MRSA spin row as NHS publishes new superbug figures

The labour government is within touching distance of hitting its MRSA target, but opposition parties have accused ministers of manipulating the data.

Latest figures show there were 1,072 cases of the superbug in England from July to September last year. This approaches the target of half the 1,925 average quarterly 2003-4 figure, but ignores the seasonal fluctuations.

But the Tories and Lib Dems accused ministers of moving the target back so it takes account of the period directly after the £50m deep clean of hospitals.

The latest quarterly figure represents an 18% fall on the previous quarter and comes after steady falls since September 2006. Decreases have also been seen elsewhere in the UK.

“There are too many people suffering from these infections. It is terribly important that trusts maintain the pressure.” Murray Devine, of the Healthcare Commission

In 2004, the then health secretary John Reid set a target of halving the rates by March 2008. But last year a leaked Department of Health memo suggested the goal was likely to be missed.

But the precise details of the target were never set out at the time and the labour government has now told the BBC News website it will consider it met if there are 963 cases or less in the quarter April to June.

Shadow health secretary Andrew Lansley said: “It appears the government are selectively choosing data to try and fix an outcome. It’s no coincidence that the time frame they selected is after hospitals finish their deep clean programme.”

Lib Dem health spokesman Norman Lamb said: “This is disturbing evidence of the government manipulating figures to hit a target. “By shifting the numbers around in this way, they are far more likely to hit a target which had previously seemed out of reach.”

Labour has denied manipulating the figures – pointing out measuring a period earlier than April to June would give a rate before the target date of the end of March.

The latest hospital infection figures from the Health Protection Agency also showed that Clostridium difficile rates were falling.

There were 10,734 cases of C difficile in patients aged 65 and over in England between July and September 2007.

This was a 21% decrease on the previous quarter, when 13,669 cases were reported, and a 16% drop on the same period in 2006.

Labour has set a target of reducing C difficile by 30% over the next three years.

Murray Devine, head of safety at the Healthcare Commission, which inspects hospitals on infection, prevention and control, said: “MRSA is clearly moving in the right direction and the signs on C difficile are encouraging.


NHS is paying for immigrant baby boom

The NHS is spending £350m a year to provide maternity services for foreign-born mothers, £200m more than a decade ago, the BBC and Health Direct has found.

Immigration has raised the birth rate so fast that some units have closed, so that midwives could be moved to areas of urgent need. A unit in Ascot, Berkshire, shut for two months in 2007 because staff had to be transferred to Slough.

The NHS says it is working to “build in” the extra capacity needed.

Maternity units have turned expectant mothers away because they could not cope with unprecedented increases in the local birth rate.

When Labour came to power, the NHS spent around £1bn a year on maternity services, with one baby in eight delivered to a foreign-born mother.

Ten years on, spending has risen to £1.6bn, with almost one baby in four delivered to a mother born overseas.

While the number of babies born to British mothers has fallen by 44,000 a year since the mid-1990s, the figure for babies born to foreign mothers has risen by 64,000 – a 77% increase which has pushed the overall birth-rate to its highest level for 26 years.

In central London, where six out of every 10 babies born has a foreign-born mother, senior consultants and health managers blame the lack of resources to deal with the pressures of migration for unacceptably poor standards.

Professor Philip Steer, editor of the British Journal of Obstetrics and Gynaecology, said: “The Department of Health has been taken by surprise. The demographic change, the sheer numbers, has in some areas increased very substantially without there being any forward planning really to allow for that.”

According to figures from the Office for National Statistics, in 2006 there were 15,000 more Eastern European babies born here than a decade earlier.

The statistics go on to show that 11,000 more babies were born to a mother from the Indian sub-continent, while 8,000 extra babies had mothers born in Africa.

Heatherwood Hospital in Ascot closed its maternity unit for two months in the summer of 2007 because of an “unprecedented increase” in the local birth rate.

Midwives were moved to Wexham Park Hospital, closer to the pressure-point of Slough where in the last year staff have witnessed an extra 150 babies delivered to foreign-born mothers.

The knock-on effect was experienced in nearby Reading where the local maternity unit could not cope with the extra demand.

Tharlie Cooper was supposed to have been born in Reading, but when mother Lavina went into labour two weeks overdue she was told that, despite her being booked in, her local birthing unit was full.

Tharlie’s father Dean was furious. “Basically we got turned away and the reply I got on the phone was wherever you ended up is where you end up”, he said.

He drove his wife to Basingstoke in neighbouring Hampshire where doctors conducted an emergency caesarean.

Births by British-born mothers down 44,000
Births by all foreign-born mothers up 64,000
Births by mothers born in Eastern Europe up 15,000
Births by mothers born in Indian subcontinent up 11,000
Births by mothers born in Africa up 8,000
Source: ONS/BBC

Peterborough has seen a huge increase in births from Eastern Europeans. There were just three such babies in 2000, but almost 200 in 2006.

At the Thistlemoor Medical Centre, births among patients have increased 33% in just two years. GP Nalini Modha fears the authorities have not planned for the new arrivals.

“Hopefully somebody who is in authority is actually looking at the figures to try and work out how they’re going to cope with the influx” she said.

“If you’re going to provide responsible care for all the population – the indigenous as well as the newcomers – then we will have to stop and think about what we can and can’t afford.”

In parts of Greater London, seven out of 10 babies are now delivered to mothers born overseas.

The Strategic Health Authority argues that this partly explains why maternity services in the capital performed so poorly in last week’s Healthcare Commission report.

Births within migrant groups can often be more difficult, more dangerous and more expensive – with much higher rates of type 2 diabetes, tuberculosis and HIV among mothers who often turn up very late in their pregnancy.

London’s chief nurse, Trish Morris-Thompson, admitted that the NHS had not realised how immigration would affect maternity services.

“The timing of the impact is much quicker than we had anticipated”, she said. “We’re working with our commissioners and our maternity providers now to ensure that we’re building in the capacity they need.”


Single sex wards are broken promise Lard Darzi a Health Minister warns

Lord Darzi believes that labour’s 2002 election manifesto to promise single sex NHS wards are impossible to achieve without considerable new investment.

But Lord Darzi said the labour government was committed to single sex accommodation whereby wards are divided into male and female bays by fixed partitions.

Labour promised to end mixed-sex accommodation in England by 2002, but that has still not been met. Campaigners have called for single-sex wards, saying fixed partitions do not give patients enough privacy.

Lord Darzi, a practising surgeon who is currently conducting a review of the NHS in England, told the House of Lords single-sex accommodation should be the “norm”.

“The only way we’re going to have single-sex wards within the NHS is to build the whole of the NHS into single rooms. That is an aspiration that cannot be met.”

But his claim drew an angry response from patient groups.

Katherine Murphy, from the Patients Association, said: “We want to see entirely single sex wards, not accommodation.

“Otherwise patients still have to share bathroom and toilet facilities with members of the opposite sex, and will have members of the opposite sex walking past them on their way to use these facilities.”

Ministers were insisting as recently as November 2006 that 99% of patients were being seen in single-sex accommodation.

But a report by chief nursing officer Christine Beasley last year – commissioned after patient surveys cast doubt on the claims of ministers – showed 15% of hospitals needed more help achieving this.


On Dec 28, 2007 Health Direct posted confirmation of another labour lie in Labour U turn on mixed sex hospital wards. Labour has abandoned its key manifesto pledge to eliminate the controversial practice of mixed sex wards, it has emerged.

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.

Cancer patient runs out of time in NHS drugs funding postcode lottery

A woman suffering from breast cancer has run out of time to benefit from a potentially life extending drug which the National Health Service (NHS) denied her, even though she was prepared to pay for it.

Colette Mills has been told by doctors that in the four months since she asked for the drug the disease has taken such a hold in her body that the cancer will no longer respond to the treatment.

She is the victim of a ruling which states that any patient who wants to pay for additional drugs not prescribed by the NHS should lose their entitlement to their basic NHS cancer care and pay for all their treatment. She was prepared to pay for the drug but not her whole treatment.

Mills, a 58-year-old former nurse, said: “I am just absolutely gutted. I just cannot believe people make these decisions about other people’s lives. It wasn’t going to cost them. I was going to pay for it. How can they say this policy is far more important than somebody’s life?

“The NHS has taken this opportunity away from me and, if they are doing it to me, they are doing it to a lot of other women as well.”

The labour government claims that to allow some patients to pay for additional drugs on top of their NHS treatment creates a two-tier system between those who can and cannot afford them.

Asked about her future prospects, Mills said: “They are not hopeful of halting it. They will give you no promises. I didn’t ask and he [the doctor] didn’t say. It is not something I want to know just yet.”

Mills, a mother of two, launched a legal action to try to force the NHS to allow her to pay for the drug Avastin which she wanted to take alongside another medicine, Taxol, which is prescribed by the health service.

But during her four-month battle with the NHS, the breast cancer has spread to other parts of her body and doctors have told Mills it is too late for her to benefit from the combination of Avastin and Taxol.

An American trial has shown that taking the drugs in combination doubles the chance of preventing the disease from spreading compared to taking Taxol on its own. Taking Avastin in addition to Taxol is also likely to keep the disease under control for almost twice as long. Leading oncologists say Avastin offers a small but significant advantage in treating breast cancer.

Mills will now be prescribed an alternative medicine but does not know how successful this will be in stopping the cancer.

Several other cancer patients are also taking legal action to win the right to pay for medicines that are not available on the NHS. The patients’ lawyer, Melissa Worth, of the law firm Halliwells, said: “Colette has been told by her medical team that she may have missed her chance. “

“If she had been given the opportunity to take the Avastin when she first contacted her medical team about it, then she would have had three months’ treatment by now. Months down the line, the policy will need to change but for those patients currently fighting their NHS trusts, it might be too late.”

Becoming an entirely private patient would have cost Mills, from near Stokesley, North Yorkshire, about £10,000 a month instead of about £4,000 solely to pay for the Avastin and its administration.

Although she could have tried to raise the funds such as finding a loan, she believes it is a fundamental principle that the NHS should continue to fund her basic care for which she has paid through her taxes.

The Department of Health, however, said top-up payments would “undermine” the “fundamental principle of the NHS, now supported by all the main political parties, that treatment should be free at the point of need”.

Mills’s case has provoked a national debate about whether NHS patients should be allowed to pay for top-up treatments.

NHS chief executives, the Patients Association, Doctors for Reform and Saga, the organisation for the over-fifties, have all backed Mills and other patients in her situation since The Sunday Times and Health Direct highlighted their plight last year.

A group of Conservative MPs, including former shadow health minister John Baron, are campaigning for co-payments to be allowed.


Health Direct finds it scandalous that the labour government is letting voters die just to save the NHS money.

The labour government wants to avoid a two tiered health system, but this is precisely what we have, not least as some have private health insurance and most of us do not. Their argument just does not work.

Health Direct can hardly understand why it is that the government would rather its citizens die in situations where they could receive treatment (albeit at private expense) all to satisfy the ideological goal of avoiding a two-tiered healthcare system.

Since it is clear this already exists with widespread healthcare postcode lotteries which they are creating- how many more people will die at Gordon Brown’s hands?

Labour units failing to meet maternity guidelines

More than four in ten maternity units in England offer poor or below average care, a report by the healthcare watchdog concludes today.

A similar proportion of hospitals fail to carry out proper ultrasound scans to check for problems affecting developing babies in the womb, the Healthcare Commission said.

Official guidelines recommend that at least 11 checks should take place, including studying the baby’s heart function, length of spine and the development of its face and lips.Yet the report found that only 61 per cent of scans performed by NHS trusts include all such checks recommended by the National Institute for Health and Clinical Excellence (NICE).

In addition, only 11 per cent of trusts were meeting screening standards for Down’s syndrome, which were updated by NICE in April 2007. The remaining women could be receiving insufficient information about the health of their child before birth, the Commission said, potentially putting themselves and their babies at risk.

Critics said that mothers and babies were not getting the high quality care they deserve.

The study found that 63 out of 148 (42 per cent) trusts with full maternity services in England were performing poorly or fairly. Poor performance and regional variations in care are largely linked to staffing shortages, the watchdog suggests.

The commission ranked 21 per cent of trusts as “least well performing”, 22 per cent “fair performing”, 26 per cent “best performing” and 32 per cent “better performing”. A survey of more than 26,000 mothers was included as well as data from NHS trusts. The Commission gave warning that some trusts had been unable to supply full information.

Norman Lamb, the Liberal Democrat health spokesman, said: “It is simply unacceptable that one in five maternity units is putting mothers and babies at risk.”

Dame Karlene Davis, of the Royal College of Midwives (RCM), said that Britain remained among the safest countries in the world in which to give birth.

48% of the trusts performed poorly or fairly
1 in 3 women did not have a named midwife
10,000 midwives needed to improve quality of care
Source: Healthcare Commission


Sacked NHS chief wins £75000 pay-off after C Diff scandal

The sacked chief executive of an NHS trust criticised for a host of outbreaks of Clostridium difficile is to get a £75,000 pay-off, it emerged today.

Alan Johnson, the Health Secretary, had been critical of the decision to award Rose Gibb a pay-off of half of her annual salary when she left Maidstone and Tunbridge Wells NHS Trust.

Ms Gibb left the trust by mutual agreement last year after a damning report from the Healthcare Commission revealed appalling hygiene standards, leading to at least 90 deaths.

Today, however, the trust board said it had determined to pay her the minimum to which she is entitled by law – six months’ pay in lieu of notice. Her salary was £145,000 to £150,000 a year, the trust said.

Ms Gibb could contest the payment, claiming unfair dismissal, so the argument may not yet be over. The trust said it had taken legal advice “and, following that advice, she will be paid only her legal entitlement of six months salary.”

The report said “significant failings” at all levels contributed to more than 1,000 patients being infected with the bug across three hospitals run by the trust.

Inadequate staffing levels, dirty wards and too much focus on debts and labour Government targets all contributed to two serious outbreaks of C diff in the autumn of 2005 and early 2006, the study said.

Nurses were found to have told some patients with diarrhoea to “go in their beds”. The affected hospitals were the Kent and Sussex Hospital, Pembury Hospital and Maidstone Hospital.

Former Bucks Fizz star Cheryl Baker has previously called for Maidstone Hospital to stop admitting patients who were vulnerable to C diff. Her mother-in-law Doreen Ford, 77, died there from septicaemia while infected with the bug.

The Trust was the subject of an undercover BBC investigation in May 2004 – months before the 2005 and 2006 outbreaks of C diff.

It found evidence of blood stains ingrained on the floor and clinical waste skips containing bags full of old dressings and bodily fluids left open in corridors used by visitors and patients.


Cancer patients fight to stop NHS withholding care

Cancer patients have launched a legal action to prevent the NHS from withdrawing care if they seek to improve their chances of recovery by paying privately for an additional drug.

The patients say the NHS will be breaching their human rights if it withdraws the treatment they are receiving.

Two of the patients, Colette Mills, 58, a former nurse from near Stokesley, North Yorkshire, and Debbie Hirst, 56, from St Ives, Cornwall, who both have breast cancer, have been told they will be made to foot the entire £10,000 monthly bill for their care if they attempt to pay privately for an additional drug, Avastin.

Ministers claim that to allow patients to pay for top-up drugs would be unfair to those who cannot afford them and lead to a two-tier NHS. The health department has issued guidance to NHS trusts warning that such co-payments are not allowed.

However, the patients’ solicitor, Melissa Worth of the Manchester law firm Halliwells, said NHS trusts would be breaching several articles of the 1998 Human Rights Act if they withdrew chemotherapy treatment. Worth also argued that in withdrawing treatment NHS trusts would undermine the National Health Service Act of 1977.

She said: “In light of the indisputable obligations of the trusts to provide life-sustaining treatment when there is a known, real and immediate risk to life, there is no legal justification for the trust threatening to withdraw all free treatment should our clients wish to maximise their chances of survival by complementing the treatment they are receiving by receiving Avastin.”

NHS chief executives, the Patients Association, Doctors for Reform and Saga, the organisation for the overfifties, have all backed Mills and Hirst since The Sunday Times highlighted their plight last month.

This weekend they were joined by one of Britain’s leading breast cancer consultants. Professor Ian Smith, head of the breast cancer unit at the Royal Marsden NHS Foundation Trust, said: “I am very sympathetic to the case of these patients. We are looking after patients with life-threaten-ing diseases and it is difficult enough telling them they cannot get the drug on the NHS without needing to then say: ‘Even if you are prepared to pay for it, you still cannot have it.’ This creates a very emotionally fraught situation and seems very harsh.”

Politicians have also pledged to campaign for a change in policy. John Baron, a Conservative MP and former shadow health minister, said: “It is absolutely wrong for the NHS not to allow tax-paying patients to top up their treatment if they so wish. Why shouldn’t patients make that extra payment for a drug that could be life-saving? This is unfair and the government should be ashamed.”

The health department said: “It is a fundamental principle of the NHS, supported by all the main political parties, that treatment should be free at the point of need. Co-payments would undermine this.”


Health Direct asks Why shouldn’t patients pay for any “extra” treatment? If we have money it is because we worked for it and are entitled to spend it as we wish. Why the big brother attitude of fairness?

Why should all suffer for the few as usual who have spent their earning on other things and have ensured that “the state must now keep them”. Isnt that a selfish attitude? Having cancer isnt selfish and I bet the people who created this silly philosophy haven’t got cancer.

If they eventually get it, as statistically twenty five per cent of us will, Health Direct wonders if they will turn to private treatment to help save their lives! Cancer patients should be allowed to spend their OWN money exactly as they choose.

NHS pay system risks heart attacks in the south

Centralised pay settlements in the NHS are killing heart attack patients because hospitals cannot recruit sufficient skilled staff, according to leading economists.

Wage controls under which nurses’ pay is set with relatively little extra for working in London or the south-east mean that hospitals in these high-cost areas struggle to recruit and retain staff, according to Carol Propper and Jan Van Reenen, professors at Bristol University’s Centre for Market and Public Organisation and the London School of Economics’ Centre for Economic Performance.

As a result these hospitals have lower productivity and higher fatality rates among patients admitted with heart attacks.

For each 10 per cent rise in the gap between the wages paid to NHS nurses and those paid to nursing staff in the private sector locally, the death rate from heart attacks rises by 5 per cent, the authors say.

“Common sense would say that hospitals located in places where outside opportunities are better are going to struggle to recruit, retain and motivate staff,” they say. “This is exactly what the study finds.” They add that this leads to “lower-quality service provision and poorer outcomes for patients”.

Hospitals in high-wage areas often try to get around recruitment difficulties by relying more on agency staff, who can sometimes be paid extra. “But they often tend to have less experience and training,” the authors say, with that too feeding into the problems with clinical care.

The study covers data from 1995 to 2002, since when London weighting and other cost of living allowances have improved in the south-east, with NHS foundation trusts no longer bound by national pay rates for NHS staff.

But few foundation trusts have introduced any large variance in nurses’ pay. And it remains the case that nurses working in London and the south-east take a bigger pay cut relative to private sector workers than their colleagues in lower-paid areas, Professors Propper and Van Reenen say.

Prof Propper said they were convinced the finding that death rates from heart attacks are higher and productivity lower, is more than just a chance correlation.

A series of other explanations – from pollution, to higher stress in the workforce in the south-east – have been examined and ruled out, while US studies suggest that deaths from heart attacks are “the canary in the mine” as a measure of the quality of healthcare, she said.


Major study on the NHS reveals over 17,000 unnecessary deaths a year

A statistical analysis of World Health Organisation data reveals that the poor performance of the NHS is causing 17,157 deaths per year and £34 billion of extra spending under Brown has made no difference to UK mortality.

Using data from the World Health Organisation and statistical techniques pioneered in the British Medical Journal, the TaxPayers’ Alliance has produced a major report on NHS performance since the 1980s.

Wasting Lives: A statistical analysis of NHS performance in a European context since 1981, analyses data from the WHO to estimate the number of deaths that could plausibly have been averted by the NHS since the 1980s. The measure used is known as “mortality amenable to healthcare”. The calculations compare the UK performance to that of Germany, France, the Netherlands and Spain.

* If the UK were to achieve the same level of “mortality amenable to healthcare” as the average of the other European countries studied, there would have been 17,157 fewer deaths in 2004, the most recent year for which data is available.
* This is equivalent to over five times the total number of deaths in road accidents and over two and a half times the number of deaths related to alcohol in 2004.
* Steady improvements in mortality rates, relative to European peers, have been made at almost exactly the same rate throughout the Thatcher, Major and Blair governments despite huge increases in spending from 1999 to date. There can no longer be any doubt that the Government’s extra NHS spending has completely failed to deliver results.
* If NHS spending had continued to increase relative to European peers at its pre-1999 rate £34.3 billion – £1,350 per household – less would have been spent between 1999 and 2004. In 2004 alone, £9.8 billion less would have been spent, 9.7 per cent of total spending in that year. This extra money has largely been wasted.

Matthew Sinclair, author of the report and a Policy Analyst at the TaxPayers’ Alliance, said:

“Thousands are dying every year thanks to Britain’s health service not delivering the standards people expect and receive in other European countries. Billions of pounds have been thrown at the NHS but the additional spending has made no discernable difference to the long-term pattern of falling mortality. This is a colossal waste of lives and money. We need to learn lessons from European countries with healthcare systems that don’t suffer from political management, monopolistic provision and centralisation.”

Professor Karol Sikora, Medical Director of CancerPartnersUK, steering group member of Doctors for Reform and author of the foreword to the report, said:

“The NHS should not be a religion, with its structure set in tablets of stone. We face a choice between a modern, consumer driven service for all or a decaying, bureaucratic system which only those with their own resources manage to escape. Politicians need to read this report carefully and determine the optimal strategy they can put to a well informed public. Those that capture the best way forward will carry the British voter with them.”


Dr Foster health information service- call for new probe

MPs should consider reopening a probe into a contentious public private health data venture Dr Foster in the light of concerns raised by a senior official involved in the deal, the shadow health secretary said.

Andrew Lansley told the Financial Times he would write to the Commons public accounts committee and the Department of Health asking them to re-examine the circumstances around the resignation of Professor Denise Lievesley, former chief executive of the Information Centre, the National Health Service’s data factory.

Prof Lievesley, a former Royal Statistical Society president, claimed this week that she was made a “scapegoat” by the Department of Health after repeatedly raising the alarm about the joint venture’s worth and its handling of information. Dr Foster Intelligence, the joint venture, strongly rejects her criticisms.

Mr Lansley said it “might be appropriate” for the public accounts committee to respond to Prof Lievesley’s claims by making new inquiries about the joint venture, whose formation it attacked last year as a “backroom deal” set up at a cost of £12m to the taxpayer.

Mr Lansley said: “It seems to me to be clear that [Prof Lievesley] was, from her own professional point of view, highly sceptical, indeed internally critical, about what was being done. The evidence at the time [of the initial inquiry] doesn’t appear to have included some of the reservations she was expressing internally.”

Prof Lievesley’s claims, which emerged this week at a hearing at Leeds Employment Tribunal, have yet to be tested by cross-examination. Prof Lievesley did not attend the hearing, citing a previous commitment.

Mr Lansley said he also planned to ask the DoH why the Information Centre had agreed a deal under which Prof Lievesley received a pay-off in exchange for her silence about her departure.

Dr Foster Intelligence – which is half-owned by the Information Centre and half by Dr Foster LLP, a private health information company – has defended the quality of the information it provides. It said it and its partners, which include Imperial College, operated to the “highest standards of data quality”.

The Department of Health has declined to comment on Prof Lievesley’s case.