Drug addicts on incapacity benefit up 12 per cent in four years

The number of people on incapacity benefit due to drug addiction has increased by more than 12 per cent in the last four years, figures show.

More than 50,000 addicts on state handouts cite drugs as the reason they cannot work, costing the taxpayer tens of millions of pounds a year.

A study earlier this year estimated the average drug addict costs the country more than £800,000 over the course of their lifetime.

The lBOUR Government has also vowed to get tough on addicts and make them seek treatment if they want to continue receiving handouts.

But the latest figures, slipped out to MPs, show the problem is still growing.

Shadow Home Secretary, Dominic Grieve, said: “This is another example of how Labour has become broken under Britain. Labour are abandoning too many people to a life of misery on drugs.

“Another consequence is extra burden on the benefit bill at a time of economic hardship. We would expand abstinence-based rehabilitation so that we starting ending, not managing, addiction.”

Statistics from the Department for Work and Pensions showed that as of February 51,300 people were on incapacity benefit who had cited drug abuse as the main reason for not being able to work.

It is estimated they cost around £38 million a year but the true cost to the public purse will be much higher.

More than 40,000 of them are in receipt of incapacity benefit credits – where the Government effectively tops up the contribution to national insurance that they would have been paying if working.

The total is up almost 13 per cent on the 45,510 who were on incapacity for similar reasons in 2004 and the numbers have grown steadily each year.

In July, the Government announced plans to make heroin and crack cocaine addicts declare their problem and agree to treatment if they are to continue receiving benefits.

A study by PricewaterhouseCoopers, this year, commissioned by the Ministry of Justice, also estimated a drug addict costs the public £833,000 over their lifetime, including the burden on . health services, the criminal justice system, loss of earnings and productivity and the cost of putting any children into care.

In reply to the written parliamentary answer to the Conservatives, Employment Minister Tony McNulty said: “Drug dependency does not of itself confer entitlement to incapacity benefits.

“The medical assessment of incapacity for work is the Personal Capability Assessment. This assesses the effects of a person’s condition on their ability to carry out a number of everyday activities relevant to work.”

“A majority of people with a recorded diagnosis of drug dependency also have other diagnoses, for example mental illness, which results in their incapacity to work.”


NHS Data losses an accident waiting to happen

Technology used by public authorities made data security breaches “an accident waiting to happen”, a privacy official warned.

Jonathan Bamford, assistant information commissioner, said too many institutions failed to ensure that they had the electronic tools to limit the confidential details they held and prevent them being copied.

His comments come before the launch by the Information Commissioner’s Office of a report aimed at helping institutions improve public confidence in the ability of the public and private sectors to handle personal data.

Mr Bamford said in an interview that embarrassing data losses by government organisations were part of the price institutions were paying for bolting data security safeguards on as an afterthought rather than designing systems with them in mind.

He said: “It was obviously a bit of an accident waiting to happen. They are all things where people have messed up rather than acted in a malevolent way, which says a lot about what the safeguards were in the technology itself.”

Mr Bamford said organisations should invest more in so-called “privacy enhancing technologies” aimed at minimising the risk of losing sensitive data.

These include stopping information being downloaded on to memory sticks, barring the collection of unnecessary details and giving staff access to data on a need-to-know basis only.

Mr Bamford said: “We have seen the shortfall in the way organisations have approached personal information and have not really valued it.”

Public officials and corporate executives have come under intensifying pressure on data security as the Information Commissioner’s Office and other data watchdogs broadened their assault on bad practices highlighted by Revenue & Customs loss last year of details relating to 25m people.

Companies accounted for 80 of 277 data security breaches reported to the Information Commissioner’s Office during the year to October, ahead of 75 by the National Health Service and other healthcare providers, and 54 by local and central government.

Mr Bamford said private and public organisations should have done better, as data protection law was not “some new-fangled thing” but dated back almost a quarter of a century.


Hospitals fail to pass latest MRSA superbug hygiene test

Only one in 10 NHS hospitals are complying fully with a compulsory hygiene code intended to prevent MRSA hospital acquired infections, the NHS inspectorate has found in a series of spot checks.

Unannounced visits to 51 big acute hospitals – around a third of the total in England – found just five following the hygiene code completely. One in five did not comply with all the requirements for safe decontamination of instruments. One in eight had inadequate isolation facilities.

Twenty-seven of the 51 were failing to keep all of their premises clean and well maintained. And in three cases the failings were bad enough for the Healthcare Commission to issue improvement notices with which, it said, the hospitals have complied.

The figures were attacked as shocking by opposition politicians. However, the inspectorate said that 97 per cent of the lapses “did not represent an immediate risk to the safety of patients”.

It added, however, that “almost all acute trusts have more work to do to get systems for infection prevention and control in place”. From April next year, they will have to comply with the code or risk fines, or even removal of their licence to operate.

Anna Walker, chief executive of the Healthcare Commission, said it was clear despite the findings that trusts were making progress on infection control. With three exceptions, the breaches of the code found were not “the most serious kind” although they showed there was still work to do.


Health trusts may face bill for top-up refunds after labour’s U turn on cancer drugs

Primary care trusts could come under pressure to refund tens of thousands of pounds to patients who have paid for top-up treatment.

One PCT has already refunded more than £23,000 to two patients who paid for care that was later deemed to be the responsibility of the NHS.

Another faces a demand for nearly £60,000 from a patient who initially funded his own treatment with Cetuximab before being accepted by the NHS as an exceptional case. The patient’s lawyer told HSJ that if the PCT did not pay up, their fight would go to court, where they hoped to set case law.

PCT network director David Stout warned that in the absence of clear guidance on how to handle retrospective claims, PCTs were likely to come under pressure to follow precedents set by others.

Worcestershire PCT agreed to “compensate” two patients for the cost of NHS care they were forced to pay for while receiving Avastin for bowel cancer. Barbara Moss was awarded £13,658 of her £21,000 treatment bill and Clifford Shore got £10,000 of his £16,000 costs.

A PCT spokeswoman said the PCT had taken legal advice. “We don’t believe this will set a precedent across the country; it will be up to individual PCTs to look at cases individually, as we did,” she said.

Patient Michael Porter is challenging East and North Hertfordshire PCT to refund £55,900 that he used to pay for Cetuximab. His claim rests on the fact he responded well to the drug and was subsequently accepted as an exceptional case by the PCT.

Swaffields Solicitors principal Simon Swaffield, representing Mr Porter, said: “It’s not satisfactory from a health service point of view to just muddle along and if you make enough noise, you might get some money.

“The reality is we’ve taken Michael’s case forward on this footing, very much with a mind to establish liability.”

Mr Stout said PCTs were expected to make judgements on whether to reimburse or not “without any real framework within which to work”.

“If some PCTs start [reimbursing], I’m sure that ratchets up the pressure on other PCTs to do the same,” he said.

He also said that where a patient had secured exceptional case funding on the basis they had proved a drug’s efficacy by self-funding initial courses of treatment, this breached the principles of the Richards review of co-payments because it created inequity.


Health Direct asks if you are happy for your private medical records to open to all?

Health Direct asks you to lobby parliament if you don’t want your medical details to be available to all. Please send labour a clear message about the use of patient information.

NHS Connecting for Health (NHS CFH) is conducting a consultation on the wider use of patient information (see http://tinyurl.com/6l2goc). Details of the consultation are at

The consultation relates to the so called “Secondary Uses Service (SUS)” whereby every time you attend a hospital appointment your post code, date of birth, GP details, consultant details, outpatient clinic, inpatient admission, procedure, cost and whether you are to be followed
up is all sent by the hospital to BT.

All these details will be stored at the regional hosting centre and can be accessed by your local Primary Care Trust, Strategic Health Authority and the Department of Health via the SUS database that BT now manage- as well as labour ministers who have given themselves the power to snoop on us. Medical researchers are also allowed access to all this personal and clinical information.

Connecting for Health claims that most data in the SUS will be anonymised but a document obtained from the Department of Health under the Freedom of Information Act by Professor Ross Anderson of Cambridge University shows that they will not be anonymising this medical data. The letter can be downloaded from

The NHS confidentiality group has already produced an opt out letter to allow patients to opt out of the upload of Summary Care Records to the NHS ‘spine’ (the central database that will be used to store electronic patient records) and they are now working on an opt out from the Secondary Uses Service.

The quick and easy to use letter template can be found at: http://www.thebigoptout.com/optoutletter

With the ‘spine’ effectively stalled this is one of the few consultations where sheer volume of negative response may have some effect – so please do help us send a message to the government that our medical records are private and should remain so.

Responses should be sent to Chrissy Brand (FREEPOST RRXB-TTRR-HJGB,
Tribal Consulting, Palatine Road, Manchester, M22 4DB) by 10th December.

GP commissioning costs lots and delivers little

A major study into practice based commissioning has found it to be an “expensive investment” that has delivered little in terms of better services for patients or financial savings.

The King’s Fund is urging the Department of Health to use the “reinvigoration” of practice based commissioning announced in the next stage review to set out a “clear vision” for the initiative.

Primary care trusts should retain responsibility for strategic commissioning but with clinician involvement. High performing practice based commissioners should be rewarded with increased independence but should not become responsible for the entire healthcare budget.

Individual responsibility

Report author and senior fellow Nick Goodwin said it was essential that the government told people “exactly what the roles and responsibilities of individual parties are”.

The report said even though GPs had received nearly £100m in incentive payments, few were commissioning new services, instead focusing on changing service provision.


Doctors will be offered cash incentives to prescribe new medicines

Doctors will be given extra cash when they prescribe newer, more expensive medicines under a pilot scheme aimed at accelerating the UK’s slow uptake of new medicines compared with other European countries.

The plan is part of a package agreed by the labour government and the pharmaceutical industry yesterday that aims to reward drugs innovation in exchange for cuts in the price the NHS pays for drugs.

The pharmaceutical price regulation scheme will lead to a 5 per cent reduction in the overall medicines bill over the next five years, starting with a 3.9 per cent cut in February.

But the labour government has pledged to sweeten the scheme with measures to link the price of medicines more closely to the value that they provide.

Companies will for the first time be able to raise prices on medicines already launched if clinical data show they provide a greater benefit than originally believed. Any such increases will be exempt from the overall 5 per cent price cut.

Richard Barker, director general of the Association of the British Pharmaceutical Industry, the trade body, said: “This landmark deal marks a turning point for patients, the NHS and the pharmaceutical industry.”

A new process will also be introduced to streamline, accelerate and make systematic the process of renegotiating pricing for medicines initially rejected as not cost effective by the National Institute for Curbing Expenditure (NICE), the medicines advisory body.

This will help the government’s attempts to limit the number of expensive new drugs that patients have to pay for because the NHS refuses to fund them.

The Department of Health, in consultation with Nice, has already approved a handful of such “risk-sharing” schemes, whereby drug companies reduce the NHS bill through discounts, free products or reimbursement for patients for whom the medicines do not work.

Incentive payments to doctors- which already exist to stimulate testing for certain diseases and encourage generic prescriptions – could prove controversial, and may also need to be supplemented by additional funding to primary care trusts.


Doubts about safety of NHS maternity care as negligence payouts reach £1 billion

Errors that caused serious harm to mothers and babies have accounted for nearly half of the £2.1 billion paid out as a result of medical negligence since 1995, Health Direct has learnt.

A total of £947 million has been spent on compensation relating directly to obstetrics, reflecting the increasing cost of lifetime care for children who have suffered brain damage, cerebral palsy or developmental delay.

The scale of the cost — enough to hire thousands of consultants or midwives — reveals the growing burden of claims on the health service at a time when maternity wards are short-staffed and the birthrate is rising.

Medical colleges say the chances of harm to mother or baby are lower than ever, but they remain concerned that shortages of consultants and midwives leave patients at risk.

Taking into account a backlog of cases from the 1990s, the cost of maternity-related claims has risen from £163million in 2003-04 to £288 million in 2007-08.

The figures, revealed by the NHS Litigation Authority in answers to parliamentary questions by Harry Cohen, the Labour MP for Leyton & Wanstead, reflect the cost of settled claims awarded under the Clinical Negligence Scheme for Trusts.

But this does not include cases that preceded the authority’s creation in 1995, some of which have arisen from health problems diagnosed years after birth.

Medical colleges said that the total bill for litigation put the £330 million pledged by the labour Government to improve maternity services into sharp relief.

As The Times reported in September, trusts have had trouble identifying specific funding promised over three years to help to implement a policy document, Maternity Matters, that promised all women dedicated care from a midwife by the end of next year.

Louise Silverton, the deputy general secretary of the Royal College of Midwives, said that the cost of claims “underlines what a false economy it is to cut back on maternity care”.

“Women keep hearing about these excellent government policy statements such as one-to-one care in labour from a midwife,” she said, “but they are not getting that sort of treatment in many areas such as the East of England, the South West and London.

Our members are telling us that they are overworked and overstretched and are running between beds dealing with, in some cases, three women at once.”

Overall NHS spending on maternity in England was cut by £55 million in 2006-07, while the birthrate has risen by 16 per cent — equivalent to 90,000 extra births — since 2001, Ms Silverton added.

Tristian Blomfield, 8, from Watford, Hertfordshire, received a compensation package of just over £8.26 million after suffering permanent brain damage at birth. He has cerebral palsy in all four limbs and requires constant care.

West Hertfordshire Hospitals NHS Trust, which manages Watford General Hospital where Tristian was born, offered his family an unreserved apology and expressed hope that the agreed settlement would provide them with security for the future.

Sabaratnam Arulkumaran, the president of the Royal College of Obstetricians and Gynaecologists, said that only one in every 6,000 births resulted in a litigation claim. But at that rate trusts had to set aside £500 for each birth as a form of insurance, he added.

“In a busy maternity unit of 5,000 births or more, we believe there needs to be 24-hour consultant cover to deal with emergencies and prevent disasters better. Rather than have more negligence cases and pay out on more claims, we should spend on more consultants, better training and reduce the number of cases,” he said.


Labour’s organ donor fiasco grows

A change in the law on organ donation may yet occur, in spite of an expert advisory body rejecting the idea.

The UK Organ Donation Task Force said that moving to a system where people are presumed to give consent to their organs being used for transplant risked damaging the “vital relationship of trust” between doctors and patients at the end of life.

It admitted that the arguments for and against an “opt-out” system were “finely balanced”.

But it concluded that a “presumed consent” system would be complex and costly and would require a secure IT system – at a time when public trust over the security of labour government held data has diminished.

However, Gordon Brown, the prime minister, said he was “not ruling out a further change in the law”.


Health Direct’s view of the the UK Organ Donation Task Force’s report is that they are barking.

Commonsence predicts that if over half of the population wants organ donation to be an opt out process then far more organs will become available for transplants in the future when a mandatory transplant system is introduced.

To additionally use the excuse of the £12 billion NPfIT white elephant as an example of data insecurity is a damming indictment of the Department of Health’s incompetence- who fund this quango.

Levels of public trust are much higher for doctors than labour politicians and nhs bureaucrats. Trying to shift the blame onto medical professionals is plainly incredulous.

Even ditherer Brown ought to realise that there are financial savings to had from more transplants in reducing NHS costs and greater economic benefit from sufferers returning to work.

Medicines shortage fears grow

British patients face the prospect of drug shortages as the falling price of medicines makes it more profitable for pharmacists and wholesalers to sell them abroad.

The weakening of sterling against the euro has reduced British drug prices, compared with levels in other countries. That has fuelled a surge in the legal “grey market” practice of exporting drugs from the UK to more expensive medicine markets elsewhere in Europe – so-called parallel trade.

Supplies could tighten further from January 1, when the labour government’s Pharmaceutical Price Regulation Scheme comes into force, imposing a 5 per cent price cut on prescription medicines bought by the National Health Service.

Andrew Hotchkiss, managing director of the UK operations of Eli Lilly, the US-based pharmaceutical company, warned of a “triple whammy” creating supply shortages, with the falling pound, price cuts and both fewer imports and more exports all creating uncertainties that could mean medicines are not available in pharmacies.

“We’re worried about patient access,” he told the Financial Times.

Britain has traditionally been an importer of medicines via parallel trade.

Wholesalers and many individual pharmacies have licences that allow them legitimately to export medicines from the UK to other countries where they fetch higher prices. Concerns are growing that this may increasingly squeeze supplies to British patients.

Martin Sawer, spokesman for the British Association of Pharmaceutical Wholesalers, whose members distribute medicines from drug companies to pharmacies, said he agreed that there were risks of supply shortages, especially since medicine stocks were likely to run low over the Christmas holidays.

The situation risked being worse than at any time in the past because the introduction of computerised stock control meant pharmacies often held smaller volumes of supplies.

Groups of pharmacies may deliberately order more medicine than they require, selling the remainder at a profit – a practice known as skimming. Prices in other northern European countries are about 10 per cent or more higher than in the UK.

Paul Johnson, UK managing director of IMS Health, the data consultancy, agreed that the UK’s share of parallel trade across Europe, traditionally about 30 per cent, had been shrinking since the spring – with faster growth in other higher priced markets. “The UK still has significant parallel imports but they have reduced dramatically in the last few months. And a whole range of products are now being exported. This is a perfect storm.”

He estimated that parallel trade accounted for nearly 10 per cent of Europe’s total prescription medicine sales and involved purchases from low-cost countries led by Greece, Spain and Portugal, with re-sale into the UK, Germany, Benelux and the Nordic region, where parallel imports accounted for nearly €5bn (£4.2bn) a year.