Smokers and fat patients thrown off NHS waiting lists

Smokers and overweight patients in need of major operations could be thrown off hospital waiting lists under “desperate” cost-cutting plans.
Any smoker referred for ‘non-urgent’ operations will not be allowed to join the queue until they have either given up smoking, or completed a 12-week course to help them ditch the habit

Patients’ groups described the tactics as an “appalling scam” to enable NHS bosses to claim waiting times are far shorter than they are, simply by denying a place in the queue to many of those referred for surgery.

Under the plans drawn up by NHS bureaucrats in Kent, any smoker referred for “non-urgent” operations – such as hip replacements or cataract surgery – will not be allowed to join the queue until they have either given up smoking, or completed a 12-week course to help them ditch the habit.

Those who are seriously overweight will also be denied a range of operations until they have completed a three month NHS diet programme.

Although every patient has a legal right to be treated in 18 weeks of being referred for treatment by their GP, the protocols agreed mean different rules could be applied for anyone with a body mass index of more than 30, or those who smoke.

Patients groups said delays getting a place on 12-week “smoking cessation” and “weight loss” programmes could leave many patients waiting even longer than 30 weeks implied by proposals drawn up by NHS West Kent Primary Care Trust (PCT).

Katherine Murphy, from the Patients Association, said: “This is an appalling kind of scam – it is a clear device to manipulate the waiting lists simply to cut their deficit. It smacks of desperation, and it is patients who will suffer.”

The plans, seen by The Sunday Telegraph, explicitly say the rules have been introduced to save money by the end of the year.

The document says: “PCTs across the country are making decisions on prioritising treatments in order to match demand to the financial resources available to the economy as a whole and to individual trusts.

“Unfortunately this does not take us far enough: we need to take additional activity to reduce activity in this financial year if we are to be in a position to hand over a balanced budget.”

Under the proposals, smokers already on waiting lists will now be taken off until they have either been on the courses or given up smoking. New referrals will not be allowed on the lists until they have done the same.

All patients with a BMI of 30 or more who are referred for several types of surgery including hip and knee operations will also be cast off the lists until they have been on a three-month diet programme.

Many primary care trusts already try to encourage patients to stop smoking or lose weight before operations, in order to reduce the risks to them.

But patients’ groups said the use of tactics to delay even putting patients on the waiting lists was a far more draconian step.

Mrs Murphy said: “This is a clear way to keep these patients off the lists in order to cut costs, while the PCT can officially claim its waiting times have not lengthened.”

Simon Clark, director of the smokers’ lobby group Forest, accused the PCT of discriminating against smokers and creating a “two-tier” system.

He said: “Of course patients should be told that smoking could have an impact on the success or recovery from an operation, but given that they have paid huge sums in taxation on cigarettes over the years, the question of whether or not they have the surgery should be one for them, not the NHS.”

A letter sent out by the PCT tells local GPs: “There is good evidence that stopping smoking prior to surgery reduces length of stay and infection rates, and improves healing time; it is also a time when people are often highly motivated to give up.”

Kent doctors accused managers of being dishonest about the real reasons why patients were having their treatment delayed.

Dr Stephen Meech, a GP from Maidstone, said: “Patients are going to be told that they cannot have an operation because they smoke or need to lose weight, when that is not actually true – it is because the health authority can’t afford to pay for it.”

Dr John Allingham, a GP from Hawkinge, said: “The plan is extremely contentious and it is a way of extending the waiting times.

“If you’ve got to do a 12-week smoking cessation course before you can have your hernia fixed, or before you’ve even gone on the waiting list to have your hernia fixed, it immediately makes those waiting lists another 12 weeks longer.”

The PCT said it was in talks with local doctors over the proposals. Marion Dinwoodie, its chief executive, said she regretted the need “to take measures in the short term that may have an impact on local people”.

She said no one with a compelling clinical need for treatment this year would miss out.

From: http://www.telegraph.co.uk/Smokers-and-fat-patients-thrown-off-NHS-waiting-lists

Politicians should say what they really think about drugs

The real debate about drugs and addiction is considered taboo by the political classPoliticians should say what they really think about drugsAs a rule, politicians only feel able to say what they really think about drugs once they’re safely out of office.

This month, Bob Ainsworth, the minister responsible for narcotics policy between 2001 and 2003, called for an end to the “war on drugs”, arguing that addiction is a medical problem and that millions of pounds are being spent without preventing the wide availability of addictive chemicals.

Peter Lilley, the former Conservative cabinet minister, agreed with him. “The current approach to drugs has been an expensive failure,” he said. “For the sake of everyone, and the young in particular, it is time for all politicians to stop using the issue as a political football.”

Do they have a point? After all, the purpose of banning drugs, when prohibition took off in the early 20th century, was to reduce the harm they do.

On that measure, our laws have been a dismal failure. Addiction costs the British economy billions every year, while channelling billions more to criminal networks.

Simply enforcing the law more stringently, as some propose, is not much of an answer, since few people want to see teenagers filling up prisons for possessing small amounts of cannabis. So what would actually happen if the prohibition on the sale of drugs were lifted?

That’s the trouble: no one knows.

The last time all drugs were legally available was the mid-19th century, and that was a more ordered era: then, you could buy laudanum – an alcoholic tincture of opium – for medicinal purposes, in your local corner shop. Some ordinary folk gulped it daily, a bit like Valium 100 years later.

In East Anglia, they grew opium poppies in the fields, and used them to fortify the beer. Even fractious babies were dosed with the stuff, which caused some unfortunate accidents. Cocaine, meanwhile, was a key ingredient in a variety of invigorating tonics.

Despite such widespread availability of narcotics, society didn’t fall apart – but then, the Victorians had social pressures which acted as restraints on behaviour. These days, more people than ever before seem to struggle with their appetites, whether for food, sex, booze or drugs. It’s possible that liberalising the law would lead to a catastrophic increase in the number of addicts.

Mind you, there is one European country where the government has tried a liberal approach: Portugal.

In 2001, the Portuguese enacted a law that decriminalised all drugs. The evidence so far shows no explosion of addiction, nor has Lisbon turned into a cesspit awash with drug traffickers, as some predicted.

“Judged by virtually every available metric,” says Glenn Greenwald of the Cato Institute, a libertarian US think tank, “the Portuguese decriminalisation framework has been a resounding success.” In the first five years of the new policy, illegal drug use among teenagers declined, as did deaths caused by drug use. Portugal now has among the lowest rates of drug use in the EU.

Amid this month’s fuss, we should remember that Bob Ainsworth is an ex-trade union leader from Coventry, not some hippy libertarian proposing hedonism for all. He simply thinks that the current system is causing more harm than good, and we should try something different. He is acknowledging that the debate is changing and that a new approach is needed.

The nature of the problem is changing, too – even the nature of the drugs themselves.

The medicine cabinets of Middle England are increasingly stocked with painkillers – prescribed by doctors – that are every bit as potent as anything than can be bought from a street-corner dealer. These are drugs, too, but they’re perfectly legal ones. So Mr Ainsworth’s remarks are to be welcomed.

At the moment, we live in a strange world in which politicians are frightened to talk about the realities of drugs in the way the rest of us do. It’s about time we allowed them to say what they really think.

From: http://www.telegraph.co.uk/Politicians-should-say-what-they-really-think-about-drugs

Flu cases rise 40 per cent claim GPs

The Royal College of General Practitioners (RCGP) reported that cases of flu in England and Wales reached 124.4 per 100,000 of the population in the week ending December 26.Flu cases rise 40 per cent claim GPsThere were 85.8 per 100,000 cases in the previous week.

A Department of Health spokesman said: ”These figures are in keeping with what we would expect during a winter flu season.

”But everyone can do their bit to help keep well – simple measures like washing your hands help stop flu spreading.

”The Chief Medical Officer has issued clear advice to get the seasonal flu jab if you are in a vulnerable group, particularly pregnant women and people with an underlying health condition, as well as those aged 65 and over.

”We are pleased to hear from RCGP that their estimates show vaccine coverage in over 65s has now caught up with last year and coverage is still going up in under 65s’ in-risk groups.”

The RCGP said that the increase was evident in all age groups except school children.

There has been a substantial increase in age groups 45-64.

The increase still falls short of epidemic levels, which experts define as 200 cases per 100,000.

The figures come after Labour was yesterday accused of dangerous scaremongering over flu jabs for children, as the Government vehemently denied claims it had ignored expert scientific advice over protecting youngsters.

The political row broke out after shadow health secretary John Healey accused ministers of having “cancelled” an immunisation programme for the under-fives.

This provoked a furious response from the coalition, which insisted it was the independent Joint Committee on Vaccination and Immunisation (JCVI) which recommended that no specific programme was required this winter.

Health minister Simon Burns called for an apology and suggested it was Mr Healey who was putting people’s health at risk by creating false fears about the risks.

From: http://www.telegraph.co.uk/Flu-cases-rise-40-per-cent

NHS Direct under growing strain as doctors told to give Tamiflu to low risk patients

HS Direct is struggling to cope as the number of people using the helpline dramatically increases due to freezing weather and the swine flu outbreak.NHS Direct under growing strain as doctors told to give Tamiflu to low risk patientsAmid claims some patients had waited for two days to speak to a nurse, officials urged patients to use a new online health information service.

Senior nurses suggested the helpline was struggling to cope with the overload of calls as figures show the number of people calling the helpline had dramatically increased over the past few days.

An NHS Direct spokeswoman admitted the telephone advice service was “experiencing extremely high demand as a result of the severe weather”. She said the service had received 50 per cent more calls than forecast.

Up to 46,000 people called the service last weekend, the equivalent of almost 960 an hour.

It was also disclosed that there had been 5,700 more calls made to NHS Direct last week compared with the same week last year.

The online “symptom checker” system was used 160,000 times while the colds and flu symptom system was the most used service with almost 59,000 checks.

NHS Direct management apologised to patients who had been forced to wait longer than expected.

It came as doctors were told they could prescribe Tamiflu to otherwise healthy people suffering from flu as the illness prompts a surge in hospital admissions.

The move is an indication of the authorities’ concern about the risks from swine flu, which has become the predominant strain of the virus this winter and is striking younger age groups than usual.

Cases of flu have risen more than six fold in three weeks, the latest figures show.

Normally antiviral drugs, such as Tamiflu and Relenza, are only prescribed to people with flu who have other conditions such as heart disease and severe asthma because of the extra risk that influenza poses to them.

But officials are so concerned at the number of otherwise healthy people who have been admitted to hospital that they are taking special measures to lift these restrictions.

Doctors will be able to use their discretion and prescribe the drugs, which shorten the length of the illness by about one day and reduce spread, to anyone they think will benefit.

The drugs are most effective if taken within 48-hours of symptoms first appearing.

Prof Dame Sally Davies, interim Chief Medical Officer, has written to all GPs with the new instructions as figures were released showing there are more than 300 people in intensive care with flu, higher than during any point in last year’s pandemic. Last week there were 180 people in intensive care.

Nine of the 17 deaths, that have so far been linked to flu this winter, were in otherwise healthy people. None of those victims had been vaccinated with this year’s seasonal flu jab or the pandemic vaccine against just swine flu that was administered last year.

Figures released by the Royal College of GPs disclosed that the number of people going to their GP with flu-like symptoms has more than doubled in a week. There were 87 consultations per 100,000 people in the week up until December 19th compared with 34 the week before.

In the week ending December 5th just 13 consultations per 100,000 people were about fly symptoms. Illness was most common in children aged between five and 14, followed by children under four, and those aged between 15 and 44.

It is not known how many of those people have had swine flu but the H1N1 virus is the most common this winter.

The letter to GPs said: “Antiviral treatments for influenza are currently only available from GPs for NHS patients who are in a designated “at clinical risk” category.

“The most recent surveillance data indicate that higher than normal numbers of patients, who are not in one of the “at clinical risk” groups, are becoming seriously ill with flu – requiring hospitalisation.

“Regulations currently say that prescribers should not order oseltamivir and zanamivir [Tamiflu and Relenza] for patients who are not in the target risk groups.”

It added: “However, the Chief Medical Officer has recommended that the current restrictions should be amended to allow general practitioners (and other prescribers) to exercise their clinical discretion so that any patient who their GP feels is at serious risk of developing complications from influenza may receive these treatments on the NHS.

“This is consistent with guidance from NICE which informs the existing statutory restrictions but which envisages that prescribers may exercise their clinical discretion in individual cases.

“Whilst antiviral manufacturers and wholesalers should have sufficient supply to meet demand, prescribers and pharmacists are asked to consider carefully the need to order sensibly and not to stockpile. Stockpiling and over-ordering could cause shortages.”

It comes as doctors in some parts of the country are preparing to open their surgeries on Christmas Day to deal with large localised outbreaks of flu.

Doctors in Leicester have said the outbreak there is the worst for ten years.

Some GP practices will open on Christmas Day and Boxing Day as well as the Monday and Tuesday bank holidays – although doctors will only see patients registered at the practice.

Ivan Brown, a public health consultant with NHS Leicester City, said: “As things stand at the moment, we are confident we are managing well but we must do anything we can to avoid unnecessary admissions to hospital.

“At the moment, we do have enough hospital beds. There aren’t a huge number to play with but there are enough.

“I understand people are going to have a good deal of anxiety but, for the vast majority of individuals, the raft of winter-related illnesses around are self-limiting and patients will recover.”

Dr Brian Gaffney, NHS Direct’s Medical Director, urged people to use the online system.

“Patients can be assured that they will receive the same quality of advice that they have come to expect from the telephone service when they access our services online,” he said.

Meanwhile sales of over-the-counter medicine have increased dramatically as patients try to keep themselves well at home.

Tesco has reported a surge in demand for cold relieving powders and drinks, cough syrup, lozenges for sore throats and other related pain relievers and is selling around half a million of these products a day.

Tesco pharmacy buyer Joy Wickham said: “As if the Arctic temperatures and horrendous travelling conditions aren’t bad enough the UK is suffering a higher than normal incidence of colds and flu illness.

“We are selling nearly half a million cold and flu remedies plus pain relievers a day while our flu jab service uptake has more than trebled.

“Since the recent heavy snowfall we are also seeing far higher than normal demand in our high street Express stores which suggests that shoppers are finding it easier to buy their essentials in urban areas.”

From: http://www.telegraph.co.uk/NHS-Direct-under-growing-strain-as-doctors-told-to-give-Tamiflu-to-low-risk-patients

Politicians should say what they really think about drugs

Real debate about drugs and addiction is considered taboo by the political class, says Andrew M Brown and prescription drugs are increasingly a problem.
Politicians should say what they really think about drugsAs a rule, politicians only feel able to say what they really think about drugs once they’re safely out of office.

Last week, Bob Ainsworth, the minister responsible for narcotics policy between 2001 and 2003, called for an end to the “war on drugs”, arguing that addiction is a medical problem and that millions of pounds are being spent without preventing the wide availability of addictive chemicals.

Peter Lilley, the former Conservative cabinet minister, agreed with him. “The current approach to drugs has been an expensive failure,” he said. “For the sake of everyone, and the young in particular, it is time for all politicians to stop using the issue as a political football.”

Do they have a point? After all, the purpose of banning drugs, when prohibition took off in the early 20th century, was to reduce the harm they do. On that measure, our laws have been a dismal failure. Addiction costs the British economy billions every year, while channelling billions more to criminal networks.

Simply enforcing the law more stringently, as some propose, is not much of an answer, since few people want to see teenagers filling up prisons for possessing small amounts of cannabis. So what would actually happen if the prohibition on the sale of drugs were lifted?

That’s the trouble: no one knows. The last time all drugs were legally available was the mid-19th century, and that was a more ordered era: then, you could buy laudanum – an alcoholic tincture of opium – for medicinal purposes, in your local corner shop. Some ordinary folk gulped it daily, a bit like Valium 100 years later.

In East Anglia, they grew opium poppies in the fields, and used them to fortify the beer. Even fractious babies were dosed with the stuff, which caused some unfortunate accidents. Cocaine, meanwhile, was a key ingredient in a variety of invigorating tonics.

Despite such widespread availability of narcotics, society didn’t fall apart – but then, the Victorians had social pressures which acted as restraints on behaviour. These days, more people than ever before seem to struggle with their appetites, whether for food, sex, booze or drugs. It’s possible that liberalising the law would lead to a catastrophic increase in the number of addicts.

Mind you, there is one European country where the government has tried a liberal approach: Portugal. In 2001, the Portuguese enacted a law that decriminalised all drugs. The evidence so far shows no explosion of addiction, nor has Lisbon turned into a cesspit awash with drug traffickers, as some predicted.

“Judged by virtually every available metric,” says Glenn Greenwald of the Cato Institute, a libertarian US think tank, “the Portuguese decriminalisation framework has been a resounding success.” In the first five years of the new policy, illegal drug use among teenagers declined, as did deaths caused by drug use.

Portugal now has among the lowest rates of drug use in the EU.

Amid the week’s fuss, we should remember that Bob Ainsworth is an ex-trade union leader from Coventry, not some hippy libertarian proposing hedonism for all. He simply thinks that the current system is causing more harm than good, and we should try something different. He is acknowledging that the debate is changing and that a new approach is needed.

The nature of the problem is changing, too – even the nature of the drugs themselves. The medicine cabinets of Middle England are increasingly stocked with painkillers – prescribed by doctors – that are every bit as potent as anything than can be bought from a street-corner dealer.

These are drugs, too, but they’re perfectly legal ones.

So Mr Ainsworth’s remarks are to be welcomed. At the moment, we live in a strange world in which politicians are frightened to talk about the realities of drugs in the way the rest of us do. It’s about time we allowed them to say what they really think.

From: http://www.telegraph.co.uk/Politicians-should-say-what-they-really-think-about-drugs

Health Direct also points out the Professor Nutt- the then head of Labour’s drugs review board, was metaphorically castrated when he menthioned that the legal drug alcohol causes far more harm to society than any other drug.

Complaints to NHS top 100,000 for the first time

Complaints about the NHS have breached the 100,000 a year mark for the first time, according to a new report.
Complaints to NHS top 100,000 for the first timeThe figures for 2009/2010 show a 13 per cent increase on the previous year – the largest ever increase .

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

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

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

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

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

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

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

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

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

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

Dieting for two days a week can almost half the risk of breast cancer

Dieting for two days every week could reduce women’s chances of developing breast cancer by almost half, scientists have found.
Dieting for two days a week can almost half the risk of breast cancerA study found that when overweight women were put on a restrictive diet there was a reduction of up to 40 per cent in cancer-causing hormones following an average drop in weight of 13lb.

The Wythenshawe Hospital study was led by Dr Michelle Harvie and examined 100 overweight women from Greater Manchester, with half following a 650-calorie-a-day diet for two days a week, and the rest following a 1,500-calorie-a-day diet for the entire week.

After six months on the diets, the women’s levels of the hormone leptin was down 40 per cent, their insulin levels down 25 per cent and their levels of inflammatory protein down 15 per cent. All three have been linked to breast cancer.

The other women followed a 1,500-calorie-a day Mediterranean diet. They showed similar weight loss and hormone reductions.

Dr Harvie said the new diet could be a life-saver for women who found it difficult to stay on a diet for a week.

Among the women who took part in the trial was research professor Gillian Haddock, who had been in a high-risk group for the disease. She lost a stone in six months on the diet and is now recommending it to her friends.

Pamela Goldberg, chief executive of the Breast Cancer Campaign, said: “There are many breast cancer risk factors that can’t be controlled, such as age, gender and family history – but staying at a healthy weight is one positive step that can be taken.

“This intermittent dieting approach provides an alternative to conventional dieting which could help with weight loss, but also potentially reduce the risk of developing breast cancer.”

Prof Haddock said: “I felt it was a really good study to be part of, and could provide women with some new options to improve their health.

“I had a family history of breast cancer, so I was relatively high risk. I found traditional diets, with calorie counting and preparations difficult to stick to.

“I used to follow the 650-calorie diet on a Monday and Tuesday and it was great because I knew that by Wednesday I would be eating normally.

“It really suited me, I did it on my busiest work days and I would mainly have the milky drinks while I was at work so I didn’t have to worry about shopping or taking in a specially prepared packed lunch.”

Example of 650 calorie day

Breakfast:
Fruit tea and a banana, or mug of milky coffee

Mid-morning:
Can of diet cola, or cup of tea and plum

Lunch:
Carrot and coriander soup and half-pint of milk, or salad, glass of squash and half-pint of milk

Mid-afternoon:
Glass of squash, or glass of sparkling water and satsuma

Dinner:
Soy sauce and ginger stir-fry with two vegetables and glass of water, or vegetable curry with two veg, half-pint of milk and cup of tea

Supper:
Pint of milk, or hot milk with cinnamon and sweeteners.

From: http://www.telegraph.co.uk/Dieting-for-two-days-a-week-can-almost-half-the-risk-of-breast-cancer

Swine flu- half of worst afflicted were previously in good health

Fears of a major swine flu crisis are growing after a letter from the country’s top doctor warned that half of the most severe cases have involved people who were previously healthy.
Swine flu- half of worst afflicted were previously in good healthProfessor Dame Sally Davies, the Government’s chief medical officer, has written to all GPs and NHS hospitals warning of a “sharp increase” in the numbers of patients admitted to intensive care because swine flu has caused their lungs to fail.

The letter says pressures on critical care services are “significantly over and above” those expected at this time of year.

Crucially, the memo, says that while “half of patients requiring respiratory support have had recognised comorbidities [underlying health problems] which increase the risk for severe influenza, half have had no recognised comorbidities.”

A spokesman for the Department of Health (DoH) confirmed that the presence of so many previously healthy people among those worst affected by the virus was “unusual” and said anyone concerned about worsening flu-like symptoms should contact their GP.

While overall flu levels remain normal for this time of year, the rate of flu has more than doubled in just seven days, latest figures show.

The official death toll from flu this winter has now reached 17, including six children. Fourteen of the deaths were linked to swine flu, and none of those who died had been vaccinated against the virus.

In the same letter, the senior doctor says pregnant women, children, young adults, and those who are overweight are among the most severely ill.

Yesterday, Prof Davies criticised the Government’s decision to axe the annual publicity campaign urging people in at risk groups to have the seasonal flu jab, which protects against the main viruses in circulation, including swine flu.

Prof Davies said: “The Government took a decision not to use the marketing campaign this year. I would prefer to have done it because I believe in belt and braces. I am a doctor – I don’t like leaving things to chance.”

For the first time, the winter flu jab is being offered on the NHS to pregnant women, who were disproportionately affected by last year’s swine flu outbreak, as well as to elderly people and those with existing health problems.

Pregnant women are being advised to be immunised, no matter how far into their pregnancy they are, since they are thought to be more than four times more likely than others to develop serious complications if they contract swine flu.

The medical officer said the number of people seeing their GP because of flu was “bang in the range” for the season.

However, the sharp rise in all flu cases in seven days and the number of people below the age of 65 being admitted to hospital were reasons why the Government was examining the patterns carefully, she said.

GPs are worried that elderly people, who suffered less than younger people in last year’s swine flu pandemic, are failing to protect themselves against other strains of flu.

Vaccination rates among the elderly are down two per cent on last year, while among at risk groups, rates are down by 6 per cent.

In some parts of the country, pharmacists and hospitals are complaining of shortages of the drug used to treat the virus. Chemists and hospitals in Yorkshire were unable to track down supplies of Tamiflu, with NHS bosses describing “difficulties with the national supply chain”. The DoH said there was no national shortage of the drugs, and that any local delays “should be short-lived”.

At least four more pregnant women with swine flu in England have undergone intensive care treatment. In Scotland, a woman with swine flu has been placed in a coma after giving birth to a daughter by caesarean section.

A spokesman for the DoH said GPs would be contacting patients in “at risk” groups to invite them to have the vaccination. He said: “It is vital that those at greatest risk are vaccinated as soon as possible.”

Anyone who did not know if they were in such a group should contact their GP, he said.

http://www.telegraph.co.uk/Swine-flu-half-of-worst-afflicted-were-previously-in-good-health

Increase in work for NHS lifts private hospitals’ profits

Private hospitals bucked the recession in 2009 – but only by massively expanding the amount of work they carry out for the National Health Service, according to the analysts Laing and Buisson.Increase in work for NHS lifts private hospitals' profitsOverall, revenue rose by 7.5 per cent to £3.76bn. But patients treated under private medical insurance fell by 30,000 between 2007 and 2009 as the recession hit. The numbers paying out of their own pocket dropped further – down by almost 45,000.

However, work for NHS patients, who now have the right to go to any private hospital willing to treat them at the NHS price for waiting-list type treatments, rocketed.

Their numbers almost quadrupled between 2007 and 2009, up from 55,900 to 212,000, so that NHS patients made up almost 22 per cent of private hospital cases, up from 6.3 per cent in 2007.

The result was a rise in independent hospital activity, with about 975,000 patients treated, against 888,000 in 2007.

Some NHS patients are sent by NHS hospitals to keep waiting times down.

But the numbers exercising their right to choose are rising sharply – running at a rate of 200,000 procedures a year in July this year, according to Laing’s Healthcare Market Review, the bible on private sector activity. That is business worth £400m a year.

William Laing of the review said senior health department officials believe patient choice activity in the private sector could triple. His own estimate is that it might ultimately rise five fold to about £2bn a year – although that would still be less than 20 per cent of NHS waiting list activity.

“Expanding the services they provide for the NHS has obvious attractions for independent hospitals because the publicly paid market is massively greater than the traditional private healthcare market.

“But it has great dangers as well, since too much focus on publicly paid patients could compromise their appeal to traditional, privately paying customers. There is a conflict which independent hospital providers have not yet fully resolved.”

If the independent sector seriously wanted to address the potentially huge public market, he said, it would “have to grow a lot more capacity”.

That could come from a mix of the existing players and new hospital providers entering the market with lower cost business models that generate reasonable profits from the prices that the NHS is prepared to pay.

The figures came on the day the Office of Fair Trading launched a wide ranging review into the private healthcare market – among other issues examining the barrier to new entrants joining it.

From: http://www.ft.com/cms/s/0/675afcb4-07b7-11e0-a568-00144feabdc0,s01=1.html#axzz18ALgaS00