The Audit Commission reports that NHS organisations face “the worst financial situation they have ever experienced”.
Pulse reports that “Private companies are poised to bid to run huge chunks of NHS care across the country”.
Waiting times rise despite David Cameron’s pledges.
Conservative election poster 2010
A few recent news articles about the UK’s Conservative and Liberal-Democrat coalition government – the ConDem’s – brutal attack on the National Health Service.
NHS organisations face “the worst financial situation they have ever experienced” as a result of government funding cuts, the Audit Commission claimed today.
It found that most trusts were only able to balance their books with financial help in 2010-11.
Sixteen NHS trusts needed £90 million to help them keep on track while cash was also distributed from underspending primary care trusts to those that had overspent.
The public-service watchdog said that although only nine out of the 276 NHS organisations in England were in deficit, six in the south-east, trusts face a challenging 12 months trying to keep on top of a £20 billion efficiency savings target by 2015.
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Exclusive Private companies are poised to bid to run huge chunks of NHS care across the country, as a host of PCTs follow NHS East of England’s controversial lead in placing entire care pathways out to tender.
NHS East of England plans to auction off £300m of services to GPs, private companies or a combination of the two, in pathways including respiratory and musculoskeletal medicine.
Eight PCTs are now planning to replicate the NHS East of England plans, which Pulse first revealed in March and are backed by an adviser to the Government’s QIPP programme.
Pulse has established that NHS Bassetlaw, NHS Hampshire, NHS Coventry, NHS Brighton and Hove and NHS Outer North East London, a cluster covering four PCTs, are all considering putting entire care pathways out to tender, with several having started discussions with GP commissioners about the move.
NHS Outer North East London said it would tender out entire care pathways and would ‘provide an outline programme of these once prioritised and agreed with GP consortia and existing service providers’. NHS Bassetlaw said it had already awarded tenders for musculoskeletal and dermatology pathways, worth £680,000 and £775,000 respectively, to NHS providers.
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The number of NHS patients waiting more than three months for tests has increased nine-fold in a year.
In June, 1,763 people had been waiting for at least 13 weeks for one of 15 diagnostic tests – including MRI and heart scans, ultrasound and colonoscopies – according to Government figures released yesterday. This compares with only 190 in June 2010.
The figures came a month after the Prime Minister personally pledged to keep waiting times low. Health ministers were quick to point to a small month-on-month improvement in June, but with nearly 600,000 people in total waiting for a test to diagnose or exclude a medical condition, June is the worst month of 2011 so far.
The BMA has issued a rallying cry for every GP in the country to join the fight to protect NHS pensions by responding individually to the Department of Health’s ongoing consultation.
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A report confirms that the NHS is incredibly efficient and successful.
The decision to force the NHS to support Circle Health’s luxurious hospital in Bath provides a real insight into the Con-Dems’ NHS ‘reforms’. It is all about destroying the NHS and supporting expensive crap, getting those donations in and having grand lunches.
Conservative election poster 2010
A few recent news articles about the UK’s Conservative and Liberal-Democrat coalition government – the ConDem’s – brutal attack on the National Health Service.
Report in the Journal of the Royal Society of Medicine finds health service second only to Ireland for cost-effectiveness
The NHS is one of the most cost-effective health systems in the developed world, according to a study (pdf) published in the Journal of the Royal Society of Medicine.
The “surprising” findings show the NHS saving more lives for each pound spent as a proportion of national wealth than any other country apart from Ireland over 25 years. Among the 17 countries considered, the United States healthcare system was among the least efficient and effective.
Researchers said that this contradicted assertions by the health secretary, Andrew Lansley, that the NHS needed competition and choice to become more efficient.
“The government proposals to change the NHS are largely based on the idea that the NHS is less efficient and effective than other countries, especially the US,” said Professor Colin Pritchard, of Bournemouth University, who analysed a quarter of a century’s data from 1980.
“The results question why we need a big set of health reform proposals … The system works well. Look at the US and you can see where choice and competition gets you. Pretty dismal results.”
The study will be a blow for Lansley, who argues that patients should choose between competing hospital services and GPs.
Pritchard’s last academic paper, which argued that surgeons were being distracted from frontline work by “unfunded” targets in the NHS, was used by Lansley to justify government reforms.
Using the latest data from the World Health Organisation, the paper shows that although Labour’s tax-and-spend strategy for the NHS saw health spending rise to a record 9.3% of GDP, this was less than Germany with 10.7% or the US with 15%.
Not only was the UK cheaper, says the paper, it saved more lives. The NHS reduced the number of adult deaths a million of the population by 3,951 a year – far better than the nearest comparable European countries. France managed 2,779 lives a year and Germany 2,395.
A union boss has hit out against job cuts at a Bradford health trust which she warned means “work simply won’t get done”.
A major national restructure of the NHS will see Primary Care Trusts disappear by April, 2013, when commissioning of services will be taken over by local clinical commissioning groups and national bodies such as Public Health England.
NHS Bradford and Airedale, which says it needs to save £2.9 million in management costs this year, has approved 34 applications for voluntary redundancy or early retirement but has warned that some staff are still at risk of losing their jobs.
Drawing a comparison with troubled care home company Southern Cross, Jackie Smith, Unison’s Bradford health branch secretary, said: “If you have a commissioning organisation that is so crippled by the Government’s cuts that we cannot be guaranteed that it is commissioning the right services and that it cannot police those services that they have commissioned because of lack of resources, you will end up with a Southern Cross scenario in health care.
“The restructure that we have been consulted on also looks very top heavy with lots of managers and fewer workers.”
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cash-strapped East Sussex Healthcare NHS Trust is walking a financial tightrope which could have a major impact on frontline services.
It has been ordered to identify £30 million in savings by the end of the year – and so far only £18 million has been found. And the trust’s board was told at a recent meeting the organisation’s ‘run rate’ shows it spending out around £1million a month more than it is bringing in.
The situation has not been helped by a drop in income from patients being referred by GPs, which has piled more pressure on the trust’s already beleaguered purse. And in a further blow the trust is having to fork out £115,000 to pay for extra Microsoft licences for IT equipment across its sites – a cost which up until now has been met at a national level under an NHS deal.
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NHS Wiltshire has been rapped for imposing a minimum waiting time of 15 weeks for people to receive hospital treatment.
The health trust imposed the 15-week limit to save money, to ensure patients are treated strictly in order and to prevent unfair competition on waiting times. But the move has been criticised by the Co-Operation and Competition Panel (CCP), an independent watchdog that advises the NHS.
In a report published last week, the CCP said: “The conduct of Wiltshire Primary Care Trust in setting uniform minimum waiting times, which in effect become minimum waiting times, restricts competition and distorts patient choice and this imposes material costs on patients and taxpayers.”
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The operator of a private hospital near Bath has won a ruling from a Government watchdog that the NHS is unfairly holding back potential patients.
Health Secretary Andrew Lansley will have to decide what sanctions should be taken against health chiefs in Wiltshire over their imposition of a minimum waiting time for patients in negotiations with Circle Health, over its hospital at Peasedown St John.
The row threatens to turn the Bath area into a test-bed for how far the Government is prepared to push the idea of increasing the private sector’s involvement in treating NHS patients.
Both the area’s biggest NHS hospital, the Royal United Hospital, and commissioning body NHS B&NES insist that no such minimum wait operates in the immediate Bath area.
But the ruling by the Cooperation and Competition Panel quango underlines the tension between patient choice and finite NHS budgets, and between private and specialist treatment centres performing routine surgery and acute hospitals such as the RUH which have to support emergency and intensive care.
Circle Health, which opened its hospital at the beginning of last year, had complained to the CCP that NHS Wiltshire – which commissions services for the county and in some cases for B&NES – was breaking health service rules on competition and co-operation.
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A Government quango has ordered health chiefs across two counties to send more patients to a private hospital which is owned by two major donors to the Conservative Party.
Union bosses said the decree ‘stinks of cronyism’ and has demanded questions be asked about the relationship between the private hospital firm and the Government.
The Government’s new Co-operation and Competition Panel (CCP) was given the job of enforcing new competition rules within the NHS, which campaigners say is a ‘back door’ way of privatising the health service.
Earlier this year, CircleBath, a private hospital in Peasedown St John, near Bath, complained to the CCP that local health trusts weren’t sending enough patients to it for routine operations.
Circle said NHS Bath & North East Somerset and NHS Wiltshire, which commission services jointly at the Royal United Hospital in Bath, weren’t playing fair in setting a cap of £6 million on operations it would fund at the new private hospital, while it spent £160 million at the RUH.
The CCP has now ruled in Circle’s favour, saying the two NHS trusts had breached the new competition rules by favouring NHS hospitals like the RUH over private hospitals like Circle. It has now given health bosses in Bath and Devizes a fortnight to respond to the ruling and outline what they are going to do.
CCP director Andrew Taylor said setting a maximum spend on using private hospitals was unfair to CircleBath, and meant a worse deal for patients. “The panel considers that the majority of the aspects of conduct raised in this complaint impose costs on patients and taxpayers that are not outweighed by any of the benefits that may arise from such behaviour. We are now keen to consult on what would be an appropriate remedy to the conduct in question,” he said.
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CircleBath is Foster + Partners’ first hospital and represents a radical departure from orthodox approaches to hospital planning. The three-storey building is set into the hills on the edge of protected green belt nine kilometres south east of Bath and its compact arrangement provides a ‘corridor-less’ environment, encouraging a sense of community and well-being.
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“We wanted a building that looked more like a five-star hotel than a hospital,” says Ali Parsa, the managing partner of health provider Circle, the scheme’s client. “We’ve forgotten what the word ‘hospital’ means. It comes from ‘hospitality’ and visiting a hospital is a very important time in your life. To make it drab is really wrong.”
If you think this is the glossy prelude to a megabudget luxury spa-type experience for the super-rich, think again. Circle is hoping to capitalise on the government’s promise to allow NHS patients to choose where they go for non-emergency specialist treatment, as long as the provider meets NHS standards, and, crucially, costs (see box). [edit: I think that is incorrect & that it is not necessary to compete on cost.]
So does the building live up to its boutique hotel billing? With just 28 beds, it is certainly boutique in scale, and it cuts a strikingly cosmopolitan figure in the mundane surroundings.
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The Department of Health fears a protracted legal battle with its IT suppliers.
The Public Accounts Committee has severely criticised the Department of Health’s renegotiation of the failed NHS records system.
Liverpool Walton MP Steve Rotheram has slammed the government’s NHS reforms, which will see Liverpool lose £33.3 million.
The BMA warns of gaps in NHS reforms.
Tory MP calls his hospital crap for not providing the NHS that the Tory party along with the Liberal-Democrat Tory party is abolishing.
Conservative election poster 2010
A few recent news articles about the UK’s Conservative and Liberal-Democrat coalition government – the ConDem’s – brutal attack on the National Health Service.
… In written evidence to the Public Accounts Committee for its latest damning report on the National Programme for IT, officials at the Department of Health admit that they fear a prolonged and expensive legal battle with three of its main ICT providers.
During the PAC hearing in May, former NHS director of informatics Christine Connelly rejected the notion put to her by MPs that US supplier CSC had the department “over a barrel” when it came to trying to renegotiate contracts that the DoH itself concedes are not working for it.
But in its written evidence the DoH paints a rather different picture, noting that the potential for legal conflict is incredibly high – and suggesting that the DoH may indeed be held over the proverbial barrel.
DoH officials warn: “Both BT and CSC have been clear that they are not willing simply to walk away. Therefore, it is safe to assume that some form of dispute will occur and that both suppliers will seek to recover costs. Legal advice provided to the Department indicates there is a risk of some unquantifiable “collateral damage” to the Fujitsu existing claim and the risk of suppliers working in unison against the Department is significant.”
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Liverpool Walton MP Steve Rotheram has slammed the government’s NHS reforms, which will see Liverpool lose £33.3 million.
Liverpool is second only to Manchester, which will lose £41.7 million, as the worst hit region of the North West.
The figures contrast greatly with areas further south, such as Surrey and Hampshire, who will benefit by £61.4 million and £52 million respectively.
Speaking upon hearing the announcement, Steve explained: “I feared from the moment David Cameron got his hands on the NHS, that hospitals and GP practices across Liverpool were going to suffer.
“It would appear my nightmare has become a reality today.
“How can this Tory government claim that we are all in this together when the Prime Minister’s Health Authority area gains millions of pounds and regions, such as ours, lose millions?
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There are worrying gaps in the government’s plans to reform the public health system in England, the BMA has warned.
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But Dr Keith Reid, co-chairman of the BMA’s public health medicine committee, said it was ‘disappointing’ that concerns remained about how health issues, such as obesity, alcohol misuse and STIs, should best be tackled.
Dr Reid added that the financial climate and NHS restructuring meant posts in public health were being cut.
‘We do not want a situation where local authorities are handed the keys to public health, only to find that the engine has gone,’ he said.
The BMA wants a commitment from the government to maintain the current level of public health specialist posts.
In an exclusive interview with GP, NHS Confederation chief executive Mike Farrar said clinical commissioning groups (CCGs) would face more difficult circumstances and tougher decisions than PCTs.
He said CCGs may struggle to find support from experienced PCT managers as many would already have left the NHS.
Mr Farrar said it was ‘very important’ that the NHS recognised just how big the challenge was for CCGs.
‘The circumstances CCGs face are tougher, there are tougher decisions to take, and PCT managers tended to have a career in being developed as managers,’ he said.
‘PCTs also had slightly easier relationships with the organisations around them.’
Mr Farrar said that although GPs were ‘very skilled individuals’ they may lack some of the knowledge that is needed to run CCGs.
He said clinicians often had little experience in controversial decision-making, consulting the public and doing media work. ‘Not every GP will be particularly happy giving lots of quotes to their local newspaper,’ he said.
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In total 21 Foundation Trusts say they will likely experience cash problems over the next year, up from 13 the last time they were surveyed.
Meanwhile 16 of the hospitals say they are at risk of failing to meet a key target to treat patients on time, while a similar amount may breach A&E waiting time limits.
And in further evidence of the pressure the NHS is coming under, more than half of the Primary Care Trusts that pay for treatment say they are failing to make unprecedented savings of £20billion by 2015 as ordered by the Government.
The regulator for the semi-independent Foundation Trust sector, Monitor, is now warning hospitals not to try to balance their books by cutting back on patient care.
Its chairman, Dr David Bennett, said: “The challenge of reducing costs must be met, but it is essential that good patient care is at the heart of this. This year we have put extra focus on identifying the potential risks to quality that could result from each trust’s plan.
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Unite has demanded that the government reverses its NHS ‘cuts’ policy in the wake of a new survey today (Thursday 4 August) showing that primary care trusts (PCTs) are struggling to meet their ‘efficiency targets’.
Unite, the largest union in the country, said that ministers have failed to realise the extent of the damage done by their edict that the NHS must save £20 billion by 2015.
An investigation by the GP newspaper revealed that 59 per cent of PCTs are failing to hit NHS efficiency targets for this year.
Unite national officer for health, Rachael Maskell, said: ‘”I have made strong representations at the NHS Staff Council about the expectation on trusts to make the largest cuts to the health service since its formation in 1948.
”It might be the case that the government has not fully understood the damage that such cuts would cause – it is one thing to look at cold statistics produced by Treasury mandarins, but quite another turning away elderly patients in pain.
”Unite is asking that these ‘efficiency savings’ are reviewed or the government will be responsible for damaging the life chances of thousands of patients.
”Ministers continue to argue that more resources are going into the NHS. However, the increased budget and the savings from the cuts are all going to fund the expensive and bureaucratic health system that David Cameron and Nick Clegg are introducing in the Health and Social Care bill.
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HEALTH Secretary Andrew Lansley was yesterday accused of breaking a pledge to give a bigger voice to patients in the NHS.
Under the Government’s NHS reform plans, patients will be given a key role in new HealthWatch networks.
Some 75 local Healthwatch pathfinders were launched yesterday to champion patients’ views and experiences and advise new groups of GPs in shaping local services.
But campaigners claimed the new organisations, which will evolve from existing Local Involvement Networks (LINks), were being starved of cash to develop before they take on new powers in October next year and were already struggling following public spending cuts of up to 70 per cent in their budgets.
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A Tory MP has attacked an NHS hospital as “chronically, institutionally, dysfunctionally crap” after it shut its A&E department for five hours because it was too busy.
Henry Smith made the comments on Facebook after patients were turned away from East Surrey Hospital in Redhill last week and diverted to hospitals in Brighton and Tunbridge Wells.
Michael Wilson, the chief executive of Surrey and Sussex Healthcare NHS Trust, said the hospital was one of the busiest in the country and needed the support of its local MPs.
Mr Wilson added: “For a short period last Tuesday evening the emergency department at East Surrey Hospital was only accepting seriously ill patients brought in by ambulance.”
Mr Smith, MP for Crawley, said: “It is absolutely appalling East Surrey closed… this is a frightening illustration that we need more provision.”
David Cameron is accused by Labour of breaking an election pledge that NHS spending would not be cut.
NHS cuts costs by delaying operations so that patients either go private or die.
Unhealthy foods kill. Lansley consults with junk food pushers.
Conservative election poster 2010
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.
David Cameron was accused of breaking his biggest pledge at the general election – a guarantee that health spending will increase every year in real terms – after Treasury figures showed a fall in spending in the coalition’s first year in government.
Labour accused the government of burying figures in a Treasury document which show that spending on the NHS was cut in real terms to £101.9bn in the coalition’s first year in office from £102.7bn in Labour’s last year in government.
John Healey, the shadow health secretary, said: “David Cameron has broken his NHS pledge. He put up posters pledging to cut the deficit, not the NHS, but we see now that the Tory-led government has already cut spending on the NHS in its first year.
“On top of this cut, Cameron’s reckless NHS reorganisation is set to cost £2bn, money which could be better spent treating patients. And there are more cuts forecast in future years. This proves again what people have seen before: that you can’t trust the Tories with the NHS.”
Labour criticised the government after figures in the Treasury’s Public Expenditure Statistical Analyses (PESA) for this month showed a cut in NHS spending in real terms from £102.7bn in 2009-10 to £101.9bn in 2010-11. The Tories opened their NHS section in their general election manifesto with the words: “We will back the NHS. We will increase health spending every year.”
In a question and answer session on 14 June the prime minister said: “I want to make this clear, you know we are not cutting spending on the NHS, we are increasing spending on the NHS. This government took a very big decision, given that the NHS is one of the biggest budgets there is in the country, we took a decision to increase by more than inflation in each year NHS spending.”
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Health bosses are deliberately making patients wait for treatment so they will remove themselves from waiting lists by either going private or dying, a report has suggested.
Some Primary Care Trusts (PCTs) are refusing to operate before 15 weeks in a bid to save money, an independent agency that advises the Department of Health has discovered.
The tactic was employed by PCTs after they found that if patients were made to wait longer “some will remove themselves from the list or will no longer require treatment when it is finally offered.
“A PCT may therefore save money overall by increasing waiting times,” the report said.
“We understand that patients will ‘remove themselves from the waiting list’ either by dying or by paying for their own treatment at private sector providers,” the report by the Co-operation and Competition Panel (CCP) said.
The government could protect lives and save the NHS money by introducing laws that restrict unhealthy foods, experts say.
According to an article in the British Medical Journal, measures such as reducing the salt content of foods and eliminating industrial trans-fats could prevent thousands of cases of heart disease in England and Wales each year.
Researchers at the University of Birmingham’s School of Health and Population Sciences concluded that measures to reduce people’s salt intake by 3g per day or trans-fats by 0.7 per cent could save the NHS £40 million or £230 million, respectively, per year.
‘The findings are reassuringly consistent with results from very different methods in the United States, Australia and the UK Treasury,’ the study authors wrote.
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The Department of Health is putting the fast food companies McDonald’s and KFC and processed food and drink manufacturers such as PepsiCo, Kellogg’s, Unilever, Mars and Diageo at the heart of writing government policy on obesity, alcohol and diet-related disease, the Guardian has learned.
In an overhaul of public health, said by campaign groups to be the equivalent of handing smoking policy over to the tobacco industry, health secretary Andrew Lansley has set up five “responsibility deal” networks with business, co-chaired by ministers, to come up with policies. Some of these are expected to be used in the public health white paper due in the next month.
The groups are dominated by food and alcohol industry members, who have been invited to suggest measures to tackle public health crises. Working alongside them are public interest health and consumer groups including Which?, Cancer Research UK and the Faculty of Public Health. The alcohol responsibility deal network is chaired by the head of the lobby group the Wine and Spirit Trade Association. The food network to tackle diet and health problems includes processed food manufacturers, fast food companies, and Compass, the catering company famously pilloried by Jamie Oliver for its school menus of turkey twizzlers. The food deal’s sub-group on calories is chaired by PepsiCo, owner of Walkers crisps.
The leading supermarkets are an equally strong presence, while the responsibility deal’s physical activity group is chaired by the Fitness Industry Association, which is the lobby group for private gyms and personal trainers.
In early meetings, these commercial partners have been invited to draft priorities and identify barriers, such as EU legislation, that they would like removed. They have been assured by Lansley that he wants to explore voluntary not regulatory approaches, and to support them in removing obstacles. Using the pricing of food or alcohol to change consumption has been ruled out. One group was told that the health department did not want to lead, but rather hear from its members what should be done.
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The Guardian reports that the cost of the Con-Dems’ assault on the NHS is rising at almost £1m a day.
Many operations are routinely refused because of cuts. This may be the beginning of the end of the NHS and exposes David Cameron as a blair-faced liar.
Conservative election poster 2010
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 cost of the government’s plans to restructure the NHS is rising at almost £1m a day, the Guardian has learned. Buried in a spreadsheet put out by the Department of Health as part of its revised business plan last week, officials admitted that the cost of transition was now £1.49bn.
This figure is £160m more than the previous estimate, issued six months ago, when the reforms bill was first published. In January the department estimated the total cost of the structural change to be £1.33bn. The health bill was amended after suggestions by a committee set up by David Cameron, the Future Forum, to head off criticism over the wide-ranging reforms. But the effect appears to have been to increase significantly the cost of the upheaval to the taxpayer.
A new impact assessment will now be completed by the Department of Health following the forum’s recommendations. Analysis by the Health Service Journal has shown that the transition to placing health budgets in the hands of GPs had already cost £228m since July last year.
The size, scale and cost of the reforms have long troubled MPs and health service professionals, who point out that cutting staff also costs huge sums in redundancy payments. Trade unions claim that three-quarters of the estimated cost of the transition will go towards redundancy payments to 20,000 staff, suggesting average settlements of more than £45,000.
John Healey, the shadow health secretary, said: “People will be shocked at the scale of wasted cost due to David Cameron’s NHS upheaval. These new figures, slipped out by the Department of Health, show that the costs of this unnecessary reorganisation are spiralling out of control.” Alan Maynard, professor of health economics at York University, said: “The delays and time taken for the reforms have really begun to affect morale and work ethic. People just won’t work if they don’t know where they will be next year or whether they have a job.”
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Hip replacements, cataract surgery and tonsil removal are among operations now being rationed in a bid to save the NHS money.
Two-thirds of health trusts in England are rationing treatments for “non-urgent” conditions as part of the drive to reduce costs in the NHS by £20bn over the next four years. One in three primary-care trusts (PCTs) has expanded the list of procedures it will restrict funding to in the past 12 months.
Examples of the rationing now being used include:
* Hip and knee replacements only being allowed where patients are in severe pain. Overweight patients will be made to lose weight before being considered for an operation.
* Cataract operations being withheld from patients until their sight problems “substantially” affect their ability to work.
* Patients with varicose veins only being operated on if they are suffering “chronic continuous pain”, ulceration or bleeding.
* Tonsillectomy (removing tonsils) only to be carried out in children if they have had seven bouts of tonsillitis in the previous year.
* Grommets to improve hearing in children only being inserted in “exceptional circumstances” and after monitoring for six months.
* Funding has also been cut in some areas for IVF treatment on the NHS.
The alarming figures emerged from a survey of 111 PCTs by the health-service magazine GP, using the Freedom of Information Act.
Doctors are known to be concerned about how the new rationing is working – and how it will affect their relationships with patients.
…
I consider this posting to comply with copyright laws since
a. Only a small portion of the original article has been quoted satisfying the fair use criteria, and / or
b. This posting satisfies the requirements of a derivative work.
Please be assured that this blog is a non-commercial blog (weblog) which does not feature advertising and has not ever produced any income.
