What happened to the Saturday surgery?

By Simon Cox and Richard Vadon

BBC Radio 4, The Investigation

What would you do if you were ill on a Saturday morning?

If you think you would go to your local GP's Saturday surgery we would advise you to check.

The Saturday surgery used to be a staple of British medical life.

It may have been just a few hours on a Saturday morning, but it helped fill the gap from Friday night until Monday morning.

Today finding a local GP whose surgery opens on Saturday is hard work.
f you go on the NHS website you can search for doctors who open their surgeries on Saturday.

According to the website there are 100 Saturday surgeries in London alone.

The Radio 4 series "The Investigation" called every one of the GPs on the list to find if they really did still open on Saturdays.

The results were clear: only eight of the surgeries actually did so. In total there are 1,300 GP practices in London.

SO WHAT DO YOU DO............................YOU GO TO A&E AT YOUR LOCAL HOSPITAL, THE GOVERNMENT WANT TO RECONFIGURE THESE, SO THEY COULD BE CLOSED AT WEEKENDS TOO, SO THE ANSWER...........................
DON'T GET ILL AT THE WEEKEND.....................................!
 

Dentists 'turning away patients'
By Nick Triggle
Health reporter, BBC News


Dentists are turning away patients because local health chiefs are running out of funds, dental leaders say.
A new dental contract started last year, but early figures suggest the government overestimated how much money would be taken in patient fees.
NHS trusts have begun to cut their budgets in response and the British Dental Assocation said this has led to some dentists refusing patients care.

A government memo has urged health chiefs to get to grips with the issue.
The memo and many trusts say dentists are treating more exempt patients than expected - children and those on low income do not have to pay for care.

Under the contract, many adult patients make a contribution towards the cost of their treatment.

The Department of Health said trusts should be making £630m from these fees, making up a quarter of their entire dentistry budget.

But health chiefs have now started warning they will not make enough, leading to cuts in budgets.

Health chiefs in Yorkshire, London, Surrey, East Anglia and the Midlands have all reported problems.

This has had two consequences - firstly trusts have not been able to expand services as much as expected and secondly dentists have been denied funds to treat patients.

The contract, which started in April, was designed to expand NHS services amid reports many patients were being forced to pay for treatment privately.
Cambridgeshire - Shortfall predicted to be £2.2m - 25% of what county expected to make in fees. Managers said "significant" problems being reported across country.

YET ANOTHER GOVERNMENT LED MESS UP
THE PCT SINCE IT'S MERGER HAS BEEN IN DEFICIT WITH LITTLE CHANCE OF BALANCING THE BOOKS
UNDER THE CURRENT FUNDING SYSTEM SO.........
CUTS &  SEVERE ONES ARE BEING MADE......

Ministers warned over NHS schemes
Ministers must keep a closer eye on big NHS building projects after incompetent local health chiefs caused the collapse of a £900m scheme, MPs have said.

The public accounts committee said the government had left the Paddington Health Campus project to local managers who were "out of their depth".

The project, designed to merge three north-west London hospitals, was abandoned after costs rose by £300m.

The government said it had already introduced tighter checks on schemes.


TOO LATE FOR HINCHINGBROOKE, THE NOOSE IS ALREADY AROUND IT'S NECK AND THEY ARE TIED UP IN A TIGHT CONTRACT FOR 30 YEARS.......HOW
MANY MORE TRUSTS WILL FIND THEMSELVES IN A SIMILAR POSITION?
 

BMA team 'stunned by GP contract'

GPs were so stunned by the terms offered to them when negotiating their new contract that they thought it was a "bit of a laugh", a doctor has said.

Dr Simon Fradd, who was one of British Medical Association's GP negotiators, said they were shocked by the approach taken by the government.

They could not believe it when GPs were given the chance not to do evening and weekend work for a 6% pay cut, he said.

Since the deal started in 2004, average GP pay has topped the £100,000 barrier.

While doctors now make less in basic pay - about £55,000 on average - they have been able to top-up their earnings by hitting targets under a performance-related bonus scheme
Opponents have often criticised the government, claiming they mishandled the contract, which is now contributing to NHS deficits.


Earlier this month, Health Secretary Patricia Hewitt admitted she wished the government had capped the profits doctors could take out of the practices because of the soaring sums.

Dr Fradd was part of the negotiating team representing the British Medical Association during the two years of talks between 2001 and 2003, although he is no longer on the BMA's GP committee.

Interviewed for BBC Radio 4's The Investigation, which will be aired on 1 February, Dr Fradd said doctors had never believed the government would be willing to allow them to opt out of out-of-hours care.

And when they did, he was surprised the NHS Confederation negotiating team, acting on behalf of the government, was only asking for a 6% cut in pay.

He added: "We got rid of it for effectively 6% of the value of the contract. It was just stunning. Nobody in my position had ever believed we could pull it off but to get it for 6% was a bit of a laugh."

Budget

Since the contract came in, nine out of 10 practices opted out of providing care.

NHS trusts have put alternative arrangements in place, but hospital A&E departments have reported an increase in patients.


In a separate interview, he told the BBC that he still thought the contract offered good value for money for patients as GPs were still taking up a relatively small part of the NHS budget.

"I think the government underestimated how much out-of-hours care was worth, but there are other parts of the contract, such as performance-related pay, which were harder to sell to doctors."

Looking back on the new contract, NHS Confederation chief executive Gill Morgan said she felt there were too many sweeteners in the deal offered to GPs. "I think it is always easy to underestimate how strongly GPs respond to an incentive that gives them money."

Dr Hamish Meldrum, chairman of the British Medical Association and a member of the BMA negotiating team, would not reveal how much the negotiators would have accepted when it came to the opt out although he said it was "not a sticking point".

"There were areas of the package where big concessions were made. We agreed to other providers in general practice and the other one was performance-related pay."

The Investigation, BBC Radio 4, 2000 GMT, 1 February, 2007.

 

Call to reform NHS charge system
By Nick Triggle

BBC News, health reporter

Health boss explains

Most NHS prescription charges in England should be scrapped and applied to 'ineffective treatments' instead, NHS public health chiefs say.

The Association of Directors of Public Health said rising demands on the NHS will lead to more rationing.

Their president, Dr Tim Crayford, said "If NHS charges should be applied at all, they should be applied to relatively ineffective treatments."

He gave tonsil removal and varicose vein surgery as examples.

"Medicine and treatment that people need for health reasons should be free. But where there's little proof of clinical benefit, the use of such treatments would reduce more quickly if they had a price tag attached," Dr Crayford added.

Doctors' representatives said more NHS care should be rationed, but they were against charging.
Dr Tim Crayford, president of the association, which represents NHS trust public health directors across the UK, said since 1998 spending on cataracts had increased by 40% to £200m, while the cost of hip operations had risen a third to £300m.
"What is wrong with asking people to contribute for some care which is not life-saving - much as we do with dentistry?.

"For operations such as cataracts and hip operations we need to decide at what point in people's lives these operations should be done.

"The Association is calling for a debate on issues such as this to allow the public to decide how the NHS's limited resources are spent.

"If the public agree a threshold what about people below the threshold? Our argument would be that below that threshold they should be allowed to contribute towards the cost as they would with a filling.

"The thing with hip and cataract ops is that they have become more common as waiting lists have fallen and surgery improved, so we have to ask ourselves is it better if patients are asked to wait until their level of pain or blurred vision is more acute.

"The NHS will not be able to do everything in the future."

Benefit


Dr Crayford also said the health service was currently carrying out a small proportion of care which had little medical benefit.

He said procedures such as certain types of plastic surgery, orthodontic surgery, and varicose vein surgery should not be widely available in the future.

"As the elderly population grows and more medical breakthroughs are made, it is clear we are going to have to think about what the NHS is there for and what it is providing."

The British Medical Association is currently drawing up proposals about what the NHS should be providing and will discuss the issue at its annual conference later in the year.

Jonathan Fielden, chairman of the BMA's consultants committee, said it was an important debate.

"We are already rationing the procedures we do, cosmetic surgery is not carried out on the NHS, and the drugs which are used are restricted.

"And I think there is scope to include other things such as varicose veins and hernias in that.

"But the question is how far do you go? If you include hips and eyes I think you are breaking with the traditional values of the NHS, I wouldn't agree with that."

But Professor John Appleby, chief economist at the King's Fund health think tank, said: "I do not buy into these doomsday scenarios. How much extra demand is there going to be on the NHS?

"I don't think there are any miracle drugs in the pipeline and as for the people living longer, what matters most is how close you are to death, not how old you are.

"We consume the most health resources in the last year of life whether that is at 50 or 80."

Professor Appleby also said it was likely there would be public appetite to increase the amount spent on health to keep pace with increasing demands.

Nigel Edwards, director of policy at the NHS Confederation, said: "The issue is quite rational; after all, care is already rationed and we already make a contribution to dentistry, but it is a very emotive and political subject.

"In the end it is going to have to be decided by a public debate and it will be the public which should decide what the NHS does."

 

Choose and Book and the Healthcare Commission's action plan.
The best and worst performing StHAs have given updates at their board meetings on progress towards the March target for 90% of outpatient referrals to be made through Choose and Book. NHS East of England, the country's worst performing StHA, revealed that it had booked just 20% of November outpatient appointments using CaB - significantly less than that month's planned trajectory of 70%. Meanwhile NHS North East, the country's best performer booked 39.5% of outpatient appointments with the system. It admitted its performance report that 'progress continues to be slow' and warned there was a 'medium risk' it will not meet the target.



http:/ / www.nursingtimes.net/ nursingtimes/ pages/ Home

THE ABOVE DOES NOT SURPRISE AFTER THE CATASTROPHE THAT I HAVE EXPERIENCED WITH CHOOSE & BOOK, SUCH AN ORGANISED CHAOS AND WASTE
OF TAX PAYERS MONEY YET AGAIN................THE G.P'S TELL ME OF THEIR PLIGHT
HAVING TO CHOOSE THE CHEAPEST TREATMENT BECAUSE OF THE PCT DEBTS
AND YET THE SHA CAN APPOINT A COMMUNICATIONS DIRECTOR ON £90,000 SALARY...............ABSOLUTELY PERVERSE
 

Bill to abolish patients' forums criticised as "disgraceful". A UK government bill to reform the way patients and the public participate in decisions about local health services had its second reading this week in parliament, where it faces opposition from the Conservatives and Liberal Democrats. The Local Government and Public Involvement in Health Bill will abolish patients' forums and replace them with local involvement networks (LINks). It will also modify the duty to consult the public about changes in health service provision. In the place of patients' forums, local authorities will be put under a duty to make contractual arrangements for the involvement of people in the commissioning, provision, and scrutiny of health services and social services. LINks will cover social care services as well as health, will be established for a geographical area, and will decide locally how members will be appointed and how others will contribute.



http:/ / www.bmj.com/ cgi/ content/ short/ 334/ 7586/ 177 ?etoc

THIS IS A BIT OF AN ISSUE BUT I AM INFORMED THAT THE NEW LINks BODIES WILL
HAVE MORE POWERS THAN THE PPI HAVE AND OVERALL MORE RESPONSIBILITY, WE
NEED TO MAKE SURE THAT THE RIGHT PEOPLE ARE IN PLACE TO HELP SHAPE LOCAL
HEALTH CARE

 

NHS 24 helpline sued over death

A woman is suing the NHS 24 helpline service for £750,000 in damages over the death of her partner.

Father-of-two Steven Wiseman died in December 2004 at the age of 30 after complaining of flu-like symptoms.
His partner Kerry Robertson, from Laurencekirk in Aberdeenshire, is now seeking compensation.
It is thought to be the first time legal action has been taken against NHS 24, which said the service had improved since Mr Wiseman's death.
NHS 24 said it had been in contact with Ms Robertson's legal team but could not comment further on the action as it was now a matter of legal process.

Toxic shock

Ms Robertson called NHS 24 about Mr Wiseman three times over three days before his death.
She said she was told that it sounded like he had flu.
At one point Mr Wiseman had to crawl in pain from his sickbed to answer questions over the phone.

He later died in hospital from toxic shock.
Ms Robertson was one of the people to give evidence at a lengthy joint fatal accident inquiry in Aberdeen, which also examined the death of Aberdeen teenager Shomi Miah.
The 17-year-old had been told by nurse advisers to take paracetamol for flu-like symptoms, but later died from meningitis.
Sheriff James Tierney said the system had failed Mr Wiseman and Ms Miah by not identifying their life-threatening conditions.

Ms Robertson told BBC Scotland: "Money's not important although it's going to help the kids.
"It's just the fact that we haven't had an acknowledgement from NHS 24 to say that they were in the right or the wrong and we've had no apologies.
"And they've stated that they don't want to make an apology because they think that they haven't done anything wrong."

Next move

An NHS 24 spokeswoman said: "NHS 24 has been in correspondence with Miss Robertson's legal team and as this is now a matter for legal process we are unable to comment further at this time."
Ms Miah's family is also said to be considering legal action.
her brother, Khalis, 29, said: "We are talking to our lawyers and discussing our next move.
"We've tried to approach NHS 24, but they're not responding. It's absolutely disappointing."

NHS DIRECT - ANOTHER POORLY FUNDED IDEA FROM THE GOVERNMENT, SO IF THEY CAN'T GET THIS RIGHT HOW CAN THEY GET "CARE CLOSER TO HOME RIGHT" THE "MODEL" THAT THE GOVERNMENT HAVE ON NHS REQUIREMENTS IS BASED ON POPULATION NUMBERS NOT POPULATION NEEDS.......................
SO TO HAVE A CALL CENTRE GIVING YOUR DIAGNOSIS FROM AFAR WE SHOULD ALL FELL BETTER?
ASK MY WIFE, HER STORY IS IN A PREVIOUS POST, HER TUMMY UPSET( AS DIAGNOSED BY NHS DIRECT) TURNED OUT TO BE A BURST OVARIAN CYST AND IF I HADN'T HAD GOT HER A GP VISIT AND AN AMBULANCE SHE WOULD NOT HAVE LIVED.......................SAVED BY HINCHINGBROOKE HOSPITAL BUT PUT IN AN UNECESSARY POSITION BY A CALL CENTRE EMPLOYEE, SHUT IT DOWN AND HAVE MORE HOSPITAL BASED "WALK IN "CENTRES....................YOU KNOW IT MAKES SENSE



 

Patient forum changes 'will fail'

Changes to how the public has its say on the running of the NHS are set to fail because of a lack of funding, leading doctors have said.



The British Medical Association said the structure of Local Involvement Networks (Links) was flawed and open to unacceptable variations.

The Conservatives have also criticised the groups, which will replace the existing patient
forums in England.



But the government said Links groups were more suited to the modern NHS.

Links groups will differ from patient forums by covering a geographical area, rather than being connected to a specific NHS body.




They will also cover both health and social care, be able to inspect NHS premises and work more closely with the voluntary sector.



Local variation



The BMA views are outlined in its response to a Health Select Committee inquiry on public and patient involvement in the NHS.



It said the proposals for Links, currently going through parliament, would mean fewer groups to represent patients.



And it warned the suggested £100,000 and £150,000 funding for each group will
not be enough to pay for staff salaries, premises and running expenses.



Plans to allow Links groups to be run locally could also mean variations in quality and the possibility that they could be dominated by special interest groups, the BMA said.

Juliet Dunmur, deputy chairwoman of the BMA Patient Liaison Group, said: "Many people would like a say in how their health services are run, but have never been given the opportunity.



"If Links are to have any real influence they will need much more support than their predecessors ever received."



And Katherine Murphy, of the Patients Association, said there had been too much change in how patients' views were represented in the NHS, with the closure of Community Health Councils and now patient forums.



"Why can't we just stand still and give these bodies time to make a difference?"



But a Department of Health spokeswoman said: "The current arrangements to support a stronger patient voice were designed to fit the health service five years ago.



"Since then, the NHS and social care system has changed and it is now time to strengthen peoples' voices further."



Shadow Health Minister John Baron criticised the way the plans for Links were added to the Local Government Bill rather than being included in health legislation.



'Day-to-day meddling'



In a separate development, the NHS Confederation, which represents the managers of most NHS organisations published an Ipsos Mori survey showing only 9% of those questioned thought politicians should have a say in which treatments are funded by the NHS.



The poll of just under 1,000 people found 70% think doctors should have a say, while 33% want patient representatives should be involved and 23% that managers should have a say.



Dr Gill Morgan, chief executive of the NHS Confederation, said clinicians and managers were working hard to meet the needs of patients within a system with "finite resources".



"It is reassuring to see, therefore, that the public believes it is clinicians, patient representatives and managers who are best equipped to make these tough choices - not national or local politicians."



The Conservatives said the NHS did not need "day-to-day meddling" from politicians.



Liberal Democrat health spokesman Norman Lamb said: "Any independence from politicians must go hand in hand with genuine accountability to patients and the wider community.



A Department of Health spokesperson said: "NICE was established precisely to make difficult decisions on the basis of the evidence and free from political interference."

 SOUNDS LIKE THE WORD UNDERFUNDED COMES TO MIND YET AGAIN

Afghan poppies 'could help NHS'

By Adam Brimelow

BBC News, health correspondent


Leading doctors say Afghanistan's opium-poppy harvest should be used to tackle an NHS shortage of diamorphine.

The British Medical Association says using the poppy fields in this way, rather than destroying them, would help Afghans and NHS patients

Diamorphine, also known as heroin, is used to relieve pain after operations and for the terminally ill.

But the UK and Afghan governments reject using the poppy fields to address the UK's diamorphine shortage.
However, UK doctors say the diamorphine shortage is getting worse, leaving them reliant on less effective, more expensive alternatives.

Dr Jonathan Fielden, a consultant in anaesthesia and intensive care medicine in Reading, said: "Unfortunately over the last year in particular, the availability of diamorphine has dramatically reduced.

"It's not clear why this is, but it has got to the stage where it is almost impossible in some hospitals to get hold of this drug for use outside very specific circumstances.

"This is a great shame because it is such a good drug".
IRONIC DONT YOU THINK.........................
THE GOVERNMENT SPENDING £540M TRYING TO DESTROY THESE FIELDS AND WE
NEED THE PRODUCT OF THEM FOR OUR NHS FOR WHICH THE GOVERNMENT CLAIM
IS £500M IN THE RED....................MAKES NO SENSE......................


 

Can NHS targets really be scrapped?

The Tories want to get rid of NHS targets. But is it as easy as it sounds?


In saying they will scrap NHS targets, the Tories may have picked on the "bete noire" of the health service.

Leader David Cameron said instead of focussing on targets such as waiting times he would look to improve what matters most to patients - the results of treatment.

 Unsurprisingly, many of those working in the health service have welcomed the move.

Dr Jonathan Fielden, chairman of the British Medical Association's consultants committee, said: "The government's obsession with crude targets has, in many places, distorted clinical priorities and ignored the health outcomes of patients."

And Dr Gill Morgan, chief executive of the NHS Confederation which represents over 90% of NHS organisations, added: "This is an important step in the right direction for health policy.

Culture

"Both the target culture and the NHS payment system incentivise outputs as opposed to outcomes.

"So we measure how many hip operations we perform, but not whether the patient actually has better mobility afterwards.

"We need to radically overhaul the way that we measure success in the NHS, by putting patient satisfaction and outcomes at the heart of a new approach."
But many experts believe this is not as easy as it sounds.

Jennifer Dixon, of the King's Fund health think-tank, said: "It is easy to criticise targets but they have done a job many patients said they wanted doing - reducing waiting lists.

"If you focus on outcomes, it sounds good, but how will it be achieved? You risk losing focus.

"If you don't have an 18-week waiting target, as we do for 2008, we will never get down to that."

Others believe the move away from "process" targets, like waiting times, to outcomes ones, such as cancer survival rates, is in line with what the government has been doing anyway.


The 2000 NHS Plan contained more than 200 targets but within five years these had been slimmed down to 20.

Focus

Joe Farrington-Douglas, a researcher at the Institute for Public Policy Research, said: "Many of the targets were a product of their time and have since been achieved.

"We are seeing more focus on outcomes, but the trick is picking things that the NHS can affect.

"If someone becomes less healthy, is it the NHS's fault or down to a change in that person's lifestyle?
"The other thing is that it requires the Tories to move away from focussing on things such as waiting lists to attack the government. It may be that some waiting is good if people are going to be treated according to clinical need."

If targets are going to focus on outcomes, there is also going to need to be someone nudging the NHS in the right direction.

The Tories have identified GPs for this role, arguing they should be given control of local health budgets to commission services.

But GPs themselves have given this a lukewarm response, and Ms Dixon believes this is not surprising when their recent track record is considered.

Family doctors already have the opportunity to run local budgets through the government's practice-based commissioning scheme, but little over a third of practices are signed up to it.

Ms Dixon said: "It seems doctors are not that interested in doing this, they just want to get on with the business of being GPs.

"So where is the NHS going to get its momentum from if central control is relinquished?"

THE VAST MAJORITY OF TARGETS CAN BE SCRAPPED ALONG WITH ALL THE STAFF
THAT COLATE THE DATA, HOWEVER IS THIS THE NEW FUNDS THE TORIES WILL
INVEST IN THE NHS?............CUT JOBS BUT LEAVE THE MONEY IN THE SYSTEM TO
REDUCE DEFICEITS?
PROBABLY........................WELL DEFINATELY...................

Fears over new NHS role for firms
Hospitals could be put under threat and the NHS fragmented by a plan to set up private centres
to take over simple procedures from hospitals, doctors say.

Health chiefs in the North West have become the first to start consulting on a new breed of
private clinics to carry out diagnostics and minor treatment.
The Clinical Assessment Treatment and Support centres have been designed to cut waiting lists, officials said.

But doctors warned they could starve hospitals of money.

The specialities covered by the proposed centres are ear, nose and throat, general surgery, orthopaedics, rheumatology and minor treatments, which combined contribute 80% of hospital workloads.

Similar schemes are expected to be put forward elsewhere in the country as the contracts are being negotiated by the Department of Health, with NHS trusts only expected to pay for the services patients use.

 They go a step further than the much-criticised independent sector treatment centres as they have the ability to carry out diagnostic tests.

Primary care trusts in Cumbria and Lancashire are carrying out an eight-week consultation over the centres which will be run by private firms, but paid for out of the NHS purse.

The two preferred bidders which have been chosen are Netcare and Care UK.

WELL WELL WELL, IT ALL COMES OUT NOW IN THE EFFORT OF CASH SAVING YET AGAIN.................BUT IN THE LONG TERM IT WONT..........................
WHEN PRIVATE COMPANIES GAIN CONTRACTS THEY "DO IT ON THE CHEAP" BUT WHAT THEY DO IS GRADUALLY RAISE THE COSTS OF THE SERVICES THEY PROVIDE TO THE GOVERNMENT DEPARTMENT THEY SERVICE AND CUT THE WAGES OF THE EMPLOYEES IN THE NAME OF PROFIT...............THIS HAS BEEN SEEN IN LOCALGOVERNMENT........
AND MOST HAVE GONE BACK TO THEIR ORIGINAL FORMATS 

BY HAVING WORK DONE "IN HOUSE"................BE WARNED............DON'T DO IT........
KEEP IT LOCAL, KEEP IT NHS

Tories aim to scrap NHS targets

David Cameron is to announce plans to scrap many of the government's health targets including those on waiting times, the BBC has learned.
The Tory leader is to unveil the first details of his health policy on Monday.

He will outline plans to set new objectives to measure the effectiveness of treatments and the health of patients afterwards.

He also wants to give doctors greater responsibility for their own budgets and priorities.

'Health results'

The Conservatives say the problem with many of the government's targets is that they simply measure whether patients are treated quickly enough.

They want to set new objectives on survival or recovery rates for serious illnesses.

Former Health Secretary Stephen Dorrell, who heads the group which helped draw up the policy, said patients would benefit from the new targets.

"We have endless forms about process and insufficient focus on the health results that the NHS exists to deliver and it is that focus that we are seeking to shift away from process towards health outcomes," he said.

Dr Hamish Meldrum of the British Medical Association's GPs committee said he would welcome measures to assess how well patients are treated but added he wanted to know more about how the Conservative policy would work.

 STILL WON'T STOP THE PRIVATISATION OF THE NHS.....................
IT WOULD BE NO DIFFERENT IF RUN BY THE TORIES, JUST CHEAPER AS THE STATISTIC'S STAFF WOULD NO LONGER BE EMPLOYED....................
A SPRAT TO CATCH A MACKERAL...........DON'T BE TAKEN IN BY EITHER OF THE 2 BIG POLITICAL PARTIES AS THEY HAVE A DIFFERENT APPROACH TO THE SAME CARVE UP OF THE NHS

PFI firms 'make £23bn NHS profit'

The private sector will make £23bn in profits and interest over the next 30 years by building NHS hospitals, campaigners have calculated.

Under the private finance initiative, a company builds a hospital and then gets "rent" from the NHS for a set term.

A report by the Keep Our NHS Public claims the government is carrying out "patchwork privatisation" of the NHS.

The Department of Health said it "did not recognise the figures" and was "committed to a publicly funded NHS".
Private involvement

The report was being launched at a conference for health campaigners in London on Saturday.
It says: "Unlike the Thatcher privatisations of the 1980s, the whole NHS is not being put up for auction.

"Instead, it is being parcelled up into bite-sized pieces and handed over to private control bit by bit.

"This is happening on such a scale and at such pace as to make it a unique phenomenon."

Alex Nunns, of Keep Our NHS Public, said: "Unbeknown to the public, the NHS is paying astronomical sums of money to the private sector.

"When the NHS is making cuts and closures across the country, it's time to ask if this is the best use of public money."

The sums

As recently as October, the government disclosed some of the figures involved in the NHS's use of PFI schemes to finance new hospitals.

The figures, which emerged in a response to a Parliamentary Question tabled by Shadow Health Secretary Andrew Lansley, showed that the NHS would pay a total of £53bn to the private firms involved.

That amount was the total cost, as opposed to the numbers in the report by Keep Our NHS Public, which relate to profits.

But the Tories claimed at the time that the new hospitals themselves were only worth £8bn, leaving "completely unjustifiable" extra costs of £45bn.

A spokesman from the Department of Health said in response to the new report that the annual payments made by NHS trusts to private sector partners covered financing charges, repayment of capital, building maintenance and, in most cases, all the non-clinical support services like cleaning and catering.

He said the last two of this list could account for between 40% and 50% of the annual payments.

"The NHS has always used the independent sector for treating patients," he said

"But the difference is now that we pay much less for this extra capacity for NHS patients thanks to our robust contracting."

He said more than 250,000 people had received treatment faster than they would otherwise have done thanks to the independent sector.

MAKE YOUR OWN MIND UP HERE, THE 30 YEAR PAY BACK TO THE COMPANIES WHO HAPPEN TO BE THE FRIENDS OF THE GOVERNMENT................
OUR OWN £22M TREATMENT CENTRE IS GOING TO END UP COSTING £93M...............
MIND YOU THE TORIES WOULD BE DOING A SIMILAR PROJECT IF THEY WERE IN CHARGE, STOP FUNDING THE UNECESSARY WARS AND FUND THE HEALTH SERVICE PROPERLY AND DO IT NOW......................
 

GP pay 'should have been capped'

By Nick Triggle

Health reporter, BBC News


The government should have capped the money GPs can make out of their new contract, the health secretary says.

The proportion of profits GPs take out of their practices has increased since the new contract started in 2004, pushing average pay above £100,000.
In an interview with BBC News, Patricia Hewitt said that in hindsight ministers would have wanted to ensure doctors did not take so much in profit.

Doctors criticised Ms Hewitt, saying she was "denigrating" GPs.
Ms Hewitt said: "I think if we anticipated this business of GPs taking a higher share of income in profits we would have wanted to do something to try to ensure that the ratio of profits to the total income stayed the same and therefore more money was invested in even better services for patients."
Statistics from the NHS Information Centre show that GPs took 40% of their gross earnings in profit once expenses were taken away in 2003-4, but this rose to 45% the following year when the contract started.

This contributed to the hike in pay GPs received, with average pay totalling £106,000 - up 30% on the year before.

Family doctors which work in practices with a pharmacy earn even more with reports of some earning over £200,000.

Accountants predict the amount earned in profit in 2005-6 was between £110,000 and £120,000.

Extra services


The new contract was designed to give general practices additional funds to invest in improving and developing services to patients.

It included incentives to reward GPs and their practice teams for driving up the quality of patient care.

A large proportion of GPs' earnings are now linked to the quality of care they provide, with payments made for the provision of extra services, such as contraception, child health and chronic disease clinics.

It also enabled GPs to opt out of night and weekend care

'Taken to the cleaners'

However, Joyce Robins, from the health watchdog Patient Concern, told BBC News that the new contract did not represent "value for money".

"I do think that the doctors' unions took the government to the cleaners with that contract because, I mean, nobody's mentioned that in fact they do a great deal less work," she said.

"They no longer do evenings, no night work, weekend work - this has all got to be paid for somewhere else. -  YES HOSPITAL'S AND THEIR A&E DEPARTMENTS

"And yet their money has gone up quite enormously.

"In fact, I understand that far more GPs are actually retiring early because their pensions have gone up so much that they can afford to do that."

Shadow health secretary Andrew Lansley said: "The government underestimated the number of points GPs would get for treating patients which in a way is really sad because it means the government underestimated the good job that GPs do.

"For Patricia Hewitt to distance herself from the GP contract is a show of how low her own performance has sunk."

Liberal Democrat health spokesman Norman Lamb said: "The government has clearly made a hash of negotiating the GP pay contracts.

"It is not helpful for them to admit incompetence after the event when the problems in the NHS are already mounting. We need an urgent review into the government's approach to such pay agreements in the NHS."

THE MAIN ISSUE HERE IS THAT THE G.P CONTRACT WAS DESIGNED TO ALLOW G.P'S
TO HAVE MORE CONTROL OVER THEIR BUDGETS AND TO EMBRACE THE PROPOSED
CARE CLOSER TO HOME (DOING HOSPITAL WORK IN THE COMMUNITY ON THE CHEAP AND WITH RISKS) HOWEVER THESE UNDERESTIMATED PROFESSIONALS MADE THEIR SALARIES UP AFTER YEARS OF LOW WAGE INCREASES.
BASICALLY HERE THE COMMUNITY CARE ROUTE THE GOVERNMENT INSIST IS THE RIGHT WAY TO GO IS FLAWED, UNSAFE AND WILL BE UNDERFUNDED BECAUSE THEY THOUGHT THAT G.P'S WOULD "DO THE RIGHT THING"
THIS GOES TO SHOW HOW OUT OF TOUCH THE GOVERNMENT ARE WITH THE PEOPLE, THE TORIES ARE JUST THE SAME THOUGH SO IT WOULD BE THE SAME OR WORSE IF THEY WERE AT THE REINS - 
THE REAL DEAL HERE IS THAT THE HOSPITAL NETWORK WAS TO BE RUN DOWN TO SAVE CASH -  NOTHING  MORE, NOTHING LESS -  BUT THIS WILL NOW HAVE TO HAVE A SERIOUS RETHINK AND RE INVESTMENT
 

A&E success 'not sustainable'


A&E departments are struggling to sustain improvements to waiting times because of NHS deficits, doctors leaders warn.

Almost 90% of doctors told the British Medical Association that the lack of inpatient beds was the main reason for not meeting government targets.
They also blamed staff shortages and patients turning up at A&E inappropriately with minor complaints.

Since 2004, 98% of patients in A&E should be seen within four hours.

Around 500 members of the British Association of Emergency Medicine responded to the BMA survey to investigate the impact of the four-hour target, which has been heralded as a success story by the government.

 

The MP, the health secretary, and an unresolved conflict

· Campaign over A&E highlights discrepancy

· Hewitt said to see protests as legitimate response



John Carvel, social affairs editor

Saturday January 13, 2007

The Guardian



Throughout last year, Kitty Ussher, an up and coming Labour MP, fought a high profile campaign to save the accident and emergency department at the NHS hospital in her Burnley constituency.



It was slated for closure and there were fears among the townspeople that lives could be lost if they had to be taken in an emergency to the hospital in Blackburn.



In June, Ms Ussher led local protesters on a delegation to London to plead their case with Patricia Hewitt, the health secretary. It may not have been too difficult for the 35-year-old MP to gain access to the minister. For three years, while Ms Hewitt was trade and industry secretary, Ms Ussher was her special adviser.

 

Revealed: the 11 government ministers fighting NHS cuts





Solicitor-general and two of Hewitt's own team have campaigned against closures



John Carvel, social affairs editor

Saturday January 13, 2007

The Guardian

At least 13 members of Tony Blair's ministerial team have campaigned over the last few months against closure of services at NHS hospitals used by their constituents, a Guardian survey has revealed.

The hitherto unrealised scale of opposition within the government's ranks to the consequences of NHS reform reflects the difficulty Patricia Hewitt, the health secretary, faces in selling her policies to the nation. Many Labour backbenchers are also showing their dissent by making campaigns to save accident and emergency departments or maternity services the focus of their constituency activities.

 

OBSCENE 
Patients can pay for NHS surgery
Northampton General Hospital offers surgery to patients who pay

A financially-struggling hospital is offering patients the chance to pay up to £6,000 to avoid waiting for surgery.

The local hospital trust has run out of cash to perform the operations at Northampton General Hospital.

Instead, patients who can provide the money can avoid waiting four months for treatments such as hip replacements, which cost around £6,000.

The move has been criticised by the Department of Health, which described it as "completely unacceptable".

One year to save NHS, doctors say


There is just one year left to save the NHS, doctors' leaders warn.

Deficits and the end of record budget rises in 2008 mean the clock is ticking to get the NHS in order, the British Medical Association chairman said.
James Johnson said the public would not understand why cuts were being made once spending was up to the level of the top-spending European countries.

And he said questions may even be asked about how the health system is funded if the problems are not resolved.

But the government has maintained reforms are improving the NHS and the funding problems will be resolved this year.

Over recent years the NHS has been enjoying yearly budget rises of over 7%. Next year that is likely to return to a figure of slightly above inflation.
But Mr Johnson said the NHS was not currently in the position one might expect after years of extra investment.

An awful lot of trusts were in "quite dire financial straits", very big savings were having to be made and people were hearing about wards standing empty and operating theatres not being used, he said.

Mr Johnson also warned that poor workforce planning by the government meant some doctors may be forced to go abroad for work.
Last week a leaked Department of Health document predicted an excess of more than 3,000 consultants in the NHS by 2010/11 that the service could not afford to pay.

Mr Johnson said it was a "disastrous waste of public money" to train doctors only for them to go overseas.

"The whole situation demonstrates an appalling lack of workforce planning.

"It costs around £250,000 to train a doctor plus many more years of specialist training.

"If juniors cannot secure suitable jobs in the future within the NHS they may look overseas for employment. What a disastrous waste of public money."

Questions

And he suggested questions may be asked over whether the NHS continues to provide everything or if people needed to contribute towards their treatment - although this was not BMA policy.

"Don't assume there's anything automatic about the system we have at the moment continuing into perpetuity."

And he added he was very worried that the public health system was "going down the tube".

He said the recent reorganisation of local health trusts, which had seen the number halved to about 150, had seen many public health doctors lose their jobs.

"This will start to hit the drive to tackle obesity, smoking and sexually transmitted disease. All the sort of things we should be doing to prevent ill-health."

Sir Gerry: NHS 'not a business'


Businessman Sir Gerry Robinson has said the NHS should not be treated like a normal business and managers should be allowed to do their jobs properly.

Sir Gerry, the star of a recent BBC TV series to try to cut waiting lists at one hospital, debated the issue with NHS chief executive David Nicholson.

Sir Gerry told BBC's Newsnight he would also look at the amount of money spent on the new NHS computer system.

Mr Nicholson said poor management in some hospitals needed to be addressed.

Treble managers' salaries

Sir Gerry, one of the UK's most successful businessmen, was given the task of cutting waiting
lists at one hospital within six months - with no extra cash - in BBC Two's Can Gerry Robinson
Fix the NHS?

One of his solutions was to treble the salaries of NHS managers.

He told Newsnight: "What other organisation that employs a million people would not genuinely go out and pay the money that it takes to get the very, very best people to run it?

"Why wouldn't you do it when the cost of that money is a row of beans by comparison to the money we spend, £100bn a year we spend, on the service. Of course you'd do that."


Mr Nicholson said there was a question over way some managers dealt with clinical staff.

"In lot and lots of hospitals they're managed extraordinarily well, the relationship between clinicians and managers works very well, in some areas it doesn't and that needs to be tackled.

"You don't tackle it by sending people letters or shouting at them, you tackle it by engaging them in discussion."

'Simplify'

Sir Gerry said most consultants genuinely wanted to do the right thing for the NHS.

"What just didn't seem to be possible was for them to be able to do that... I've never come across it to quite such an extent before, that sense that you simply couldn't change it. That needs to change."

Sir Gerry said the huge size of the NHS was not necessarily a barrier to being able to run it efficiently.

"The NHS is not a business, for God's sake let's simplify the way we get the money down to the hospital, but still manage the hospital so we know whether the hospital is run well and if it's not something happens about it very quickly."


Mr Nicholson said most hospitals had a good management system


He said improving the NHS was not down to constant new initiatives being provided by government.

"I would love to see government pulled out of the equation as much as possible frankly, and
David and his team allowed to get on with it.,"

Mr Nicholson said there needed to a consistency of purpose across the NHS, allowing managers the freedom to make changes at a local level.

"I can't possibly manage the NHS from Whitehall, but what I can do is create an environment where clinicians and managers can work together.

He said the NHS's budget had grown by a third in the last five years, which it received because of the political process, so it was important the system still engaged with the government.

THIS IS REALLY AN EXTENSION OF THE RADIO INTERVIEW ON RADIO 5 LIVE FROM TUESDAY THIS WEEK IT CAN BE HEARD AGAIN OR DOWNLOADED FROM
http://downloads.bbc.co.uk/rmhttp/downloadtrial/fivelive/thedailymayo/thedailymayo_20070109-1700_40_st.mp3
IN THE INTERVIEW SIR GERRY REALLY SAYS WHAT MOST OF THE NHS STAFF
AND THE PUBLIC ALREADY KNOW AND THE GOVERNMENT  AND NHS ACCOUNTANTS AND THEIR ALLIED STAFF DON'T WANT TO ADMIT - WHERE MONEY IS BEING SQUANDERED AND WHERE THE SERVICE CAN BE MADE MORE EFFICIENT AND FIT FOR THE MODERN WORLD, WITH THIS IN PLACE "CARE CLOSER TO HOME" IS A POINTLESS AND CASH GUZZELING EXERCISE BUT THE CONCLUSION IS DON'T CUT SERVICES AND KEEP HOSPITALS OPEN, JUST REMOVE THE UNECESSARY RED TAPE AND FIGURE PROCESSING , 
SIR GERRY SAYS THE NHS 
IS NOT A BUSINESS, IT A A SERVICE AND A PERSONAL ONE AT THAT.............ENOUGH SAID

 

Safety changes 'neglected by GPs'

There is concern for patient safety

Reforms to improve the quality and safety of NHS care are not hitting home in GP surgeries,
says a report from the National Audit Office.

It says many have not implemented 'clinical governance' systems found elsewhere in the health service.

Edward Leigh MP, chairman of the House of Commons Public Accounts Committee, said the current shake-up of primary care trusts should address this.

Health Minister Lord Hunt said a new 'quality framework' for GPs would help.
This once again shows that patient safety is still too far down the NHS agenda

Clinical governance was first introduced in 1998 as a way to drive improvements in the care offered by hospitals, GP practices and pharmacies.
No reporting

In a survey of GPs, three quarters admitted that they did not report "adverse incidents" - events which either did or might have caused harm to patients - to the National Patient Safety Agency, a central plank of clinical governance.

Sir John Bourn, head of the National Audit Office, said: "Good clinical governance is essential if patients and the public are to have greater confidence in the NHS.

"Whilst Primary Care Trusts have made good progress in getting structures and processes in place, there has been less progress in actually implementing the fundamental components of clinical governance, particularly patient and public involvement."

Mr Leigh said: "Many primary care organisations have demonstrated limited progress in implementing the Department of Health's clinical governance agenda.

"This once again shows that patient safety is still too far down the NHS agenda.

"Most NHS organisations that provide or commission primary healthcare services have systems and processes in place to give assurance that the services provided by GPs, pharmacists and others are safe and of good quality.

"But that is a fat lot of good when they all too often fail to apply these systems and processes in practice."

 IF THIS REPORT IS 100% FACTUAL THEN THE NEW "CARE CLOSER TO HOME" SYSTEM BEING PILOTED BY LORD WARNER & HIS BAND OF ASSOCIATES IS JUST NOT SAFE AND WE SHOULD ALWAYS, ALWAYS CHOOSE OUR LOCAL HOSPITAL WHICH IS A CLINICALY SAFE ENVIRONMENT, LETS PUT IT INTO PERSPECTIVE, YOU HAVE A TREATMENT DONE AT HOME & AN ERROR IS MADE (YOU COULD BE UNAWARE AS A PATIENT) AND IS NOT REPORTED THROUGH THE CLINICAL GOVERNANCE SYSTEM AND THERE ARE COMPLICATIONS OF SOME SORT.......................WHY WAS THIS NOT REPORTED?, WHO TAKES THE BLAME?
SO IN ESSENCE CHOOSE YOUR HOSPITAL NOT YOUR HOME OR G.P  SURGERY FOR YOUR OWN SAFETY

NHS trust debt prompts cutbacks

North Yorkshire's health care bosses have approved cost-cutting measures to clear a £45m debt.

The North Yorkshire and York Primary Care Trust is the most overspent organisation in the NHS.

At a meeting in Harrogate on Tuesday managers decided on plans to cut debts within the next three months.

They agreed to measures including some hospitals refusing to treat "trivial" cases in casualty, and delaying some patients' non-urgent operations.

"It's inevitable that these proposals will cause some concern and unhappiness, what we are doing is looking to slow down some areas of activity, and in a small minority of cases, some patients will wait longer for their treatment or surgery."

Cases reviewed

 some patients waiting for non-urgent procedures such as the placement of ear grommets could find their cases being reviewed.

"It depends on the urgency of the case and the view of the GP or referring clinician and certainly the primary care trust is going to put in place an exceptions panel to consider all patient cases based on the individual details for that patient."

 THIS IS HAPPENING HERE IN CAMBRIDGESHIRE, THE PCT IS HEAVILY IN DEBT AND THERE IS NO CLEAR WATER AHEAD WITH THE CURRENT SPENDING PLANS UNLESS YOU AND I THE "CUSTOMER" LOSE OUT ON TREATMENT, MUCH OF IT ESSENTIAL, I MYSELF HAVE BEEN REFUSED TREATMENT RECENTLY BY A TICK OFF PROCESS, AFTER REVISITING MY G.P I HAVE BEEN RE REFERRED DUE TO THE SEVERITY OF MY CASE.........................

Maternity cuts 'a risk to care'

The government has promised mothers choice by 2009

Maternity services are being pared back, putting the care of women at risk, midwives say.

Staff are being cut and training funds raided as the NHS racks up debts, the Royal College of Midwives reported.

A poll of 102 out of 216 department heads found two thirds thought their units were understaffed and one in five had lost staff in the last year.  

The midwives who responded to the survey reported that 66% of their trusts were in deficit in 2005-6.
Of those who had lost staff, the average decrease was 3.5%, with evidence emerging trusts were increasingly relying on maternity support workers, who are not qualified midwives, to fill the gaps.

The college also found trusts were cutting training budgets, with one in five reporting the entire funds had gone and a similar number saying three quarters had gone.

The results come at a time when the government has pledged to improve access to services.
Ministers have promised that by 2009 women will have a choice of where they give birth and have a named individual midwife to care for her.

But the college said the country's 40,000 midwives were struggling to provide good care

ENOUGH SAID, MASSAGING BUDGETS TO SUIT AN END
THIS IS WHY HANDS FOR HINCHINGBROOKE HAS BEEN SET UP TO RAISE FUNDS FOR MATERNITY AND TO KEEP THIS HIGHLY REGARD AND HIGHLY TRAINED UNIT WHICH IS KNOWN FOR IT'S SAFETY RECORD, OPEN AND FULLY FUNDED AND WITH THE CHOICE AS TO WHERE TO GIVE BIRTH IN 2009 WE NEED TO KEEP THIS UNIT OPEN TO ALLOW MUM AND MUM'S TO BE TO HAVE A REAL CHOICE AND TO BE TREATED IN PERSONAL SURROUNDINGS AND BY HIGHLT TRAINED STAFF BOTH IN AND OUT OF HOSPITAL

Slash & Burn

"NHS 'on track' to balance books"


The NHS is "on track" to break even within three months but jobs will be cut, the health secretary has said.
Patricia Hewitt did not specify how many redundancies there would be However, there would "some reduction" in jobs for administrators, although staff retiring or moving to other areas could account for some of the decrease.

The NHS ended the financial year 2005-06 more than £500m overdrawn.

Ms Hewitt said she was "confident" of the NHS balancing its books.

"I have made it clear that we do need to get the NHS back into financial balance by the end of March," she said

WELL THIS WILL ONLY BE DONE BY JIGGERY POKERY AND MANIPULATION OF FIGURES TO SUIT WITH NO CARE ABOUT PATIENTS

 

Call for shorter hospital stays

Keeping patients in hospital too long takes up the equivalent of 13,000 beds a year and costs £1bn, a think-tank has estimated.

The Institute for Public Policy Research (IPPR) says the bed space and money could be saved if more care was provided outside hospital.

Cutting the number of locations where specialist services are offered would also help, it said.

The Department of Health said parts of the NHS could be more efficient.
The IPPR report uses figures from the independent NHS Institute for Innovation & Improvement, with additional analysis by Dr Foster Intelligence.

 THE GOVERNMENTS BIG BUDDIES ARE AT IT AGAIN - DROPPING THIS INTO THE MIX WHILE THE CARE CLOSER TO HOME PILOT'S ARE BEING RUN PRIOR TO THE STEERING GROUPS REPORT TO LORD WARNER
THIS SOUND'S OKAY IN PRACTICE BUT IN REALITY CARE IN THE COMMUNITY IN IT'S CURRENT FORMAT IS GROSSLY UNDERFUNDED AND SHOULD THE DEPARTMENT OF HEALTH PUSH MORE INTO THIS AREA THEN WHO WILL GUARANTEE THE CORRECT FUNDING FOR THIS?
IF YOU, USING THE VISION OF THE LOCAL PCT & THE DOH, PUT MORE CARE OR WHAT SHOULD BE  CALLED TREATMENT INTO THE COMMUNITY THEN THERE HAVE TO BE THE
EXTRA COSTS AND RISKS ASSESSED, YOU WILL HAVE TO PROVIDE VEHICLES FOR PRACTITIONERS, IF THEY WERE NOT PAID TO USE THEIR OWN, SO MORE TRAFFIC ON BRITAIN'S ALREADY CONGESTED ROADS, PROVIDE MOBILE COMMUNICATION FOR LONE WORKER SAFETY, 
AGREE THE 
AMOUNT OF VISITS PER DAY FOR EACH PRACTITIONER, BE AWARE OF RISKS FOR
THE SAFETY OF THESE PRACTITIONERS OF THEY ARE CARRYING DRUGS OR MEDICAL SUPPLIES SO THIS IS JUST THE  START OF IT THERE MUST BE MORE CLINICAL ISSUES THAT THE MEDICAL WORKERS CAN IDENTIFY AS PROBLEM AREAS BUT THE CRUX OF THE MATTER IS...............WHERE IS THE SUSTAINABLE FUNDING FOR THIS OR IS IT JUST ANOTHER SMOKE SCREEN AND GOAL POST MOVING EXERCISE TO MASSAGE THE BOOKS TO ALLOW MINISTERS AND THE GOVERNMENT TO LOOK GOOD IN THE EYE'S OF THE PUBLIC?

MAKE YOUR OWN MINDS UP BUT REMEMBER IT'S YOUR CHOICE AS TO WHERE YOU HAVE YOUR TREATMENT, ACT NOW BEFORE THEY CLOSE THESE BUILDINGS SO THAT YOU CAN ONLY HAVE YOUR TREATMENT DONE IN THE G.P'S OR IN YOUR OWN HOME

NHS waiting lists are lowest ever

NHS waiting lists in England have fallen to an all-time low according to Department of Health figures.

Between October and November 2006, NHS inpatient waiting lists dropped by 8,000 to 769,000.

This meant the number of patients waiting for treatment was the lowest since the records began in 1987.

However, Liberal Democrat Shadow Health Secretary, Norman Lamb MP said the figures should be taken with a "strong note of caution".


He said: "The government's emphasis on bringing down waiting times above all else has pushed many hospitals into the red as they are forced to manipulate resources to meet strict targets.

"Patient care can also suffer as resources in some hospitals are diverted solely to meet waiting time targets."
IT IS NO WONDER THE LISTS HAVE BEEN CUT WHEN APPOINTMENTS ARE BEING CANCELLED AND G.P'S ARE NOT REFERRONG PATIENTS TO HOSPITALS -
MY OWN PRE ARRANGED APPOINTMENT HAS BEEN CANCELLED SO THE PROCESS TO GET REFERRED BEGINS AGAIN - YES ONE WAY OF MASSAGING FIGURES TO MAKE THE BOOKS LOOK GOOD BUT ON TOP OF THIS AND EMPLOYEE OF HINCHINGBROOKE HOSPITALS RELATIVE VISITED HER G.P AND WAS TOLD THAT SHE COULD NOT BE REFFERED TO HER LOCAL HOSPITAL - YET ANOTHER WAY TO CUT WAITING TIMES , NOT ALLOWING PATIENTS TO VISIT HOSPITALS, THIS ESPECIALLY WHEN THE SHA DENIED IN PUBLIC THAT G.P'S WERE BEING NOT DIRECTED AS TO NOT TO REFER TO HINCHINGBROOKE, CLEARLY THIS IS UNTRUE AND A DIRECTIVE HAS BEEN ISSUED BY ONE DEPARTMENT, BE IT DOH, SHE OR THE NEW PCT - BUT WHO WILL OWN UP TO IT?

 

Shortage of NHS staff predicted

Job cuts are proposed at NHS trusts across England

There will be a shortage of GPs and nurses in four years' time, but the NHS will have to shed hospital doctors, leaked government documents show.

The prediction of a shortfall of 14,000 nurses was included in the Department of Health paper, it was reported.

The strategy has been labelled a "yo-yo attitude" to planning. The leak comes amid news of extensive job cuts as the NHS tries to save money.

But the government said it was a "prudent and sensible" analysis.

The leaked documents were reported in the Health Service Journal.

The draft version of the NHS pay and workforce strategy for 2008 to 2011 for England showed the health service will experience a shortage of 1,200 GPs, 14,000 nurses and 1,100 junior and staff-grade doctors by 20

 

Doctors angry over 'op meddling'

Patients are referred to hospital via management referral centres

Doctors have criticised the increasing interference in the way patients are referred for surgery.

Over half of English GPs are being forced to use referral management centres which have been rolled out over the last two years.

The centres act as "middle-men" between GPs and hospitals by recommending where and when patients are treated.

But the British Medical Association said they were being used to ration care and create unnecessary red-tape.


The centres are manned by primary care trust staff, some of whom are not medically qualified.

A recent survey by doctor's magazine Pulse found 53% of GPs were having to use them to refer patients to hospital - in many of these cases they were being barred from naming the consultant they wanted their patient to see.

But a spokesman for the Department of Health said: "Referral management schemes should ensure NHS patients see the most appropriate clinician in the most convenient setting.

"These schemes must only be set up where they will benefit patients.

"The department has issued a wealth of guidance to ensure this message gets through to the NHS and trusts should be reviewing existing schemes to ensure they create put the patient first.

"If a patient needs to be referred to hospital then, clearly, they should be referred.


THIS IS VERY PERSONAL TO ME, I WAS REFERED BY MY G.P BEFORE CHRISTMAS AND I WENT THROUGH THE CHOOSE & BOOK SYSTEM (TOTALLY FLAWED) AND TODAY 3RD JANUARY 2007, 12 DAYS BEFORE THE AGREED APPOINTMENT I TOOK A CALL FROM MY G.P SURGERY INFORMING ME THAT THE APPOINTMENT HAD BEEN CANCELLED, THE LADY DID SAY THAT SHE WILL ASKING THE G.P TO FOLLOW THIS UP, THE REASON GIVEN - "THIS DOES NOT MEET THE REFERAL CRITERIA" - MORE PCT MEDDLING?, DOH MEDDLING OR SHA MEDDLING, JUST GOES TO PROVE THAT THE SUGGESTIONS OF G.P'S BEING INSTRUCTED AS TO NOT TO REFER TO HINCHINGBROOKE (REFUTED BY THE SHA) IS ENTIRELY TRUE.......
 

Controversy over child referrals

By Graham Satchell

BBC News






The NHS in Milton Keynes is in debt - by 18 million pounds at the last count.

GPs are concerned the initiative could put children at risk

Like many health authorities across the country, it's trying to save money.
But the way it's doing it is proving controversial.



GP's here have been sent a letter detailing the cost of referring children to the local hospital.


It asks whether any of this could be done more cost effectively.
The letter says the trust spent £1.5 million referring children to the local hospital last year
It points out that 79% were discharged within a day and goes on to say "this area of activity was one which was likely to achieve cost savings"

'Value for money'

The letter has horrified local GP Eric Rose.

For him it's a veiled threat to doctors to think twice before sending sick children to hospital.
Dr Rose says: "I think if you're fairly new to the job, you're impressionable, you're given the impression that you're referring unreasonably - you might think again."


"I think it's potentially dangerous. It would only take one child that should go to hospital not to be sent to hospital and for there to be a tragedy and I think there would be a lot of questions asked."

Parents at a local toddlers group were concerned. They thought a child should see a specialist if it was sick - and that money should not be a factor.

There are now fixed prices across the NHS for treating patients in hospital and health bosses in Milton Keynes think the local hospital is charging too much to see children. 

IT BEGS THE QUESTION......................HAS A SIMILAR TACTIC BEEN APPLIED BY CAMBRIDGESHIRE PCT? - THE SHA SAY NO................BUT DO YOU KNOW DIFFERENT?

 Stomach pain leads calls to NHS
The service received seven million calls last year


Stomach and jaw pain dominated calls to the NHS Direct, the health service's telephone helpline over Christmas, statistics show.

Vomiting, toothache and diarrhoea were also among the top 10 reasons for calling the helpline in England.

Last year as a whole, the service received around seven million calls.

Over the Christmas period, it took a quarter of a million calls, while the busiest day was 30 December, when there were nearly 35,000 calls.

NO DISRESPECT FOR THIS "HANDS OFF SERVICE" BUT WHEN I HAVE CALLED NHS DIRECT PREVIOUSLY FOR AN ISSUE WITH STOMACH PAINS WITH MY WIFE, I WAS ADVISED IT WAS A STOMACH BUG AND WILL BE GONE 
IN 24HRS, IT TURNED OUT THAT AFTER SHE HAD BEEN TAKEN TO HINCHINGBROOKE VIA AMBULANCE IN AGONY THAT SHE HAD A BURST OVARIAN CYST, SO THERE IS NO REAL ALTERNATIVE TO G.P'S & A&E AND IN THE ABSENCE OF LITTLE OR NO "OUT OF HOURS" ASSISTANCE WE ALL GO TO A&E

Generic Drug Fear

NHS patients face fake drug risk

Patients are being put at risk as counterfeiters target the NHS supply chain with fake drugs, regulators say.

The Medicines and Healthcare Products Regulatory Agency (MHRA) warned it is investigating twice as many counterfeit cases as it was five years ago.

The growth in fake drugs is said to be driven by huge demand for lifestyle medicines such as Viagra.

Counterfeits can be weaker doses of established drugs or medicines produced with substances
such as paint.

BEFORE GENERIC DRUGS ARE AGREED TO BE USED, THERE SHOULD BE AN INSPECTION PROCEEDURE IN PLACE, A LIFE COULD BE LOST IN THE QUEST TO CUT NHS BUDGETS, WHO WILL TAKE THE RESPONSIBILITY FOR THAT?

AS A REGULAR USER OF PRESCRIPTION DRUGS IT MAKES ONE VERY WARY OF THIS KIND OF APPROACH, WHY NOT STRIKE A DEAL WITH THE DRUG COMPANIES TO PROVIDE MEDICINES AT THE CORRECT PRICES RATHER THAN THE OVER INFLATED ONES THE NHS PAYS?
 

Doctors forReform Fact File 

1. NHS managers increasing at three times rate of medical staff
2. The UK is now spending at more than the EU average on health
3. Average hospital waiting times are rising
4. Social insurance systems offer choice for all including poorest
5. Countries such as France or Germany have no waiting lists at all
6. There will still be a shortage of doctors in 2010

Doctors for Reform say....................

The NHS cannot meet public expectations today. It is highly unlikely that it will meet them tomorrow. Future generations will seek rapid access to care, greater choice and more information about their treatment. We need a healthcare system which is equal to rapidly rising costs and demand, and which enables professionals to retain the essential bond of trust with their patients.

The time has come to look at new ways to supply and fund healthcare. We believe that these core principles should underpin reform:


The fundamental NHS principle of care being universally and equitably available must remain.
The primacy of the doctor-patient relationship, which politicians have undermined, must be restored.
Management and administration must be more effective.
Politicians must be removed from the day-to-day running of the health service.
Patients must be able to exercise real informed choice about where, how and by whom they are treated.

There needs to be a proper and informed national debate on the choices ahead of us. The issues are beyond party politics and we believe that, as professionals, we will make a profound mistake if we leave this debate to politicians.

In December 2005, Reform published a study - Maternity services in the NHS, Reform, 2005 which showed that NHS maternity services are under considerable strain. Authored by two NHS obstetricians, an NHS midwife and a leading health economist, it warned that midwife hours are falling, consultant cover is inadequate and administrative burdens are rising. It showed that reform based on choice and diversity of provision would allow the development of networks of smaller modern units which would be more convenient for mothers and better able to cater for births of different levels of risk.

The report showed that the key trend of the last 30 years has been for NHS maternity units to become larger and more centralised. The largest English unit – Liverpool Maternity – delivers over 8,000 births per year


The current NHS funding system undermines the best units. Because funding does not follow the mother to a particular unit, the most popular units can find themselves with more patients but not greatly increased resources, leading, at worst, to an increase in clinical risk.


The reform principles of choice and diversity of provision would be just as beneficial for maternity services as they have proved in other areas of the NHS, such as elective care where waiting times have fallen and value for money has increased. Real choice for mothers would lead to a shift to smaller, more specialised units provided both by the NHS and the private sector.



 

REFORM says..................

Health

The problems of British healthcare are not due to lack of resources. Recent spending increases have lifted Britain above the European average spending on healthcare and by 2008 Britain will
be spending at the levels of countries such as the Netherlands and France.




But despite some marginal improvements, such as a reduction in the longest waits for hospital treatment, standards of care remain far behind peer countries. Rather than a lack of resources,
the reason for poor performance lies in the structure of the National Health Service.


There are three steps to reforming healthcare:


Change the NHS mission statement, from maximising the health of the nation to focusing on individual patient need;


Liberate provision; and


Put spending power in the hands of patients.


 





 

NHS 'facing make or break year'

Reconfiguration of services is proving controversial



Failure to tackle rising costs or to invest in modern services has put the long-term future of the NHS in England under threat, a report warns.

The study, by the think tank Reform, argues that the long-term strength of the NHS is weaker than two years ago, despite record levels of investment.

It calls for deficits to be written off, and for increased patient choice and competition to drive faster reform.
Thousands of people across the country have protested about reconfiguration of NHS services, which the government argues is needed to boost services, but which opponents fear will have the opposite effect.

A key problem was that the Department of Health had failed to control the spiralling long-term costs of manpower and infrastructure
As a result, some planned service reconfigurations were being driven by the need to reduce deficits.

The best way to proceed, the report argued, was to separate the issues.

First, deficits had to be written off, then measures introduced to ensure rigorous financial discipline, better value for money, and service reconfiguration based on the aim of increased patient choice.

Professor Bosanquet said: "The Department of Health has been so busy fire-fighting that it has not developed a process for getting real value.

"The beginning is the abolition of deficits to allow a fresh start; then investment in new services and competition can follow."
The spokesman for the DOH said the NHS would be in overall balance by the end of the current financial year, and would deliver a surplus by the end of 2007-08.

But he said there was no question of deficits being wiped out.

"It would be unfair for overspending organisations to bailed out by those that underspend."

 AS CAN BE SEEN FROM THIS REPORT, THE ONLY SATISFACTORY WAY FORWARD IS TO WIPE THE DEBT AND START AGAIN AND TO RECONFIGURE SHOULD THAT BE APPROPRIATE AND ACCORDING TO DOH WISHES INCLUDING DAY SURGERY (THAT PART IS CONTROVERSIAL AS DAY SURGERY IS THE REASON CITED FOR HINCHINGBROOKES FINANCIAL PROBLEMS

Website checks two-day GP target

Patients should get an appointment within 48 hours

An MP has set up a website for people to report problems getting appointments with their GPs within the 48-hour national target.

Grant Shapps, Conservative MP for Welwyn Hatfield, is convinced many are not seen quickly - and that official statistics do not reflect this.

Since its launch earlier this month, the website - www.48hourgp.com - has received dozens of complaints.

THE PCT NEED TO SORT THIS OUT BEFORE TARGETING HOSPITAL'S AS A MEANS TO CUT THEIR WASTEFUL OPERATING COSTS