NHS news: There are reports of changes to the NHS without the legislation having passed and doctors and nurses warning against such changes, reports of operations and other treatments being restricted due to cuts and the government increasing the use of the hugely expensive and discredited Public Finance Initiative (PFI).
The Federation of Surgical Specialty Associations reports that routine procedures are being refused as a result of government cuts.
A few recent news articles concerning the UK’s Conservative and Liberal-Democrat coalition government – the ConDem’s – brutal attack on the National Health Service.
The government has been accused of “ploughing on regardless” with its restructuring of the health service in England after the head of the NHStold staff to “maintain momentum” for the planned changes during the listening exercise being undertaken by ministers.
The timescale for implementing key parts of the health and social care bill, including handing over commissioning powers to GP groups from April 2013, remains the same despite the “pause” in the legislation going through parliament, according to David Nicholson, the chief executive of the NHS.
His message in a letter to colleagues will fuel concerns that the government’s promise to take on board ways it might “improve” its plans during a “natural break” is little more than cosmetic.
Labour said it was clear ministers planned to make little change, the head of the Royal College of Nursing (RCN) warned against “things ploughing on”, and the leader of the British Medical Association said the government must not make “irreversible” decisions.
Growing numbers of patients are being wrongly denied a new hip, a weight loss operation or even cancer treatment because of NHS cost-cutting, the leaders of Britain’s surgeons have warned.
Increasing rationing of operations is forcing patients to endure pain, injury or disability because NHS primary care trusts (PCTs) are ignoring evidence about the effectiveness of certain treatments simply to balance their books.
The warning from the Federation of Surgical Specialty Associations (FSSA), which represents the nine major types of surgeon in the UK, is in an open letter passed to the Guardian.
It accuses trusts of letting down needy patients by branding forms of elective surgery as of limited clinical value in order to help them cope with the NHS’s tough financial climate.
The FSSA, which represents about 15,000 surgeons, says it is “concerned that lists of surgical procedures and interventions, deemed of low clinical effectiveness or of ‘lower value’, are being used by PCTs to limit access to certain procedures … Review of the lists reveals that there is little or no evidence to support the view that many of the procedures are of limited value to individual patients”.
The unprecedented statement goes on: “For example, the lists include types of hip, spinal, ENT [ear, nose and throat], dental, bariatric [obesity] and cancer surgery for which there is overwhelming evidence of benefit. The only justification for these lists can be that they are a means of reducing expenditure at a time when the NHS faces a financial crisis.”
The surgeons’ move highlights the fact that PCTs across England are increasingly delaying or denying patients access to surgery to repair a hernia, replace an arthritic hip or knee, and remove cataracts, infected tonsils, gallstones, wisdom teeth, adenoids and varicose veins. Some are even restricting the number of patients who can have a hysterectomy or have their baby in a planned caesarean section. Surgeons, heath charities and patients’ groups are increasingly frustrated that PCTs are introducing what they regard as arbitrary lists of treatments of supposedly low or no clinical value despite medical evidence that many help relieve patients’ symptoms.
Prime Minster David Cameron was forced yesterday to promise “proper and substantive” changes to NHS reforms following a barrage of criticism.
Mr Cameron’s latest attempt to pacify criticism follows the coalition’s promised “pause” in the Health and Social Care Bill’s passage through Parliament for up to three months.
However the supposed delay for a “listening tour” received a frosty response among nurses at the RCN conference last week who delivered an unprecedented vote of no confidence in Health Secretary Andrew Lansley.
Criticism over plans to accelerate the NHS market has mounted steadily in the last few weeks causing further tension within the already shaky Con-Dem alliance.
Unison has long campaigned against what it argues is an unmanageable debt burden being levied on hospitals because of the PFI at a time of cuts. Under the schemes, private consortia finance key projects such as hospitals or other public infrastructure and are paid a fixed rate, guaranteed return over 30 years.
A brisk trade has developed in the City in selling on these debts to financiers or private equity partnerships with no involvement in the original projects. But it has emerged that because the payments are so highly prioritised – and quickly and steeply rise in cost – several NHS hospitals are being forced to close beds, cut jobs and sell off assets to make the payments at a time of reduced budgets.
Bart’s in central London is reported to have been forced to close down new beds before even opening them.
The pro-NHS campaigning group Health Emergency says that throughout the health service PFI hospitals are closing beds and cutting jobs in a “desperate bid” to balance their books.
At the new £256 million 1,200-bed Queen Alexandra Hospital in Portsmouth, which opened in 2009, 700 jobs and 100 beds are being cut with more on the way.
Chancellor George Osborne has given the go-ahead for 61 PFI projects, worth a total of £6.9bn, since coming into power.
PFI, a way of using private finance and companies to build public infrastructure projects like hospitals and roads, exploded under the Labour Government but was roundly criticised by leading members of the then-opposition, including Mr Osborne and Nick Clegg.
Labour said the model allowed the financial risks of constructing large infrastructure projects to be borne by private companies, not the taxpayer, but before the election Clegg, now Deputy Prime Minister, branded them as a “a bit of dodgy accounting – a way in which the Government can pretend they’re not borrowing when they are, and we’ll all be picking up the tab in 30 years”.
Mr Osborne said in 2009 that the model was “discredited”.
A DORSET man is facing losing the sight in one eye because the local NHS has refused to pay for the injections his GP and specialist recommend.
Accountant Mike Fort, 48, of Corfe Mullen, was diagnosed with a rare form of wet macular degeneration two and a half years ago, when he was living in Weymouth. The disease happens when tiny abnormal blood vessels begin to grow behind the retina, the innermost coating of the eyeball. They usually leak, damaging the middle of the retina, or macula, and cause a rapid loss of central vision, making it difficult to read, watch television or recognise faces.
Through his employer’s private health insurance, Mike was given injections into his eye of a drug called Lucentis, which works by preventing the growth of the abnormal blood vessels.