Unions’ strike means thousands of operations to be postponed today

Hospital managers are planning to postpone thousands of non emergency operations today, because of the public sector unions striking over pension changes.Unions' strike means thousands of operations to be postponed todayPatients across the UK have been sent letters warning them of the disruption.

Diagnostic tests and outpatient appointments will also be delayed, but hospitals insist emergency and critical care will not be affected.

Managers say they are preparing as they would for Christmas or bank holidays.

An estimated 400,000 nurses and healthcare assistants, as well as paramedics, physiotherapists, and support staff like cleaners and administrators have said they will join the action on 30 November over changes to public sector pensions.

However, the main medical unions – the Royal College of Nursing, the Royal College of Midwives and the British Medical Association are not taking part.

The Department of Health in England said it was expecting at least 5,500 non-emergency procedures like hip and knee operations to be rearranged.

More than 12,000 patients are likely to have diagnostic tests postponed, and 40,000 outpatient appointments are expected to be rescheduled.

On an average day, 28,000 patients have planned treatments or operations in England and there are 60,000 diagnostic tests.

However, managers say they are putting plans in place to make sure people can still get emergency or urgent care, in the way they do on bank holidays or at Christmas.
999 calls

Patients needing urgent treatment like chemotherapy and kidney dialysis will still be able to get it, and maternity units will remain open.

Calls to 999 will still be answered, but patients are being urged to think hard and only call if it is a genuine emergency.

The Health Secretary, Andrew Lansley, said health service workers should not take action that harms the interests of patients.

“I would ask staff to consider carefully whether going on strike is the right thing to do,” he said.

Labour wasted cancer cash on NHS salaries and PFI schemes

Cancer care on the NHS lags behind that in many other developed countries because Labour wasted billions of pounds on PFI schemes, bureaucracy and inflated salaries for managers.Labour wasted cancer cash on NHS salaries and PFI schemesA report by the Organisation for Economic Co-operation and Development (OECD) has found that, despite record spending on health care, cancer survival rates in Britain are worse than in Slovenia and the Czech Republic.

Survival rates for breast cancer, prostate cancer and cervical cancer were below the average for the 34 developed countries in the study.

Mr Lansley lays the blame for the poor performance on the previous government’s failure to make sure that extra investment in the NHS reached the front line. He claims patient care was ignored in favour of increased salaries and botched computer systems.

Writing in The Daily Telegraph, Mr Lansley says: “Unfortunately this report shows how much work there is to do to deal with Labour’s legacy of neglect and mismanagement of our NHS.

“They hugely increased spending on the Health Service, but wasted much of it on managers, failed IT projects and unsustainable PFI projects.

“They failed to focus on what really matters – patients – which is why we still have some of the worst cancer outcomes amongst comparable countries.”

Under Labour, spending on the NHS trebled, reaching almost £100 billion in 2009, but money for treating cancer still lags behind much of the rest of the world.

A report by the Policy Exchange think tank last year found that England spent around 5.6 per cent of its health care budget on cancer care, compared with 7.7 per cent in France, 9.6 per cent in Germany and 9.2 per cent in America.

In September it emerged that private finance initiatives, introduced by Labour to fund capital projects, have left 60 NHS hospitals on the “brink of financial collapse”. Meanwhile, the pay of NHS chief executives has risen, with typical earnings now more than £150,000.

The OECD figures reveal that the best breast cancer survival rates were in the US, where 89.3 per cent of women were alive five years after being diagnosed. The average across all OECD countries was 83.5 per cent, while in the UK it was 81.3 per cent.

Survival rates for cervical cancer were worse. Norway topped the table with 78.2 per cent still alive after five years, compared with 58 per cent of women in the UK. There were also more hospital admissions for asthma and other lung conditions than the average and infant mortality was higher.

The report also showed that consultations by doctors have fallen, and were below he OECD average in 2009.

Katherine Murphy, the chief executive of the Patients Association, said: “The NHS provides some excellent care but it does fall down on many counts. We know from patients phoning our helpline that the quality of care that they have experienced can be very poor and sometimes it is downright neglectful.

“Rather than trying to tackle the issue of poor care, the Department of Health is demanding that the NHS makes £20 billion of efficiency savings while spending a million pounds a day on a reform plan that doctors, nurses, patients and NHS managers all say risks irrevocably damaging the NHS.”

From:  http://www.telegraph.co.uk/Cancer-cash-wasted-on-NHS-salaries

Doctors and dentists to receive new tax warning letters

About 2,500 doctors and dentists have been targeted by the tax authorities as probable tax dodgers.Doctors and dentists to receive new tax warning lettersHM Revenue & Customs (HMRC) will send them warning letters in the next few days, telling them to pay within 21 days or face possible prosecution.

The threats are part of the Revenue’s efforts to recover unpaid tax owed by various professions and trades.

People selling on internet marketplaces, and electricians, will be targeted early next year.

As well as doctors and dentists, HMRC has already been paying special attention to the tax affairs of restaurant owners and their staff, plumbers, private tutors and scrap metal dealers, as well as people with money hidden in offshore bank accounts.

Last month, the Revenue added to its list of potential miscreants, announcing it would also be focusing on wealthy people who own homes abroad, as well as commodity traders.

Gary Ashford of the Chartered Institute of Taxation (CIOT) said doctors and dentists should not ignore the Revenue’s latest letters.

“HMRC will either ‘make a determination’, which would result in the taxpayer incurring significant additional charges, or refer the case to their criminal investigations department with a view to prosecution,” he said.

“They have offered the carrot of a relatively low penalty rate for doctors to get their affairs in order and 1,500 health professionals took it up, bringing in £10m for the Exchequer.

“Now they are wielding the stick at those who have not come forward,” he said.

Mr Ashford pointed out that the Revenue had been gleaning information from employers of doctors and dentists, such as locum agencies, drug companies and medical insurance firms.

“What we are now seeing is HMRC starting to use that information, to identify who has not notified HMRC of all their tax liabilities,” Mr Ashford pointed out.

New drug could help obese patients lose tenth of their weight in just one month

A new drug which destroys blood supply to fatty tissue could help people lose a tenth of their body weight in just one month, a study indicates.New drug could help obese patients lose tenth of their weight in just one monthObese rhesus monkeys lost on average 11 per cent of their body weight after four weeks of the experimental treatment.

Body mass index (BMI) and waistline also were reduced, while all three measures were unchanged in untreated control monkeys.

Imaging studies also showed a substantial decrease in body fat among treated animals.

A research team led by scientists at The University of Texas MD Anderson Cancer Centre carried out the study.

Co-senior author Professor Renata Pasqualini, at the David H. Koch Centre for Applied Research of Genitourinary Cancers, said: “Development of this compound for human use would provide a non-surgical way to actually reduce accumulated white fat, in contrast to current weight-loss drugs that attempt to control appetite or prevent absorption of dietary fat.”

She said previous attempts to treat obesity have predominantly focused on drugs aimed at suppressing appetite or increasing metabolism, but these efforts have been hampered by their toxic side-effects.

The MD Anderson group designed a new drug, which includes a homing agent that binds to a protein on the surface of fat-supporting blood vessels and a synthetic peptide that triggers cell death.

Their blood supply gone, fat cells are reabsorbed and metabolised.

Co-senior author Professor Wadih Arap, said: “Obesity is a major risk factor for developing cancer, roughly the equivalent of tobacco use, and both are potentially reversible.”

In earlier preclinical research, obese mice lost about 30 per cent of their body weight with the drug, now called Adipotide.

The drug acts on white adipose tissue, the scientific name for the unhealthy type of fat that accumulates under the skin and around the abdomen, and is a disease and mortality predictor.

Prof Pasqualini said: “Most drugs against obesity fail in transition between rodents and primates.  We’re greatly encouraged to see substantial weight loss in a primate model of obesity that closely matches the human condition.”

The primate model also shares other physiological features associated with human obesity, such as metabolic syndrome, characterised by an increased resistance to insulin, which can lead to the development of type 2 diabetes and cardiovascular disease.

Adipotide-treated monkeys showed marked improvements in insulin resistance – using about 50 per cent less insulin after treatment.

Now the research team are preparing for a clinical trial in which obese prostate cancer patients would receive daily injections of Adipotide for 28 consecutive days.

Prof Arap said: “The question is, will their prostate cancer become better if we can reduce their body weight and the associated health risks?”

He said some prostate cancer treatments, such as hormone therapy, cause weight gain.

Greater weight can lead to arthritis, which in turn causes inactivity that leads to more weight gain.

Fat cells also secrete growth hormones that cancer cells thrive on.

Weight, BMI and abdominal circumference all continued to drop for three weeks after treatment ended before turning back up during the eighth week of the study.

Treated monkeys’ abdominal fat levels fell by 27 per cent during the study. Fat levels increased slightly in the control group.

Lean monkeys did not lose weight in a separate study to test for potential effects of the drug in non-obese animals, indicating that the drug’s effect may be selective for obese subjects.

Monkeys in the studies remained bright and alert throughout, interacting with caretakers and demonstrating no signs of nausea or food avoidance.

This is potentially an important finding since unpleasant side-effects have limited the use of approved drugs that reduce fat absorption in the intestines.

The principal side effects were noted in the kidneys.

Study first author Dr Kirstin Barnhart, a veterinary clinical pathologist said: “The renal effect was dose-dependent, predictable and reversible.”

The results were published in the journal Science Translational Medicine.

NHS among best health care systems in the world

Britain has one of the best healthcare systems in the world, according to results of an international survey published this week. NHS among best health care systems in the worldThe Commonwealth Fund survey consistently ranks the NHS highly on a range of measures looking at how health systems deal with people with chronic and serious illness.

It finds people in Britain have among the fastest access to GPs, the best co-ordinated care, and suffer from the among the fewest medical errors, of 11 high income countries surveyed.

The countries examined were: the UK, France, Germany, Switzerland, Sweden, Norway, the Netherlands, the US, Canada, Australia and New Zealand.

Britain and Switzerland were consistently among the best performers, found the analysis of answers from over 18,000 adults with chronic and serious illness.

For example, the Washington DC based organisation reported: “UK and Swiss patients reported more positive health care experiences than sicker adults in the other countries: they were more likely to be able to get a same- or next-day appointment when sick and to have easy access to after-hours care, and they were less likely to experience poorly coordinated care.”

The success of the NHS stands out despite the fact that per capita health spending in the UK is the third lowest of the 11, at £2,170 per head, compared with £3,200 in Switzerland and £4,950 in the US.

The Commonwealth Fund is a private foundation which claims to support “independent research on health policy reform”.

However, it is widely seen in the US as being strongly in favour of President Obama’s health reforms.

Today’s report is highly critical of current US healthcare. Karen Davis, its president, says the country “practically stands alone when it comes to people with illness or chronic conditions having difficulty affording health care and paying medical bills”.

A spokesman for the Royal College of General Practitioners said the survey “shows yet again that the excellent work carried out by GPs in the UK is recognised worldwide, leading the field in ease of access, coordinated care and good patient doctor relationships”.

He added: “If the current reform of the NHS is to achieve anything, it must preserve and build on the strengths of general practice by producing more GPs, who are trained for longer so that they can do even more to improve the health of their patients.

“The NHS stands out internationally as an example of excellence, and general practice is what makes the NHS safe, fair and value for money.”

Bed blocking rise of 11pc in last year

Elderly patients are increasingly being kept in hospital beds because there is no one to support them at home, or there are no places available in residential homes, figures indicate.Bed blocking rise of 11pc in last yearThe number of hospital bed days lost to so-called ‘bed blockers’ across NHS hospitals in England has risen by 11 per cent in the past year, official figures show.

The rise comes after years of success in tackling the problem, and illustrates growing pressures on the NHS and social services.

According to Department of Health statistics, the number of hospital bed days lost to bed blockers rose from 115,648 during September and October 2010, to 128,517 in the same two month period this year.

That comes after a sustained period of falls between 2003 and 2009, as a result of concerted ministerial action to tackle the problem.

With the average cost of providing a hospital bed for a day estimated at £255, that means the daily NHS bill for bed blockers has risen from £483,000 to £537,000.

Aside from this economic cost, it also means hospitals cannot admit new patients as quickly, which can delay waiting times for pre-planned operations.

The statistics confirm what many have been fearing for months: that reductions in local authority social care budgets would quickly lead to clogged up hospital wards.

In February Bupa warned that “chronic under-funding” of care home places would lead to an “intolerable” bed-blocking crisis in the long term, costing the NHS millions of pounds a day.

Oliver Thomas, director of UK care homes for Bupa, said last night: “If you slow down the number of people placed in residential care, because you are trying to manage your budgets better, then inevitably people will stay longer in the acute sector.”

Others described the latest figures as a “warning” of worse to come and a “pinch point”.

Jo Webber, of the NHS Confederation, which represents health service authorities, said: “This is a worrying sign of the pressure which is building in the system. Like waiting times, it is a pinch point.”

Last month The Daily Telegraph reported that government funding for nursing homes and home help for pensioners had been cut by almost a fifth, with some councils cutting spending by up to 30 per cent.

At the same time many hospitals are cutting hospital bed numbers, by up to 10 per cent, in part to meet tough efficiency saving targets.

Dr Ian Donald, of the British Geriatrics Society, said: “The trouble is hospitals operate on such tight margins. Even small delays can cause problems.”

The term ‘bed blocker’ tends to imply the patient is the cause of the problem, but Dr Donald emphasised that was not the case.

“Delayed discharges are not just statistics, but individual patients who are frail and vulnerable. “To them and their families it can feel like they are stuck and lost in the system,” he said.

The new figures follow the introduction in August 2010 of a new monthly reporting system for counting ‘delayed discharges’ – incidents when an otherwise healthy patient is kept in due to lack of community care facilities – brought in due to concerns over quality of data.

From: http://www.telegraph.co.uk/Bed-blocking-rise-of-11pc-in-last-year

Amy Winehouse was killed by alcohol- the UK’s favourite drug

Death by misadventure was the verdict at the inquest of Amy Winehouse, who died in July.Amy Winehouse was killed by alcohol- the UK's favourite drugOn the afternoon of July 23, the day Amy Winehouse died at the age of 27, a friend rang me with the sad news, saying: “Shows just how deadly heroin is, doesn’t it?” I replied that heroin certainly can be dangerous but that far, far more people kill themselves with booze, with nothing added, than die of taking heroin.

Either they die of a slow disease, like cirrhosis of the liver, or the booze can kill them there and then by poisoning them, depressing their central nervous system until everything stops.

Why did it have to be so called illegal drugs that killed her?

As an example of acute alcohol poisoning, I mentioned (in a blog I wrote that day) the sudden death of Dylan Thomas: his post mortem pointed to “insult to the brain”, caused by alcohol. Supposedly, Thomas had drunk 18 straight whiskies, which is about 36 single measures of whisky in British terms.

Winehouse’s friends had spoken of her having been so drunk, earlier that week in July, that she couldn’t stand. Later her boyfriend, Reg Traviss, and members of her family made it clear she had not taken illicit drugs for some time.

Today the coroner has spoken: the poor singer’s blood contained 416mg of alcohol per decilitre*. “The unintended consequences of such potentially fatal levels,” said the coroner, “was her sudden and unexpected death.”

Professor Suhail Baithun, a Home Office pathologist, said people start losing their faculties at 200mg of alcohol per decilitre, and “when you have levels of 350mg, it is associated with fatalities”.

Why do we always assume illicit drugs are responsible in these sudden deaths? Sometimes they are, obviously. But I also think we blame drugs because they’re strange and frightening, and we don’t like to think of booze like that, we don’t like to think of it as deadly stuff.

Booze is supposed to be our friend, it’s part of our culture, it helps us to relax. Many of us couldn’t cope with life’s daily challenges without it. It is, in the words of those bossy health education campaigns of old, “our favourite drug”.

We prefer not to think about what it can be — a strong poison that kills in overdose.

*This has been expressed in most news reports as five times the drink-drive limit. In Britain the drink-driving limit is normally given in milligrams per 100 millilitres (one deciliter) of blood, or, most commonly, in micrograms per 100 millilitres of breath. The drink-driving limit is 80 milligrams of alcohol per 100 millilitres of blood. It’s certainly a lot of alcohol.

From: http://blogs.telegraph.co.uk/amy-winehouse-was-killed-by-alcohol-our-favourite-drug/

NHS 111 health direct number- 1 in 8 calls unanswered

One in eight calls to the NHS’s new non emergency health direct phone number are going unanswered, amid reports people are having to wait over half an hour.NHS 111 health direct number- 1 in 8 calls unansweredMinisters want 111 to be the only number people need to call in England, “if you urgently need medical help or advice but it’s not a life threatening situation”.

But a pilot in four areas – Luton, County Durham and Darlington, Lincolnshire, and Nottingham – is highlighting worrying problems.

Official statistics show that in September, 12 per cent of calls went unanswered.

Across the four areas there were 33,707 calls to the service.

The Department of Health expects 12 million calls a year to the free 111 number in England, based on scaling up that figure.

Writing on the NHS’s own web page about the 111 number, one caller expressed frustration at being unable to get through despite waiting 35 minutes.

“All I wanted was a bit of advice. I now need to go to work and have had no help from anyone,” the caller wrote. “I had the sense to take pain killers myself, hope this new service gets better.”

A month ago Andrew Lansley, the Health Secretary, announced that 111 would be rolled out nationwide by April 2013, abolishing the concept of “out-of-hours” care. It is also meant to encompass NHS Direct.

The Department of Health claimed the September statistics showed an “encouraging picture”.

A spokesman said: “Lessons learned from the pilots will ensure that when the service is rolled out nationally it will provide people with a first class service.”

He added: “We know that unanswered calls are usually callers who get through to the NHS 111 message and hang up. This could be because they wanted to speak to their GP practice, but it was still in the ‘out of hours’ period and they were therefore transferred to NHS 111.

“This figure does not mean patients are receiving a poor service.”

A spokesman for NHS Direct echoed this, saying the vast majority of the 12 per cent of unanswered calls were of people who chose to hang up, after learning they were being put through to the 111 service when they wanted to speak directly to their GP.

From:  http://www.telegraph.co.uk/NHS-111-number-1-in-8-calls-unanswered

Weight loss diets work better with WeightWatchers than the NHS

NHS weight loss programmes are more expensive and less effective than WeightWatchers, a study has found.Weight loss diets work better with WeightWatchers than the NHSDiet programmes such as Weight Watchers, Slimming World and Rosemary Conley are cheaper and far more effective than those run by the NHS’s nanny state, according to new research.

Dieters lost more weight and kept it off for longer by joining a slimming club than after having counselling from specially trained staff in GP surgeries or pharmacies, it was found.

Experts said money would be better spent on encouraging people to attend classes run by commercial companies.

The study, Comparison of range of commercial or primary care led weight reduction programmes with minimal intervention control for weight loss in obesity is published online in the British Medical Journal (BMJ), involved 740 obese or overweight men and women recruited from one NHS trust in Birmingham.

They were divided into six groups and attended either Weight Watchers, Slimming World, Rosemary Conley, a group-based NHS programme run by advisers and dieticians called Size Down, one-to-one counselling sessions in GP surgeries, or one-to-one counselling in pharmacies.

Another group was provided with 12 vouchers for free entrance to a local fitness centre.

At 12 weeks, data was available for 658 of the participants and 522 after one year.

All programmes achieved weight loss at 12 weeks – from an average of 1.37kg in the GP group to 4.43kg in the Weight Watchers group.

But the NHS programmes were found to be no better than the people exercising at a local fitness centre at this point.

At the one year mark, all the programmes except the GP and pharmacy groups had resulted in “significant weight loss”.

However, Weight Watchers was the only programme to achieve significantly greater weight loss than the control group – and was the best attended group.

Compared to the NHS programmes, commercially-run ones meant people typically lost an extra 2.3kg.

The authors, from the University of Birmingham, the Nursing and Midwifery Council and NHS South Birmingham concluded: “Commercially provided weight management services are more effective and cheaper than primary care based services led by specially trained staff, which are ineffective.”

A spokesman for the Department of Health said: “Weight management programmes can be very cost-effective and make losing weight easier for some people, but the best way to lose weight will be different for everyone.

“The local NHS must think about which weight management service will work best based on an individual patient’s needs.”

In September, another study conducted in the UK, Germany and Australia showed that a year-long Weight Watchers programme was far more beneficial than helpful doctor’s advice.

That study was published in The Lancet medical journal.

Glasgow Royal Infirmary protest at PFI parking fee hike

Health workers at a Glasgow hospital are staging a protest later over a 113% increase in parking fees.Glasgow Royal Infirmary protest at PFI parking fee hikeThe monthly cost of a permit for the multi-storey at Glasgow Royal Infirmary (GRI) has risen from £42 to £89.50.

Parking fees at most Scottish hospitals were abolished in 2009 but remained at three sites where car parks were built under Labour’s Private Finance Initiative (PFI) .

NHS Greater Glasgow and Clyde said a limited number of £25 permits were available for staff who needed cars.

The multi-storey car park, which opened in 2005, is owned by Impreglio Car Parking and managed by Apcoa under contract to the health board.

Approximately 940 subsidised permits are issued with priority given to staff such as consultants who need to travel between different sites.

Other staff can apply for these permits, but demand outstrips availability and not all applicants are successful.

At the time, Scottish Health Secretary Nicola Sturgeon urged health boards to limit and reduce the charges until the contracts came to an end.

In September, the issue was raised in the Scottish parliament by Glasgow Kelvin MSP Sandra White.

She was told that the first minister sympathised with the staff, but the Scottish Government was bound by the terms of the PFI agreement signed by the previous Labour administration.

A spokeswoman for NHS Greater Glasgow and Clyde said: “Unfortunately, as the car park is privately-owned, we do not have any control over any tariff increases that Impreglio choose to make.”

The protest was due to take place at the hospital car park from 13:00.

From: http://www.bbc.co.uk/news/uk-scotland-glasgow-west-15622723