.
“There’s a feeling that India’s time has come and there’s a huge need for these people to come back,” Anupam Sibal, director of the Apollo hospital in Delhi, said yesterday.
Doctors say they are moving to India because of its economy, state of the art equipment, higher standards than the NHS and a better quality of life. In particular, they say hospitals in India, which many Britons still imagine to be impoverished and dirty, suffer less from hospital-acquired infections such as MRSA.
India has no equivalent of the NHS but there has been a boom in private hospitals that resemble luxury hotels, with marble foyers and corridors mopped by an army of liveried cleaners.
One of those who has made the transition is Mahesh Kul-karni, an orthopaedic surgeon, who left Bristol Royal Infirmary after 10 years in Britain. He is now a consultant at the Aditya Birla Memorial hospital in Pune.
“The hospitals are better than in Britain,” he said. “This hospital is spotless and clean compared with the old hospitals in the UK, some of which are more than 100 years old. I started in January this year and I have not seen MRSA here yet.
“It’s had a lot of investment, and things I couldn’t do in Britain I can do here. We have ‘clean air’ operating theatres [that remove dust from the air], and our intensive care unit here is fully equipped with special monitoring instruments.
“When I went to England 10 years ago, India was 10 years behind Britain. Now there’s hardly any difference.”
Bristol Royal Infirmary defended its record, saying there had been a 35% increase in spending on new equipment and that its latest inspection had found cleanliness was “acceptable”.
Ameet Kishore had worked as an ear, nose and throat consultant in Glasgow Royal Infirmary for 12 years when he moved to the Apollo hospital in Delhi two years ago. Although reluctant to criticise the NHS, which had taught him so much, he said that the new Indian hospitals were cleaner and better resourced.
He contrasted the number of cochlear implant operations that he could perform: at Crosshouse hospital, Kilmarnock, the main ENT centre for the west of Scotland, he was limited to 40 a year; in Delhi he had done 70 in the past six months.
Other doctors cite new European Union rules for their decision to move. Shailendra Magdum, a specialist registrar in neurosurgery at Radcliffe Infirmary in Oxford until he left for India in August last year, said that rules favouring EU doctors over Indians had played a part.
The EU’s working time directive had also lowered NHS standards, he added, by restricting the amount of time that young doctors could spend on the wards.
“For a neurosurgeon to be good you have to spend a lot of time on the wards, but in Britain the working time directive is running down training,” he said.
Although salaries are usually lower in India, doctors are finding that their standard of living is better. Kishore said he lived in a bigger house with a driver, cleaner, cook, nanny and watchman to look after him, his wife and two young children.
Health Direct laments the wasted cost of training overseas medical staff- only for the UK to let these talented people slip through our fingers.
Health Direct wishes all of you a Merry Christmas
Patricia Hewitt cashes in on health post
The disclosure has led to renewed calls for more stringent rules to stop politicians from cashing in too quickly on their time in office.
Hewitt, who resigned in June, has been inundated with consultancy jobs since leaving the Department of Health. She is set to be the latest in a series of health ministers and senior officials to move into the private sector.
Lord Warner and Alan Milburn, both former health ministers, have also benefited, moving to healthcare jobs soon after leaving office. Liz Kendall, Hewitt’s former special adviser, is now a healthcare consultant to a number of organisations, including private sector companies.
Hewitt, who was health secretary from May 2005 but stood down when Gordon Brown took over as prime minister, is expected to take up her roles in the new year.
Warner’s jobs, revealed this month, include advisory roles for Xansa, a technology company in Reading, Berkshire, that has a partnership with the Department of Health to provide finance services to National Health Service bodies, and Byotrol, an antimicrobial company that sells products to the NHS.
Warner also has an advisory role with DLA Piper, which advised ministers on the NHS’s £12 billion IT programme. Warner was responsible for this while a health minister.
The move into consultancy will raise fresh questions about whether companies are gaining a strategic advantage by hiring ministers with recent experience of the highest levels of government.
Norman Lamb, the Liberal Democrat health spokesman, said: “There is a question about whether they could exploit their continuing links with the government. We need a far greater cordon sanitaire to prevent any suspicions.”
Hewitt confirmed that she had received a number of offers and was likely to decide which ones to take up after Christmas. She said: “I haven’t taken up any appointments and I will only do so after I have had the advice from the Advisory Committee [on Business Appointments].”
This committee vets private sector roles for former ministers to ensure there is no conflict of interest. It often imposes a cooling-off period before such job offers can be taken up.
Considering Hewitt’s inept performance as a labour government minister, Health Direct is surprised to learn that any company would consider touching her with a ten foot pole.
Health Direct wonders if the companies that are offering Hewitt the chance of gravy are either stupid, given her demonstrable lack of any ability, or hope to gain some advantage from employing a labour politician-I wonder what it could be ?
Ms Hewitt does however confirm a diagnosis of complete cynicism and a sickness in the body politic which will take many years to heal.
Ministers back GP plan that sidesteps contracts
Ministers have given their backing to an initiative in Birmingham that is seeking to sidestep the controversial GP contract by encouraging doctors effectively to reapply for their jobs.
The project has angered the British Medical Association for seeking to corral GPs working alone into multi-doctor health centre “franchises” that would have set standards, longer opening hours and offer services ranging from x-rays to mental health advice.
“The idea that you can franchise health care and put health service workers in a uniform franchise like McDonald’s sounds so ridiculous I cannot believe anyone would consider doing this,” said Laurence Buckman, chairman of the BMA’s GPs committee. “Working evenings and weekends . . . is the only thing that matters to Gordon Brown.”
The Heart of Birmingham Teaching Primary Care Trust’s corporate franchise strategy suggests the model could eventually allow private providers, such as “Virgin, Tesco or Asda”, to quote the document, enter the market for GP services.
Managers are unable to force GPs to give up their single-practice surgeries. But they believe making doctors sign up to franchise agreements – overlaid on their existing contracts – will make them extend opening hours and offer more services, which would be easier to achieve in a bigger surgery. Doctors who opt out would face intense competitive pressure from other surgeries, managers believe.
The initiative may give the labour government a way to meet its pledge to increase out-of-hours care without having fully to renegotiate controversial GP contracts that gave family doctors a sharp pay rise through incentives that tended to shorten opening hours.
Health officials are closely monitoring the Birmingham scheme to see whether it can be used as a nationwide model. Ben Bradshaw, health minister, said: “Improving the quality and flexibility of GP services is a priority for the public. I applaud initiatives such as Birmingham’s to respond to the views and needs of the local community.”
Health Direct notes that this is the same Brown Mr Bean that negotiated away the need for doctors to work weekends in the first place.
On January 31, 2007 Health Direct posted BMA team ‘stunned by GP contract’ as a bit of a laugh
GPs were so stunned by the terms offered to them when negotiating their new contract in 2004 that they thought it was a “bit of a laugh”, a doctor has said.
Dr Simon Fradd, who was one of British Medical Association’s GP negotiators, said they were shocked by the approach taken by the labour government. They could not believe it when GPs were given the chance not to do evening and weekend work for only a 6% pay cut, he said.
NHS threat to halt care for cancer patient if she buys her drugs
Colette Mills, a former nurse, has been told that if she attempts to top up her treatment privately, she will have to foot the entire £10,000 bill for her drugs and care. The bizarre threat stems from the refusal by the government to let patients pay for additional drugs that are not prescribed on the NHS.
Ministers say it is unfair on patients who cannot afford such top-up drugs and that it will create a two-tier NHS. It is thought thousands of patients suffer as a result of the policy.
Mills, 58, is thought to be the first to take a public stand in challenging her NHS trust to allow her to pay for the drug as part of her NHS treatment.
She wants to top up her treatment with Avastin. “The policy of my local NHS trust is that I must be an NHS patient or a private patient,” she said.
“If I want to pay for Avastin, I must pay for everything. It’s immoral that the drugs are out there and freely available to certain people, yet they say I cannot have it.”
With many “wonder drugs” in the pipeline that the NHS is unlikely to fund, her predicament is likely to be shared by increasing numbers of patients who could afford additional life-extending drugs but not the cost of their entire care.
Mills, a mother of two, who lives near Stokesley in North Yorkshire, is being treated with the drug Taxol, which is available on the NHS, but believes that her chances of halting the cancer would be improved by also using Avastin.
She is prepared to pay South Tees Hospitals NHS Trust for the Avastin and the cost of its administration. This would amount to at least £4,000 a month. Mills does not want to pay for all of her NHS treatment, however.
“The costs would increase from £4,000 a month to about £10,000 to £15,000 for all my care. I would need to pay charges for seeing the consultant, for the nurses’ time, for blood tests and scans,” she said.
Some doctors support her case. Professor Karol Sikora, medical director of CancerPartners UK, a private cancer company, said: “This is unfair to taxpayers who are entitled to NHS care. If this patient wishes to pay for another drug, that should be her choice.
The patient should be invoiced by the NHS for the extra treatment, with a mark-up to cover the hospital’s costs.” The government is opposed to the so-called “co-payments” because they would lead to patients in the same NHS ward receiving different drugs based solely on their ability to pay.
But doctors say this already happens where private and NHS patients are treated at the same NHS unit.
Some patients have got access to the drugs by going fully private. Others have continued with their basic NHS care while receiving an additional drug from a private company at home. By contrast, Mills believes that it is her right for her local NHS trust to provide the drug if she is prepared to pay for it.
South Tees Hospitals NHS Trust said: “If a patient chooses to go private for certain drugs they elect to become a private patient for the course of their treatment for that condition. That is the trust policy.”
The Department of Health said: “Co-payments would risk creating a two-tier health service and be in direct contravention with the principles and values of the NHS.”
Health Direct points out that this postcode lottery is a very strange stance for the Trust to take – but then again, perhaps not. We are after all dealing with the petty bureaucracy of the NHS – when NHS dental practices, those which remain that is, are allowed to mix private and NHS care.
It would be interesting to hear the same views of the anonymous spokesperson (or a senior manager) if his/her life, or that of a close relative were on the line. I’ll bet you anything a way would be found round the rules. These are meant only for the hoi polloi who have the temerity to have saved up enough for additional care.
Prostate Cancer- a health disservice
Although the annual death toll from prostate cancer is the equivalent to the crashing of a fully laden jumbo jet every fortnight, little is heard about this silent killer, and it is hard to see how the forthcoming guidance from the National Institute for Health and Clinical Excellence aka National Institute for Curbing Expenditure (NICE) will do much, or indeed anything, to reverse the situation.
Compared with breast and lung cancer the cancerous cells of the prostate are relatively slow growing, often doubling in number only every two years or so.
This slow growth rate provides a window of opportunity for cure, since prostate cancer can be reliably eradicated while it remains within the gland, but becomes incurable once it spreads to the lymph nodes or bones.
Indeed, every one of those men who have died of the disease this year could potentially have been cured, if only their disease had been recognised earlier.
Yet Nice pays scant attention to early detection of the disease, and the labour Government has just ruled out the introduction of a mass screening programme.
Current draft guidance from Nice suggests that as a one-off measurement, blood tests marker for prostate disease are not accurate enough.
In fact, if screening happens regularly enough, checks on the rise of Prostate Specific Antigen, rather than its absolute value, enable us to detect the cancer risk increasing.
Meanwhile, the body dismisses new methods of treatment that are so often employed abroad, preferring instead to endorse “watchful waiting” as the disease develops and eventually spreads.
Doctors working in the field want to eradicate the cancer while causing minimal “collatoral damage” to sexual and urinary functions.
We know from experience how central these are to a man’s quality of life. New technologies in robotics now permit the removal of a cancerous prostate through a tiny keyhole near the belly button with minimal blood loss, preserving the tiny nerves which protect erectile function.
High intensity focussed ultrasound (HIFU) permits a minimally invasive means of destroying cancer, while cryosurgery kills cancer cells by freezing them.
Nice has the luxury of time to hedge its bets and await the results of long term medical trials, which could take decades to provide results.
The problem for those of us sitting opposite a patient and his family in clinic is what to do here and now.
Nobody wants to die from prostate cancer – often a slow and painful demise – but of course no one wants unnecessary treatment, especially if impotence and incontinence are the result.
New treatment options take us nearer to the “Holy Grail” of effective treatment with minimal side-effects. What is needed is a health service which harnesses today’s scientific breakthroughs and focusses on the future.
Unless it does so, the death toll among Britain’s men will continue to rise needlessly.
Written by Prof Roger Kirby who is chair of the charity Prostate Cancer UK.
NHS U-turn on prostate cancer treatment by NICE
The groundbreaking ultrasound therapy has been shown to kill nine out of 10 prostate tumours, and five years after treatment, 80 per cent of patients show no sign of the cancer recurring.
Compared with surgery or conventional radiotherapy treatment, it is not invasive and is far less likely to lead to devastating side effects such as impotence or incontinence.
Suitable for treatment in the early stages of the disease, when it is not known how quickly it will spread, the ultrasound therapy is regarded by doctors as a vital new weapon in the battle against prostate cancer.
The UK’s most prevalent cancer among men, prostate cancer kills 10,000 a year, with 35,000 more cases diagnosed annually. A third of men over 50 contract it.
Three years ago, the National Institute of Health and Clinical Excellence (Nice) said men across the country should be offered the treatment, called High Intensity Focused Ultrasound (Hifu), free on the NHS.
But The Sunday Telegraph has learnt that Nice has now decided to reverse that decision. In the New Year, the controversial rationing body will massively restrict the use of the HIFU treatment.
Instead of it being available to all prostate cancer sufferers, it will now be restricted only to those who have already failed to respond to conventional treatment and whose cancer has returned.
The decision, set to be made in February, means Hifu will not be available to the vast majority of prostate cancer sufferers.
Cancer charities and senior doctors last night attacked the move as a U-turn.
Mark Emberton, a consultant urologist at University College Hospital, London, said he was worried that patients would be forced into the private sector, “which would be a disaster”, if they wanted the treatment.
He also questioned the logic of only offering Hifu to men whose cancer had returned, while denying it to patients in the early stages of the disease.
Meanwhile, Stephen Brown, a consultant urologist at Stepping Hill hospital, Stockport, said: “We think Hifu is a really good option for patients who want a lesser procedure.”
Prof Roger Kirby, who chairs the Prostate UK charity, also decried the decision. He said: “Restricting the treatments available will have a massive impact on the patient.”
Since Nice made its original ruling, permitting the use of Hifu, just 300 men have been given the treatment on the NHS.
Primary care trusts have so far been slow to foot the bill for the treatment, which is one-off but costs about £13,000.
This amount compares with £3,000 for radiotherapy, which takes six weeks, and £5,000 for surgery.
It is understood that Nice, which has refused to comment on its new guidelines, will rule that there is insufficient evidence to prove that Hifu has long-term value.
The U-turn comes despite the research published last month in the European Journal of Urology which found that eight out of 10 men were healthy five years after being treated with Hifu.
NHS patients’ records frequently leaks personal data
Confidential medical records should only ever be seen by doctors and nurses who are working with the patient concerned, with the government spending some £13bn to digitise the medical records of every patient in Britain.
By 2010, the NHS Care Records scheme aims to have an electronic NHS Care Record for all patients.
The record will detail the key treatments and care given to each of the NHS’s 50 million patients.
But in the last year there have been incidents in Gloucester and Cheltenham where staff have shared passwords, giving unauthorised people access to confidential records.
At Bath’s Royal United Hospital the same type of breach took place while breaches of security also took place in Swindon and Bristol.
The North Bristol NHS Trust has reported catching a member of staff looking at friends’ records, although they were just issued with a warning.
The NHS electronic patients’ record has an electronic audit trail built into the system that shows who has accessed what record, how and why, and for how long. Any pattern of unusual activity can be flagged-up and appropriate action taken.
Somerset GP Dr Harry Yoxall told of two instances he encountered where records were accessed by inappropriate people.
“On the first occasion an employer of a relatively small computer supplier to the NHS was looking up information about one of his relatives by getting access to a GP medical records system,” he said.
“Then an employee of a hospital trust was using his access to their medical system to look up information about one of his relatives.”
One campaigner from the pressure group NHS Confidential Opt Out is encouraging people to remove themselves from the database system.
Helen Wilkinson said: “My concerns are that they need to put more stringent safeguards in place and also that they need to consider, perhaps, smaller local databases that actually link up, but with explicit patient consent, so that would put the patient in control.”
Richard Caves of the South West Strategic Health Authority said: “I am confident that a trust – where it suspects an individual member of his own staff as having unauthorised access to a record – that trusts will be able to take measures to track that down.”
NHS database will weaken patient security MPs learn was posted by Health Direct on Thu 22 Nov 2007- The man in charge of setting up the NHS medical records database has admitted that “you cannot stop the wicked doing wicked things” with information. Richard Jeavons, director of IT implementation at the Department of Health, said there were instances where staff “abuse their privileges”.
These had to be “pursued”, he told the Commons home affairs committee. The plan to put 50 million patients’ records on the database is part of a £12bn NHS IT overhaul.
The scheme has raised concerns over cost and the security of information.
A poll for the Guardian suggests that 59% of GPs in England are unwilling to upload any record onto the database without the patient’s specific consent.
Three quarters of more than 1,000 doctors questioned believed medical details would become less secure when they are put on a database that will eventually be used by the NHS and social services.
Government chief information officer John Suffolk told the MPs that setting up a nationwide database going across Whitehall departments and other government agencies would create more problems.
He said: “When you work at a national scale, to continue to put more eggs in a single basket is a foolhardy approach.”
Mr Suffolk added: “The more and more you put it into a large database, with more and more people having access, it becomes more complex…
“If we can avoid setting up large-scale citizens’ databases, that would be a wise thing to do.”
Health Direct asks if you are still 100% confident that labour will keep all of your medical data secure?