Health News Blog
22nd March 2017
13 Councils announce their opposition to their STP plans
13 Councils’ have responded negatively to their Sustainability and Transformation Plans – which Defend our NHS campaigners have variously dubbed Switch to Private, Slash Trash and Privatise, and Secret Theft Plans. Check on their responses here.
Health trusts say waiitng times will soar again
Longer waiting lists for operations and delays at accident and emergency departments in England loom under the present financial constraints, said NHS Providers, a trade association that represents acute, ambulance, community and mental health services.
Privatised NHS GP records: huge backlog of patient data
More than 200 high priority clinical documents are still awaiting further clinical assessment after more than 700,000 items of patient data were found undelivered in a warehouse last year. They were supposed to have been delivered to GP practices by former primary care support services provider NHS Shared Business Services (SBS), a joint venture company owned by the DH and IT systems firm Sopra Steria. Payments to GP practices to assess the information, which includes test results, have now exceeded £2.4m.
Not enough GPs for A&E triage: but Jeremy got the headline
Former GP Dr Sarah Wollaston, Tory chair of the Commons Select Committee, warned ministers the GP workforce would not stretch to cover the plans to have GPs at A&Es as announced by chancellor Philip Hammond in his spring budget. See below, 13th March.
13th March 2017
A stick to beat GPs with...
GP leaders have warned against using practice waiting times data to measure practice performance after NHS England's chief executive set out plans to publish data that will be collected later this year. NHS England chief executive Simon Stevens said the health service would begin collecting data on 'availability of GP appointments for routine conditions'.
Surgery rationing rules must be axed, but...
“Arbitrary” rationing measures restricting NHS surgery to those in most pain must be lifted, health officials have ruled. NHS England has warned clinical commissioning groups (CCGs) to stop denying hip and knee operations to patients using criteria which only allow surgery to those in the worst discomfort. NHS England clearly pretend that the need for rationing is nothing to do with them.
Another headline-catching idea that's unworkable
Simon Stevens told MPs at an evidence session on GP access with the House of Commons public accounts committee (PAC) that NHS England would set a requirement for all hospitals with an A&E department to have 'comprehensive front-door screening with GPs by next Christmas'. This prompted warnings from GPs that an already overstretched GP workforce would struggle to cope.
9th March 2017
Poll finds public thinks NHS is getting worse
Growing numbers of Britons think the NHS is getting worse and fear for its future, a survey has found. Ipsos Mori polling last month found that 57% of people believe that the NHS’s ability to deliver the care and services it provides worsened over the last six months, up from 52% in January.
Privatised primary care support service is a disaster
2 doctors have to wait 6 months for Capita to perform a simple administrative precedure, so that they could practice in England. They were finally placed on the performers list in the last two weeks after months of frustration with the registration procedure. which is part of the support services contract awarded to Capita by NHS England.
Over half of NHS staff work unpaid overtime
The latest NHS Staff Survey reveal that staff report being satisfied with the opportunities to work flexibly, but 59% are, on average, working additional unpaid hours each week. Overall, the proportion of staff working additional hours is 72%, indicating that not enough has been done to alleviate workloads.
ID checks will cost more than they save
From April the government is demanding ID checks before giving treatment. The cost of so called 'health tourism' is 300m a year, just 0.03% of the overall NHS budget. ID checks are likely to cost more money than they save, just like the fit-to-work assessments. People may be to afraid to seek care, be unable to pay; this puts lives at risk. This policy will encourage the perception that immigration is the reason for our social ills, rather than the government's austerity policies.
6th March 2017
Video of Saturday's the 250K march for the NHS
A march for a properly funded publically-owned NHS took place in London on 4th March. Organised by Health Campaigns Together it was campaigners response to the cuts and privatisation that are a central plank of the government's STP programme.
So that's the reason it was hushed up...
The loss of more than 700,000 items of patient data was kept quiet by the government to protect GP practices from being inundated with inquiries, health secretary Jeremy Hunt has told MPs. It's wonderful having such a caring Secretary of State for Health isn't it?
Hundreds of GP practices facing funding cuts
Nearly 800 GP practices faced average losses worth more than £50,000 per year under the national PMS contract review, with around 200 at risk of being unable to manage losses safely for patients. There are 3 contract types for primary care - GMS, PMS and APMS. PMS (Personal Medical Services) are local contracts between NHS England and the practice. The GMS (General Medical Services) contract is nationally agreed, see the BMA site for details.
A very anodyne explanantion of STP by the BBC
With only scant mention of the massive cuts and privatisation that the NHS will suffer under STP changes the BBC's health correspondent Hugh Pym does indeed pull his punches in describing what's in store for us. What he does emphasise is that it's the end of the purchaser/provider split, some also see it as a recognition of the failure of the Health and Social Care Act.
Video of explaining 4 failed NHS privatisations..
Here's a video of four disastrous privatisations, Nottingham hospital cleaning to Carillion, the collapse of the proposed West Sussex Muscular-Skeletal services to BUPA, the appalling Peterborough community services fiasco, and the once-trumpeted take over of Hinchingbrooke Hospital by Circle who withdrew from it in 2015.
Why is this children's heart unit facing closure?
The Royal Brompton hospital’s heart centre is among the best in the country, so why is it earmarked for closure? Ther is an argument that small, specialist hospitals are outdated, but the fear is that under the cloak of rationalisation the NHS is being scaled down, fragmented and privatised.
The contradictions of government's NHS policy
The only way to plan to achieve the £22 billion cuts that STPs will impose must include cutting the number of hospital beds; there's no other way. But now Stevens says that STP planning must not include bed reduction...the lunatics are definitely in charge.
2nd March 2017
Need the low-down on STP?
If you find the so-called Sustainablility and Transformation Plans confusing and want a simple guide to explain the underlying drive behind Conservatives motives, then this Youtube video is for you; because the two main under-reported fundamentals of STP under the shelter of integrating health and social care, are to cut NHS budget and to privatise the lot.
NAO report on integration disappointing
The National Audit Office (NAO) scrutinises public spending for Parliament. Here's a recent NAO report on Health and Social Care Integration, itself a commendable policy, provided it's resourced properly. This the government proposes to achieve via the Better Care Fund. Unfortunately all government initiatives seem to have as an aim cost cutting - isn't improving public service a good enough aim? The NAO has found no compelling evidence to show that integration in England leads to sustainable financial savings or reduced acute hospital activity.
Why did so many older people die in 2015?
Research by Professors Martin McKee and Danny Dorling reported in the Journal of the Royal Society of Medicine investigated rises in mortality rates in 2015. Their disturbing conclusion is that some people may be dying from the underfunding of health and social services.
Critical assessment of STPs
STPs are put under the microscope by senior lecturer John Lister in report A Critical Assessment. He finds that the plans rest on implausible assumptions and lack credible implementation measures. Given that the scale of the planned reduction in hospital services implies rationing and risks the collapse of some services, Lister remains unconvinced by "the wishful thinking and positive vision" of the STPs.
STPs dodgy legal status and lack of accountability
Professor Chris Newdick writes about the Problems of Legal Status and Accountability with STPs teams - the envisaged interagency groupings who will implement the meat of the STPs. Newdick explains the pitfalls of the fudges that come with promising to “do more, with less” - just when we need to be clearer than ever about rights and duties in the NHS. He concludes that, "We need a new National Health Service Act to stabilise the NHS".
27th February 2017
Another privatisation disaster: NHS data lost
Thousands of patients are feared to have been harmed after the private company NHS Shared Business Services lost more than half a million pieces of confidential medical correspondence, including test results and treatment plans. Yet again when private firms are brought in with the aim of cost-cutting a crisis results.
STPs 'not credible' without more community care
The Kings Fund says that STPs 'present an opportunity to move care closer to home and moderate demand for hospital services'. But it warns that plans to cut numbers of hospital beds are not credible 'unless investment is first made in services in the community', and that the ongoing NHS crisis could 'divert attention from work to transform care'.
..But is good care in the community cheaper than hospitals?
STPs are predicated on the idea of moving hospital care into the community, on the assumption that care in the community is cheaper. But is it? The only evidence I can find suggests that only a limited range of hospital cases can be moved into the 'community'; and what does 'into the community' mean - is it into people's homes or into care or nursing homes? To echo the Kings Fund as above, where's the planning to expand community care to accommodate this transfer? I've heard it say that good community care can uncover patients that should be in hospital and aren't.
23rd February 2017
NHS crisis continues: fifth of hospitals now on high alert
A fifth of hospital trusts in England have reported a high-level alert - warning of extreme pressure affecting patient care - on 50% of days in 2017 to date or more. The crisis is at its most acute across the South of England NHS region, with the area's 36 hospital trusts reporting a level three or four alert on an average of 17 out of 30 days.
Homeless GP service, rated outstanding, privatised
A GP service for homeless patients in Leeds, awarded an outstanding CQC rating just two months ago, has been handed to a new provider after a tendering process offering a reduced budget. Another excellent NHS service sacrificed on the altar of shameful meanness. No matter how good a public service is, it’s replaced by some sub-standard privatised incompetence.
Risk averse NHS 111 sends more patients to A&E
The NHS 111 telephone advice service is sending growing numbers of people to A&E or calling an ambulance because its staff are too risk-averse when dealing with illness. The 42 regional NHS 111 services are run by NHS ambulance trusts, groups of GPs and private firms such as Care UK, which has recently won more contracts. It uses far fewer nurses and many more call handlers than NHS did, then called NHS Direct, until then health secretary Andrew Lansley scrapped it.
Thousands of doctors may quit after Brexit
About two in five doctors who qualified in the European Economic Area are considering leaving the UK in light of the referendum result, research by the British Medical Association reveals. BMA chairman said "These are the people who staff our hospitals and GP surgeries, look after vulnerable patients in the community, and conduct vital medical research to help save lives."
20th February 2017
Is it that the government doesn't give a damn?
The NHS is at “breaking point” with a decline in the number of hospital beds leading to delays and cancelled operations, the British Medical Association (BMA) has warned. Analysis by the BMA found the number of overnight beds in English hospitals fell by a fifth between 2006-07 and 2015-16.
Patient would have survived if hospital bed was available
A woman died from a brain haemorrhage after at least three hospitals refused to admit her for surgery because they had no intensive care beds. In a case that brings the deepening NHS bed crisis into sharp relief, a coroner said it was likely that she would have survived if she had been given immediate surgery to stem the bleeding.
Award-winning alcohol treatment service scrapped
Despite saving the NHS hundreds of thousands of pounds, NHS commissioners in Cambridgeshire have said they will no longer fund the innovative Gainsborough Foundation alcohol treatment service. Cambridgeshire and Peterborough CCG said that it could no longer afford to support the community recovery and detox service because it is not a statutory requirement.
Reversed in 2011, now mortality has increased in 2015 ...Why?
A report by the Royal Society of Medicine found that in 2015 we then saw one of the largest increases in deaths in the post-war period. The report suggests that there is a strong case for arguing that more staff and funding for both health and social care are required urgently to prevent further avoidable mortality.
BMA: "STP plans are unworkable"
NHS leaders do not have 'anything like' the money needed to implement sustainability and transformation plans as soaring hospital deficits swallow billions of pounds in capital funding, a BMA analysis warns. They could have added that you can't offer a comprehensive healthcare system by cutting £22 billion from the annual budget.
13th February 2017
Private hospital rated outstanding while under investigation over death
The family of a man whose death was blamed on negligence at a private London hospital have said they are “horrified” by the decision of health watchdog CQC to rate the clinic “outstanding”, even as a coroner’s investigation into its conduct and the actions of some of its nursing staff is ongoing.
GPs allowing fee-paying patients to jump the queue
Family doctors in Bournemouth have set up the first private GP service at which people who pay up to £145 a time will be seen faster and get longer appointments than their NHS patients. NHS England considered it 'questionable', but whether it will take action to stop it isn't yet clear.
Inadequate social care is wasting surgeons time
Clare Marx, president of the Royal College of Surgeons, and Chris Hopson, chief executive of NHS Providers, blamed cuts in social care for delays to operations caused by a shortage of beds. “Because of bed shortages, staff including surgeons are now sometimes left kicking their heels, waiting for beds to become available so they can operate."
Two-thirds of young hospital doctors 'under stress'
Almost two out of three young hospital doctors say their physical or mental health is being damaged because pressures on the NHS are putting them under intolerable strain. Many are so relentlessly busy that they go through entire shifts without eating or drinking, while others suffer stress, burnout, exhaustion and sleeping problems.
6th February 2017
Why do they order an enquiry?
The answer is under-funding of social care. But an NHS trust has launched a formal inquiry after an 89-year-old woman who was medically fit to leave hospital was trapped on a ward for six months, costing the NHS more than £80,000.
Underfunding causes Kent to halt non-urgent surgery
West Kent CCG has run so short of money that it has banned patients in its area from having non-urgent surgery for up to 102 days in an unprecedented move that doctors have condemned as unfair and damaging.
Medics highlight Trump's threat
A group of doctors sign a letter that condemns Theresa May's apparent embracing of the new president's actions, in particular the threat to our NHS of predatory US health corporations. They accuse her of appearing happy to accelerate the fragmentation and sale of NHS services to US markets.
Private ambulances increasingly used for 999 calls
Since 2010/11 the ambulance service has been finding £75million a year in efficiency savings. Ambulance services are increasingly calling in private firms to respond to 999 calls in the latest sign that NHS care providers are struggling to cope with the sharply rising number of patients who need urgent medical attention. And yet we're constantly told the economy is doing so well!
Seeing the same GP reduces hospital admissions for older patients
A BMJ study has found that patients who saw 'the same general practitioner a greater proportion of the time experienced fewer admissions'. Continuity of care among elderly patients reduced hospital admissions for ambulatory care sensitive conditions - those that could be managed in primary care - such as asthma, diabetes, influenza and pneumonia.
2nd February 2017
Consultancies get £2.3 million to write STPs
Private firms have been paid a ‘shocking’ £2.3m to draw up controversial plans which will cut health and social care spending by more than £1bn in a part of London. According to health leaders drawing up the North Central London STP (sustainability and transformation plan), six-figure sums were paid to eight different companies, including accountants Deloitte and management consultants McKinsey, for services stretching from ‘administrative support’ and ‘financial modelling’ to ‘communications support’.
RCGP: Many STPs must be rejected
A significant number of sustainability and transformation plans (STPs) should be rejected for failing to address general practice sustainability and workforce issues, the Royal College of GPs has said. STPs (aka Slash, Trash and Privatise) drawn up by local NHS organisations and councils, were in some areas planning for a reduction in GP numbers or zero growth in the workforce.
Nursing recruitment slumps after bursaries abolished
Applications by students in England to nursing and midwifery courses at British universities have fallen by 23% after the government abolished NHS bursaries, figures show. Nursing leaders said the sudden slump revealed by the latest university application data was inevitable given that student nurses now faced paying annual tuition fees of more than £9,000.
GPs have to beg for hospital appointments for their patients
GPs sometimes have to plead with hospitals to get a referral for a patient. Scrutiny by NHS clinical commissioning groups is causing exasperating holdups. Here a hospital CEO who has 'turned around' three hospital says if 'she [May] carries on with her current denial – and inaction – the NHS will soon cease to be able to cope'.
NHS entitlement scheme scheme could deter patients
A pilot scheme in which patients are asked to show two forms of identification before receiving NHS treatment could compromise access to care. The public accounts committee urged caution before officials extend the scheme, saying it could lead to entitled patients staying away from hospital.
30th January 2017
Hospitals 'dangerously full' in winter crisis
Hospitals were dangerously full during the recent onset of the winter crisis and breached an edict from NHS bosses to keep one in seven beds free, new analysis by the King’s Fund thinktank reveals. England’s 153 acute hospital trusts were told by NHS Improvement, the health service regulator, on 9 December to run at no more than 85% bed occupancy between 19 December and 16 January.
NHS intensive care 'at its limits' due to staff shortages
The NHS’s network of intensive care units is “at its limits” because they are overwhelmed by staff shortages and the sheer number of patients needing life-or-death care, senior doctors are warning in an unprecedented intervention.
Record number of cancelled urgent operations
Hospitals cancelled a record number of urgent operations last year as bed shortages left them struggling to cope with the growing number of patients needing surgery, NHS figures show.
Reaction to PM saying 'there's no crisis in the NHS'
Leaders of the BMA and the Health Financial Management Association and former health minister Norman Lamb take Theresa May to task for her denial of the crisis in the NHS.
27th January 2017
Over 100 complaints about Capita's take over of primary care services
In 2015 Capita was given the contract to run primary care services - administering payments to GPs and handling patient transfer records. There's been a catalogue of failures after the privatisation of centralised back office functions including patient record transfer delays and late payments for trainee reimbursements.
Routine GP referrals now blocked
GPs continued to face blocks on routine referrals as the number of NHS hospitals declaring the highest possible level of alert more than quadrupled in the second week of 2017, official data show.
What if the patient can't pay?
Patients could face paying their family doctors for out-of-hours appointments and minor procedures that fall outside the surgery’s contracted NHS work, under new plans being proposed by some GP leaders.
Weekend access is not key to improve NHS
...it just needs to be funded adequately! A report by Nottingham University Business School's centre for health innovation, leadership and learning found that patients wanted quick ideally same-day access to GP appointments, but that they did not express a strong preference for seven-day services.
23rd January 2017
Doctors - NHS 'will fail' this winter without extra cash
Hospital doctors have warned Theresa May that the NHS “will fail” this winter and patient care will suffer unless she provides an emergency cash injection. The leaders of 33,000 doctors from 30 medical specialties urged the prime minister to recognise that hospitals are “paralysed by spiralling demand” and warned of an exodus of personnel quitting the already understaffed NHS. It's likely this plea will fall on deaf ears, why? It seems the Tories are happy to see the NHS collapse.
Another reason why there's a shortage of GPs
Newly-qualified doctors are not moving into GP work in the numbers required. GP income has fallen for 7 years in a row and now GP practices have been denied a share of £218m of potential funding after NHS bosses withheld the largest ever share of quality premium funding from CCGs for the last financial year.
All hospitals leave nurse shifts with unfilled vacancies
Almost every hospital in England has fewer nurses on duty than each believes are needed to guarantee safe patient care, research shows. Analysis of official data by the Health Service Journal (HSJ) found that 96% of NHS hospital trusts in England had fewer nurses covering day shifts in October than they had planned and 85% did not have the desired number working at night.
PM wrong about GP opening hours
Almost nine in 10 GP practices in England provide appointments outside of core opening hours, according to official data that undermine Downing Street claims that GPs are adding to pressure on hospitals by failing to provide the 'access that patients need'.
Rally in Brighton to defnd NHS against STPs
Hundreds of people have attended a march and rally in Brighton to demand more money for an NHS "in crisis". The Brighton protest, organised by a coalition of groups, ended with a rally outside the railway station. Shadow Chancellor John McDonnell said the city, which has a hospital in special measures, was at the forefront of a crisis caused by underfunding.
Last community dental service in London shuts
NHS leaders has been accused of letting down patients in pain by shutting London’s last community-based A&E-style service for people needing emergency dental treatment. The British Dental Association "it’s absurd that NHS111 operators are asking patients to do ring-rounds [of dental surgeries looking for a free slot at short notice]."
18th January 2017
OBR: NHS needs £88 billion massive funding boost
The NHS budget will need to increase by £88bn over the next 50 years, meaning governments could have to raise taxes or cut spending in other areas to fund it, the Office for Budget Responsibility (OBR) has said. Or make extra effort to collect all taxes that are evaded.
Theresa May's 'wilful ignorance of NHS crisis'
Doctors' leaders have accused the government of 'wilfully ignoring' the crisis in the NHS after the prime minister again dismissed claims of a 'humanitarian crisis' in the service.
STP consultation in Cornwall 'absolute shambles'
An NHS consultation meeting on its Sustainability and Transformation Plan (STP) descended into shambolic chaos in Penzance, Cornwall. The meeting showed that NHS executives are underestimating the strength of feeling in local communities. Around 400 people attended the meeting on Tuesday 10 January. The organisers did not predict so many would show as it was standing room only. Here's a video of the meeting.
NHS cannot carry on as it's funded
Here's a realistic assessment from the chair of a London NHS foundation trust, Lord Bob Kerslake. "Increasing demand and continuing advances in healthcare mean that it needs additional funding year on year of around 4% above inflation. Whenever it has not had this for any sustained period of time, it has run into trouble.". Underv the Coalition and now the Tories it's been getting less than one percent increase - to talk of 'protecting' the NHS is very wide of the mark.
Is it right that GPs are asked not to make hospital referrals?
This is what is happening, so the danger is that this pressure results in a serious medical condition not getting proper treatment.
Commons watchdog slams government's 7 day access plans
The government has failed to consider fully the consequences and cost-effectiveness of plans to roll out seven-day GP services across England by 2020, according to a damning report by the National Audit Office.
One of the reasons why you have trouble getting a GP appointment
GP practices have been denied a share of £218m of potential funding after NHS bosses withheld the largest ever share of quality premium funding from CCGs for the last financial year.
2nd January 2017
Government underfunding = hospitals' toughest winter
As if you didn't know, England's NHS is underfunded; that is, despite a small increase in overall NHS budget, it isn't anywhere near that required to meet increasing demand for healthcare. Now, figures released by NHS Digital - I've never heard of them either - show that record numbers of patients are leaving A&E units without being treated. A further point lest you believe the stories that we can't afford a National Health Service, the NHS costs less than that of most other developed countries.
Father dies and scheme to relieve pressure on A&Es suspended
A scheme to reduce pressure on an Accident and Emergency unit has been suspended following the death of a "devoted" father denied casualty treatment just six days after it launched. The trial was one of dozens being set up on health officials’ orders amid a growing crisis over hospital overcrowding. Alternatively, the government could a) fund the NHS adequately (see above), and b) initiate a comprehensive public health programme to improve diets, increase rates of exercise and reduce smoking prevalence, so that demand for healthcare reduces in the long term. Instead, the government cuts public health budgets.
Number of urgent operations cancelled hits record high
The number of NHS patients in England who had urgent operations cancelled hit record numbers in November, soaring to almost double the level a year ago, according to government data.
NHS rationing:Needless suffering of hip and knee patients
Hundreds of thousands of elderly people are needlessly suffering in pain while they wait for hip operations because care is being rationed by the NHS, leading doctors have warned.
Shortage of paramedics
Ambulance services are facing serious shortages of paramedics just as 999 calls hit new peaks and hospitals gear up for a potential winter crisis, new official NHS figures reveal. The 10 regional ambulance services in England are short of 873 paramedics, data shows, and some are recruiting paramedics from Poland, Finland and Australia to plug gaps in winter services.
"NHS should shift focus to home-based care"
The NHS needs to spend more money looking after people in their own homes rather than in hospital, the chief nursing officer for England has warned. Jane Cummings of NHS England said too much cash was being pumped into caring for patients in “old and expensive” hospitals, rather in a more efficient domiciliary setting. But is there conclusive evidence that home-based care is cheaper? "The majority of the published evidence fails to contain robust cost information on infrastructure, planning and start-up costs."
19th December 2016
NHS patients wait while hospitals take more private patients
Income received by NHS hospital trusts from private patients has risen by 23% in the last four years, as waiting lists for non-paying patients have soared. Under the government’s reforms, hospitals have been given the right to raise 49% of their funds through non-NHS work, often from patients seeking to avoid waiting for surgery. Prior to this, there had been a 2% cap on income that could be raised from private patients.
Winter crisis: Hospitals told to delay operations
Hospitals in England have been advised to halt elective surgery over Christmas to ensure enough beds are free for patients who need emergency treatment at the end of the year. In a sign of the intense pressures on NHS resources over the winter months, the regulator NHS Improvement said all hospitals should make more beds available between now and mid-January.
Another drug firm accused of NHS over-charging
Following the scandal of Pfizer's overcharging, see below 12th December, Actavis UK hiked the price of ‘lifesaving’ drugs by over 12,000% compared to branded versions, the government’s competition watchdog has alleged. Actavis charged ‘excessive and unfair prices’ for generic versions of hydrocortisone, the Competition and Markets Authority (CMA) claimed.
12th December 2016
Sharp rise in A&E waits
There has been a sharp rise in “trolley waits” – the length of time people wait for a hospital bed in England after being admitted in an emergency. 473,453 patients waited more than four hours between October 2015 and September 2016 – almost a fivefold increase since 2010-11. More than 1,400 patients faced delays of more than 12 hours. Three-quarters of hospitals in England are reporting bed shortages. Bed occupancy is not meant to exceed 85%, to give staff time to clean beds, keep infections low and ensure patients who need beds can be found them quickly.
Acutely ill children wait 9 hours for bed
Seriously ill children are waiting up to nine hours for an intensive care bed to become available, while others are being transported up to 120 miles from their homes to receive the medical treatment they urgently need, senior paediatricians have revealed. In addition, NHS England is having to send anorexic patients to Scotland due to a shortage of mental health in-patient care.
Better Care Fund is failing to deliver
Government scheme designed to relieve the strain on overcrowded hospitals, the Better Care Fund, is failing to deliver its aims of keeping older people healthy at home and so cutting “bedblocking”, despite £4bn a year being poured into it. Under the Better Care Fund councils receive money, mainly from the NHS budget, in return for introducing schemes to reduce demand for hospital care.
Pfizer fined £84.2 million for NHS overcharging
The pharmaceutical company Pfizerhas been fined a record £84.2m by the UK’s competition regulator after the price charged to the NHS for an anti-epilepsy drug was increased by up to 2,600%. Pfizer sold the rights to another company which deregulated it, allowing it to raise the price.
Dorset CCG denies plans to close most GP surgeries
An STP plan for primary care in dorset proposes to reduce the number of GP locations across the county from 131 to as few 36. The plans would see the existing 97 practices, consolidated into practice networks delivering core services at fewer locations supported by centralised primary care hubs. This would end the cornerstone of NHS primary care, the partnership GP, and open the door to corporate takeover of our family doctors.
5th December 2016
BMA: STPs are cuts in disguise
The docile doctors union wakes up to the real purpose of government plans. If we let it happen £22 billion will be wiped from the annual NHS budget, and in addition each area (footprint) must pay off its deficit accrued due to underfunding since 2010. Unless we stop it this is the end for a comprehensive health service.
The corporate take over of commissioning takes shape
Four sustainability and transformation plan areas will spearhead system leaders’ plans for regional back office mergers across the NHS, which could require significant changes to local governance structures. (So long the idea of local GPs controlling commissioning). The Greater Manchester, Kent and Medway, mid and south Essex, and north west London STPs have been selected to be “pathfinders” for the programme. Which of the "big four" will get the contract I wonder?
Children needing intensive care moved long distances
Seriously sick children are having to be transported long distances to receive intensive care this weekend because of a lack of beds in major cities. In England, 85% of beds available in paediatric intensive care units were full on Friday night. But some units in cities including London and Leicester have been forced to declare themselves as “at capacity”.
Town with dwindling GP service
There are fears that general practice in one English town could 'go under', with five practices having closed their list and a sixth practice set to close for good, potentially leaving 7,000 patients without a GP practice. All six practices in the north Yorkshire coastal town of Bridlington have stopped registering patients.
First public consultation on STP
The reason for the secrecy surrounding STPs is about to be revealed as Dorset becomes the first footprint (area) to consult the very people who pay for the NHS, about plans to put massive NHS cuts in place. Since £22 billion is to be cut from the English NHS budget, the public can have its say on the way that Dorset's STP leaders pretends it can provide a comprehensive health service on already stretched funding. Whether the STP leaders take any notice of the public's fears is another matter.
1st December 2016
Hammersmith & Fulham threatens legal action over STP
Hammersmith and Fulham have threatened to pursue legal action in a bid to protect local health services from cutbacks and closures. Campaigners fear new plans will cut more than £1 billion from the local NHS budget and lead to the closure of acute hospital services.
Hunt says call for more funds is a 'misjudgement'
Jeremy Hunt has said calls for more money for the NHS are a “misjudgment” less than a year after the health service received a “good settlement” from the government. His deception can't hide the fact that NHS funding has increased by the smallest proportion since the 2nd World War and that record hospital trust deficits have accumulated as a result.
Ambulance target failures highlight NHS crisis
Figures showing that every ambulance service in England failed to meet response time targets for the past 16 months are a sign of a system-wide problem, NHS England has admitted. They also showed that the number of patients waiting for ambulances for more than an hour had almost tripled in the past two years, and that ambulance crews were wasting more than 500,000 hours queuing outside hospitals.
28th November 2016
STP deskills NHS nursing
It's becoming clear that the primary aim of STP is cost cutting. Workforce costs in a south of England region will be cut by more than £30m through changes to the nursing skill mix including greater use of “generic support workers”. The Buckinghamshire, Oxfordshire and Berkshire West sustainability and transformation plan says it will achieve the savings by the “use of generic support workers (across health and social care), reduction of nursing grade input, increased use of healthcare assistants and physicians associates.
Preparing for corporate take over?
A US-style Accountable Care Organisation will be formed by Oxford University Hospitals Foundation Trust, Oxford Health FT and GP federation Oxfed. It will take over responsibility for primary care in 2017/8. Although initially a not-for-profit organisation, it's a copy of US organisational healthcare, so is this preparation for eventual corporate privatisation?
NHS hospitals in chronic bed shortage crisis
The Royal College of Surgeons has warned of a chronic shortage of NHS hospital beds in England, after occupancy rates for overnight stays topped 89% for a fourth successive quarter. The maximum occupancy rate for ensuring patients are well looked after and not exposed to health risks is considered to be 85%, a figure that has not been achieved since NHS England began publishing statistics in 2010. In response the government is not to plan investment in more NHS provision (we have one of the lowest hospital bed rates in Europe) but to tell hospitals to divert patients to private hospitals.
Care for elderly close to collapse
The medical profession, together with Tory, Labour and Liberal Democrat leaders in local government, have demanded a funding U-turn, warning that the safety of millions of elderly people is at risk because of an acute financial crisis completely overlooked in chancellor Philip Hammond’s autumn statement.
24th November 2016
Another example of the waste due to privatisation
Here's an example of why the NHS is perhaps, no longer the most efficient health service in the world, as it once was; non-medical overheads have shot up as a result of the Health and Social Care Act. Humber Foundation Trust has launched a legal challenge after losing out on a five year contract to run community services. It has asked the High Court to halt the procurement process and consider the criteria used by East Riding of Yorkshire Clinical Commissioning Group to award the contract to a rival bidder. The trust is the CCG’s current provider of community services.
Don't know what STPs are?
Then go to the Stop The STPs website. Sustainability and Transformation Plans will be full of promises - claims about how wonderful it will be - and jargon, MCP (multispeciality community provider), ACO (accountable care organization) being just two expressions trying to convince you of its competence, there to confuse and to obscure its real objective, which is to reduce the cost regardless of consequence.
Leaked STP docs reveal A&E downgrades
The sustainability and transformation plan for Cheshire and Mersey includes the downgrade of at least one accident and emergency department, along with a major consolidation of elective care. The document refers to the downgrade of the emergency department at Macclesfield District General Hospital to a minor injuries and illnesses unit as part of a “remapping” of services at East Cheshire Trust. There's another STP euphemism to watch out for - remapping. It also says it will need £755million of capital to deliver its STP - where from I wonder?
Government auditor doubts whether STPs are sustainable
The National Audit Office called on the government to assess whether national and local sustainability plans, which aim to save £22bn by 2020/21, are achievable. The NHS should set realistic and informed efficiency and savings targets for local NHS bodies, it added, warning against ‘overly optimistic targets’ that could be ineffective.
Doctors to boycott plan for patients to show passports
Doctors have reacted with fury to a plan, put forward by a senior official in the Department of Health, for patients to show passports when seeking healthcare. Dr Simon Stallworthy described it as “disgusting”, saying it was not the role of the NHS to be “actively working to kick migrants out”.
Private providers are part of NHS's problem, not the solution
In a letter to the Guardian, a founder member of Keep Our NHS Public, rebuffs a commentor who says private companies can help the NHS. She says the private sector has always been there, but as a peripheral presence and not competing with the NHS. The compulsory competition introduced by Andrew Lansley has been a very costly failure. The private sector is expensive, unaccountable, and will walk away when it can’t make a profit.
21st November 2016
The idiocy of STPs: GP numbers to be cut
Under proposals drawn up by local NHS and council leaders GP numbers will fall, while practices will be expected to employ a greater range of new staff. The STP for Somerset is the second to propose a reduction in GP numbers over the coming years as part of NHS reforms.
Cost cutting under STPs
You are less likely to see a doctor under sustainabilty and transformation plans being reluctantly revealed. Now STPs will replace trained hospital nurses with less qualified staff.
STPs 'shrouded in secrecy'
A report from the usually cautious thinktank the Kings Fund says the latest government plans for reorganising health and social care in England have been kept shrouded in secrecy by NHS England and taken little note of the views of the public and frontline staff. The planned cuts are laid bare in this BBC article.
Could STPs collapse as the result of the coming winter crisis?
As winter approaches, NHS managers in England will be even busier than usual handling the increased volume of emergency admissions to hospitals and juggling demands for beds will be as tough as ever. On top of that will be a raft of meetings discussing sustainability and transformation plans (STPs), designed to cut NHS budgets.
Private sector profiting as NHS crumbles
It seems the Conservative austerity programme will continue, despite lengthening waiting lists, greater rationing and mounting concern over how the NHS will get through the winter. In contrast, an investigation shows private healthcare in the UK is buoyant; major healthcare companies are seeing profits more than double.
Call for increased social care funding
Phillip Hammond is being urged by senior Tories to give the crumbling care system a double boost in his autumn statement, amid growing alarm that social care and the NHS will be unable to cope with demand this winter. NHS bosses say the promised extra £8 billion for the NHS is not enough.
14th November 2016
Teresa May 'in denial over NHS funding'
Meg Hillier, the chair of the Commons public accounts committee, wrote in a letter to the prime minister on that growing evidence disproved her insistence that the NHS was getting enough money. She wrote "... concerns have also been raised by the chair of the health select committee, Dr Sarah Wollaston MP, in her letter to the chancellor of the exchequer on 26 October. I was dismayed that the official government response was to deny there was any issue. This flies in the face of the evidence that our committees and the National Audit Office have uncovered.”
Tax dodging Branson wins social care contract
Virgin Care is a subsidiary of Richard Branson’s Virgin Group Holdings Ltd. Virgin uses 13 intermediate holding companies to distance the firm’s healthcare division from its parent company, which is based in the tax haven of the British Virgin Islands. Now it has won a £700m contract to deliver 200 types of NHS and social care services to more than 200,000 people in Bath and north-east Somerset. It is right that a tax dodging company should profit from our NHS budget?
MP demands compensation for 'shambolic' Capita GP service
An MP hits out at the appalling primary care support service now run by Capita. It was granted a 10 year contract last year. The MP identified late payments, problems with patient record transfers, shortages of prescription pads and other concerns that practices have raised.
GP partner vacancies unfilled after a year
Almost half of vacancies for GP partners and a third of vacant posts for salaried GPs have been unfilled for more than a year. Also more than 5m patients in England could be forced to look for a new GP over the next year as surgery closures hit record levels. The government is clearly not uncomfortable with the difficulties faced in primary care, no doubt viewing corporate take over of our GP service.
Cancer patients not getting care on time
Hospitals are struggling with growing number of people suspected of having the disease. More than 130,000 patients a year are not receiving vital NHS cancer care on time because hospitals are struggling to look after the growing number of people suspected of having the disease.
2nd November 2016
At last! Private firm loses patient transport contract in Sussex
The privatised patient transport service in Sussex, criticised for delays in taking patients to hospital, has lost its contract. Thousands of people signed a petition calling for the NHS to end its agreement with Coperforma in Sussex. There has been a catalogue of problems since Coperforma took over patient transport, with patients left stranded at hospital or at home and missing appointments.
MPs challenge May's claim for extra NHS money
Theresa May’s claims that the government is putting £10bn extra into the NHS are untrue and the underfunding of the health service is so severe that it may soon trigger rationing of treatment and hospital unit closures, a group of influential MPs have warned Philip Hammond. MPs led by the Conservative Dr Sarah Wollaston, the chair of the Commons health select committee, have written to the chancellor demanding the government abandon its “incorrect” claims.
Extra NHS funding: how much and crucially - when?
The competing claims about additional NHS money are confusing. So this article attempts to unravel the stories. It transpires that it's an accumulation of extra money in ther next few years. But since demand for NHS services is rising at an alarming rate, £8 billion over the next 5 years is no where near enough.
Tory MP calls for more money in Autumn statement
House of Commons health select committee member Dr James Davies said the chancellor should allocate new capital funding to the NHS in this month’s autumn statement to support new care models being developed under sustainability and transformation plans (STPs).
STP care home plan impossible without investment
A scheme in the Sustainability and Transformation plans for South West London to fund regular named-GP visits to local care homes to provide healthcare, health and wellbeing reviews and end-of-life planning, is not achievable. Sutton LMC chairwoman Dr Rebekah Dowdy said the scheme is not viable without the extra funding.
31st October 2016
Theresa May accused of lying over NHS cash increase
Theresa May’s claims that the government is putting £10bn extra into the NHS are untrue and the underfunding of the health service is so severe that it may soon trigger rationing of treatment and hospital unit closures, the Commons health select committee has warned.
Privatisation of primary care begins
A private GP service that delivers a ‘GP to your door’ for £120 has launched in Birmingham after proving popular in London. GP Delivered Quick says it is the first of the new online app GP services to offer on-demand home GP visits. Should private GP services for the affluent be allowed, while NHS GPs are under massive strain trying to administer to the less well-off?
Hunt announces a transfer of hospital services to GPs
Jeremy Hunt has announced a new programme aimed at moving more patient services to GP practices from hospital. Mr Hunt said that under his ‘GP one-stop programme’, the NHS will be going through ‘condition by condition’ to see which can be handled in general practice rather than secondary care. How can the pretense that GPs can absorb work done in hospitals go on? NHS GPs are at breaking point. GP partnership income has fallen constantly since 2010. There’s a massive shortage of GPs; recent government changes have made primary care unattractive to the newly qualified.
Sussex patient transport crisis: government minister misled parliament
See below, 27th October, for details of Sussex's privatised patient transport disaster. Now Caroline Lucas has revealed that a government minister lied to parliament by saying that a firm that didn't have a licence to operate has been told to stop working.
27th October 2016
Private companies profit as our NHS is at breaking point
An investigation has revealed that private companies are boosting their profits by up to 100% as the health service struggles to cope. An analysis of company reports and statements from all the major private hospital chains that make their figures available shows all have boosted their revenues this year.
Privatised patient transport may be illegal
The privatised ambulance service in Sussex has been plunged into fresh controversy after it emerged that one company may not even have a licence to operate. The body responsible for regulating England’s health and social care services cannot confirm whether Docklands Medical Services Ltd (DMS) are in breach of the law. The contract was given to Coperforma who take calls and hand them on to sub-contractors one of whom, Docklands, may be operating illegally. The Department of Health say it will investigate, or is this just a way of playing for time?
NHS privatisation plans hidden from the public
Plans for shocking levels of cuts to the NHS, under the guise of cost saving, have been hidden from the public for months. But a group of NHS workers and campaigners have now begun to expose the extent to which services may be cut and privatised. They’re raising awareness by marching for seven days across the north of England.
LMC leader says ST plans are 'undeliverable'
Local Medical Committees (LMCs) are local representative committees of NHS GPs and represent their interests in their localities to the NHS health authorities. Sustainability and Transformation plans must 'modernise' NHS services and crucially, eliminate the record-breaking deficits that have accumulated due to underfunding since 2010. The leader of Birmingham's LMC says it just isn't possible to deliver a comprehensive health service and yet make massive cuts.
20th October 2016
Caroline Lucas's letter on NHS privatisation
Her letter to a local paper starts "Of all of the government failures in recent years perhaps the most profound is the systematic undermining of our most precious public service, the NHS."
Hospitals save millions by cutting agency nurse fees, but...
The NHS has slashed more than £600m from the billions it pays every year for temporary doctors and nurses by cracking down on fees paid to “rip-off” staffing agencies, new figures reveal. Of course had the Coalition not cut nurse training places then those nurses would have been fully-trained and looking for jobs now; and now the Tory government has cut bursaries for nurse training. Now if I were a conspiracist I would say they're out to destroy the NHS - silly me for thinking such a thing!
STPs told to publish sanitised summaries
In an article for the Health Service Journal NHS England has instructed STP leaders to publish summaries that "...articulate tangible benefits for patients” in language that is “clear and compelling..explaining how the plans will strengthen primary care, improve secondary services, achieve access targets, prevent illness and create financial sustainability." So watch out for some inventive euphemisms for massive health cuts coming to your area!
March in Ilfracombe to oppose hospital cuts
A march was held in Ilfracombe to raise awareness of the threat to acute services at North Devon District Hospital, and to garner support for a similar event in Barnstaple this coming Saturday 22nd October. Brilliant Ilfracombe and Barnstaple, keep it up, we're simply not being told of the extent of cuts planned for our NHS.
17th October 2016
Teresa May: 'No extra money for the NHS'
Despite the news of the NHS reaching a crisis (see below) the prime minister dashed any hopes of a cash boost in next month’s autumn statement. She has told the head of the NHS that it will get no extra money despite rapidly escalating problems that led to warnings this week that hospitals are close to breaking point.
'Areas of NHS will implode'
Parts of the NHS “will implode” this winter, an expert has warned, as new figures show falling A&E performance over the past few months. Dr Mark Holland, the president of the Society for Acute Medicine, said the days when summer used to provide a respite for busy emergency departments had gone, and instead the NHS faced an “eternal winter”.
Eigth in 10 NHS hospitals not safe enough
Eight in ten hospitals are not safe enough, with rising numbers overloaded by a crisis in care of the elderly which is approaching “tipping point." A major report by the Care Quality Commission (CQC) reveals Accident & Emergency departments buckling and patients suffering harmful blunders as pressures mount.
80% of GPs dissatisfied with privatised service
Capita took over responsibility for running Primary Care Support England (PCSE) in September 2015 in £400 million deal for up to 10 years, and promptly closed many of the regional administration centres. But now responses from more than 1,000 GP practices on satisfaction with the primary care support service provided in the first half of 2016 show that just 21% overall were satisfied.
13th October 2016
Virgin Care makes unnecessary appointments to boost profits
Healthcare provider Virgin Care has been forcing patients to attend extra appointments to boost profits, says former employee and the Labour MP for Dewsbury, Paula Sherriff. She accused Virgin Care of insisting on “extra consultations before surgery, boosting their profits at the expense of the taxpayer and patient safety”. Before she stood for parliament, Sherriff worked in Virgin Care’s dermatology service in West Yorkshire.
GP sustainabilty plans are 'undeliverable' says NHS Providers
Regional sustainability and transformation plans (STPs), which have to secure the future of general practice across England will fail because they are 'vastly overambitious', MPs have been warned. Chris Hopson, the chief executive of NHS Providers, an organisation representing NHS trusts told the House of Commons Health Committee that nearly every member of NHS Providers is working on undeliverable plans to meet their 2020/21 financial allocation set out by NHS England.
NHS underfunding: hospital 'tipping point' soon
Since 2010 government has failed to increase the NHS budget to keep pace with increrasing demand for healthcare. There have been small increases but no where enough. Now a major report by the Care Quality Commission (CQC) reveals Accident & Emergency departments buckling and patients suffering harmful blunders as pressures mount.
10th October 2016
Concern for the NHS is public's top issue
The state of the NHS has narrowly replaced immigration and Brexit as a key issue facing Britain in the minds of most voters, according to a new survey of public opinion by pollsters Ipsos Mori. Two out of five (40%) mentioned the health service, hospitals or healthcare as a concern to them – more than cited for any other issue.
Could GPs opposiiton on STPs force a rethink?
Opposition from GPs could force a rethink on sustainability and transformation plans (STPs), health minister David Mowat has told the RCGP conference. He said 'STPs will not go forward if they are not right. It does seem to me to be very hard in an area if there is a consensus of GPs that has concerns about the STP to say that it is right'. I'll believe it when it happens.
Royal Colleges warn Hunt off his anti-foreign doctors proposal
In his conference speech Hunt pledged that the NHS in England will be “self sufficient” in doctors after Britain leaves the European Union by allowing medical schools to offer 1500 extra student places. But the presidents of two of the profession’s medical royal colleges tell the health secretary that his move has demoralised overseas doctors already working in the NHS and could deprive it of the long-established supply of foreign medics it depends upon.
6th October 2016
Crisis in children's mental health services
There is a crisis in children's mental health. Since 2010 there's been a £50 million reduction in spending on children's mental health services resulting in unacceptable waiting times for a child referred for mental health support. Here children seeking help tell their stories.
Health minster says don't object to STP cuts in NHS services
Health minister Phillip Dunne told a meeting that many STPs are ‘likely to involve some changes’, including changes to ‘bricks and mortar’. meaning selling off NHS sites. He said that while such proposals ‘inevitably gives rise to concern that they (the public) are losing a cherished facility’, he hoped politicians would recognise the integration and transformation the plans were trying to achieve were a ‘good idea’. So shut up and don't complain when they take away your local A&E!
Hunt tells GPs to copy bankers
Jeremy Hunt told an RCGP fringe meeting at the Conservative party annual conference in Birmingham that better use of new technologies could help patients do more to manage their own health, and give GPs more time for complex patients. He said they should copy what bankers have done - but not cause an economic crisis I hope.
Hunt: safety not improved by more funding
Jeremy Hunt has said, in his conference speech 'just writing a cheque doesn’t raise standards’. Is he in touch with what's really going on in the NHS? I suspect that most hospital trust finance directors, and over-worked doctors and nurses, would tell you that an immediate injection of funding is imperative.
29th September 2016
Junior doctors challenge: Not a total victory for Hunt
The high court decision on the junior doctors challenge to Hunt's imposition of a new employment contract has been widely reported as a victory for the government. The judge said that the Secretary of State does not purport to exercise any statutory power to compel employers to introduce the new contract, even though Hunt repeatedly stated his intention to impose it; in principle individual employers are free to negotiate different terms with employees.
Former head of NHS commissioning speaks of 'shameful pace of STP rollout'
Julia Simon, until earlier this month the head of NHS England's commissioning policy unit said forcing health and care organisations to come together so quickly to draw up the complex plans was likely to backfire. Up against tight deadlines, organisations were likely to make unrealistic financial forecasts and claims about benefits to patient care
26th September 2016
MP says Sussex patient transport must go back to NHS
Sussex MP has called for a privately-run patient transport service to be brought back into the NHS. Coperforma has faced intense criticism since the non-emergency hospital transport service in April. Patients say they have experienced delays reaching appointments and sub-contractors have said they were .
NHS providers warn of imminent collapse
In an unprecedentedly bleak assessment of the NHS’s own health, NHS Providers, which speaks for hospital trust chairs and chief executives, tells ministers that widespread breaches of performance targets, chronic understaffing and huge overspends by hospitals mean that it is heading back to the visible decline it last experienced in the 1990s; in fact the last period of Tory government.
Kings Fund: read STPs with scepticism
The respected think tank The Kings Fund says "STPs should therefore be read with a degree of healthy scepticism when the final versions that are submitted in October are published." Hospital bed occupancy this summer was 90% - the rate seen in recent years only in the depths of a winter crisis. So how can there be a reduction in hospital beds in STP plans?
Out of hours services without doctors
NHS out-of-hours services are being run without a single doctor in some parts of the country, as other practices turn to refugee medics to plug desperate shortages of GPs.
22nd September 2016
NHS is 'underfunded, undoctored and in crisis'
A report by the Royal College of Physicians states that NHS funding and numbers of doctors in training must urgently be increased to ease pressure on a health service increasingly struggling to cope with soaring demand.
Chronic shortage of GPs predicted by RCGP
Patient safety will be at risk unless the 'chronic shortage' of GPs is addressed, the Roayl College of GPs says, with 594 GP practices at risk of closure by 2020 and a likely shortfall of 9,940 GPs. RCGP chair Dr Maureen Baker said: 'It is imperative that we recruit huge numbers of medical students and foundation doctors into general practice in order to keep the NHS on its feet'.
Consultants will be forced to reveal earnings from private work
At the inception of the NHS in 1948 the Royal College of Surgeons committed itself to the NHS only if surgeons were allowed to perform private work. Now will have to reveal the amount of money they earn from private work under new plans to improve transparency. Shouldn't we demand transparency for bankers pay as well, especially since we're suffering austerity due to their greed?
RNIB: Patients in England wait 15 months for cataract operations
A report by the Royal National Institute for the Blind says that patients in England are having to wait up to 15 months to have cataracts removed from their eyes amid increasing rationing linked to the NHS’s deepening financial woes. It states ther long delays caused by NHS drive for ‘efficiency savings’ causing misery for mainly elderly patients.
The truth about STP by an NHS campaigner
A blog run by NHS campaigner reveals the truth behind the management reconfiguration drival spouted by NHS England. It's really about cutting budgets and privatisation.
19th September 2016
Hunt challenged in court today by junior docs
Justice for Health – a campaign group established by five junior doctors, including two GP trainees, issued a legal challenge 'against the imposition of an unsafe and unsustainable contract'. A judicial review will be held today and tomorrow at the Royal Courts of Justice, London. Despite a mainstream press blackout of such news I feel the 5 doctors should be held as heroes upholding the founding principles of comprehensive high-quality healthcare for all.
Ongoing disaster of privatised patient transport in Sussex
Employees working in the privatised Sussex patient transport service turned up to find several bases closed. Coperforma took over the contract back in April and according to the company itself the service is ‘now on the road to recovery after its disastrous start six months ago’. But a day later staff working for Docklands, one of Coperforma’s sub-contractors, have turned up to work to find stations closed in St. Leonards, Worthing, and Bognor.
STP leaders told 'Don't let old-style contracting hinder your STPs'
So STP leaders, go out and choose those cheap and nasty private companies that provide disastrous services because cutting NHS budgets is really what STP is all about. Expressed by the National Health Executive as redesign and reconfigure NHS services to improve and make them suitable for the 21st century.
16th September 2016
Letter from doctors asnd scientists challenge Hunt's weekend claim
Stephen Hawking, Robert Winston and a number of senior doctors are urging Theresa May to hold an inquiry into Jeremy Hunt’s claim that 11,000 patient deaths a year are caused by a lack of medics on duty in hospitals.
Patient safety at risk due to privatisation
Patient safety is being compromised due to multiple serious failures in key primary care support (PCS) services run by Capita, the BMA has warned. Multiple failures’ in back office support services since they were taken over by outsourcing firm Capita have compromised patient safety, the BMA has said.
The first 5 day junior doctors strike called off
The BMA is suspending the industrial action planned for the week of 12 September. The remaining programme of industrial action stays in place. To quote from the BMA " [Hunt] .... continues to force upon junior doctors a contract that discriminates against carers, parents, doctors with disabilities and women, a contract that devalues our time and a contract that disincentives careers in our most struggling specialties. He continues to strive towards an uncosted, unfunded, unstaffed extended seven day service. He continues to disregard the concerns junior doctors have about staffing shortages and patient safety."
Quarter of CCGs and half NHS trusts will end the year in deficit
A total of 23% of CCGs and 47% of NHS trusts said they expected to end 2016/17 in deficit, the Kings Fund's quarterly monitoring report found. The proportion of CCGs predicting a deficit has doubled since this time last year.Meanwhile, key NHS performance targets are now being missed not just in winter but all year round as demand facing the health service hits unprecedented levels, the report's authors warned.
GP numbers will drop by one third under STPs
What a way to run a health service! GP work has been made so unattractive to newly-qualified med students that there's a shortage of GPs, and now STP will drive primary care into to certain collapse.
7 day GP services not cost effective
Seven-day GP services and extended opening can significantly reduce patients' use of A&E, but the cost of the services far outweighs savings generated in hospital, a study suggests. Findings from research on an extended access scheme in Manchester shows that funding of £3.1m across 56 GP practices generated savings in hospital worth just £767,976. The study compared GP and A&E attendances in 2014 at the 56 practices funded to extend their opening hours into evenings and weekends with 469 practices across the area that did not receive this funding.
2nd September 2016
Junior doctors to strike for 5 consecutive days in September
The British Medical Association has announced a new wave of strikes by junior doctors in England over their contract, beginning with an unprecedented five-day walkout this month. Its members rejected the the government’s final offer on the contract and will commence with a “full withdrawal of labour” between 12 and 16 September, with further dates to be announced.
Hunt proceeds with contract imposition despite strike announcement
So no sign of a conciliatory approach from Hunt. His response to the strike announcement on BBC Radio 4's Today programme was to restate his determination to impose the rejected junior doctor contract.
STP: Details of massive cuts in surgery numbers emerge
Campaigners have been saying that the central thrust of Sustainability and Transformation Plans will be severe NHS budget reductions resulting in draconain cuts to our health services. And so it is slowly being revealed, this first revelation of the undemocratic and secretive STP process, is that local areas are proposing to reduce GP surgery numbers as part of significant long-term plans to make savings.
Public health spending: Say one thing and do the opposite
MPs have slammed a 'growing mismatch' between spending on public health and the importance attached to prevention in NHS strategy. The head of NHS England Simon Stevens’ said in his Five Year Forward View "The first argument we make in this Forward View is that the future health of millions of children, the sustainability of the NHS, and the economic prosperity of Britain all now depend on a radical upgrade in prevention and public health." But under this Conservative governement public health budgets have been slashed.
Head of NHS finance joins private lobbying group used by Virgin Care
The Department of Health official in charge of money at the NHS has left the civil service to join a lobbying firm that represents Virgin Care and a host of other health privatisers. In February 2016, Richard Douglas, the Department of Health's Director General of Finance, joined lobbying firm Incisive Health. Incisive Health is a health consultancy set up in 2013 by Bill Morgan, who was previously special adviser to Tory Health Secretary Andrew Lansley, when Lansley pushed through the latest round of NHS privatisation.
29th August 2016
Hunt's 7 day NHS plan: officials have concerns
Leaked Department of Health documents reveal senior civil servants have concerns over Jeremy Hunt's proposed seven day NHS service. They say the health service has too few staff and too little money to deliver the government’s promised “truly seven-day NHS” on time and patients may not notice any difference even if it happens.
STP - bound to enrage local commumities
NHS England's Sustainability and Transformation Plans (for explanation of STP see articles in 7th and 1st August, and 18th July below) are bound to trigger major political battles ahead. The plans mean that today's massive hospital trust deficits have to be paid off by 2020. Significant cuts in services are inevitable; A&Es will close, hospital wards shut down, hospitals themselves downgraded to little more that urgent care centres.
Investigation reveals government's plans for cuts and closures
Owing to ever-increasing demand, the NHS budget requires a 3% to 4% annual increase just to provide the same level of service. but has been receiving less than 1%. Thus hospitals have accumulated unprecedented levels of deficits. An investigation reveals that there are NHS closures and radical cuts on the way.
Local cuts to NHS services
The Guardian newspaper invites readers to write in to report cuts to their local NHS services. Wendy Savage, president of Keep Our NHS Public, suggests abandoning market reforms would save the NHS millions.
Privatised service fails yet again
Capita won a 10 year contract for primary care support services but has repeatedly failed in the service it provides. Now it's has done it again. Following the report of its failure in transferring patient records (see 1st August below), now GP practices have been left without thousands of pounds of trainee salary reimbursements this month.
22nd August 2016
Why sustainability and transformation plans are dangerous
Dr Bryan Fisher explains why STPs are likely to endanger the NHS. For example, they are focused on reducing NHS spend. In south-east London, for instance, the STP has to bridge a £1.015bn gap in NHS funding over five years to 2020/21. And, after all the talk around the 2012 NHS Act about giving control to local areas, there's central government control. Unless STP plans meet the funding demands of the Treasury, areas will not receive any transformation money.
GPs say they are excluded from STP planning
GP leaders have said they are being 'excluded' from discussions over vital new plans currently being drawn up by CCGs, hospital trusts and local authorities that could reshape general practice in their area.
Look who's behind a new OOH and 111 service
A new service in the West Midlands sounds so wonderful, until you read “Providers contracted to provide the service include Badger, Shropdoc and Vocare, Care UK and Primecare” and then you know that it’s really about making profit by cutting staff costs and probably downgrading T&Cs for those that remain.
Petition launched against privatising Brighton & Hove's children's services
A petition has been launched to prevent community health services for children being run by a private company. Brighton and Hove City Council’s public health team has drawn up a new contract to run services including health visiting and school nursing in the city. Local campaigners fear it will mean reductions in staffing, downgrading conditions of employment for those that are left, and a resulting poorer service, to provide the profit margin if the contract goes to a private provider.
The accelerating closure of GP practices
Figures from NHS England’s local commissioners show the full extent of the contract chaos inflicted on the service since the health service reforms of three years ago. One GP leader said the figures confirmed the extent of the ‘catastrophe’ engulfing general practice. Also, read the comments at the bottom of this article to get the mood of partner GPs over how they have been treated by the government.
Why the NHS is now less efficient due to the Health and Social Care Act 2012
The process introduced by the Act requires NHS contracts to be offered to the market. This in turn demands legal and financial expenditure in the process called commissioning. This has lead to a reduction in the proportion of the NHS budget that goes to the medical front line because "NHS procurement" now involves a costly specialist organisation, where before there was minimal admistration. Billions could be saved by abandoning market reforms introduced by the 2012 Act.
7th August 2016
STP exposed as a privatisation ploy
Alex Scott-Samuel, professor of public health at Liverpool University, offers an alternative title to the guidance document published by NHS England, called 'Strengthening Financial and Accountability 2016-2017'. He renames it “Policing the government’s privatisation plans.” A priority for 2016/17 is “to facilitate independent sector providers to form NHS partnerships” - code for privatisation.
Healthy patients to be axed fron GP lists
The latest move by NHS England is to remove patients who haven't seen their GP for 5 years, thus the healthy patients, from GP lists. It has employes the outsourcing company Capita to begin a process of “list cleansing”, with the aim of cutting costs by ensuring accuracy over which patients are using which services. Under the initiative, those who have not seen their GP for five years will be sent two letters asking them to respond.
Diabetes drugs cost NHS nearly £1 billion a year
The cost to the NHS of prescribing drugs for diabetes has soared to almost £1bn a year, as the number of people diagnosed with the disease has risen sharply alongside the surge in obesity. With this cost likely to rise as obesity increases you may therefore question the wisdom of cutting public health budgets. The politically neutral Kings Fund describers cutting public health funding as the "falsest of false economies".
Huge profit made as NHS blood plasma supplier is sold again
A Chinese investment group, Creat, has just bought the privatised NHS plasma supplier from Bain Capital, only three years after the American private equity firm bought the NHS’s Plasma Resources UK from the Department of Health in 2013. This privatisation evaded Parliamentary scrutiny, as it was announced just as MPs were about to take six weeks holiday.
1st August 2016
Another failure of a privatised NHS support service
Following Capita's failure in patient record transfers, another scandal in a privatised support service. GPs have been missing out on correspondence dating back to 2011 due to errors made by private company ‘Sopra Steria’.
New GP contract demands that hospital admissions are reduced
Once again NHS England has found a way to cut GP income. This time GP practices that fully sign up to NHS England's new voluntary GP contract will see their funding decrease if they fail to reduce admissions. It's worth reading the comments by GPs about this proposal at the end of the article.
Southern NHS Trust underfire again
Following failures to investigate unexplained deaths in its hospitals, Southern Health NHS Foundation Trust is in the spotlight again. It's revealed it paid millions of pounds to consultancy firms run by previous associates of its under-fire chief executive, Katrina Percy.
Stevens admits new fund will go to pay off hospital deficits
Each area of England, or 'footprint' as they're called by NHS England, is required to submit Sustainability and Transformation Plans, in which it must balance its books by 2020. Thus the deficit that each area has accumulated because of underfunding through the Coalition years, must somehow be paid off. Only then will it qualify for a fund called STF - the Sustainabilty and Transformation Fund. Now the head of NHS England, Simon Stevens, admits that this year's tranche of the fund won't be for Sustainability and Transformation at all, but will go towards paying off the record deficit the NHS has accumulated.
25th July 2016
Dodgy accounting gets Hunt off the hook
The health secretary is likely to face a parliamentary inquiry into his department’s figures after the Commons public accounts committee accused him of “underhand” behaviour in publishing his department’s figures on the last day before MPs leave for their summer break. The Department of Health avoided busting its £118.3bn budget in 2015-16 only because it received £417m more than planned in extra national insurance receipts because of an “administrative error” for which it will not be punished.
Privatised medical records contract is a disaster
The BMA warns that problems with the primary care support service run by Capita had caused 'serious disruption for general practice'. GPs have experienced failures in patient record transfer, delivery of supplies and payment problems since NHS England handed over responsibility to Capita. Capita won a 7 to 10 year contract worth around £400 million to take over primary care support services in 2015 - see 9th June below.
Nine CCGs in special measures
For 2015/16 CCGs were rated according to five criteria. As a result nine CCGs have been placed into special measures by NHS England following the assessment of how commissioners have been discharging their responsibilities. In new measures announced by NHS England in future the CCGs could be disbanded, other CCG's might share management, or a new accountable care organisation might take on responsibility for the local population’s healthcare.
21st July 2016
Health spending to rise about half what government claims
Health spending in England is set to rise just £4.5bn in real terms by 2020/21 despite government claims it would increase by £8.4bn. The House of Commons health select committee said cuts to public health and training budgets and the use of transformation and capital funding to plug short term deficits made it far more difficult for the NHS to achieve ambitions set out in NHS England's plans.
GP collaboration doesn't result in patient satisfaction
The widespread development of large-scale GP provider organisations has so far failed to improve quality and is linked to falling patient satisfaction, a study has found. While three quarters of GP practices are now part of some form of collaborative organisation, such as federations and networks, the Nuffield Trust found no marked improvements in quality of care compared to the national average. Whereas, the head of NHS England, Simon Stevens, said there was a lot of convergence among the 44 local plans being developed to deliver under Sustainability and Transformation ‘bringing GP practices together, scaling them and integration with community nursing services’.
NHS deficit driven by underfunding of primary care
Systematic underinvestment in general practice and district nursing, coupled with deep cuts to social care, are the main factors driving financial meltdown in the NHS, according to landmark research by primary care academics. Researchers from NHS Greater Glasgow and Clyde show that slipping targets for NHS finance and performance across the UK are directly linked to cuts in GP services.
18th July 2016
NHS hospitals borrowed a record £2,800 million last year
The government had to lend cash-strapped hospitals a record £2.825bn in the last financial year so they could pay staff wages, energy bills and for drugs needed to treat patients. The Department of Health was forced to provide emergency bailouts on an unprecedented scale to two-thirds of hospital trusts in the 2015-16 financial year because they were set to run out of money.
STP - Kill or Cure?
Professor Colin Leys on Sustainability and Transformation Plans: Predictions that the NHS is facing disaster have been issued so often that people no longer pay much attention. This time there is unanimity. The Kings Fund normally gives cautious support to government policy but now its Chief Executive, Chris Ham, finally broke with precedent and in effect told the government it was in denial in maintaining that services can be maintained and even improved when funding per patient is already too low.
Campaigning works - U turn on Manchester cuts to mental health services
A judicial review launched by campaigners has prompted health authorities to back down over plans to axe eigth mental health services. Campaigners had warned the cuts would lead to a rise in suicides and called on national NHS funding bodies to step in. This comes as GPs call the cuts to young people's mental health services 'a national disgrace'.
One in threee London GP practices could close
The GP situation in London is worsening with around 30% of GP practices in London either planning to end their NHS contract or considering closure – up from 20% six months ago, a new LMC survey of GP practices in the capital has shown.
13th July 2016
Patients say NHS is underfunded
More than nine out of 10 people in the UK believe the NHS is underfunded and 42% would support paying more through taxation to support it, according to researchers. Or we could abandon the expensive commissioning system and use the savings to direct more to the medical front line.
Hunt to impose his junior doctors contract
Health secretary Jeremy Hunt has confirmed that the government will impose the junior doctor contract agreed in emergency talks earlier this year despite BMA members voting to reject it.
Survey on Sussex reaction to privatised patient transport & GP closures
The second Brighton Citizens’ Health Services Survey will be carried out by a team of University of Brighton academics headed by lecturer Dr. Carl Walker. It will be focusing on how the loss of six GP practices in the city has affected patients, and on the disruption caused by the disatrous outsourcing of patient transport service since it was taken over by private firm Coperforma in April.
Public concern forces care.data scheme is to be scrapped
The Departrment of Health has announced that the care.data programme will be axed following publication of two reviews into how data is used and shared in the NHS. One of the reviews, the Caldicott review, concluded that trust in the way personal data is used by the NHS ‘has been eroded’ and work must be done to engage them and show them the benefits of data sharing.
Ironic that Lansley says NHS budget must rise
The architect of the infamous Health and Social Care Act 2012, the Act that has forced the marketisation of the NHS on us, now says that the government must substantially increase NHS funding in budget plans to be set out this autumn.
27th June 2016
BMA chief attacks 'safe in my hands' promise
The leader of Britain’s doctors has accused David Cameron and George Osborne of betraying their promises that the NHS was safe in Conservative hands and would be funded properly. Dr Mark Porter claimed that the government’s pursuit of a seven-day NHS, its dispute with junior doctors and cuts to public health showed it could not be trusted with the health service. But does the government care that the NHS is collapsing?
Health chiefs attack cuts to student nurse funding
The Royal College of Nursing, the British Medical Association, the Royal College of General Practitioners and the Patients Association, a coalition of more than 20 charities, medical and professional bodies and trade unions releases an open letter to David Cameron saying that moves to drop funding for student nurses and midwives are an “untested gamble”. The government propose to drop bursaries that support nurses during their training and switch them to student loans – something health experts warn will risk reducing the supply of future nurses. But does the government care that the NHS is collapsing?
NHS England withholds info about funding Virgin Healthcare
Details of an APMS contract (Alternative Provider Medical Services, in other words, a private firm) awarded to private provider Virgin Care to take over an Essex practice forced to close after £400,000 funding cuts will not be made public because the information is 'commercially sensitive', NHS England has said.
GP practice closures are at a record level
GP practice closures hit record levels over the past year with 201 forced out of business, GPC chairman Dr Chaand Nagpaul told the BMA annual meeting. With increasing workload and falling income, see 'Wonder why there's a shortage of GPs?' 20th June below, GP work has been made difficult and unappealing to newly qualified doctors. But does the government care that the NHS is collapsing?
Ambulance trust rehires 6 managers it made redundant
An ambulance trust has been criticised over its decision to allegedly rehire six senior managers after spending £1million making them redundant. The crisis in ambulance services has been created by cuts to trusts extending back to the Coalition government. But does the government care that the NHS is collapsing?
20th June 2016
What would Brexit mean for the NHS?
Would the NHS have more funding if we left the EU, as the Leave campaign asserts? Well, no-one knows; but according to the Institute of Fiscal Studies, leavibg the EU . "...would leave us spending less on public services, or taxing more, or borrowing more.”
Privatised patient transport disaster in Sussex
Sussex patient transport, formerly with the South East Ambulance Service, has been outsourced to the private firm Coperforma. The service immediately descended into choas, with many appointments missed. Now a patient who missed his appointment for a scan of his lungs because the Coperforma ambulance didn't arrive, has died.
Wonder why there's a shortage of GPs?
Why don't newly quaified doctors enter into general practice in the numbers they used to? Well, here's part of the answer. A report by the government's Health and Social Care Information Centre shows that GP income has reduced for the seventh consecutive year. Meanwhile surgeries run by the private firm The Practice in Brighton, and who operate under the government's PMS contract, are closing as they see their profits disappear due to reduced government funding. Equally in Norfolk, PMS funding cuts cause private firms to pull out of GP surgeries.
A&E department threatened with closure on safety grounds
An A&E at North Middlesex hospital has been threatened with closure on safety grounds for the first time in the NHS’s history, amid fears that its 500 patients a day are at what the medical regulator calls “serious risk” of suffering harm. Is the cause local mismanagement as we are lead to believe by media reports like this, or central government NHS underfunding?
9th June 2016
Outsourced GP support services chaos
Primary care support services were privatised in June 2015, to Capita. As a result Capita closed 30 offices with a 1000 job losses. Now following the failure of Capita to provide prescription pads and the non-collection of patient notes, GPs have been invited to give their honest opinion of the service.
NHS in crisis - underfunding or lack of leadership
What's the cause of the crisis in the NHS? Some would say it's lack on managerial leadership. The Kings Fund points to the fact that the NHS needs 3 - 4% budget increase just to stand still, to meet increases in healthcare demand and to pay a rising drugs bill, and that it's getting less than one percent.
6th June 2016
Poll suggests junior docs will reject new deal
Just over half of respondents to an online poll in a closed Facebook group for junior doctors said they planned to vote against the deal. Only one in five said they planned to back it, with many others undecided.
Child deaths at Priory prompt calls for end of NHS contract
A 14 year old was placed at NHS expense in a private home, in one of the country’s most expensive private hospitals. But she died of neglect. Her death was the culmination of months of serious failings at the hospital.
Government plans for GPs "too little too late"
The GP Forward View contains some positives for general practice, but leaves huge questions unanswered and still looks like too little, too late to drag the profession out of crisis, warns Socialist Health Association honorary vice president Dr Brian Fisher.
The appalling state of dementia care in England
The view of a mental health professional who specialises in the care of dementia patients. She looks after those who cannot really be cared for in a nursing or residential care home. The private sector doesn’t want them, she works in one of the few surviving NHS continuing care units in the country...now set to close.
31st May 2016
What is Sustainability and Transformation
This article is the sort of managerial language that serves to confuse rather than throw light on the subject of what are Sustianability and Transformation Plans. As you see from a review by us - the NHS Support Federation - that somehow absorbing the deficits so that the government doesn't pay up, is really the motive behind STP. This, says the Kings Fund on page 4, is "inconceivable that the NHS will be able to achieve both financial sustainability and large-scale transformation within these financial constraints".
Delays in discharging older due to cuts
Delays in discharging older patients from hospital when they no longer need care is costing the NHS £820m every year, a report by official auditors has concluded. The report said the main drivers for this rise are people waiting longer for home care packages or nursing home places. Local authority spending on adult social care has reduced by 10% in real terms since 2009-10.
26th May 2016
BMA agrees an end to dispute, but will the doctors agree?
Junior doctors will be consulted by the BMA in a referendum in late June or early July this year, and the deal remains subject to their agreement. The deal now agreed with the government includes a framework to ensure that the more Saturdays a doctor works, the more bonus pay they receive. But will it get agreement from the doctors themselves?
GPs to be balloted on industrial action
GP leaders at the BMA's Local Medical Committee conference overwhelmingly backed calls to ballot the profession on their willingness to take industrial action, and on their willingness to hand in undated resignations unless the government adopts steps to save the profession.
Delays in discharging patients costs £820 million
Cuts in spending on adult social care mean people wait longer for home care packages or nursing home places, leading to increase of ‘bed-blocking’, says National Audit Office. A failure to fund or organise help outside hospital for those over 65 once they are ready to leave medical care has led to an increase of so-called bed-blocking.
The real NHS deficit may be a lot worse
NHS providers have reported colossal deficits . The scale of the cash crunch is unprecedented in the history of the health service, amounting to around £2.5bn. But this may be a significant understatement of the financial problems facing the service. The IPPR's assessment is that the true underlying position is a deficit as high as £3.5bn.
16th May 2016
Jeremy's telling porkies again
Britain’s leading health thinktank has accused our health secretary of misleading voters by wrongly claiming that the budget increase ministers have given the NHS this year is one of the most generous ever. The King’s Fund has rejected his claim that the NHS is receiving “the sixth-biggest increase in its history”.
Yet more evidence that the NHS is in free-fall
The number of hospital operations cancelled at the last minute because of a lack of staff or beds has risen to its highest in 15 years, new NHS figures show. A total of 74,086 patients in England suffered the frustration of their procedure being postponed at the 11th hour during 2015-16 for what the NHS calls “non-clinical reasons”.
Rich GPs get good ratings, least funded get low ratings
A BMA study suggests that practices' ability to perform well in CQC inspections is ‘clearly’ linked to the amount of funding they receive. It found that ‘outstanding’ practices receive an average of £152 per patient, ‘good’ practices receive £140 and would you believe it practices rated inadequate received £128 per patients.
90% of GPs think Hunt should go
Almost 90% of GPs believe that Jeremy Hunt should step down as health secretary, a survey reveals. The poll of 817 GPs found that 87% of the profession believed that Mr Hunt should resign or be removed from his post, while more than 95% said they did not have confidence in his ability to manage the health service.
12th May 2016
Another privatisation failure: Capita's take over of GP support services
Primary care support services administer GP payments and patient records and has been outsourced to Capita who were awarded a 10-year £400m contract from September 2015; the new provider had to slash the costs of provision by 40%. Now following concern voiced by GPs over piles of notes bagged up for transfer to other surgeries not being collected, the GP committee of the BMA has called for a halt to further roll-out of new primary care support services until they have been properly tested.
"No coherent attempt" to work out staffing for a 7 day NHS
The influential House of Commons public accounts committee accuses the government of bad planning and cost cutting and of leaving ther NHS short of vital frontline staff. It said NHS trusts had been given conflicting messages - being urged to cut overheads to save money, while investing in staff in the wake of the Stafford Hospital scandal. This has created a situation whereby the NHS had reduced the number of training posts available for core groups such as nursing, while struggling to retain staff, despite increases in demand for services.
"We are under-doctored, underfunded and overstretched"
Professor Jane Dacre, president of the Royal College of Physicians said that the circumstances that led junior doctors to take industrial action have been building up over a long period of time and do not only relate to terms and conditions of service. Read her speech to the BMA here.
9th May 2016
Dear Jeremy, research shows that fewer die at weekends
Fewer people, not more, die in hospital at weekends than during the week, according to a major study by professor Matt Sutton at Manchester University which contradicts evidence cited by the health secretary, Jeremy Hunt, to justify the imposition of new contracts on junior doctors. Hunt has repeatedly stated that junior doctors must routinely work at weekends because the higher death rate is linked to lower staffing levels.
GP service at risk of collapse
Face-to-face consultations in general practice rose three times faster than the GP workforce over the five years to 2014/15, according to research by the King's Fund that offers fresh insight into the scale of the crisis facing the profession.
Non-EU migrants to be charged for NHS
Non-EU migrants entering the UK are to be charged for using the National Health Service, under plans to be set out in the Queen’s Speech. The bill, which will be published on May 18, will seek to make new arrivals pay for diagnostic tests and scans, prescriptions, ambulance trips, NHS dental services, eye care and even emergency medical care. But do we know the exact value of the work performed on non-EU patients? No, we don't, it can only be estimated. So why focus effort on this at the cost of pursuing tax avoidance on a colossal scale by corporations and the super rich?
5th May 2016
Junior doctors agree to a temporary halt to srikes
Junior doctors have agreed to temporarily hold off calling further strikes to enable fresh talks to take place with the government, giving hope that the long-running pay dispute could finally be heading towards resolution. It is unclear whether Jeremy Hunt would give enough ground to allow negotiations to resume after a three-month break.
Mental health champion sacked after criticising government
The government has dropped its mental health champion for schools after she publicly criticised current education policies, in particular the testing regime, which she claims is detrimental to children’s mental health. Natasha Devon was appointed last August to raise awareness of and reduce the stigma surrounding young people’s mental health.
Google given access to patient data
Google has been given access to information to an estimated 1.6 million NHS records triggering concern from privacy campaigners. It plans to use the data to develop an early warning system for patients at risk of developing acute kidney injuries and claims the data is encrypted, But critics have questioned why it needs full information about patients – including full names as well as patient histories, including sensitive information such as abortions, mental health history and HIV status – to create such a specific application.
TTIP delayed, or is it now dead?
Talks on the Transatlantic Trade and Investment Partnership (TTIP) began in the summer of 2013. But are now delayed by the US presidential election, the differing regulatory regimes and a growing hostility to the whole idea.
BMA chief talks of the government's 'profound failure' to run the NHS
The BMA chairman, Dr Mark Porter, was scathing in his criticism of the government's handling of the health service and its treatment of doctors. He accused the government of allowing ‘piecemeal privatisation of services to destabilise the NHS’.
Campaigner calls for an end to CCG leaders meetings with private providers
Dr Coral Jones, honorary secretary of City and Hackney BMA interrupted a dinner and policy discussion for CCG leaders in a private room of a riverside London restaurant earlier this year. The dinner interrupted by Dr Jones was organised by Impower, a private consultancy firm dedicated to ‘redesign’ and ‘reform’ of public services, and was addressed by NHS England’s commissioning strategy group director Michael Macdonnell.
3rd May 2016
News of international opposition to TTIP
You may know of the Stop TTIP campaign, but here's evidence of further European campaigning against the neo-liberal pro-corporate anti-democratic agreement. First Dutch and then German.
Confused about Sustainability and Transformation Plans?
I would be surprised if the answer isn't yes, and our suspicion is aroused precisely because it is confusing; my conspiratorial side says it's meant to be. However, here's a brief high-level explanation, that is a round-up of what we already have been told. As to the details, we just have to wait to see what our masters in the "footprints" tell us - you didn't expect a democratic process did you?
General Prictice Forward View - promises..promises
Part NHS England's recent output is the "General Practice Forward View", which promises more funding for GPs. Like all NHS England pubilcations it is confusing and brimfull of "how wonderful it's going to be" in equal measures. Meanwhile, GPs share my deep suspicion - almost half of GPs are still willing to submit undated resignations.
28th April 2016
Almost 80% of junior doctors took part in strike
Four out of five junior doctors took part in the first all-out strike in NHS history on Tuesday, as David Cameron blasted their withdrawal of emergency care. At some hospitals, almost 90% of junior doctors refused to work between 8am and 5pm, in an escalation of their campaign against the new contract that Jeremy Hunt intends to impose on them.
Hunt's contract: Over half of junior doctors might quit
More than half of junior doctors are thinking about quitting the NHS in England in protest at the contract Jeremy Hunt is forcing on them, a survey has found. The research said difficulty in arranging childcare and the impact of even more anti-social shifts on doctors’ relationships with their partner and children were the key reasons for widespread disillusionment.
Campaigners storm Royal College to shut private healthcare conference
An alliance of NHS patient and staff groups stormed the revolving doors of the Royal College of Physicians (RCP) in an attempt to shut down a global conference of private healthcare executives being hosted there.
25th April 2016
Junior doctor resigns on air over Hunt's contract
A junior doctor announced his intention to resign live on television over the government’s imposition of the contract. Dr Ben White told ITV’s Good Morning Britain he would be leaving his post to focus on fighting the contract.
2500 consultants say strike will not put patients at risk
More than 2,500 consultants, GPs and senior doctors have signed a letter to David Cameron and Jeremy Hunt in support of their striking junior colleagues, offering assurances that patients will be kept safe during next week’s walkout.
An indefinite strike by junior doctors is likely
Junior doctors are considering an indefinite walkout in protest at the new contract Jeremy Hunt is forcing on them if the all-out strikes that start tomorrow do not force him to reopen talks. The junior doctors insist that the threat of contract imposition must be lifted for them to negotiate.
Hospital private work "putting profit before public service"
England's NHS hospital income from private patients jumped from just over £408m in 2010 to £526m last year – a rise of almost 30 per cent – according to a parliamentary written answer. This is the result of the Coalition's Health and Social Care Act 2012 which abolished the limit on private income, permitting hospitals to offer 49% of their beds to private patients.
NHS England continues to record the poor performance
In February the NHS in England has suffered its worst ever performance, for the second the second successive month . As in January, hundreds of thousands of patients were forced to wait longer than they should for time-critical care as the NHS missed almost all its key waiting time targets. The health service “on its knees” with patients stuck on trolleys for hours in overcrowded casualty departments, said the shadow Health Secretary.
Care UK "sent packing" in North London
Camden and Islington Keep Our NHS Public has celebrated a victory by the contract for out-of-hours GP services in north-central London being awarded to a GP-led not-for-profit consortium, and taken off the private health giant, Care UK, following heavy criticism at Care UK’s handling of the service.
4th April 2016
Female doctors may be forced to quit under Hunt's contract
Prof Jane Dacre and Clare Marx, the presidents of the Royal College of Physicians and the Royal College of Surgeons have said female doctors will face widening pay gaps with male colleagues and may be forced to quit medicine because the new junior doctors’ contract discriminates against women, especially mothers.
NHS paid private provider £165K for each home visit
NHS England has paid £165,000 for a contract that has seen a private provider carry out just one out-of-area GP patient home visit and 18 phone consultations since last July. The West Midlands local area team awarded a contract to health and social care provider Primecare in July last year to provide home visits to patients who are registered in practices outside of their area as part of the GP Choice scheme.
Devolution: Manchester becomes the first region to run its healthcare
Local authority leaders in Greater Manchester hailed a 'new era' as it becomes the first region in England to take full control of health and social care in a £6bn devolution deal that begins on 1 April. But is it just a further extension of the Tories ridding themselves of responsibility for the nation's healthcare? Can tax raising at government level but responsibility at a local level ever work?
Email claims Cameron has starved the NHS of funds
The Brexit campaign group backed by the justice secretary, Michael Gove, is trying to persuade senior NHS staff to sign a letter that accuses Cameron of having starved the health service of funding. But we know this anyway - the NHS was getting annual increases in its budget just to meet rising demand and an increasing drugs bill. But the Tories are now expected ridiculous levels of "productivity improvements" in the remaining years of this parliament (see page 14 of Kings Fund report), when the NHS is already on its kness.
BMA launches a judicial review of Hunt's contract
The BMA has formally launched a judicial review over government plans to impose a new junior doctors contract, as NHS Employers published details of the deal. The doctors’ union alleges the government failed to give proper consideration to an equality impact assessment as required by law when it decided to impose the disputed contract.
29th March 2016
Junior doctors escalate strike action with a planned full walkout
Junior doctors are set to escalate industrial action over the government's decision to impose a new contract, after BMA leaders announced that England's first full walkout - including emergency staff - would go ahead next month. It will be the first full walkout in the history of the NHS.
NHS boss slams £600 fines for missed targets
Hospitals are being fined £600m a year for missing key NHS patient treatment targets in what bosses claim is a “shortsighted” system, that hits patients and pushes them deeper into debt. So the government sets up rules that fine trusts when it doesn't fund the NHS sufficient to meet rising demand and increasing drug costs.
Government pressures NHS trusts to "fiddle the figures"
NHS trusts are being placed under pressure from Government to change the way they report on their finances, in what critics described as a desperate attempt to reduce a looming health service deficit. The health service is currently forecasting a deficit of £3 billion by the end of this month – the highest in the history of the NHS – amid widespread failures by NHS trusts to cut their spending, owing to rising agency employment costs, created by a cut in nurse training places under the Coalition.
22nd March 2016
Want to help fund junior docs legal challenge?
A group of junior doctors are trying to fund a judicial review of Hunt's imposition on them of his employment contract. The first target has been reached but more money is needed to cover costs further down the legal path. So if you would like to support them financially then go to their website.
Is devolution the same as integration?
The two ideas seem interchangeable in the management-speke of reports from NHS England. A Lewisham GP says the risks of devolution probably outweigh the benefits, for example, the Devolution Act could lead to the deregulation of NHS services, which will inevitably result in downgrading of health services and medical standards.
Downing Street leant on NHS bosses
Downing Street "leant on" the NHS England chief to get him to reduce the amount of funding he said the health service would need, a former Liberal Democrat minister has said. David Laws said Simon Stevens was told by the Prime Minister and the Chancellor that unless he revised down his request for £15bn to run the NHS properly it would be "discredited".
NHS funding £22 billion 'black hole'
The parliamentary Public Accounts Committee reports that there's no convincing plan to plug a £22bn “black hole” in the NHS that will accumulate over the next five years. A significant number of acute hospital trusts are in “serious and persistent financial distress”, there is a “spiralling” trend of increased deficits and the current payment system is “not fit for purpose”.
14th March 2016
Tories talk out Caroline Lucas's NHS Bill
Four Conservative MPs talked out the NHS Bill, a private member’s bill, introduced by the Green MP for Brighton Pavilion, Caroline Lucas, in the House of Commons on Friday 11 March. The aim of the bill is to reverse recent changes to the NHS including the “creeping marketisation” of health care. A big crowd turned out at Brighton Station at 7.30am to see her off with banners, placards and music from a samba band.
Junior doctors contract to be challenged in court
The government’s new contract for junior doctors is to be challenged in the courts by a group of doctors and patients on the grounds of patient safety. The challenge will centre on the detrimental impact of the proposed new contract on the safety patients as well as the stability of the NHS as a whole.
9th March 2016
The next phase of junior doctors strikes begins
The bitter dispute enters a more serious phase with the first of 3 planned 48 hour strikes, with neither side showing any willingness to give way. There are no further planned negotiations. BMA junior doctors committee chairman Dr Johann Malawana has said doctors will not be bullied.
MPs slam government 'complacency' over GP workforce crisis
A report by the House of Commons public accounts committee has accused the government of complacency over its failure to anticipate the impact of rising demand on general practice, and demanded 'detailed plans' to tackle the GP recruitment crisis by December.
The real NHS issue is privatisation, not a 7 day NHS
Neil Singh argues that Hunt's insistence upon creating a 7 day working NHS is really a smokescreen for what is going on, that the NHS is being fragmented and privatised.
7th March 2016
US firms keen to grab big slices of NHS budget
There are now a number of US private companies, Health Corporation of America, Tenet Healthcare, Aspen Healthcare, United Health (under the guise of Optum), that are profiting from NHS privatisation by the 2012 Health and Social Care Act. Yet still you hear Conservative spokemen say they're not privatising the NHS.
Atos contracts to be reviewed
Atos, the controversial outsourcing company, is facing a government review of all of its major Whitehall contracts, which amount to more than £500m, following another serious IT failure. The decision to launch the review follows severe criticism by the National Audit Office of Atos's role in the development of an IT system designed to allow the extraction of data from GP practice systems.
Hospice UK attacks plans to charge non-EU patients
The hospice movement has condemned moves by the Department of Health in England to include end-of-life care in its plans to widen charges for treating overseas visitors and migrants using the NHS. ?Hospice UK, the charity that champions the work of about 200 organisations, said the suggestion was inappropriate and not in keeping with the principle of “free, unprejudiced care”.
Frail patients forced out of hospital and thrust on over-worked GPs
Forcing so-called 'bed blockers' out of hospital before they are ready and expecting GPs and community health teams to cope is a recipe for disaster, warns Dr Zahid Chauhan. Cuts to social care leave many discharged patients returning to a cold home, no food, no one to look after them. It is a frightening scenario.
3rd March 2016
When you cut nurse training places you get a recruitment crisis
In its frenzy of ill-thoughtout fiscal retrenchment, the Coalition government cut nurse training capacity. Now we're paying for this short sighted policy; there's a 24000 NHS nursing shortage with trusts paying expensive agency rates and conducting nurse recruitment abroad.
Outsourcing out of favour?
Not strictly a health issue, but it's interesting to note that the shine seems to be coming off the passion for local government outsourcing. This might well spill over into NHS privatisation with BBC Radio 4 suggesting in its File on Four programme, on the collapse of Cambridgeshire's outsourced community health services, see 11th February below, that perhaps this same impression is might be filtering into NHS management.
29th February 2016
NHS budget: is it enough?
The UK spends far less of its GDP (gross domestic product) than France and Germany. The NHS needs an annual 4% increase just to keep up with increasing demand, due mainly to an ageing population and increasing drug costs. The Kings Fund states that "The growing gap between us and our European neighbours should give pause for thought."
NHS whistleblower's career is wrecked
A junior doctor who raised concerns about staff shortages says his career has been “wrecked” by an alleged lack of protection for whistleblowers. Dr Chris Day is awaiting an employment appeal tribunal ruling that could have a massive impact on whether the NHS’s 54,000 junior doctors dare risk their jobs by raising safety concerns. Jeremy Hunt has said "I am totally determined to make sure we stamp out the unacceptable bullying, intimidation and victimisation" [of NHS whistleblowers]. Still, it got you a headline Jeremy!
Child obesity: government backs down on sugar
The already delayed childhood obesity strategy will not be published until the summer, the government has said – and campaigners say it is unlikely to include a sugar tax. The delay in the strategy will cause great concern among health campaigners.
25th February 2016
Junior doctors set more strike dates
In a further escalation in the long-running dispute, which is fast becoming the most bitter breakdown in relations between the government and medical profession since the NHS was created, junior doctors are to take part in three more strikes and launch a judicial review as part of their fight against the government's decision to impose a new contract in England.
Tories to sell of NHS recruitment agency
The Department of Health is going ahead with plans to sell the National Health Service’s in-house recruitment agency, NHS Professionals (NHSP). Rumours of privatization have hounded NHSP for years, but two sources have finally confirmed that the government is ready to unload the agency, which serves as the main provider of temporary medical staff to NHS trusts across the country.
Urgent cancer scans are being blocked
Nearly one in three GPs in England have had a referral on the two-week cancer pathway bounced back or downgraded to 'non-urgent' in the past 12 months, a poll reveals. One in five GPs who had a referral blocked later discovered the patient had cancer. GPs reported that trusts are using subtle tricks to limit referrals on the two-week cancer pathway, gaming the target or actively cutting back on direct access to key diagnostic tests.
22nd February 2016
Cleaning and catering hospital contract to private firm collapses
A controversial contract which saw a private company providing catering and cleaning services to Leicester's hospitals is to end four years early. The seven-year contract, worth £300 million, was awarded to Interserve three years ago. Leicester hospital bosses and Interserve announced the contract would be ending on April 30 – four years ahead of schedule.
Survey shows NHS funding crisis and poorer care
A survey by The King's Fund thinktank said the NHS was nearing “make or break” , with “widespread pessimism” within the service. It also noted a return to central control of budgets from Westminster with funding decisions increasingly tied to tough cost reduction targets. The survey also noted patients are getting poorer care from the NHS in England as its funding crisis deepens, with trusts forecasting a £2.3bn deficit by the time the financial year ends.
GPs across England have seen services such as weight management, smoking advice, sexual health and contraception cut back. Out of 303 GP partners who responded to a poll on public health and sexual health provision, a third (33%) revealed that public health services commissioned from their practice had decreased since local authorities took control in April 2013. This despite NHS England's 'Five Year forward View' stating that there must be a '...radical upgrade in public health' (see page 3); this is one recommendation that the government isn't following.
15th February 2016
Hunt to impose his contract on junior doctors
Under the cloak of "establishing a 7 day NHS", which really requires a fully operational hospital - radiography, comprehensive laboratory testing, nurses, porters, receptionists and administrators - Jeremy Hunt is to impose his contract. There is now likely to be a mass exodus of junior doctors abroad. As if the effects of working in an underfunded NHS and then having your terms and conditions of employment ripped up isn't the cause, Hunt then launches an urgent enquiry into junior doctors morale. Meanwhile junior doctors vow to fight on.
Foundation trusts may not impose new contract
Hospitals may go it alone and refuse to impose the new contract on junior doctors proposed by the health secretary, Jeremy Hunt on NHS trainee medics from August. None of the 152 foundation trust hospitals in England will be obliged to force their junior doctors to accept the deal and can instead offer them better terms.
Leaked report reveals the scale of crisi in mental health
A leaked report by a government taskforce has painted a devastating picture of England’s mental health services, revealing that the number of people killing themselves is soaring. While the prime minister is expected to trumpet his focus on mental health – six years after he pledged to put mental wellbeing at the centre of his government – his own taskforce condemns years of underinvestment and lays a significant portion of the blame on the current administration.
Leaders write to "call time on falied privatisation experiment"
Health trade union leaders and the chief executives of professional bodies write a letter to condemn the effects of the Health and Social Care Act and to say there's a real danger of ending up like the US health system where income, rather than need, dictates the level of care that a patient can expect.
11th February 2016
Privatisation is threatening free NHS care
Trade unions representing half a million NHS workers have warned that a “surge in privatisation” of the health service risks creating a system based on ability to pay, rather than need. Contracts monitored by the NHS Support Federation show that private firms have won £5.5bn worth of NHS clinical contracts since April 2013 – more than a third of the total value of contracts put out to tender. Unison boos Davde Prentis said "There is no evidence to suggest the private sector does health any better than the NHS". In fact Dave, they're a lot worse.
Outsourced Cambridge contract fiasco on File on 4
In case you missed it, here's the BBC Radio 4 "File on 4" programme from 31st January, on the disastrous outsourcing of community care to UnitedCare, see 28th January below.
Trust finance director says commissioning is "pointless"
Trevor Shipman, finance director of Central and North West London NHS Trust, says he finds the commissioning system “frustrating and pointless”. What does he spend on contracting? “It costs us over a million a year, with one team doing nothing else. What a waste of money and time managers should spend on something useful.”
Survey finds thousands of GPs ready to resign
Three out of five GP partners in England are ready to resign en masse if the BMA cannot secure an emergency funding package for general practice in the next six months, a GPonline survey suggests. A walk-out on this scale could see thousands of GPs across England quit - potentially as early as this summer - risking the closure of thousands of GP practices serving millions of NHS patients.
1st February 2016
NHS funding crsis: hospitals told to cut staff
Hospitals are being told to shed staff to rescue the NHS from an acute funding crisis, leaving nurses and other frontline medical workers at risk of the sack. NHS regulators have taken the controversial decision despite intense concern among hospital bosses and health unions that reducing staff will hit quality of care, patient safety and staff morale, while increasing waiting times.
Private company that benefits from the NHS pays no tax
The shadow Health Secretary has called for an inquiry into the tax affairs of a major NHS supplier, after it was revealed that GE Healthcare pays barely any tax despite being based in the UK and making millions of pounds in profit through sales to the NHS.
BMA backs motion calling for GP mass resignation
GPs at a special conference backed a motion calling on the BMA canvass the profession on their willingness to submit undated resignations. In the strongest call for government to support general practice from the BMA in years, GPs voted heavily in favour of the call for the profession to be asked about handing in undated resignations.
GPs defend decision to stop care home responsibility
Doctors’ leaders have defended a vote by GPs’ leaders to stop looking after care home residents, saying such patients have complex needs beyond the capacity of their practices. Chair of the GP committee of the British Medical Association, said government healthcare policies were pushing back into the community many patients who previously would have been in long-term hospital care.
28th January 2016
Huge Cambridgeshire outsourcing project fails
A five-year £800m NHS out-sourcing contract has ended after eight months because the company running it said it was not "financially sustainable". UnitingCare won a competitive tender to run the contract, which started in April last year, to supply older people and adult community healthcare. Signed in November 2014 after a 15-month procurement process that cost more than £1m, it was strongly opposed by local campaigners and trade unionists. It is a significant defeat for NHS England's Strategic Projects Team that signed off the contract.
Hunt apologies for baby's death
While not openly accepting responsibility as Secretary of State for Health, Jeremy Hunt offered a public but not a personal apology for the death of baby William Mead. A report said there were failures at the privatised NHS111 service, manned by non-medical script readling call-handlers, and by doctors encouraged not to prescribe antibiotics or send patients to A&E.
NSPCC reports mental health services "shames our nation"
NHS mental health services’ ability to help abused children cope with their trauma is so inadequate that it “shames our nation”, the NSPCC has warned as it publishes a damning survey of relevant professionals. The Kings Fund reported that mntal health services have been severely cut.
25th January 2016
Consultants accuse Hunt of mislrepresenting statistics
Britain's top stroke doctors have accused Jeremy Hunt of "misrepresenting statistics" to justify his seven-day NHS. Professors and prize-winners are among 59 who blasted the Health Secretary's statement that stroke patients are 20% more likely to die on weekends. They warned claims like his have already harmed stroke patients because they are putting people off seeking help on the weekend.
Seven things health insurance adverts don't tell you
In the US they over treat, over a third of surgery isn't necessary; private health clinics are not inspected to NHS standards. This and more in this Open Democracy article.
A&E now turn away more patients
The number of hospitals that have to turn patients away from A&E rose sharply at the start of the year, compared with the same period in 2015. Referred to as diverts, such incidents reflect the enormous pressure the health service faces, especially in winter. In the first two weeks of 2016, there were 52 diverts, compared with 35 in the same period last year, according to NHS data.
NHS for sale - profit-seeking bidders welcome
Barts NHS Foundation Trust, offers a contract worth £400 - 600 million to the private sector. Barts is the Trust that has the highest PFI debt - the interest alone is rising by £500K every month. So, with massive debt acquired because it pursued market ideology in our health service, Barts is seeking more private setor involvement.
21st January 2016
Kings Fund disputes government claims on NHS funding
Britain’s spending on its health service is falling by international standards and, by 2020, will be £43bn less a year than the average spent by its European neighbours, according to research by the King’s Fund. The UK is devoting a diminishing proportion of GDP in health and is now a lowly 13th out of the original 15 EU members in terms of investment.
Saturday working is the junior doctor negotiation sticking pooint
A row over whether Saturdays should become part of junior doctors’ normal working week is threatening efforts to resolve the long-running dispute, despite next week’s strike being called off. The divide between the sides currently involved in talks over the issue is so wide that those involved fear it may scupper any chance of a deal.
Can the NHS really get £20 billion "efficiency savings"
A professor of health economics argues that it's 'nirvana' to attempt it, plus other letters critical of the government's bullying approach to negotiations with junior doctors.
18th January 2016
New rules 'hide the NHS strain'
Health chiefs have been accused of covering up the strains on the NHS by changing the rules for when hospitals say they are struggling to cope. An internal NHS document reveals that hospitals have been banned from declaring a “major incident” even if they are so overcrowded that patient safety is at risk. In addition, trusts can no longer go on “black” alert, which is used to indicate when they are so overwhelmed that patient safety is at very high risk, except in highly unusual circumstances. These include patients being at risk in all the other hospitals in the area.
Say no to outsourcing Sussex NHS patient transport
GMB, the union for workers in the health service, is calling on the joint Sussex Clinical Commissioning Groups to step back from handing private provider Coperforma Ltd a new 5 year £63.5 million contract for Sussex Hospital Patient Transport Services. The new contract to the Hampshire based company from 1st April 2016 is currently delivered by the South East Coast Ambulance NHS Trust (SECAmb).
Hunt's lies of the week blog
The clever way Hunt twists data to support his new junior doctor contract knows no barriers. What's more, such lies are faithfully reported in the media, without challenge and certainly without the representatives of junior doctors having their say. Check them out here.
14th January 2016
Poll finds public support junior doctors
A majority of the public in England support junior doctors' strike action so long as they provide emergency care, an Ipsos MORI poll commissioned by BBC Newsnight suggests. Overall 66% of respondents said they support the strike, and 16% oppose it.
Senior GP: Junior doctors' fight is our fight
Here's a video of LMC chair and BMA council member Dr Jackie Applebee speaking on the picket line outside the Royal London Hospital in east London, Tower Hamlets, warning that if junior doctors quit the NHS, general practice will not survive.
Many NHS key targets missed
Hospitals in England continue to miss many of their waiting time targets, official figures for November show. Ambulances, the 111 phone service and cancer services all missed key targets. And A&Es only managed to see 91.4% of patients in four hours - the worst performance in November since record-keeping began in 2010. Meanwhile, the target for 99% of patients to have their diagnostic test in six weeks was missed. It is now two years since it was last met.
Manchester health service devolution: massive cuts coming
The full list of services which could be axed from North Manchester General has been revealed - amid growing fears of a downgrade. Documents show that cardiology, gynaecology, ear, nose and throat services, acute medicine and facial surgery could all go. They also raise the prospect of an A&E downgrade. Health chiefs have repeatedly refused to reveal details of their plans since the local newspaper revealed in-patient surgery couls be moved out. Local campaigners have set up their own website - Manchester deserves better.
The huge waste of NHS funds on the market
There's one easy way to find a massive fund of extra cash for the NHS. It's true that no-one knows the exact cost of this bureaucratic ‘marketplace’, estimates vary from the recent estimate by rebel Lib Dems as high as £30 bilion a year. Dr Jacky Davis and other doctors and campaigners including the National Health Action Party have put it at £10 billion a year. The Centre of Health & the Public Interest put it at a ‘conservative’ £4.5 billion a year.
11th January 2016
Hunt lambasted for politicising dispute
Jeremy Hunt has been accused of trying to politicise the Paris terror attacks after it emerged his officials helped orchestrate a letter from the NHS chief medic questioning whether striking junior doctors would be available to help in the event of a major incident in the UK.
Soundtrack for the junior doctors dispute
London GP Dr Anna Martin who last year joined NHS volunteers working in Sierra Leone to tackle the Ebola outbreak said that she and 'several GPs nationwide' had joined the choir because they were proud of working for the NHS and determined to protect it.
6th January 2016
Junior doctor strike to go ahead
Industrial action by junior doctors in England is set to take place next week after the Government ‘misinterpreted and misconstrued’ the BMA’s intentions for a new contract. Talks over a new contract for trainees ended on 4th January following the Government’s failure to address doctors leaders' concerns with robust contractual safeguards on safe working, and proper recognition for those working unsocial hours.
Hunt's plans for GP recruitment unravelling
The health secretary's plans to recruit thousands of extra GPs by 2020 is unravelling as officials admitted the 5000 new doctors they promised to bring in over the next five years will actually include existing GPs. Mr Hunt highlighted his intention to create 5000 new jobs in Parliament last year, stating that "under-investment in general practice has been going on for decades". No Jeremy, the GP recruitment crisis has been caused since 2010 by cuts in GP funding made by Coalition and Tory governments.
Pressures on NHS will increase in 2016 - but do the Tories care?
The government has made empty promise after empty promise about how it plans to recruit an additional 5,000 GPs by 2020, yet it doesn’t face up to the reality that there aren’t enough entering the profession. A BMA survey showing that a third of GPs plan to retire within five years suggests the problem is only going to get worse.
1200 senior nurses gone since 2010
David Cameron has consistently pledged senior nurses should be at the heart of NHS care. But an investigation shows that on his watch, the number of matrons has dropped by a fifth.
4th January 2016
The end of CCGs?
After all the Tory hype that surrounded the Health and Social Act 2012, that is was breaking central government diktat over health spending and giving control of the NHS to local clinicians, plans for the completion of the underhand privatisation of our NHS is revealed. This article reports, but totally fails to challenge, the "idea" in NHS England's Five Year Forward View (5YFV) that "providers", in other words, private health companies, are "....better placed to make decisions regarding service provision". Just like the 5YFV itself, it suggests this without a shred of supporting evidence that it would work.
Now plans for devolution of NHS in London
The government, the NHS (in other words the governnment) and local authorities have signed an agreement to devolve control of health services to local commissioners and councils. It was always stated that, due to the Health and Social Care Act local commissioners i.e. CCGs, had control of their health services, wasn't it? So is this really about the government washing its hands of the responsibility for the nation's health? Yes let's have integration of health and care services, but shouldn't the government be responsible for providing health service? What exactly is government for if it isn't?
Another reasaon for the A&E crisis
The dire state of care for children with mental illnesses is revealed today, as figures show the numbers arriving at A&E departments with psychiatric conditions has risen to nearly 20,000 a year –more than double the number four years ago. Sarah Brennan, chief executive of YoungMinds, a charity working with children with mental illness said that a chief cause is an absence of out-of-hours community care for vulnerable under-18s, with children being advised to attend A&E after 5pm.
Junior doctor negotiations falter
Junior doctors look likely to carry out their threat to strike after three weeks of talks with NHS bosses and the government failed to resolve the bitter contract row. Both sides are increasingly pessimistic about resolving their differences when they meet for the last time on 4 January, following a blunt warning from the British Medical Association (BMA) to ministers to make major last-minute concessions or face industrial action.
17th December 2015
NHS cash crisis: patients denied care
Patients are being denied mental health care, new hips and knees, and drugs to boost their recovery from illnesses including cancer as the NHS increasingly rations treatments to try to overcome its growing cash crisis. A survey of doctors reveals that three-quarters said they had seen care rationed in their area over the last year – including treatments such as speech therapy, operations to remove varicose veins, Botox to help children with cerebral palsy move better and even potentially life-saving stem cell transplant surgery.
Why doesn't Hunt take responsibility?
The NHS is underfunded and trusts are running out of cash; yet our health secretary takes every opportunity to criticise any health trust that, despite its best efforts to cope, runs into trouble. Whether it's West Kent or Southern Health, our Jeremy washes his hands of responsibility. But shouldn't he, as secretary of state for health, feel ashamed of the state the NHS is now in? You get the feeling that ministers are happy that the NHS fails so that they can have the excuse to privatise it ....no, that would seem really conspiratorial.
GPs have lost confidence in CQC inspector
CQC chief inspector of general practice Professor Steve Field has 'lost the confidence of the GP profession' and must apologise for 'baffling and unfounded' negative comments about general practice, the RCGP has said.
14th December 2015
Care bodies demand talk with Osbourne over funding shortfall
Leading care and health bodies are demanding crisis talks with ministers over the unravelling of measures in Georger Obourne's spending review that were supposed to prop up the tottering social care system. Four groups representing care and health organisations are warning of an accelerating rate of closures of care homes and companies providing homecare.
NHS England no longer publishes weekly A&E figures
There has been much criticism of NHS England for not releasing weekly figures, with suggestions of a deliberate plan to reduce news coverage during the difficult winter weeks. Just a few days ago the statistics for October were published and they showed another downward slide below the 95% target. This release of data didn't make happy reading for NHS chiefs in England. Six out of seven key targets were missed - the only one met was on referral to treatment times (the proportion of patients on a waiting list for less than 18 weeks).
Two thirds of GPs want a ballot on industrial action
Almost two thirds of GPs want the BMA to ballot the profession over industrial action, a survey has revealed, as BMA branches, LMCs, prepare for next month's emergency conference. In a survey of more than 650 GPs, more than 40% said they would support industrial action involving the refusal to carry out non-core work.
Hospitals run out of beds
Hospitals have run out of beds, had to temporarily close their A&E unit and been battling outbreaks of norovirus this month, even though winter has not yet brought its usual major problems for the NHS, such as flu and bad weather. Official figures released by NHS England, for hospital performance in the first week of December, show many are already struggling to cope with the extra pressures, even before the heaviest strain of norovirus, which usually arrives in January.
Cuts to mental health result in failings
People who have mental health along with substance use problems (known as dual diagnosis) have multiple needs, and yet struggle to find services to help them.Dual diagnosis is one of the biggest challenges facing mental health and substance use services, but after 15 years of a variety of initiatives it’s hard to see how things have changed on the frontline.
GP underfunding shows a contempt for primary care
Persistent underfunding of NHS general practice reflects a 'deep, continuing and historical contempt for primary care', the outgoing NHS Alliance chairman has warned.
7th December 2015
Junior doctors strike could go ahead in January
Junior doctors' leaders have said they remain prepared to take strike action if negotiations with the government and NHS Employers do not work out, after action was suspended. The planned action and two further strikes this month were called off by the BMA after an eleventh hour deal. Following talks at the conciliation service Acas, the government agreed temporarily to lift the threat of contract imposition. But why didn't Hunt agree to this weeks ago?
Half of junior doctors left NHS after foundation training
Almost half of all junior doctors are opting not to continue their training in the NHS threatening a “disaster” that senior medics fear will worsen the service’s shortage of frontline clinicians. This year only 52% of junior doctors who finished the two-year foundation training after medical school chose to stay in the NHS.
Hunt's plan to charge visitors attacked by doctors and unions
The government is under fire from doctors’ leaders and unions over controversial new plans to charge migrants and other foreign visitors from outside Europe for emergency treatment on the NHS. There's no evidence that migrants come primarily for healthcare, and what happens when migrants can't pay - do we let them die? It's in all our interests that everybody gets good healthcare.
30th November 2015
Spending review extra funds at expense of other services
The chancellor confirmed an additional £3.8bn for the NHS in 2016/17, frontloading some of the £10bn a year increase promised by 2020. Nuffield Trust chief executive Nigel Edwards said that a 25% cut to the DH budget announced by the chancellor represented a £1.5bn cut in a single year to budgets that include clinical training and public health.
Is this where Osbourne's extra funding is going?
We are all aware that a smaller percentage of the NHS budgets is actually deleivered to the medical front line now that the NHS has commissioning and privatisation. According to the national director for patients and information, Tim Kelsey. at NHS England he needs between £3 billion and £5 billion to support digital technology in the NHS. So will the inadequate amount announced in the spending review find its way to doctors and nurses?
7 day access imposed without understanding demand or capacity
Plans to roll out seven-day GP services across England by 2020 are being implemented without the necessary data to understand demand or capacity of the existing service, the National Audit Office (NAO) has said.
26th November 2015
Hunt U turn - he agrees to conciliation
The government has backed down over BMA proposals for talks to resolve the junior doctor contract dispute through the conciliation service ACAS. Just days ahead of planned strikes by junior doctors, health secretary Jeremy Hunt wrote to the BMA to reverse his decision earlier this month to reject fresh talks through the conciliation service.
Weekend neonatal death rate - the truth
A study has reported ‘approximately 770 perinatal deaths and 470 maternal infections per year above what might be expected if performance was consistent across women admitted, and babies born, on different days of the week’. The authors chose a midweek reference day of Tuesday for their comparisons, and this did show a significant increase in in-hospital neonatal mortality at weekends; in fact the weekend death rate was less than 1% in a 1000 births higher at weekends. Except if they had used Thursday as the comparator, then they would have shown that death rates at weekends were lower. The on-line medical news website Pulse explains all.
Government plans for NHS kept quiet
People who found out about a vital NHS debate with days to spare have had their comments blocked in a computer gaffe. The row emerged after critics claimed a consultation on the NHS Mandate, which was reported here, see 16th November below had been swept quietly under the rug. But when worried doctors and patients tried to give their views, their e-mails bounced straight back because the Department of Health's mailbox was full.
23rd November 2015
Junior doctors vote to strike with a huge 98% in favour
A ballot by the BMA of more than 37,000 junior doctors returned a 99% vote for action short of a strike, with 98% voting for strikes. Last week the BMA announced that action would see a walkout with emergency cover on 1st December, followed by two full walkouts on 8th December and 16th December from 8am to 5pm. The overwhelming vote for action makes strikes almost inevitable.
Cancer doctors say Hunt's contract will harm patients
Proposed changes to junior doctors’ working conditions will have a damaging effect on cancer research and care in the UK, more than 150 oncologists have warned. The Association of Cancer Physicians (ACP), which represents medical oncologists in the UK, urged Jeremy Hunt to re-enter meaningful negotiations with the British Medical Association.
Hunt rejects BMA call for ACAS concilliation
Health secretary Jeremy Hunt has rejected the BMA's offer of conciliation talks with the independent arbitration service Acas. In justifying his position Hunt said the current proposal had already been through the independent pay review process and the BMA must come back to negotiations first, but this would involve doctors accepting the anti-social extra hours as part of their regular working time, and that hospitals would again be allowed to work junior doctors excessive hours, fundamental issues junior doctors have with his proposed new contract.
Protesters stop Hunt talk in Ealing
Health Secretary Jeremy Hunt failed to show in Ealing on Thursday 19th November as hundreds of protesters, from Ealing Save Our NHS gathered outside a venue he was due to attend as a guest speaker of the Southall Conservative Association.
Spiralling GP crisis triggers first special GP conference in a decade
The GP committee (GPC) of the BMA has called an emergency special conference for early in the new year to highlight the growing crisis in general practice. This is the first special conference since 2003.
16th November 2015
Junior doctors prepare to walk out in December
Thousands of junior doctors are preparing to go on strike next month in protest against the proposed weekend working pattern. The British Medical Association is set to hold a ballot on 18th November with 40,000 junior doctors deciding whether to take industrial action. One doctor said "I am striking because I don't want to see this unsafe and unfair contract imposed on us. I am concerned about the removal of financial penalties against trusts who overwork their junior doctors."
One thing you can do to save the NHS
The government is setting out what the NHS can do in the next 5 years, and there are lots of worrying signals. This is the mandate - it's what Jeremy Hunt talks about whenever he’s accused of no longer having any proper responsibility or political accountability for securing a comprehensive NHS service, since the 2012 Act. You can add your opinion on this, but you've got until 23rd November to do it. Start here.
Support for NHS chief who spoke out
Christopher Smallwood, chair of St Georges University Hospital Trust, spoke out about the the fact that the NHS is facing "financial collapse". Now senior NHS executives write of their relief that someone in a senior position has spoken out and of their support for what he is saying.
It's not winter yet but NHS misses more targets
The NHS in England missed several key targets for A&E admissions, cancer referrals, ambulance response times and NHS 111 calls in September as it braces itself for a busy winter period. Dr Mark Holland, president of the Society for Acute Medicine, has warned that A&E units are facing a nightmarish scenario that will heap on the pressure in the buildup to winter.
Government claims for 7 day access not backed up
David Cameron is under pressure to abandon his pledge to make GPs available seven days a week following a survey which has found that few patients want a weekend appointment and there is almost no demand for Sunday appointments. The findings are a blow to the prime minister’s determined drive to ensure that patients in England will be able to consult a GP from 8am to 8pm seven days a week by 2020.
12th November 2015
A&E consultant's plea to public "Please save the NHS"
A doctor desperately worried about the future of the NHS has written an open letter to the general public begging for support. Dr Rob Galloway, an A&E Consultant at Brighton and Sussex University Hospitals NHS Trust, has issued an impassioned plea to try and stop what he describes as 'unprecedented damage' to the NHS. In the letter, which has already been shared on Facebook more than 4,000 times, he accuses the Government of bringing the health service to its knees - and warns it 'may not survive much longer'.
Junior doctors are fighting to save our NHS
Jeremy Hunt has vaulted over the BMA to write directly to every “Junior” Doctor about the government’s attempt to impose a new contract, dangling an 11% rise in basic pay. Junior doctors (any doctor who is not a GP or a Consultant, whatever their age or experience), have responded furiously to Hunt's bypassing their union and to his blatant spin. BMA junior doctors’ committee chairman, Johann Malawana, declared: “In short, there is nothing new in what the government is putting forward. That is why our decision to ballot our members still stands...”
CCG board members give contracts to their own companies
Groups of GPs who control local NHS budgets have handed £2.4bn of taxpayers' money to organisations they have vested interests in, an investigation has revealed. A total of 437 contracts, worth at least £2.4billion, were awarded to organisations in which CCG board members owned or worked for, an investigation by the BMJ and the Times has revealed.
NHS unlikely to get a funding boost
Despite all the pleas from managers, see 9th November below, that the NHS is facing a financial crisis, Hunt tells them that the NHS is unlikely to get a significant boost to its budget in George Osborne’s forthcoming spending review.
New concerns about devolving health to regions
The King’s Fund health thinktank has voiced worries about plans to devolve NHS budgets. In a briefing paper on health and social care devolution it says: “A key concern is whether the NHS can cope [with devolution] at the same time as it attempts to tackle some of the pressing challenges it currently faces. The NHS is already under considerable pressure, needing to act urgently to tackle growing financial and operational pressures.”
Arriva may face fraud inquiry over ambulance contract
Ministers have hinted that the transport giant Arriva could be subjected to a Serious Fraud Office inquiry after it inflated figures on an NHS contract. In September, Arriva self-reported that figures were wrong on a deal to provide non-emergency patient transport in Greater Manchester. This earned the group £1.5m extra in incentive fees for good performance – despite hundreds of complaints about its work last year.
9th November 2015
NHS facing "financial collapse"
Chair of south-west London trust says hospitals will be unable to pay staff next year unless Jeremy Hunt doubles annual funding rise to £4bn. Christopher Smallwood, chairman of St George’s University Hospitals NHS foundation trust claims that years of underfunding have left hospitals short of staff and unable to meet waiting time targets for cancer and A&E care. The NHS, he said, s gripped by “an accelerating financial disaster”. describes the health secretary Jeremy Hunt’s insistence that the NHS deliver £22bn of efficiency savings by 2020 as “for the birds”.
Hunt accused of threatening royal colleges
The Department of Health has dismissed allegations by the chair of the BMA Junior Doctors Committee that a meeting called by Hunt about the junior doctors strike, would be used to pressure the royal colleges into opposing industrial action.
Access to GPs on Sunday is "little benefit"
A mere 2% of patients who report that their practice is not open at convenient times say Sunday opening rather than Saturday opening would make access to GPs easier, the study by University of East Anglia researchers found.
999 trusts operating a "scandalous" policy
Thousands of “life threatening” calls which apparently miss the response time target have been retrospectively assessed and counted as a hit regardless of whether the patient was seen by professionals, a whistleblower has reported.
5th November 2015
Hunt clever announcement just before junior docs ballot
After years of negotiations, including Hunt tearing up the original basis for a new contract, our Health Secretary suddenly offers the junior doctors an 11% pay rise, in an attempt to weaken the medics resolve to stand up to his bullying over evening and weekend pay. Although, is it really 11%, some doubt it.
Commissioning was introduced without any supporting evidence
The whole idea of the purchaser-provider split, whereby health organisations are either buyers, e.g. in those days PCTs, or sellers of healthcare e.g. hospital trusts or GPs, was introduced by the Thatcher government. Some campaigners said at the time that it really was an essential step to the future privatisation of the NHS - how prophetic they were. Thus commissioning was born. But now it's acknowledged that there isn't any benefit from commissioning, as the House of Commons Health Select Committee said in 2010.
A&Es face the worse winter ever
Record numbers of patients will be stuck on trolleys in corridors or the back of ambulances this winter as hospitals run out of beds because of soaring demand and limited funding, the country’s leading A&E doctor has warned.
2nd November 2015
Huge increase in prvate patients in NHS hospitals
The Health and Social Care Act 2012 removed the limit on income from private patients for NHS hospitals; under this Act they are now permitted to earn 49% of their income from private patients. The result as shown by data on hospital revenue demonstrates increasing waits for NHS patients as private patients queue jump.
Health Select Committee inquiry into Public Health post 2013
The Parliamentary Select Committee on Health is to hold an inquiry into public health provision post 2013, i.e. since, under the Health and Social Care Act it was transferred to local authorities. The committee should highlight the fact that now that the 3 year ring-fencing has been removed from public health funding, public health is undergoing massive cuts - so much for health being safe in Tory hands. Submissions must be made by 4th December 2015.
Junior doctors crisis: consultants savage Hunt's new contract
Senior medics at Barts Health NHS Trust have written a letter to the hospital’s junior doctors saying they "categorically disagree" with the Government proposals and the way minsters have gone about "imposing" a proposed contract for doctors below consultant level.
22nd October 2015
Junior doctors will leave under Hunt's new contract
Thousands of junior doctors in England will quit the NHS if Jeremy Hunt presses ahead with his threat to impose an unpopular contract on them, a survey shows. In all, 2,949 (71.4%) of the 4,129 junior doctors polled said they would move abroad, become a locum or give up medicine altogether if the contract is forced on them.
Lansley to advise private health company on NHS reforms
Despite David Cameron’s pledge to close the “revolving door” between Whitehall and the private sector, Andrew Lansley, the architect of the coalition government’s efforts to privatise the NHS, has taken a job advising corporate clients on healthcare reforms.
Pharmacy fined for illegally selling patient data
A major online pharmacist has been fined £130,000 by the information commissioner for selling on the data of more than 20,000 patients to secondary marketing companies. Pharmacy2U was fined £130K by the Information Commissioners Office for selling data without patients' consent, in contravention of the Data Protection Act. The BMA has called for a those responsible to be jailed.
Should GPs get incentives for not referring?
In at least nine Clinical Commissioning Groups GP practices are being offered large payments for keeping within targets for outpatient referrals and follow-ups. Some of these schemes even count emergency admissions and two-week cancer wait referrals towards their target.
19th October 2015
Junior doctor leaders to Hunt: "reopen negotiations"
The leader of NHS junior doctors in England has urged Jeremy Hunt to stop treating them like “the enemy” and instead reopen negotiations in a bid to stop their threatened strike. Dr Johann Malawana told the health secretary he must stop lambasting junior doctors if he wants to settle a long-running dispute over his threat to introduce new NHS contracts.
7 day plan doomed without 38000 more doctors
David Cameron's plan for a seven day NHS has been dealt a blow after the President of the Royal College of Physicians claimed it is doomed to fail without 38,000 extra doctors and more money.
Financial crisis: Now it's backtracking on patient safety
In order to cut costs to help tackle a £2billion black hole that has left 80% of hospitals facing deficits of up to £100m each, NHS bosses have told hospitals they no longer have follow the safety recommendation of the Mid Staffs report, that one nurse cares for no more than eight patients at a time. Further to this, Bliss, the premature baby charity says two thirds of neonatal intensive care units do not have enough nurses and doctors, and a similar number are consistently working at higher than safe capacity.
CQC report: 2/3 of hospitals give substandard care
Two-thirds of hospitals are offering substandard care, according to the Care Quality Commission, which also warns that pressure to cut costs could lead to a further worsening of the health service in the coming years. Its report also said that levels of safety are not good enough in almost three-quarters of hospitals, with one in eight being rated as inadequate.
NHS is at risk from Osborne's regional devolution
The NHS and local government is being transformed at pace and scale, yet most people have no awareness of this, have had no consultation and even less involvement. What are the arguments in favour of regional devolution? How do ordinary people have a say?
Restriction on immigrant nurses removed
Rules restricting the flow of nurses into Britain are to be lifted in response to widespread shortages of workers across the NHS. Nurses will be added to the Government's Shortage Occupation List on an interim basis, pending further work by the independent Migration Advisory Committee.
GP says 7 day working "a smokescreen for underfunding"
Facts are stacking up in support of the argument that government plans to bring increased access to GP appointments are wasteful, unattainable and potentially downright dangerous.
Brighton's Argus newspaper - "NHS is in crisis"
The health service is on a knife edge" and getting worse with the lives of patients being put at risk as staff are being overworked and stretched too far. That was the warning from NHS workers in Brighton as they joined 20,000 others for a mass demonstration on Saturday amid growing concerns about the future of the service and a cap on using agency staff.
12th October 2015
Tory policy of destabilising the NHS
Now that the NHS is on its knees it's easy to privatise it. That's the devious motive behind ignoring the NHS financial crisis and plugging nonsense like 7 day working. So the sneaky Tory plan is progressing nicely.
Junior doctors demand concessions on the new contract
Rank-and-file junior doctors have warned Jeremy Hunt he must make further concessions on the proposed new contract to prevent them striking or taking other industrial action over pay and weekend working. More than 2,000 medics and students have written to the health secretary saying his attempts to impose new terms and conditions on 53,000 NHS staff “remain unfair to doctors and unsafe to patients”.
Is it really all the GPs fault?
Another GP practice closes after an inspection, this time in Liverpool. But does the policy of inspection simply transfer the responsibility for our health service from the government to local providers? And is setting up standards that hasten the closure of independent GP practices collapse really a policy to justify and hasten corporate take over of primary care?
What is TTIP?
The Transatlantic Trade and Investment Partnership is a series of trade negotiations being carried out mostly in secret between the EU and US. TTIP is about reducing the regulatory barriers to trade for big business, things like food safety law, environmental legislation, banking regulations and the sovereign powers of individual nations. It is, as War on Want says,"...an assault on European and US societies by transnational corporations.”
Whereas Trans-Pacific Partnership is different
Another trade deal is TPP. Doctors Without Borders (aka Medicin Sans Frontiere) claims the TPP will “go down in history as the worst trade agreement for access to medicines in developing countries.” That’s because the TPP will extend patent protection for brand-name drugs, thereby preventing similar generic drugs (which are far less costly) from entering the market. This will drive up the prices.
5th October 2015
Junior doctors on verge of quitting over new contract
Young doctors are seething with anger over new contracts threatening lower pay, longer hours and increased stress. Here, an A&E junior doctor explains why. The junior doctor contract row is explained here, and a Tory MP reveals the government has reneged on last year's agreement.
NHS is in crisis - Addenbrooke is the 24th in special measures
Oliver Letwin's rule number one when wanting to privatise public services is to run them down, and so the government's NHS policy is to starve hospitals (and GPs) of funds, and then its inspectors can report hospital care is inadequate. Adenbrooke hospital is one of England's most prestigious but the Care Quality Commission has put it into special measures. As with so many, the hospital has found it difficult to recruit and, owing to rising demand and reduced government funding it now has a £1.2 million weekly overspend.
Tories accused of hiding extent of NHS cash crisis
Government ministers have buried NHS statistics that show the service hurtling towards an unprecedented £2bn deficit to avoid overshadowing the Tory party conference, say top NHS officials. One senior figure at the health service regulator Monitor said his organisation had been “leaned on” by Whitehall to delay its report, which shows that NHS finances are worsening.
No demand in half of pilot 7 day week surgeries
Almost half of the GP surgeries that began opening in evenings and at weekends to fulfil David Cameron’s pledge of 8am to 8pm seven-day access have cut their hours because so few patients came.
"Disgraceful" £410K pay off to Hunt's advisor
The government is proposing a £95K limit to all public servant pay offs; but not to Jeremy Hunt's close advisor David Flory, who was given £410,000 in addition to his £235,000 salary.
14th September 2015
Nearly a third of CCGs consider rationing
The Health Service Journal restricts access to its articles so the first paragraph is copied here. "Almost a third of CCGs have implemented or are considering restricting access to services. CCGs are making joint decisions in their region on procedures of 'limited clinical value'. Commissioners have brought in limits amid financial pressures. The Health Service Journal sent freedom of information requests to all 209 CCGs asking whether they had introduced or planned limits to access or eligibility for services during 2015-16 for financial, efficiency or value reasons."
GP surgeries in London are at “saturation point” and cannot provide any more care to patients, family doctors’ leaders in the capital have warned in a dossier of evidence sent to MPs.
Health Secretary Jeremy Hunt promises us a rosy and optimistic picture of a 'technology revolution’ and a '7 day revolution’, all "human-centred", of course. This dishonest vocabulary aims to fool the public into supporting a host of dubious changes. It glosses over the fact that public funding is being withheld and wasted on market bureaucracy.
7th September 2015
BMA calls for a review of personal health budgets
Personal health budgets in England are NHS funds that can be allocated to certain groups of patients to allow them together with their NHS support staff, to purchase services or equipment that they believe will enhance their health andwell-being. But a study has found that millions of pounds of NHS funding were spent on luxury items and holidays. The BMA therefore has called for a review of the entire scheme.
Surgeries club together to offer 7 day access
Seven practices in one of three localities within the South Hampshire vanguard will open the shared facility at a community hospital run by a provider which is a partner in the vanguard scheme. This despite the BMA saying that nationally, 7 day opening is not achievable because GP work is now seen as unattractive by trainees.
Poor weekend survival rates not just down to staffing
It is true that survival rates of weekend hospital admissions are poorer. But such survival rates may be only partly explained by unavailable services due to lower levles of staffing.
3rd September 2015
Bristol says no to Branson take over
Hundreds of people protested at the offices of the local Clinical Commissioning Group, who are set to decide whether to hand children's NHS services over to Virgin
Failure of Nottingham's privatised hospital cleaning
The number of hospital beds out of action due to outbreaks of viruses almost doubled under the care of Carillion, which has a contract to maintain the City Hospital and Queen's Medical Centre. Patients caught superbugs in hospital wards after the private firm, which is paid £200 million to clean them, failed to do its job properly.
Brighton hospital takes privatised cleaning back into NHS
The Brighton Sussex University hospital Trust awarded Sodexo a £15 million a year contract to provide the services at the Royal Sussex County hospital in December 2012. However it has been beset with problems from the start, including concerns about safety because of a lack of basic equipment such as working wheelchairs and trolleys and mops and cleaning cloths.
Corbyn - Labour must clean up the PFI mess
"Every penny paid to a PFI company is money withdrawn from those waiting for an operation, money removed from the training of clinicians, and money denied for life-saving treatments. Much of the PFI debt is now owned offshore, to avoid paying tax on the profits generated from the taxes you and I pay."
Dismanting the NHS in 10 easy steps
As if you didn't know anyway, here are the steps taken by our governments to incrementally destroy our NHS as explained by an east London GP.
24th August 2015
700 jobs at risk with Capita oursourcing
NHS England has completed a £330m, seven year deal to outsource primary care support services to Capita, putting more than 700 jobs at risk. Yet another example of the pursuit of profit trumping the quality of the service and people's jobs.
7day service and 5000 new recruits "impossible"
The figures for the current situation 1) 632 GP trainee posts across England were left unfilled 2) north-east England struggled to fill even half of its available places 3) more than half of the regions in England filled less than three-quarters of available GP trainee posts. "These figures lay bare the huge scale of the crisis facing GP services and patient care," says GPC chairman Dr Chand Nagpaul.
Jeremy's got it in for medics
Millionaire bankers that cause economic chaos get away scot-free but Hunt intends to jail medics who get a free ball-point pen from their drug rep.
Increasing number of GPs asked to refer patients to food banks
The number of GPs having to refer patients to food banks is increasing, with more than one in five having to take drastic action due to increasing poverty levels. A survey of 695 GPs found that 22% had been asked to refer a patient to a food bank in the past 12 months – an increase of 16% on previous year.
20th August 2015
The future of the NHS - if we do nothing
Admittedly it's one person's assessment, but it might foretell the future of the NHS. to quote..."No doubt some will accuse me of scaremongering. I concede that the picture I will paint is grim but I truly believe it to be a real possibility. I will not suggest a precise timescale these events – that would really be stretching it too far – but suffice to say we are talking months to a couple of years rather than decades."
GPs risk being devoured by hospitals
This writer argues that it's possible, as outlined in an NHS England document, that integrated primary and acute systems (PACS), a vertical integration controlled by hospitals, will employ all GPs. Put simply, this means the hospitals run everything.
NHS regulator - "Fill only essential NHS vacancances"
NHS trusts have been told by Monitor, the health service regulator, to fill vacancies “only where essential” as it warned that current financial plans are “quite simply unaffordable”. In a letter to NHS trusts, Monitor’s chief executive David Bennett warned of an “almost unprecedented financial challenge” as he said no stone should be left unturned to find savings.
Another surgery closes - 4000 without a GP
A single-handed GP practice in Grimsby is set to close unless NHS England finds another GP willing to run the practice, affecting 4,500 patients. The decision to terminate the Ashwood Surgery contract followed a CQC ‘inadequate’ rating and the absence of an action plan to tackle underlying causes,
27th July 2015
Hunt's U turn on social care cap
Jeremy Hunt has quietly shelved a key Tory manifesto commitment to cap care costs for the elderly, as experts claimed that the policy fiasco has cost taxpayers up to £100m. Hunt has announced that the plan to limit care bills from next year to £72,000 for the over-65s and for younger adults with disabilities has been delayed until 2020, despite the fact it was trumpeted by the Conservatives in the runup to the general election.
Care UK boots out patients to meet targets
A private firm running NHS services is allegedly discharging patients before they have been treated to avoid breaching guidelines. An undercover probe into Care UK Britain’s biggest provider of out-of-hours services, has revealed patients are put at “huge risk”. Healthcare providers face fines for missing the national four-hour target for all emergency departments to conclude 95% of cases.
Hunt's speech: Is the NHS becoming a pay app?
In Hunt's speech delivered at the Kings Fund, entitled “"Making healthcare more human-centred not system-centred", he created headlines about 7 day access and consultant pay. However, he also referred to his next 'big idea' - an ‘app’ that gives access to NHS-accredited primary care professionals. Will this be his way of creating a two tier NHS, where you get an enhanced service if you can pay for it?
Government inquiry into a pay NHS
A quiet announcement in the House of Lords by a little known minister, the newly ennobled “Under Secretary of State for NHS Productivity", Lord David Prior, was made in the rarefied atmosphere of a House of Lords.
23rd July 2015
Pointless to force consultants to work weekends"
It is utterly pointless to force consultants to work weekends – there is very little they can do without a dedicated team of nurses and technicians, says consultant Anamika Basu. And another medic starts a Tweet I'm in work Jeremy that gets thousands of supporting tweets.
Damning report on the running of the NHS
The head of the NHS has dismissed Lord Rose, the retail expert who criticised the management of the health service, as an underwear salesman. Mr Stevens, the head of NHS England, said that the "complexity" of managing the health service "more than rivals that of selling underwear".
20th July 2015
Hunt raises the spectre of charging patients for the NHS
Jeremy Hunt has raised doubts about the NHS remaining an entirely taxpayer-funded service in the long term, days after a fellow health minister also warned that soaring demand for patient care could force a rethink on where its money comes from.
The truth behind "joined up" healthcare slogans
A Kings Fund paper hides the commercial imperative behind the confusing terminology. Chris Ham's paper, "Commissioning and funding general practice, Making the case for Family Care Networks", page 34, says that the new accountable care organisations are modelled on the American HMO, Kaiser Permanente. HMOs are health maintenance organisations which, yes do commission and provide, on a contract, but they have to make money, and they do it by tying their doctors and other medical staff into managed pathways of care which they must follow.
NHS will "fall well short of £22 billion savings target"
Senior figures at NHS England expect the service to fall well short of its £22bn target, and that it will therefore need a further £7bn injection from the Treasury, on top of the £8bn, in order to maintain standards of care – £15bn in all. How can a health service which has an increasing demand function with decreasing funding?
When a profit motive controls the health service
A US oncologist is sentenced to 45 years in jail for running a fraud scheme in which he prescribed unnecessary chemotherapy and other cancer treatments to patients who didn’t need it.
14th July 2015
London facing a GP crisis
A Londonwide BMA survey of 431 practices in the capital found that one in 10 expect a GP to retire within three years and that they were considering terminating their GP contract as a result. This view is supported by a piece by a GP who says London general practice is at breaking point.
Hunt's idea to solve GP crisis a non-starter
Less than a third of GPs would be prepared to employ physician assistants, despite the Government promoting them as a way of solving the GP recruitment crisis, a survey has revealed. A poll of more than 450 GPs across the UK found that only 32% of practices would be prepared to employ physician assistants, while over 40% ruled out any possibility of hiring them.
Another GP closure - 8000 patients displaced
Over 8,000 Scottish patients could be left without a GP when their practice closes at the end of September. GPs at the Brimmond Medical group in Aberdeen, which is due to close at the end of September, said they are increasingly concerned about the lack of progress being made to secure GP cover for its 8,300 patient list.
30th June 2015
5 year plan "a plan for NHS destruction"
Read the article further down on this link entitled "Five year forward plan - a plan for NHS destruction". 'When the code behind the plan (NHS boss Simon Stevens' plan) is translated it means that clinical care is to be packaged into vehicles attractive to takeover by multinational corporations. Behind the appearance of wanting to make the NHS sustainable, it hides a fast track ‘journey’ to the American model.'
Doctors to launch a Save Our Surgeries campaign
Doctors have called on the BMA to launch a national campaign to save GP surgeries from closure, in a decisive vote at the union’s annual conference. A motion calling for the BMA to ‘recommit to a full-blown “Save our Surgeries” campaign’ was carried with well over the two-thirds majority required for extra BMA investment, despite delegates being urged to consider alternatives by the BMA chair.
CCGs putting enhanced services out to competition
GP practices face more competition for their local enhanced services, with rising numbers of CCGs using a full tender or Any Qualified Provider (AQP) when commissioning enhanced services. Enhanced services can range from stop smoking services to programmes for early diagnosis of dementia. This latter service is an example of the ones GPs themselves often provide. The NHS reforms stated that services would have to be put out to competition unless it could be proved that there was only ‘a single potential provider’, leading to fears that GP practices would have to go through long and costly processes to provide enhanced services.
25th June 2015
Hunt rolls back on "5000 GPs" pledge
Health Secretary has put more distance between the Government and its pre-election pledge to deliver 5,000 more GPs by 2020, saying today that the figure was the ‘maximum’ that was achievable; this after his plans to boost GP recruitment in under-doctored areas have been undermined after it was found that data being used to identify the worst hit areas are ‘seriously flawed'.
Scots NHS satisfaction soars as England's falls
Since devolution, the NHS in Scotland has taken a very different path to that of NHS England. It has embraced co-operation rather than competition. New figures show that Scots reckon that it delivers for them. Findings just released from the Scottish Social Attitudes Survey (SSAS) 2013 have found satisfaction with Scotland’s NHS increased by over 20 per cent since 2005.
22nd June 2015
Nurses will be deported under visa rules
Thousands of nurses will be deported under new immigration rules which will trigger critical shortages of staff across the NHS, nursing leaders have said. Almost 7,000 overseas nurses are likely to face being sent home by 2020, under the Government’s migration cap, research suggests. The rules under which immigrants are sent home after six years if they do not earn enough could increase NHS spending on overseas recruitment.
Nottingham dermatology privatisation a "disaster"
The privatisation of a renowned dermatology centre which led to its near-collapse, was an "unmitigated disaster", according to an independent review of the privatised service. Nearly all consultant dermatologists in Nottingham left when forced to transfer from the NHS to Circle. The unit, previously a national centre for excellence at the Queen's Medical Hospital, now has a reduced service with some patients sent to Leicester.
Hunt in crisis talks about surgery closures
Jeremy Hunt has met with five MPs who have raised concerns over the threat of practice closures in their areas. Practices are being represented by Dr Naureen Bhatti of Limehouse practice, which is under threat of closure because of MPIG losses, and Virginia Patania, practice manager at Jubilee Street Practice and board member of Tower Hamlets CCG.
18th June 2015
Are charities the stalking horse for privatisation?
Tory ministers often cite the value of say MacMillan to justify the involvement of non-NHS providers. So charities are wonderful aren't they? Yet a new report from the National Coaltion for Independent Action (NCIA) shows how the reverse is true; the corporate third sector has acted as a willing accomplice in the privatisation ‘arms race’.
NHS hasn't got a funding crisis, it's leadership crisis
"Health experts" have called for the publication of the list of 90 English trusts that have not achieved foundation trust status, drawn up last year by the NHS Trust Development Authority (TDA), the body which supervises them. The Health Service Journal (HSJ) asked a panel of leading thinkers in health policy to analyse what Naylor has called a “crisis in NHS leadership”.
7 day GP access pilot scheme dropped
Government plans to guarantee seven-day access to GP appointments have suffered a blow after one pilot area announced it would be ending its scheme after only four months because a lack of patient interest. Only 12 per cent of Sunday appointments and only half those offered on Saturday were filled, Hambleton, Richmondshire and Whitby Clinical Commissioning Group (CCG) said.
Report says NHS could save £5 billion
NHS Procurement and Efficiency Board says it could save this amount by improving workforce productivity and making sure hospitals pay the right price for medicine and supplies. Of course the NHS could save huge amounts by not hiring expensive executives on fancy salaries.
Choose and Book system to be replaced
Following a drop in usage of the web-based system Choose and Book that, with their GP, lets patients choose their appointment time and place, the Department of Health has decided to replace it. Choose and Book cost £356 million in 2004 and was outsourced to Atos. The new e-referral system will be built in-house by the Health and Social Care Information Centre.
5th June 2015
A partial victory in Staffordshire cancer care contract
Local campaigners demonstrated the strength of public opposition to privatising Staffordshire cancer care with the submission of a 64000 signature petition. Virgin or United Health failed to win the contract; the CCG has said it will accept the bid from a consortium headed by two NHS Trusts, The Royal Wolverhampton Hospitals NHS Trust and the University Hospitals of North Midlands NHS Trust. However it transpires that the winning bid is led by Interserve Investments.
NHS data released against patients' wishes
The body responsible responsible for managing NHS patient data to organisations including insurance companies has admitted information about patients has been shared against their wishes. The Health and Social Care Information Centre (HSCIC) told MPs that it “does not currently have the resources or processes to handle such a significant level of objection".
Regulators take control of 3 regions
Key NHS bodies -NHS England working with Monitor, and the NHS Trust Development Authority - will impose a newly-devised and euphemistically named “success regime” on the three parts of the country, Essex, North Cumbria and Northern, Eastern and Western Devon. The move is an unprecedented measure to correct system-wide failure in three regions....or was it just plain-old chronic under-funding?
NHS can't take more cuts to social care
As the government searches for possible cuts to those departments that remain unprotected, health service chiefs fire a warning that the NHS cannot continue to be the support for inadequate social care provision.
Hunt: "no more agency doctors"
Health secretary Jeremy Hunt has told hospital trusts to cut its soaring £3.3bn bill for agency staff, which has resulted in hospitals paying up to £3,500 for a doctor to work a single shift. The health secretary is introducing curbs on the use of employment agencies, some of which he says are “ripping off” the NHS by charging “extortionate” rates. It's called the efficiency of a market-based approach to healthcare Jeremy.
28th May 2015
Showdown forecast over NHS 7 day a week running
The Queen’s speech, setting out the government’s agenda for the new session of parliament, confirmed ministers' plan to ensure more NHS services run on weekends. But with the NHS needing an immediate cash injection to run exisiting services you may reasonably ask where is the funding coming from.
Should we really be surprised by hospital trusts in financial difficulty?
Inspectors have criticised the NHS’s largest hospital trust after finding it is seriously understaffed, focuses too little on safety and has cancelled operations on numerous occasions because there were too few beds. The Care Quality Commission has found a series of failings in the safety and quality of care being provided at Barts Health Trust which has a deficit approaching £100m. But hospital incomes have been slashed, and with rising demand for healthcare it can't be a surprise. Who's fault is it really?
NHS England's 'hospital chains' plan is a gamble
NHS England chief executive Simon Stevens has announced plans to develop hospital chains - making smaller hospitals clinically and financially sustainable by linking them with a major regional centre. Stevens is calculating that hospital chains will help the NHS achieve the barely-credible target of £22bn in efficiency savings over the next few years while avoiding the need to burn up huge amounts of political capital in local battles to close hospital services.
If you cut training then you pay for agency staff
Ballooning levels of spending on agency nurses and doctors mean NHS trusts are paying the equivalent of £750,000 a year just to fill one post. A new report by NHS regulators reveals an £822 million deficit across the NHS, which can be blamed entirely on spiralling spending on temporary workers. Freedom of Information requests submitted by the Royal College of Nursing (RCN) exposes the staff shortage on the cuts the Coalition made in training budgets.
21st May 2015
"Recruit 5000 new GPs" is a pipe dream
Chairman of the GP committee of the BMA says "Ministers must halt their surreal obsession for practices to open seven days when there aren’t the GPs to even cope with current demands. The newly elected government must wake up to this alarming reality not only because it will fail dismally in its pledge for 5,000 extra GPs, but crucially because unless it turns this around we won’t have a comprehensive general practice service in parts of the UK."
An example of GP recruitment crisis
A health board has had to take over a Scottish practice where two remaining GPs were left struggling with a patient list of 10,000. The Kersiebank Medical Practice was left in the unsustainable position after five out of seven GPs based at the practice left over the space of a few months.
Three quarters of NHS111 referrals to GPs are wrong
A survey of the new privatised NHS phone service, answered by non-medical staff reading from a script, reveals that only one in four NHS 111 GP referrals is clinically appropriate, with GPs warning that some referrals are ‘harmful’ and an ‘insult to professional integrity’. GPs said they had known of call handlers citing suspicions of ebola because the patient had visited Barbados, which the call handler thought was in West Africa, ambulances being sent out for a heavy painful period and 80-year old patients being asked if they were pregnant.
"Salary too low" Tory minister takes private healthcare job
Conservative Mark Simmonds prompted an angry reaction last summer by claiming that he could not survive on the salary and expenses of a junior minister. Now he has become a strategic adviser to the International Hospitals Group (IHG), a firm based in Buckinghamshire, which is involved in constructing hospitals in developing countries.
18th May 2015
Surge in cancelled NHS operations
More than 20,000 operations were cancelled at the last minute by NHS hospitals in England during the last quarter, the worst performance in a decade. Hospitals are experiencing growing bed shortages, with too many patients being admitted because of a lack of care in the community, and ending up stuck in hospital because there is no help available in their home. Latest published figures show hospital occupancy levels reached a record high in the last three months of last year - at 89.5 per cent.
NHS over-riding 700000 patients who opted out of data scheme
Health managers have admitted they have been unable to implement 700,000 patient opt-outs to GP data being shared. The Health and Social Care Information Centre has said that 700,000 patients registered an objection to their identifiable information being passed from the HSCIC to a third party before the aborted rollout of care.data in March 2014. However, it admitted that it doesn’t currently have the resources to deal with this volume of objections.
BMA finally gets the message
This BMA document" Securing a Healthier Future for the NHS" is a PDF download, so you will have to save it to your computer. The point is that on page 4 it says "..."...the health secretary’s statutory responsibilities to secure and provide universal and comprehensive healthcare must be restored and explicitly stated."
14th May 2015
Is primary care the Tories' target?
Health secretary Jeremy Hunt has said a 'step change' in GP services is his top priority. This implies his support for for-profit corporate GP organisations that research has shown offer an inferior service, but that he will say can offer 7 day access, over the traditional surgery run by partner GPs. Clare Gerrada, former chief of the Royal College of GPs, agrees.
Worrying times in primary care
On the face of it, a foundation trust has stepped in to save struggling GP surgeries in Chesterfield. But set against the facts, which are that general practice has been systemically and purposefully defunded over the past 10 years, that GPs have been given impossible workloads and are falling ill with depression and other illnesses, and now there is an inability to recruit and retain GPs, it's a worrying development. Independent GPs are patients' advocates and can speak out about the health services provided locally, but not if they are employed by the very foundation trust that runs the service.
Is this good news about TTIP?
Barack Obama’s ambitions to pass sweeping new free trade agreements with Asia and Europe fell at the first hurdle on Tuesday as Senate Democrats put concerns about US manufacturing jobs ahead of arguments that the deals would boost global economic growth. A vote to push through the bill failed as 45 senators voted against it, to 52 in favor. Obama needed 60 out of the 100 votes for it to pass.
Met police takes over ambulance role
Hundreds of patients are being taken to hospital by police because ambulances fail to arrive in time, new figures reveal. Scotland Yard said it was forced to transport people to hospital on 903 occasions last year. The figures, released by the Metropolitan police following a freedom of information request, showed officers stood in for paramedics more than twice a day in 2014.
11th May 2015
Are GPs really controlling the NHS?
David Cameron has said the plan “is to put the power in the hands of local doctors so that they make decisions on behalf of patients..". But a new list of approved suppliers to the NHS has heightened fears of a multi-billion pound land grab by a handful of corporations. Competition for contracts to supply support services to the GP-led commissioning groups will be dominated by management consultancies, outsourcing giant Capita, and the US health insurer UnitedHealth.
Mental health services failure puts pressure on A&Es
Large numbers of people with mental health issues are ending up in A&E wards because of “system failure”, according to leaked minutes of a government-attended steering group. The minutes from the mental health crisis concordat steering group, attended by health minister Norman Lamb, suggest that the failure to treat mental health patients properly is contributing to pressure at A&E wards.
Nicholson: NHS 'like sick patient in early-stage terminal decline'
Sir David Nicholson, who ran the NHS in England until last year, is among the signatories of a letter to the Guardian that says the health service needs higher levels of investment than any of the parties have pledged.
'Ban NHS doctors from doing private work'
To get surgeons to agree to the setting up of the NHS, Nye was forced to let them do 2 days private work. Thus allowing the well-off to jump the queue. In an article by a consultant cardiologist he says this should be banned.
US doctors caution against creating inequality in healthcare
"As American health care professionals who often use the example of the NHS to advocate for a fairer and better system in the US" a group of American doctors say in a letter to the Guardian. But is the government listening?
Commercial out-of-hours services worse than that by non-profit organisations
Patients reported a poorer experience of care from commercial providers than from non-profit organisations in a study published in the British Medical Journal. Minority ethnic patients and those unable to take time away from work reported the worst experiences of care.
30th May 2015
Why Queens Speech should include Reinstatement Bill
Read Alysson Pollock and Peter Roderick's persuasive article, as much for its withering attack on the Health and Social Care Act and Labour's tenure, as for the need to reconstruct the NHS. For example, did you know that '...foundation trusts must draw up “patient eligibility criteria.” Since when were NHS hospitals legally required to choose in advance whom they would and would not treat? Since section 103 of the 2012 act."
Tories promise 7 day GP access: vacancies up 50% in year
A Pulse magazine survey reveals that the number of vacancies for GPs has risen by almost 50 per cent in one year, sparking fears that a national shortage of doctors is worse than was feared. How can the Tories claim to provide 7 day a week GP appointments when they’ve made primary care so unattractive by loading GPs with yet more work and at the same time cutting their income.
Why are hospitals in crisis? One word - cuts
The government has cut the cash it pays hospitals by over 40% for a quarter of treatments – and by over 70% for one in 10 hospital treatments, new research by False Economy for the TUC and UNISON has revealed.
27th April 2015
Traditional partner GPs beat private sector GPs
Private sector and other alternative providers of GP services in the NHS do not do as well as traditional GP practices, research carried out at Imperial College London has found. Since 2004 for-profit companies such as Virgin Healthcare and Care UK, as well as voluntary organisations and social enterprises, have been able to win contracts to provide GP services. The report has found that these providers perform worse than typical surgeries on 15 of 17 key indicators – such as patient satisfaction, diabetes control and keeping patients out of hospital.
Hospitals spending next winter's funds already
The NHS is spending funds which were intended to cope with pressures next winter now amid fears of a “spring crisis”. Health officials have been told to keep running schemes which were set up this winter to ease the burden on hospitals until the end of April, amid concern about poor Accident & Emergency performance. A BMA spokesman suggested the decisions were a bid to avoid a crisis as Britain prepares to go to the polls.
Far more NHS contracts go to private sector
Profit-driven firms have been winning far more NHS contracts than ministers admit and privatisation has increased significantly under the coalition government, the latest evidence shows. Contracts monitored by the NHS Support Federation, that's us really, reveal that private firms have been winning 40% of contracts CCGs have put out to tender, worth a total of £2.3bn, only slightly fewer than the 41% awarded to NHS bodies.
20th April 2015
An analysis of election promises
The NHS electioneering has so far been dominated by arguments about whether the Tories 'unfunded' £8bn pledge is better than Labour's 'funded' £2.5bn pledge. Caroline Molloy's excellent article follows former NHS England boss David Nicholson's intervention on BBC Radio 4. He said that £8 billion won't be enough and criticised all parties.
NHS struggling to monitor privatised services
The NHS is struggling to monitor and assess the safety and efficacy of services it has outsourced to private providers, according to a report published this week. A growing number of the contracts are with large multinationals and companies backed by private equity, of which only seven have been terminated due to failings, a report by the independent think-tank Centre for Health and the Public Interest (CHPI) discovered.
Worcester hospital in A&E crisis
The pressure on the A&E department at a West Midlands hospital was so intense last week that the ambulance service sent in one of its own doctors as paramedics treated patients in corridors, the NHS trust running the facility has confirmed.
13th April 2015
Public want taxes raised to fund NHS
The public are clear on their preference: raise more money. Of those surveyed, 59% wanted increased taxes in order to maintain the current level of spending, care and services through the NHS.
Mental health cuts and a mother's 118 mile trip
Reports of children with severe mental health problems being shunted up and down the country’s motorways have become a familiar theme over the past three years, as families experience the fallout from Andrew Lansley’s huge NHSrestructuring and continuing cuts to child and adolescent mental health services (Camhs).
GPs set up there own service after NHS service was cut
GPs have set up their own private insurance scheme because the local area team has removed an ‘exemplary’ occupational health and psychiatric treatment service. This follows what GPs described as NHS England's 'wilful destruction of an excellent occupational health service' in Devon and Cornwall.
9th April 2015
Top doctors attack Coalition on NHS
Leading doctors in the NHS have accused the coalition government of a catalogue of broken promises, funding cuts and destructive legislation which has left the health service weaker than ever before. In a letter to the Guardian, more than 140 senior doctors pass a damning judgment on the government’s stewardship of the NHS, which they say is under pressure because of unnecessary market-oriented changes.
Public backs tax rises to increase NHS funding
A majority of people in Britain support tax rises as a way of funding the NHS, a poll suggests. The Ipsos MORI survey of nearly 1,800 people for the Health Foundation think tank found 85% thought the NHS should be protected from cuts - significantly more than other public services. When presented with a range of options setting out how that could be achieved, 59% said they supported tax rises.
BMA: "NHS might have to start to charge for services"
Patients could have to start to pay charges to use basic NHS services such as GPs because the health service’s finances have become so dire, the leader of Britain’s doctors has warned. Dr Mark Porter, the head of the British Medical Association (BMA), said that whoever took office after the general election would inevitably be tempted to bring in charges.
NHS spending inefficiently on non-permanent staff
The NHS should train more staff rather than spending around £2.5bn a year on locum doctors and agency nurses, a thinktank has suggested. Civitas, a cross-party thinktank, said a larger pool of dependable permanent staff would also enhance workforce stability and patient safety. But why is it necessary to hire contract staff, especially by recruiting from abroad? Because on coming to office the Coalition cut staff training creating a home-grown nursing staff shortage.
20th March 2015
Scandal of a huge chunk of NHS being sold off
11 firms stand to pocket up to £780m in a contract for heart, joint and other types of operations and scans, X-rays and other diagnostic tests on patients. The contract has raised concern because three of the 11 profit-driven companies involved have been heavily criticised, including two by the NHS regulator, for providing poor quality of care in hospitals and care homes. The firms are Vanguard, that left dozens of patients with impaired vision, Circle, that had a distastrous tenure of Hinchinbrooke Hospital, and Care UK criticised for its running of care homes.
GPs burdened by social care under funding
Nine out of 10 GPs believe deep cuts to social care under the coalition have added to the growing overcrowding at both their own surgeries and hospital A&E units.
CCG board members on the make
More than a quarter of board members on Clinical Commissioning Groups, the bodies charged with commissioning care for the NHS, have links to the private health sector. Research by the Unite union showed that nearly 1,000 board members have professional connections to private healthcare firms – with many holding directorships or owning such firms outright.
Circle's bid "based on optimistic projections"
Oversight of the contract to run the first privately-managed NHS hospital was "poor and inadequate", said Margaret Hodge, chair of the Public Accounts Committee. In 2013 the committee had warned that Circle's bid was not properly risk assessed, and now it reports that ".., oversight of the contract ... was poor and inadequate and no-one has been held accountable for the consequences."
Personal health budgets "a diversionary gimmick"
Personal Health Budgets (PHBs) which were introduced as a means of allocating NHS funds to patients represent the privatisation of the National Health Service, according to research by the University of Liverpool. PHBs are NHS funds allocated to certain groups of patients to allow them to purchase services of equipment that will meet their healthcare and well-being needs. In an article published in International Journal of Health Services, Public health expert, Professor Alex Scott-Samuel, exposes the different views about the effectiveness of PHBs in addressing healthcare needs.
9th March 2015
Hunt accused of a cover-up by select committee
Health secretary Jeremy Hunt faces allegations of a politically motivated cover-up after the Tory head of the health select committee said his department’s refusal to publish a damning report on NHS management before the general election was not acceptable
"If only politician's had the passion of Michael Sheen"
Actor Michael Sheen makes an electrifying defence of the NHS. Speaking at a rally in Tredgar, the birth place of the NHS, he contrasted Bevan's commitment with the attitude of comtemporary politicians, criticisng Labour and Tories alike.
Manchester GPs not involved in decision about Manchester
GPs were not consulted about the plan to create a new Greater Manchester Strategic Health and Social Care Partnership Board from 2015/16, says Dr Tracey Vell chairwoman of greater Manchester LMCs.
Hunt's promises to support whistleblowers challenged
A former NHS boss who says he was sacked for raising patient safety concerns has asked the health secretary for an apology and a "comparable" job. In a letter to Jeremy Hunt, ex-United Lincolnshire Hospitals Trust boss Gary Walker argues he is a whistleblower whose actions have been vindicated.
2nd March 2015
TTIP: trade deal wording leaked
A draft of what the European Union wants excluded from a new trade deal with the United States has been leaked. The document describes itself as the EU's "initial offer" in negotiations over the transatlantic trade and investment partnership. It includes the wording that UK ministers have said will protect the NHS from privatisation. Campaigners say a specific exemption for the NHS is still needed.
Control of health and care budget given to Manchester
The Coalition has announced that from April Greater Manchester will have control of its budget for the NHS and care services. But hang on, hasn't the Health and Social Care Act 2012 given control of its NHS to GPs, overseen by the Council's Health and Wellbeing Board? All CCGs and councils in the Greater Manchester are will have another layer of bureancratic control imposed. A local GP thinks it's really a way of passing off blame for failure, whereas a local MP thinks "we're being handed a funding crisis".
Are we now heading for a GP crisis?
There are increasing numbers of news stories about GP shortages and GPs who are close to breakdown due to a collapse of morale and increased workload. Firstly there's a report that a GP had to stop or face burnout. Then such is the shortage of GPs that one authority is appealing for GPs who emigrated to Australia to return home. Now a survey reports that a GP crisis is looming because half of them plan to retire early.
FMG: more than 2600 treated since September
More than 2,603 women and girls who went through female genital mutilation have been treated by the NHS since September, according to updated official figures.
26th February 2015
NHS reinstatement bill
The Bill proposes to fully restore the NHS as an accountable public service by reversing 25 years of marketization in the NHS, by abolishing the purchaser-provider split, ending contracting and re-establishing public bodies and public services accountable to local communities. You can support it by clicking on the 'Take Action' menu.
Out-of-hours funding has fallen every year of the Coalition government
The total amount spent on GP out-of-hours services in 2013/14 was £399.4m, down more than £20m in real terms since the 2010 election. The figures come after the Royal College of GPs published a report warning that GP practices have been priced out of the out-of-hours market, because private companies are winning contracts and are driving down costs by using less qualified staff.
Coalition sneaking out regulations to speed up privatisation
Labour has accused the government of trying to sneak out legislation to accelerate the privatisation of NHS services. Andy Burnham, the shadow health secretary, said regulations tabled in parliament on 6 February without any government announcement would force all contracts worth more than £625,000 to be put out to tender.
23rd February 2015
A&E targets missed for 20th week in a row
Accident and emergency departments in England have failed to meet the target of 95% of patients being seen within four hours for the 20th week in a row. NHS England said 91.6% of patients spent four hours or less from arrival to admission, transfer or discharge in the week ending 15 February, down from 92.9% the previous week.
Half of foundation trusts in deficit
Foundation trusts are health trusts with more financial independence. They can operate more like private organisations, to raise capital, sell assets, pay staff differently (or break national pay agreements depending on how you see it). More than half of all foundation trusts, given as a so-called mark of excellence, are now in the red, Monitor's quarterly report warned. The report, which looked at 147 trusts between October and December last year, said the use of expensive agency staff was having a drastic impact on budgets.
CCGs that are taking control of primary care
NHS England has begun to approve what's called "primary care co-commissioning", but is really the CCG, run mainly by GPs, taking over control of.... well, GPs really. So there's m,assive conflict of interest that's just side-lined as an issue. Now it has approved primary care co-commissioning for 64 CCGs that will take fully delegated powers from April.
19th February 2015
Private health firms now take £18 million a day of NHS funds
Private health companies are pocketing a record £18 million each day from the NHS budget as more and more health contracts are passed over to the private sector. New figures from the Department of Health show that last year £6.6 billion was taken from the NHS coffers to pay private health providers - a 50 per cent rise from before the coalition took power. So why does the government say that they're not privatising the NHS?
NHS England misses urgent cancer target
NHS England has admitted that it has missed its urgent cancer treament target. More than 20,000 people with urgent cancer referrals waited more than two months to start treatment in England last year; the target is that 85% of people should start treatment within 62 days of a GP referral.
Patients suffer when NHS buys expensive drugs
The NHS is doing more harm than good by approving expensive drugs for a limited number of conditions such as advanced cancer, which use up funds that would benefit other parts of the health service, according to an analysis by Karl Claxton, professor of health economics at the University of York.
16th February 2015
Patients removed from private hospital after CQC report
NHS England is to relocate vulnerable patients from Vista Healthcare hospital in Hampshire. Health chiefs have ordered the removal of vulnerable patients from a private hospital that failed a care inspection in the first sign of a new determination that there should be no repeat of the Winterbourne View care home scandal.
Cornwall out-of-hours service returns to GPs
One of the early privatisations was the outsourcing of the Cornwall's OOH service, when Serco undercut the service provided by local doctors. It was then found that Serco's service was substandard and it was forced to terminate the contract. Now the saga has gone full circle with the returning of the service to local doctors.
20000 NHS winter operations cancelled
Number of surgical procedures called off in the last three months of 2014 up by almost a quarter in the last year. Almost 20,000 patients had their operations cancelled at the last minute in the last three months of 2014 as the NHS struggled to cope with the onset of winter causing overcrowded A&Es and bed shortages.
NHS private health provider accused of US hospice fraud
One of the private health firms awarded the chance to earn contracts worth up to £5bn to provide back-office services to NHS doctors is being pursued through the courts over allegations of a major fraud of the American hospice system.
The destruction GP services
A report that chronicles the destruction of community-based GP services at Princes Park Health Centre in Toxteth following privatisation, has been published by Keep Our NHS Public Merseyside. It shows what happened when in April 2013 the management was taken over by Wigan-based SSP Health Ltd and the surgery, which at one time was widely acclaimed as a pioneer in the provision of primary care, fell to near the bottom in national ranking.
12th February 2015
Kings Fund says NHS Act was "distracting and damaging"
In its report "The NHS under the Coalition government" the Kings Fund also says the NHS governance is now "complex and confusing". It also said that "claims of mass privatisation are exaggerated". This contradicts research by our sister site NHS For Sale that found that 67% of all contracts awarded between April '13 and April '14 went to non-NHS providers. Thus, the coming election not withstanding, in 10 years there will be mass privatisation.
Francis report on whistleblowers criticised
The report by Sir Robert Francis, "Freedom to Speak Up" provides a review of how the NHS treats whistleblowers. But the Guardian says it will be hard to see patient safety campaigners, medical negligence lawyers and, crucially, whistleblowers themselves viewing Francis’s prescription as the cure
9th February 2015
80% of foundation trusts report deficits
You are probably aware of what foundation trusts are about - they can act like private companies, raise capital, sell assets (like hospital buildings) without consulting the public, negotiate their own pay agreements i.e. break national agreements, and the executives can pay themselves what they like. So they're based on the belief that aping private sector activities in running a health service is meritorious. Well a Monitor report tells us that most are financially insolvent.
Hospital property prepared for sale
Many of our precious hospitals are being prepared for handover to private developers. From PropCo to the Infrastructure Bill, the government is stripping away barriers to this firesale.
Mental health patients forced to travel for care
More than 400 adults with acute mental health problems are being forced to seek treatment at hospitals more than 30 miles from their homes. In some cases patients from Derbyshire are being treated in south Devon and others from south Devon are being treated in Birmingham.
NHS investigations into care "appalling"
Patients who complain about their care are being let down by “appalling” NHS investigations, a highly critical review has found. More than a third of investigations into deaths or avoidable harm at hospitals were found to be “inadequate”, according to an investigation by the Parliamentary and Health Service Ombudsman (PHSO)
What's really causing the A&E crisis?
This writer thinks that it's privatisation that caused the problem, from the new NHS111 service that refers too many to A&E, an inadequate number of hospital beds and a reduction of the district nurse workforce.
4th February 2015
BMA demands 'urgent analysis' on NHS111
The BMA has called for the Government to launch an ‘urgent analysis’ of the impact of NHS 111 on the wider health service after claiming there had been a major increase in the number of referrals made to GPs between 2013 and 2014. GPC leaders said they are hearing more examples of patients being referred from NHS 111 with minor ailments, such as colds and sore thumbs.
Locum doctors at £1760 a day
Senior A&E specialists are profiting from chronic NHS staff shortages by working as locum doctors and charging hospitals £1,760 a day for their services, according to a parliamentary inquiry. The NHS in England’s bill for agency staff has risen to £2.6bn a year because of hospital trusts’ difficulty in recruiting and retaining enough doctors and nurses, the public accounts committee also discloses.
Labour privatiser's links with private healthcare
Guardian letter exposes that Alan Milburn sits on the strategic advisory board for WellDoc, has been a vice-chairman of the Lloyds Pharmacy advisory board and chairs iWantGreatCare. is a consultant to private healthcare through AM Strategy, and now is chair of PriceWaterhouseCooper’s health industry oversight board. Commenting on his appointment, Milburn claimed that there were “strong opportunities for growth” in the private healthcare sector, which he would help PwC to exploit.
2nd February 2015
NHS mental health care "at breaking point"
The lack of acute beds available to mental health patients has left the system at breaking point, the Royal College of Psychiatrists has said. Marjorie Wallace, chief executive of mental health charity Sane said it was “profoundly worrying” that there were days when no NHS beds are available. It is a cruel result of a longstanding agenda to reduce mental health beds and treat all mental health patients – no matter how unwell – by already overstretched mental health teams in the community.”
Hospitals refuse to sign up to budgets cuts
England’s biggest hospitals are refusing to sign off their annual budget deal with the NHS claiming that the £1.7bn of cuts involved will mean they can no longer guarantee the safe care of patients. The organisation representing hospitals said they '..could no longer “achieve the impossible” by absorbing a fifth successive year of cuts to the payments they receive for treating patients under the tariff system.'
US business man uses the NHS
He says " sorry America but the NHS really is better". Of course we all know that this view is backed by American research as well, where the NHS is found to be the best in the world, based upon evidence gathered before the Health and Scoail Care Act.
29th January 2015
Amending the rules when a major NHS incident is called
Labour has accused the coalition government of changing the criteria under which NHS hospitals can declare major incidents, in a bid to prevent the negative publicity that they attract. Earlier this month, as performance in emergency departments fell to an all-time low, as measured by government targets,at least 16 hospitals declared a major incident, which means they are struggling so much with demand that they are being forced to cancel planned operations or ask people to come to A&E only in an extreme emergency.
NHS hires 3000 foreign trained doctors
Up to 3,000 doctors have been hired from overseas in the past year, as the service battles to tackle staff shortages that medical professionals say are serious and growing. Dr David Rosser, medical director of University hospitals Birmingham blames NHS central workforce planning and the tightening of visa rules under the coalition, which has made it harder for junior doctors from the Indian sub-continent to stay in Britain long enough to complete their training.
SNP talks of NHS privatisation, so at last the BBC says it too
The words "NHS privatisation" were not used on the BBC until after the Health and Social Care Act was passed in 2012. But now that the Scottish National Party say that they want to protect their NHS from the private sector the BBC is actually able to mention that this is what is happening to the English NHS.
Scrap the market says BMA vice chair
Dr Kailash Chand says the NHS reorganisation is privatising care, which wastes money on profits instead of using it all to run the NHS. The creation of a market ethos-led NHS and the corporate philosophy of treating health as a commodity and the patient as a target have resulted in a colossal waste of funds with little real benefit to the patient.
26th January 2015
Contract with Circle collapses
Heralded as the way forward by NHS privatisers, the contract with Circle to run Hinchingbrooke was the first of many private inventions to show us how better is the private sector at running the NHS. Well the contract has now collapsed. Circle Holdings said its franchise is "no longer viable under current terms". A September 2014 CQC report had previously said that patients are being neglected, hygiene is inadequate and staffing problems are affecting care.
LibDem calls for cross party unity on NHS but only ....
...after they have they have supported the Tories in the biggest destruction of the service ever seen. The Liberal Democrat health minister, Norman Lamb, has appealed for an end to party political conflict over the future of the NHS. It's thanks to the LibDems that the Health and Social Care Act and its notorious Section 75 came into force.
Top A&E doctor says overcrowding has killed 500 patients
Up to 500 patients died last year as a direct result of harm they suffered when hospitals became dangerously overcrowded, Britain’s A&E doctors have warned. The College of Emergency Medicine’s president, Dr Clifford Mann said estimates were based on international studies which show that patients who arrived at emergency departments when hospitals are overcrowded were at greater risk of dying.
NHS is 'creaking at the seams'
The Kings Fund has warned that the NHS is “creaking at the seams” with problems spreading from A&E units to other parts of hospitals, forcing patients to wait longer for cancer treatment and planned operations
5th January 2015
Ambulance services at breaking point
Ambulance services in England are stretched close to breaking point with three of the country’s 10 ambulance trusts declaring themselves under intense pressure over the Christmas period. High levels of demand forced the three ambulance services to rate themselves as reaching a “critical” state, just one short of the “potential service failure” ranking on a six-point scale.
A&E in crisis: aspecial report
If you can wade through this lengthy Telegraph article, then there are some nuggets. Like for instance "hospitals are paid 1.3 per cent less, year after year, for carrying out the same operation. As a way of screwing efficiency out of the system". What it doesn't say is that a) the Coaltion cut nurse training soon after coming to power and now the NHS has to go abroad for nurses b) a fragmented service provided by a variety of different organisations is less efficient than unified collaborating one, c) a lower proportion of the NHS budget is now going to the medical front line due to commissioning expenses.
BMA attacks "unfunded undefined" 7 day week working plan
Doctors have warned that plans to transform the NHS into a seven day service are a waste of vital resources that could threaten the quality of care during the week and prove a danger to patient safety. The British Medical Association accuses NHS England of pushing ahead with an “unfunded, undefined” strategy that is “wholly unrealistic” given the health service’s chronic staffing and financial problems.
Eye clinic faces claims over faulty lenses
The multibillion-pound corrective eye surgery industry has been thrust into the spotlight as regulators announced they were investigating claims that a new artificial lens implanted into the eyes of thousands of patients had caused serious loss of vision. Officials have launched their inquiry after a number of concerned surgeons submitted testimony that patients had complained of defective vision, with some, according to one doctor, struggling to see clearly beyond the outstretched length of their arms.
NHS managers on £300K doubles in a year
The number of NHS managers being paid the equivalent of more than £300,000 a year has doubled in just 12 months, it can be disclosed. In some cases, cash-strapped health trusts are hiring temporary executives for hundreds of thousands of pounds.
29th December 2014
BUPA contract will push West Sussex hospitals into deficit
It's official, even PWC admits that the proposed outsourcing of MSK will not only make running A&E departments at Worthing and Chichester impossible, but will force the hospital trust into financial ruin. It was only after signing the contract the West Sussex Coastal CCG decided to do this impact assessment. Why not before?
Clegg tries to calm fears over TTIP
Under the Transatlantic Trade and Investment Partnership (TTIP) proposed "Investor State Dispute Settlement", companies will be able to sue governments whose regulations put future profits at risk. So fracking firms could take the government to court for banning risky drilling, or private healthcare providers could sue a government that wants to take the NHS back into public ownership. But, good ol' Nick says he "..would never endorse TTIP if that were the case". Do you believe him? See also this article in the Huffington Post.
NHS crisis fears as flu levels start to rise
Figures from Public Health England show flu levels have risen to their highest seasonal level for three years. The country’s most senior doctor urged elderly people, pregnant women and those with health conditions to be vaccinated urgently, amid warnings that the NHS is “creaking” under pressures even before winter sets in.
Ambulance target times could be lengthened
A document drawn up by the Association of Ambulance Chief Executives dated 16 December, includes a proposal to change the response time for some “Red 2” patients – those with “serious but not the most life-threatening” conditions – from eight to 19 minutes in England. The plans come as ambulance services struggle to cope with increased demand. Andy Burnham, the shadow health secretary, said “The government is rewriting the rules and moving the goal posts during the winter… without proper debate or proper consultation.”
Despite all the evidence Maude says NHS neeeds more privatisation
We know about Serco in Cornwall and at Guys and St Thomas's hospitals, and the disaster of Harmoni's out-of-hours service in Hackney, so why does Francis Maude think there should be more private firms involvement in the NHS?
'Needless deaths' under new NHS plans
Under new NHS funding proposals, hospitals which provide specialist care to increasing numbers of patients will be reimbursed just half the cost of every extra case. The formula is part of attempts to divert more funds into out-of hospital care, and long-term prevention of disease. But hospital consultants say the 50 per cent funding rate for extra cases will cause devastation, given that the numbers of patients will inevitably rise with Britain's ageing population.
18th December 2014
Serco overcharged NHS by millions
An old story but I missed it first time round. Outsourcing giant Serco is embroiled in a fresh misuse of public funds scandal after a company it set up overcharged NHS hospitals millions of pounds. Internal documents leaked to Corporate Watch suggest Britain’s biggest pathology provider, established by Serco in partnership with Guy’s and St Thomas’ hospitals in London, overcharged the hospitals millions of pounds for tests and services.
Now the pilot scheme for care.data may be delayed
Pilot schemes for the delayed and controversial NHS programme to share data from patients’ medical records might not start until well into the new year, it has emerged. The launch of the care.data programme was postponed for at least six months in February this year well past its planned date of April 2014. NHS has now said it will not even have completed signing up GP practices for experiments in how it might work until the new year.
Winter crisis looms for Hunt
A sudden slump in the performance of A&E units has heightened fears that the NHS is slipping into a winter crisis and is “cracking under extreme pressure” from an increase in patients seeking care.
OOH 'super contract' could push out local suppliers
Plans to create an integrated urgent care 'super contract' covering much of north London would push out local providers and affect patient care. CCGs covering five boroughs across central north London, with a population of almost 1.4m, are in discussions to develop a joint, integrated GP out-of-hours and 111 service.
Concern over privatising primary care support
GP leaders have warned of 'grave concerns' over outsourcing of primary care support services; and Unison slammed the decision to keep the names of the bidders secret.
NHS litigation claims double under Coalition
The number of litigation claims made against the NHS in a year has almost doubled under the coalition, prompting claims that the service is failing to deal with growing demands on its limited resources. The scale of the clinical negligence claims is unprecedented, with 11,945 cases reported by NHS trusts over the last financial year compared with 6,562 in 2009-10.
552 care homes fail to meet basic legal standards
New figures show that of the 5,332 care homes and home-help services assessed in the last 12 months, 522 failed to meet the most basic legal standards for staffing. The findings suggest tens of thousands of elderly and disabled adults across England are being looked after by workers who are not properly trained, have no relevant experience, or in some cases may even have criminal records.
Never Again?... the story of the NHS Act
If you need more detail, this report gives you 1) how Andrew Lansley was banned from talking about the detail of his plans aheadof the election, 2) what happened at the meeting that called “the pause” on the legislation, and 3) and how the Coalition finessed its legislation through the House of Lords.
GP practices demand compensation from CQC
A leading primary care solicitor says practices had ‘potentially been defamed’ and may be able to claim damages. The Care Quality commission (CQC) published data, based not on an inspection but on information e.g. number of complaints, placing every practice in England in one of six risk bands and published this information online. A total of 1,200 practices were placed in bands 1 or 2, the highest-risk categories, triggering hundreds of negative headlines in national and local media.
24th November 2014
NHS workers stage 4 hour strike today
The government's refusal to implement the measly 1% pay rise and cuts to pension rights are the reason why staff have been forced to strike today. Midwives chief Cathy Warwick said "This is not about our members demanding huge banker-sized bonuses or asking for the similarly large bonuses and pay increases given to many senior managers in the NHS."
Coalition MPs who voted for Act have private healthcare links
One in five Coalition MPs have links with private firms who could profit from the Government’s NHS reforms, a damning dossier will reveal on Tuesday. David Cameron, former Health Secretary Andrew Lansley and his successor Jeremy Hunt are among 64 Tory MPs named in a study by the Unite union. Nick Clegg and Business Secretary Vince Cable are among seven Liberal Democrats on the list.
A&E crisis: Hunt delays report into pressure on hospitals
Jeremy Hunt is under pressure to order the publication of a set of reports showing the full extent of pressures on hospitals in England, amid accusations that the Government is attempting to downplay the scale of a potential winter A&E crisis. A number of hospitals have been forced to declare "black alerts" in recent weeks – the highest level of alert, which usually means bed capacity has been reached.
Police: "Stop using us as ambulances"
Police chiefs have begun a national inquiry into mounting concerns that their staff are being forced to act as ambulance drivers. According to senior officers, patrol cars and other police vehicles are being used to transport sick patients to hospital when ambulances are unavailable. In some cases, officers are even having to administer rudimentary first aid to patients at the scene.
21st November 2014
MPs will vote to amend some wrongs of H&SC Act
Today, the same MPs who voted through the Coalition's destructive Act, will debate and vote on Labour MP Clive Efford's private member’s bill. “The bill wouldn’t repeal the entire Health and Social Care Act. But it cuts the heart out of it. It would repeal some of the worst elements of it that impose market forces on the NHS,” he said.
Private firms will net £9 billion worth of NHS contracts
Analysis by ..... well, us really (NHS Support Federation) reveals that profit-driven companies such as Bupa, Virgin Care and Care UK have so far won a total of 131 contracts worth a combined £2.6bn to provide NHS services since the Health and Social Care Act came into force in April 2013.
GP reveals "shame" at meeting about privatising othopaedics
A meeting in Worthing heard of the "shame" of a local GP, on the board of Coastal West Sussex CCG, but who opposes the contract to transfer Muscular Skeletal services from Worthing and Chichester Hospitals to BUPA. The transfer has been postponed, but not cancelled, pending an impact analysis - the fear is that the hospitals will not be able to provide A&E services.
Health chiefs stop privatisation after 12000 signature petition
It's news that's a month old, but it proves that campaigning works. Campaigners fighting the privatisation of the NHS have hailed a decision by health chiefs to keep their pathology service in-house as one ‘small victory’. Dorset County Hospital bosses asked eight different private companies to bid to run the hospital’s own pathology services, but ended up deciding to keep employing their own existing staff.
17th November 2014
More hospitals face crisis like Colchester
Dr Clifford Mann, president of the College of Emergency Medicine, says hospitals are feeling acute pressure over accident and emergency units, in part because these are often inadequately funded under the system through which the government finances healthcare. A key element of this, he said, was the system by which hospitals were paid for providing care, which Mann said did not properly reimburse them for emergency services.
Unacceptable wait for cancer scan results
Tens of thousands of suspected cancer patients are facing waits of more than a month to find out if they have the disease because of delays in analysing scans and x-rays. The Royal College of Radiologists (RCR) said that the NHS’s “chronic shortage” of specialists who can interpret CT and MRI scans and x-rays lies behind the problem.
It's official: no one knows who's in charge
Relations with the Department of Health and NHS England, a House of Commons Public Accounts committee report states, are "extremely complicated and still evolving". This is another way of saying 'we have no idea who is actually in charge'.
13th November 2014
Trusts in financial difficulties doubles
A report by the National Audit Office (NAO) shows that the gross deficit of NHS trusts has almost tripled in just 12 months, reaching £743m in 2013/14. Last year, 63 trusts ended the year in the red, compared with 25 the previous year. Does this fit with Jeremy Hunt speech today in which he'll tell the NHS to save £10bn a year by using fewer temporary staff and management consultants, selling off unused buildings and reducing drug errors. Why then did the Coalition cut training places in nursing training forcing trusts to use temporary staff?
Patients 'facing unacceptable wait for scan results'
Tens of thousands of suspected cancer patients are facing waits of more than a month to find out if they have the disease because of delays in analysing scans and x-rays. The Royal College of Radiologists has warned that the hold-ups could endanger patients’ chances of survival if the tests confirm they have a malignant tumour. It says that the NHS’s “chronic shortage” of specialists who can interpret CT and MRI scans and x-rays lies behind the problem.
UKIP pitches for the popular vote every time
Farage used to propose an insurance-based health service. But wait, he now realises that saying that the NHS as a publicly-owned service is popular with voters, so now they're saying don't privatise the NHS.
6th November 2014
Under new plans GPs will not control CCG
NHS England is putting forward tough measures to guard against conflicts of interest. The report, written by national director for commissioning strategy Ian Dodge, said CCG decision-making committees would have a lay and executive majority and have a lay chair, putting control out the hands of GPs. The’ measures against conflicts of interest would also see enhanced training for lay members, public registers of interests and decisions, and observer rights for local authority and Health Watch representatives.
Childrens mental health services in crisis
A Health Select Committee report has concluded that there are serious and deeply ingrained problems with the commissioning and provision of children’s and adolescents’ mental health services It says the whole system - from prevention and early intervention through to inpatient services - has issues. While demand for care is rising, in many parts of the country funding is being frozen or cut.
3rd November 2014
New NHS boss defends privatisation
Simon Stevens says privatisation helps patients get treatment. So, lets take Coastal West Sussex CCG's recent decision to privatise orthopaedic services out to BUPA, putting the existence of A&E services at Worthing and Chichester hospitals at risk. How is this enabling patients to get treatment?
Serco and G4S to pay out for youth restraint claims
Fourteen children who were assaulted by G4S and Serco staff while being detained in secure training centres (STCs) between 2004 and 2008 have received damages. Do you trust such companies to run your NHS services?
GP practices in deprived areas face closure
Due to a review by NHS England to cut costs, APMS (Alternative Provider Medical Services) practices in many deprived areas of England face funding cuts or closure. In London, 25 GP-led health centres could have break clauses in their contracts invoked by NHS England to push through funding cuts. One practice said its funding could be cut by 43%, leaving it unviable.
2 in 5 fear NHS will soon cease to be free
More than two out of five people fear the NHS will cease to be a free service over the next 20 years, a new survey reveals. When asked how likely it was that the NHS by 2034 would still be free at point of use, 44% said it was unlikely and 37% thought it was likely to be the case.
Massive £5.5 billion bill for agency nurses
NHS spending on agency nurses and staff has spiralled to more than £5.5bn over the past four years and is continuing to rise amid a debilitating recruitment crisis in the health service. Dr Peter Carter, general secretary of the Royal College of Nursing, said: “These spending figures beggar belief and are the result of truly incompetent workforce planning. Nursing staff are sometimes seen as an easy target for cost savings, only for the NHS to find itself dangerously short-staffed and having to plug the gap".
20th October 2014
Private health company eye surgery: report revealed
The report, which NHS health bosses still refuse to publish, was obtained by the Guardian. Eye operations carried out by a private company on behalf of an NHS hospital appeared “rushed” and surgeons were allowed to press on even after patients reported serious complications. Marked “strictly confidential”, the report reveals that Vanguard agreed to perform 20 cataract operations a day, at least six more than the hospital’s own surgeons would usually undertake.
MPs want inquiry into third sector boss £1 million bonus
Not a health story in itself, but it's interesting to note the high income of the bosses of some so-called charity organisations. Apologists for alternative providers to the publicly-run NHS often imply third sector orgainsations are caring benign orgainsations.
16th October 2014
Senior Tory: NHS Act is "a disastrous mistake"
A cabinet minister is reported saying this, and that the Act is "unintelligible gobbledygook". He goes on, referring to a cabinet meeting "‘He [Lansley] kept saying his grand plans had the backing of the medical establishment and we trusted him. In retrospect it was a mistake."
Private health firm eye surgery: now it refuses to publish report
On 15th August this blog reported that a contract for cataract removal by private health firm Vanguard Healthcare, was terminated after dozens of people were left with impaired vision, pain and discomfort. Now the hospital is refusing to publish its report into the disaster.
G4S and healthcare in detention centres
Four years ago G4S was involved in the unlawful killing of an immigration detainee called Jimmy Mubenga. The company is best known for its involvement in the death after heavy restraint by three G4S guards on a plane. Last year an inquest jury found that Mubenga had been unlawfully killed. Now G4S winning NHS contracts to care for detainees at medical facilities at four detention centres.
13th October 2014
Advances in care "going into reverse"
The number of patients forced to wait on trolleys before being admitted to hospital is soaring as “exceptional pressures” on the NHS mean key aspects of care are starting to deteriorate. Research by the Nuffield Trust and the Health Foundation also found it is getting harder for both children and adults to access mental health services promptly.
NHS finance in crisis
The chief executive of Addenbrooke's hospital in Cambridge talks about how its finances are under serious strain. "A financial squeeze unprecedented in the NHS’s 66-year history has meant, for example, having to extend the expected life of some of Addenbrooke’s scanners, which identify cancer".
Patient database given go-ahead despite privacy fears
The care.data scheme, a widely-criticised plan to gather the personal data of millions of NHS patients despite widespread privacy concerns, has been given the go ahead. NHS England states that they have “listened carefully” to the concerns of doctors and patients and insist safeguards will prevent the sensitive information falling into the wrong hands. But experts say the safeguards are unclear and are concerned that the NHS has a poor track record of losing patients’ data.
Radiographers to strike
Health workers, including nurses, midwives and porters, in England will take part in a four-hour walkout in a dispute over pay. But the Society of Radiographers has announced a UK strike on 20 October - as it did not have enough time to give formal notice to join the other unions.
6th October 2014
Tory linked companies win NHS contracts
Private companies with financial links to Tory politicians have won NHS contracts worth £1.5bn in the past two years, according to research by the UK’s largest trade union, Unite
Hinchingbrooke hospital crisis: further details
Further to the link below about the patient neglect at the private hospital, John Lister's article provides far more detail about how the private venture was hailed as a success but the reality is now revealed by the Care Quality Commission.
29th September 2014
CQC: Private hospital "neglects patient and has inadequate hygiene"
In 2012 to great fanfare, Hinchingbrooke became the first hospital in the NHS to be managed by a profit-making firm when it was taken over by Circle. Now the Care Quality Commission reports that patients are being neglected, hygiene is inadequate and staffing problems are affecting care.
Some privatised care homes are "truly awful" says regulator
Most long term care was transferred in to the private sector during the 1980s. Now, the chief inspector at the CQC says "week in, week out our inspectors discover some truly awful care". Is this where the NHS is heading if privatisation continues under the Health and Social Care Act? The Centre for Health and public Interest thinks it might well be.
NHS to pay for Ashya King's proton beam therapy
The boy with a brain tumour whose parents disappeared with him to Spain will now have the course of treatment paid for by the NHS. UK doctors said that it offered no advantage, because the entire brain and spine would have to be irradiated whichever method was used. However, he now needs "...a course of radiotherapy as a matter of urgency."
The developing crisis in primary care
The chair of the Royal College of GPs says that waiting times for an appointment, owing to a shortage of GPs, is a "national disgrace". Now a member of the GPs Committee (GPC) of the British Medical Association has lauched a major broadside against the CQC’s new inspections regime, claiming that inspections are ‘chaotic’ and ‘not fit for purpose’. Why doesn't the government regulate and intimidate bankers as healthcare staff, teachers, fire fighters, social workers are now?
25th September 2014
First case of CCG falling foul of Section 75
Two CCGs failed to ensure that GPs were promoting patients’ choice to use a private provider over an NHS trust, Monitor has found in the first major test of competition regulations. Spire Healthcare complained to Monitor NHS Blackpool CCG and NHS Fylde and Wyre CCG in Lancashire had asked GPs to direct patients away from the Spire Fylde Coast Hospital, towards the Blackpool Victoria Cross.
Labour: GPs will be under control of hospital trusts
Labour has announced plans for every hospital to become an ‘integrated care organisation’ with ‘GPs at the centre’, but GP leaders have warned this could lead to the ‘destruction of practices’. Speaking at the Labour party conference, Andy Burnham said he wanted hospitals to grow into the community and ‘into people’s homes’, providing an ‘end-to-end journey’ for patients.
BMA Scotland calls for an NHS debate
BMA Scotland chairman Dr Peter Bennie said: ‘It is time to deal with the big challenges facing the NHS in Scotland. Our population is growing and it is getting older. More people are living with chronic disease and often have complex care needs.....we can continue to focus on co-operation across the health service in Scotland, rather than the approach being taken in England of competition and commercialisation."
22nd September 2014
"Stop reorganising the NHS and invest more"
The Royal College of Physicians has called on the political parties to stop reorganising the NHS, to increase funding and to commit to a health service free at the point of delivery. It said the next government must "...must increase funding quickly to safeguard the NHS from an impending financial crisis".
Obesity could bankrupt the NHS
The chief executive of NHS England has warned that obesity will bankrupt the health service unless Britain gets serious about tackling the problem. Simon Stevens further said the health of millions of children, the sustainability of the NHS and the economic prosperity of Britain all now depend on a radical upgrade in prevention and public health. He proposed a new system for England, in which employers would be financially rewarded for introducing schemes to help workers shed the pounds.
Hunt backs campaign to stop practice closures...??
Health secretary Jeremy Hunt has backed a campaign to stop the closure of GP practices. But, wait a minute....isn't it his policy of cutting the Minimum Practice Income Guarantee (MPIG) that has caused the problem? Silly me, the Health Secretary doesn't have anything do with the NHS ...of course, it's NHS England that's caused the crisis.
15th September 2014
Unfair healthcare fund distribution
Under the Coalition, Jeremy Hunt now decides how much budget is allocated to the NHS and to public health. Auditors identified a wide variation in the extent to which the funding received by local commissioners differs from their target allocations, which are supposed to be based on relative need. In 2014-15 over three-quarters of local authorities and nearly two-fifths of CCGs are more than five percentage points above or below their fair share of funding per person.
Labour to introduce an NHS tax?
Milliband is under pressure to to face down his shadow chancellor, Ed Balls, by backing a rise in national insurance contributions as a way to fund the NHS for future generations. Balls believes that people pay enough tax. He believes it will leave the party open to Tory charges that Labour is returning to a high-tax, high-spend agenda.
85% of GPs think NHS privatised within 10 years
Almost 85% of GPs believe the NHS will be privatised within ten years, with 45% predicting it will occur within five years, a survey of 1,137 NHS staff has revealed. The survey also revealed that GPs felt less engaged in the CCG decision-making than practice managers. It found that 91% of GPs felt the reforms resulted in more work,
Labour will phase out MPIG more slowly
The Labour Party will halt the withdrawal of MPIG and the sweeping PMS clawbacks affecting GPs if it wins the next general election, However, Andy Burnham, Labour shadow health secretary said "MPIG can be phased out eventually it has to be done over a longer period of time to the point where no practice has its viability threatened.’
9th September 2014
Another private hospital contract reviewed
Private hospital Mount Stewart in Torquay is the second private provider to be suspended following cataract surgery. Earlier this month, see 15th August below, a contract between Musgrove Park hospital, Taunton, and Vanguard Healthcare had been terminated after only four days. Now operations at Mount Stewart, part of Ramsay Healthcare have been suspended after patients reported problems with their eyes following operations.
The NHS Reinstatement Bill
Leading public health expert Professor Allyson Pollack has launched a consultation on a new Bill that aims to reverse the failings of the Health and Social Care Act 2012 and fully restore the National Health Service in England as an accountable public service.
EU's PR strategy on TTIP revealed
This is not a new article but it implies that the warm words from European officials, as reported below in July, were just that, and the threat to the NHS remains as real as ever.
Orthopaedic services in West Sussex given to private company
A £235 million contract for orthopaedics in Chichester ans Worthing hospitals is given to BUPA. This will mean that the Western Hospitals Foundation Trust that runs these hospitals will lose this funding and staff will be outsourced. Services at the hospitals will face fragmentation, administration costs will mushroom as the separate bureaucracies of the Trust and BUPA interact, as orthopaedic patients are transferred to services run by the Trust, e.g. xray, transport and general hospital healthcare.
1st September 2014
GPs denounce NHS privatisation
More than a 100 GPs have responded to a GP backed letter in the Daily Mail opposed to a moratorium on privatisation of the NHS as proposed by Labour. The counter letter, compiled by Lewisham GP and National Health Action party member, Dr Louise Irvine states that those GPs are not representatives of the profession, and that many GPs don’t believe competition and privatisation are good for patients.
NHS central to Labour campaign
Labour will seek to convince voters that the Conservatives, who have tried to push through major reforms of the NHS, cannot be trusted to protect it. The party believes it can win over the electorate in marginal constituencies where healthcare services are being cut and privatised.
NHS chiefs meet with private US health insurers
Consultancy firms and a health insurance giant bidding for NHS contracts have been operating a discreet forum at which they receive regular briefings from senior health service managers charged with ushering in the new era of competition among its providers The Commissioning Support Industry Group (CSIG) is largely unknown to outsiders. Its members are jockeying to win an estimated £1bn of contracts advising the new doctor-led clinical commissioning groups.
28th August 2014
Hospital pharmacies go private due to VAT loophole
Lucrative hospital pharmacy services are being sold off to private companies such as Boots and Lloyds because a tax loophole puts the NHS at a huge disadvantage. An historical loophole in tax law allows private pharmacies to reclaim the 20 per cent VAT they pay suppliers for medicines – unlike those operated by the NHS.
Care.data extraction now to include sensitive data
NHS England wants to expand its care.data extraction scheme to also include ‘sensitive’ patient information, despite initially saying these conditions would be excluded. Diagnoses such as HIV or AIDS, sexually transmitted infections and medical history mentioning abortions, convictions or abuse have been classed as ‘sensitive’ and are set to be excluded when the scheme. NHS England is preparing to consult on expanding the scheme to include some or all of this information.
Mental health cuts: self-harm rises by 56%
Growing numbers of people being treated in mental health units are harming themselves and trying to take their own lives, new NHS figures suggest. Labour blames cuts in mental health budgets, but the president of the Royal College of Psychiatrists said that increases were due to better reporting.
22nd August 2014
Another privatised care home taken to a tribunal
Eleven female carers to the elderly, on zero-hours contracts, are taking their employers to a tribunal claiming they were only paid by the minutes they spent with clients rather than their rostered working hours. They are employees of Apex Care in Romsey, Hampshire and are paid less than the minimum wage of £6.31 an hour. Some employees of Apex, commissioned to provide the home care service by the council, estimate their real hourly wage was close to £3.50.
NHS hospitals income from private patients soars under the NHS Act
Now that the private patient income cap has been lifted by the Coalition's Health and Social Care Act 2012, NHS hospitals are filling more of their beds with queue-jumping private patients; meanwhile NHS patients go to the back of the queue.
Why aren't private hospitals scrutinised like NHS hospitals?
A think tank scrutinising the role of markets and competition in the NHS, the Centre for Health and the Public Interest (CHPI), says figures obtained from the Care Quality Commission (CQC) show just over 800 patients died unexpectedly in private hospitals in England between October 2010 and April 2014. Peter Walsh's blog, demonstrates the way legislation puts possible NHS failings under the spotlight, but ignores the failings of private healthcare.
18th August 2014
Voters happy to pay extra tax for the NHS
Almost half of voters say they would be happy to pay more income tax as long as the money went directly to the NHS, which is facing a £30bn gap in its finances by 2020. Polling firm ComRes found that 49% of people would be prepared to pay more tax to help fund the health service, one in three (33%) people said they would not be ready to do so, and 18% did not know either way. What better use of government funds is there than the NHS?
NHS privatisation is failing patients
Alysson Pollock writes on the effect of privatisating the NHS. "The NHS is footing the bill for dozens of people left damaged by eye operations provided by private healthcare operations. The diversion of scarce funds out of the NHS destabilises NHS services. This leads to service closure and staff redundancies, undermining the training of juniors and quality of care,"
LibDems challenge Clegg over NHS reforms
Nick Clegg faces a renewed battle at his party conference with senior MPs and activists who plan to force the Liberal Democrat leader to back a repeal of the government's NHS reforms.
15th August 2014
What it's like to be employed by Care UK
Fifty carers for the disabled are staging one of the longest strikes in the history of the health service to secure a living wage for staff working in privatised services formerly run by the NHS. Care UK, whose former chairman Lord Nash is now a government minister, took over services for people with severe learning disabilities in Doncaster this year, cutting wages of staff who had been on NHS terms by up to 35% while bringing in 100 new workers on £7 an hour.
Brits, don't be fooled: the NHS is brilliant
Australian Paola Totaro, used to paying healthcare insurance, as most do down under, tells us, after the care she received for breast cancer, that the NHS is brilliant. But she notes "...not a day goes by when the National Health Service isn’t in the news,...from the red top tabloids to the circulation busting, Daily Mail, sticking the knife into the NHS seems to have become a favoured British sport."
NHS is facing a huge bill for botched privare eye ops
Patients have been left with impaired vision, pain and discomfort after undergoing operations provided by a private healthcare company. The routine cataract operations were carried out in May to help to reduce a backlog at Musgrove Park hospital in Taunton, Somerset. But the hospital's contract with Vanguard Healthcare was terminated only four days after 30 patients, most elderly and some frail, reported complications, including blurred vision, pain and swelling
MPIG cuts: two year reprieve for a small number of surgeries
You will have read below that GP surgeries in poorer areas face closure after the government, no sorry NHS England, cut the Minimum Practice Incoem Guarantee. Now, following the Save Our Surgeries campaign, NHS England's London region confirmed that a small number of practices would receive ‘additional financial support for two years,
4th August 2014
Funding cuts: council backs Save Our Surgeries
It's funny how, when we are constantly told that NHS funding is protected, we have to have campaign against cuts in funding; anybody would think that we've had a) a top-down reorganisation that has cost £3 billion b) we waste money on the complexities of commissioning in the private sector. However, funding cuts are exactly what we've got. Funding to GPs, called the Minimum Practice Income Guarantee (MPIG) is being removed, threatening surgeries in poorer areas of London, and probably other cities too.
Patient to sue Hunt over surgery closure
A patient has launched a High Court legal bid against the health secretary and NHS England claiming they breached their duties. It comes as GP campaigners representing 22 east London practices at risk of closure due to funding cuts have been invited to 10 Downing Street next week to hand over a 16,000-strong petition to Prime Minister David Cameron calling on him to step in and stop closures.
31st July 2014
NHS will miss £20 billion savings target
The Kings Fund latest quarterly report which surveys NHS trust and CCG finance directors found the numbers of CCGs predicting the NHS was at risk of missing the £20bn savings, now in the final year of a five-year plan, has increased from 48.9% last quarter to 59.6%. A further 20% of CCG finance directors said patient care in their local area had got worse in the past year.
NHS redundancy payouts total £1.6 billion since 2010
Here's one reason why the NHS frontline is struggling ...the cost of redundancy payments for NHS managers has hit almost £1.6bn since the coalition came to power and embarked on its sweeping reorganisation, according to the latest Department of Health accounts. The total includes payouts to some 4,000 "revolving door" managers, who left after May 2010 with large payouts but have since returned either on full-time or part-time contracts.
LibDems: An NHS tax to fill £30 billion shortfall
An NHS tax is being examined by the Liberal Democrats as a solution to the current crisis in funding for the health system. The plan is regarded by senior figures within the party as a necessary step towards filling a forecasted £30 billion black hole in the NHS finances over the next five years.
General practice is close to collapse
A report by a taskforce commissioned by the DH and NHS Education England warned that ‘there is a GP workforce crisis which must be addressed immediately even to sustain the present role of general practice in the NHS, let alone enable it to expand’. Labour's Andy Burnham says this is the direct result of the coalition's reforms.
22nd July 2014
So privatising care homes hasn't worked
Hunt declares that too many care homes are failing...as if it wasn't Tory policy that privatised them in the 80's. What are the implications for the NHS now the Tories are privatising it? The wihiff of hypocrisy is very evident.
Thatcher wanted a US style health system
Ken Clarke reveals Thatcher's hatred of the NHS. "She wanted compulsory insurance, with the state paying the premiums for the less well-off. I thought that was a disaster. The American system is hopeless … dreadful." Well he's seems to be the only Tory who's prepared to admit this.
14th July 2014
Is there a better use of taxes than NHS?
There seems to be constant chatter that either we can't afford the NHS or that there has to be "honest discussion" about what health service we can afford. Now a survey of health bosses finds that 47% think it unlikely that comprehensive healthcare will be free at point of use by 2024. Cameron finds funds to spend on increasing surveillance, but the NHS still suffers from the £20 billion cuts owing to the bankers crisis. Does this seem an odd set of priorities to you?
TTIP fears allayed?
There were fears that the Transatlantic Trade and Investment Partnership (TTIP) would risk the possibility of ever bringing the NHS back into public ownership. Now the lead EU negotiator has given an undertaking that US healthcare companies will not be allowed to run NHS services. Well we'll wait and see how it turns out before celebrating.
Hunt's assertion that medical tourism costs the NHS refuted
This is old news I know, but I still hear people talk of foreigners abusing the NHS. Here's actual research that medical tourism is a lucrative source of income for the NHS.
7th July 2014
Cancer care could be privatised in Stafford area
Cancer care in the NHS could be privatised for the first time in the health service's biggest ever outsourcing of services worth over £1.2bn. A host of private healthcare firms have already expressed interest in securing a £689m, 10-year contract to provide cancer care at four NHS GP-led clinical commissioning group areas in Staffordshire. So if this is the case, watch the reduction in staff numbers, and after a while, the pressure on nurses to sign new contracts; and will the service be as good?
Labour backing for bill to repeal competition
Labour is backing a private members bill intended to repeal the competition provisions in the coalition's NHS reforms. Clive Efford's bill would rewrite the rules which force market tendering of services and embeds competition law in the health service. The bill would also scrap elements of the Health and Social Care Act which open up the NHS to EU competition law.
Should CCGs control primary care?
Won't there be a conflict of interest if the control of contracts for GPs is in the hands of CCGs, whose boards are dominated by GPs? The BMA thinks so. But most CCGs have bid to do just that.
Widow of GP criticses Hunt's name and shame plan
The widow of a GP who died of cancer earlier this year has hit out at health secretary Jeremy Hunt's plan to name and shame GPs who fail to spot the disease. Do you get the feeling that there's a 'blame everyone but me if the NHS goes wrong' campaign by Hunt?
30th June 2014
Hospital short of nurses pays huge salaries to executives
Foundation Trusts have the "freedom" to pay their bosses whatever they like, whereas ordinary NHS trusts are not. Medway Foundation Trust has hired more than 30 interim managers on six-figure packages over the past few months. The highest paid is receiving up to £540,000 a year. However, the hospital is about to be rated “inadequate” by regulators, the worst possible level, and even its own reports admit the trust needs 120 more nurses to provide patients with safe care. So why does the Coalition want to make all hospital trusts into foundation trusts?
Tories call for more cash for NHS
Stephen Dorrell, a former Conservative health secretary, Sarah Wollaston, a Tory MP, and Paul Burstow, a former coalition health minister, say that with the economy growing the NHS must receive a real terms increase in spending. Chris Ham, of the King's Fund, and a former Downing Street adviser, raises the spectre of another major NHS disaster on the scale of the Mid Staffordshire scandal if more money is not found to relieve the pressures on services.
A quarter of A&E patients couldn't get a GP appointment
Almost six million patients a year are turning to Accident & Emergency departments because they cannot get an appointment with their GP, new research suggests. The study by Imperial College London. provides evidence of how many patients arrive at A&E because they could not get a timely appointment with their GP.
26th June 2014
Reverse cuts or face a fight says BMA
The BMA chairman has attacked the government's 'economic illiteracy' and called on ministers to reverse 'four years of waste and cuts'. He said the supposed 'efficiency of the private sector is a myth'.
Over half of public unaware of care.data
More than half of the public have still 'never heard of’ NHS England’s flagship patient record sharing scheme, care.data, despite it being delayed to ‘build public understanding’ of its benefits, an IPSOS MORI poll has revealed. The results of the survey commissioned by the Joseph Rowntree Reform Foundation also found that more than half of the public did not think the scheme should be run on an ‘opt-out’ basis.
23rd June 2014
The NHS is brilliant: so why the reform?
Will Hutton says that the cheapest but best health care system in the world can only suffer when profits come first. On effectiveness, safety, patient centredness, co-ordination, quality and access, the NHS scores number one. Yet right-wing claptrap spews from so-called thinktanks like Reform.
GP referral management in the spotlight
Errors by schemes that scrutinise GP referrals have delayed care and breach patient confidentiality. This is the finding of a survey that found 62% of GPs agreed referral management was eroding their professionalism.
Politicians can't be trusted with the NHS
The majority of British people believe the NHS has become a political football used cynically to win votes and should be trusted to professionals who understand how best to provide healthcare, according to an opinion poll carried out for the British Medical Association.
19th June 2014
NHS is world's number 1 - so why the reforms?
The respected American healthcare comparison organisation, the Commonwealth Fund, in its 2014 study, ranks the NHS as the best in the world for complex care patient services. The Kings Fund asks "why change it?"
"NHS stripped down like a derelict house"
Read people's eulogy to the NHS, the hopeless health service prior to '48, and Oliver Letwin's comment in 2004 that the NHS will not exist "..within 5 years of a Conservative government". Then read "we will mourn the NHS when it's gone", a piece by a GP, comparing the NHS to the costs of an insurance based health system.
Boots, your local family-friendly chemist?
Far from the friendly high street chemist we would like to it be, since its amalgamation into a multinational conglomerate, Alliance Boots is now a tax avoider par excellence, One estimates gives the tax illegitimately avoided by Alliance Boots since 2007 amounts to £1.21 billion – enough to pay for 85,000 new nurses for one year,
Hundreds march against funding cuts to GPs
The protest was organised by GPs and supporters from the Save Our Surgeries group launched by the Jubilee Street Practice, which has said it will close in October without a funding solution, owing to the withdrawal of the Minimum Practice Income Guarantee. See below, 29th May.
5th June 2014
Labour commits to repeal competition rules
Labour has pledged to roll back the dramatic extension of competition in the NHS that has occurred under the coalition. Section 75 of the Health and Social Care Act will be scrapped. Labour would remove the duty on Monitor, the NHS's economic regulator, to promote competition in the health service. Freedom of information laws show that hospitals in England are spending about £20m a year in order to ensure they are complying with competition that the legislation brought in.
GPs say care.data should be opt-in
Three-quarters of the doctors at their annual BMA conference (74%) in York said care.data extraction should be reliant on patients opting-in to the programme. The Health and Social Care Act says that GPs are legally required to provide data to the Health and Social Care Information Centre for the care.data programme. But under the Data Protection Act GPs are also controllers of patient records, meaning they have a duty to ensure a person’s personal data is handled transparently and in a way they would ‘reasonably expect’.
BUPA 'bribes' members to use NHS
Bupa has been accused of ‘bribing’ its patients with up to £2,000 to use the NHS rather than private hospitals. The medical insurer offers financial incentives to those who agree to have heart, cancer or gynaecological surgery in NHS hospitals.
Private hospital to charge patients £95 for GP appointment
A private hospital group has introduced a new ‘GP Private Service’ which will see patients paying £95 for a 30-minute consultation, which it claims is a result of the ‘frustration’ of patients in obtaining a ‘timely GP appointment’.
29th May 2014
GPs conference rejects calls for appointment charging
Calls to introduce GP appointment charges have been rejected by the profession's leaders, who said it would be 'mistaken and dangerous' step that would destroy patient trust in their doctor. Dr Laurence Buckman said "You do not manage demand by making patients pay - you then get survival of the richest, not treatment of the sickest."
Private firms waiting to take over surgeries hit by funding cuts
A senior GP with links to the Conservative party and the commercial healthcare sector said the threat of closures from MPIG withdrawal and other recent funding changes (see 8th May below) was an ‘opportunity’ for commercial providers and GPs. Tower Hamlets GP and health campaigner Dr Kambiz Boomla said destabilisation was deliberate government policy to privatise services. A senior NHS England official has admitted that practices could close as a result of ongoing GP funding redistribution such as the withdrawal of the minimum price income guarantee.
Scottish healthcare staff form NHS for Yes
About 100 healthcare staff, including surgeons, consultant physicians, GPs, pharmacists, dentists, hospital porters and janitors have joined NHS for Yes, to protect Scotland's NHS from future Westminster funding cuts, and the damaging impact of privatisation south of the border.
22nd May 2014
Survey: A&E not overused
Research by the organisation that represents A&E medics, the College of Emergency Medicine, states that only one in seven people who attend A&E could be dealt with by a GP but the rest are justified in going to an NHS emergency department
Cameron: out-of-hours opt out wrong
David Cameron thinks that allowing GPs to opt out of out-of-hours services was a mistake. But Care Quality Commission's investigations report that current OOH services were "serving communities well".
Should GPs charge an appointment fee?
The BMA's local medical committees' conference is about to debate its support for charging for appointments. Here are two viewpoints about the issue. Wiltshire GP Dr Helena McKeown says extra funding for the service would help to liberate GPs from ‘political control’ and enable GPs to focus on patients’ welfare; whereas BMA deputy chairman Dr Kailash Chand says for the very poor healthcare would be out of reach.
19th May 2014
Wasted funding on NHS111 procurement
NHS England will have to spend £33 million on the re-procurement of NHS 111 services - a sum described by a BMA official as ‘wasted’ money. This is the first time the costs of the re-procurement have been revealed following the urgent care phoneline’s troubled rollout last year in the North West, West Midlands and London
Public wants Serco banned
Nearly 80 per cent of the public think Serco, the scandal-hit outsourcing company that runs many NHS contracts, should not be allowed to bid for public service contracts, according to new research. The company is to be investigated by MPs after it was forced to disclose a secret internal report revealing evidence that it failed to properly investigate a claim of repeated sexual assaults by one of its staff against a female resident at Yarl's Wood immigration detention centre.
Hunt's support for homeopathy
Supporters of homeopathy repeatedly duck the challenge of peer-reviewed studies into the non-placebo effectiveness of homeopathy. The government's chief medical officer, Dame Sally Davies, has categorically dismissed homeopathy as a waste of time and money. But Hunt has asked her to commission expert reviews into three homeopathic remedy studies carried out by a commercial French company.
How to increase NHS funding: idea No 1
Providing a comprehensive health service ought to be the government's highest priority - what other department is of higher importance? The Coalition has asked maverick Labour MP Frank Field about his idea to improve funding - a national insurance increase. But this is a tax on all working people; why not increase taxes on those most able to bear it?
15th May 2014
Coalition's NHS organisation's lavish expenses culture
The chiefs of the organisation at the heart of the NHS reforms, NHS England (formerly NHS Commissioning Board), had a culture of lavish expenses. Nine health officials spent almost £200,000 last year on fine dining, taxi fares and hotels at up to £500 a night. The highest individual bill was for Tim Kelsey, national director for patients and information, who spent £46,000 during the year. He is responsible for foisting the care.data scheme upon us. Care.data involves the selling of GP patient data to private firms.
RCP: End of life care deficient
A Royal College of Physicians report states that fewer than half of NHS patients who were in their last hours or days were told that they were dying by hospital staff, while a significant number of families and relatives are left feeling they have no emotional support. What the report doesn't state is that there aren't enough staff in the NHS to provide this level of care.
12th May 2014
Choose and Book to be scrapped
Governments have been preoccupied by "choice" and Choose and Book is a system for making outpatients appointments online; it's part of the concept of giving patients choice. But giving patients choice hasn't worked as expected, Now the government is to replace the system.
GPs: referral management is a waste of money
If your GP wants to refer you to a specialist it's likely the process will be interc epted by a company that will examine the referral and possibly direct you to somebody else. This is referral management. GPs attacked the practice as 'an appalling waste of time and money' that delayed patient access to care. One respondent said the schemes were 'insulting' for GPs
BMA conference to vote on charging for GP visits
The BMA's Local Medical Committees conference next month will vote on whether the BMA's General Practice Committee should ‘explore national charging for GP services'
GP practice opts all its patients out of care.data
The Consulting Rooms practice, in Oxhey, Hertfordshire, has posted on its website that it will opt all patients out unless they choose otherwise as this ‘gives our patients more of a decision when it comes to the sharing of data’.
8th May 2014
GP practices in poorer areas under threat due to funding cuts
The way GP practices are are funded is complicated; see this paper for detailed explanation. Part of their income derives from Minimum Practice Income Guarantee (MPIG), a payment that corrected overall income in poorer areas. Government plans to drop MPIG altogether puts poorer areas practices under threat of closure. Now a London campaign has started to counter the threat of MPIG withdrawal.
Hunt's plans in disarray
The £3.8bn-a-year Better Care Fund was supposed to have been launched last week, but its introduction has become mired in doubt after the Cabinet Office voiced deep disquiet about its viability and argued that there was little or no detail about how the expected savings would be delivered.
BBC consultation states "no coverage of NHS privatisation"
Did you think that BBC reporting of the passage of the Health and Social Care Bill on the BBC lacked any inclusion of the fact that the NHS was to be privatised? Well all too late of course, but here's there proof. See bottom of page 3.
There's no evidence that privatisation works
Polly Toynbee asks the question in this article. I ask myself this question "What privatisation under Thatcher or anybody since has been good for the ordinary citizen?" Would even the most ardent supporter of privatising, Oliver Letwin for example, cite railways, or water, or energy? Of course shareholders and senior executives have got rich on privatisation, but it's the ordinary person who pays the price.
Right wing hatred of the NHS: part 3
Continuing in our series of articles in the media that try to make us hate the public sector, especially the NHS, here's a Telegraph article titled "Who would dare put their trust in the NHS?". Well the answer to this is most people, if genuine research is to be believed rather than fundamentalist political dogma. But hey, when the NHS is run by a Tory government...well we're not so sure.
1st May 2014
Hospital care suffering due to staffing cuts
The inevitable decline in hospital care, as the result of the £20 billion NHS funding cuts is identified in a report by the Care Quality Commission (CQC) that reveals a sharp decline in standards in England’s hospitals over the last 12 months. CQC inspectors, have observed examples of unacceptably poor care at one in five hospitals. By March this year, the care regulator listed 45 hospitals not providing safe care following 215 inspections – close to three times the 16 hospitals failing on this measure in the same month in 2013. This chimes with a Kings Fund report saying the NHS is heading for a crisis without extra funding. These reports have been totally ignored by mainstream media.
Care.data scheme trial of up to 500 surgeries
A trial of up to 500 surgeries will take place in the Autumn of 2014. In March 2014 the patient data extraction scheme was postponed owing to revelations that data will be sold to commercial interests.
Improving Labour's health policy
The Socialist Health Association asks Labour to stop using vacuous phrases in its draft health policy like "the private sector will be allowed to offer patient services only where NHS cannot improve" or "intelligent targets will remain where appropriate".
28th April 2014
Senior obstretician: understaffing may affect baby mortality
Dr David Richmond, president of the Royal College of Obstetricians and Gynaecologists, says it is legitimate to ask whether understaffing of maternity care and labour wards is contributing to Britain's stubbornly high rates of baby death and brain damage.
Burnham: US/EU agreement will "carve up" the NHS
The NHS could be "carved open" for profiteering US private healthcare companies by the end of this year Labour has warned, as concerns grow over the implications of a landmark trade treaty between the US and the EU that critics say would give US healthcare giants, "irreversible" powers to bid for any NHS contract.
Video of Rufus Hound in launch of NHA party campaign
"You can have your operation because your a banker. But you, because you teach special needs children, will have to wait" says comedian, actor and now National Health Action party candidate.
Hunt's "special administrator" fiddled the figures
One of the criteria for the dissolution of the Mid Staffs Hospital Trust was the falling numbers of people using the Stafford hospital. It has now emerged that data showing the number of children treated at Stafford Hospital was removed from an official paediatrics report without consent. Over the past year, there has been a history of challenging the official Trust Special Administrators figures. Support Stafford Hospital campaigners are considering a legal challenge based on the discrepancies.
24th April 2014
Media blasts out its hatred of the NHS
A report that attempts to improve current medical diagnosis is twisted by the Telegraph into an attack on the NHS. A condition that patients often develop before they arrive in hospital causes kidney failure and is easily missed. But the Telegraph's headline "Thousands die of thirst and poor care in the NHS" implies that it's an NHS institutional rather than a diagnostic failure.
Paramedic workload is causing patient deaths
A Harlepool man died on his bathroom floor waiting for 2 hours for an ambulance. Overworked 999 crews are driving 300 miles a day because of savage NHS cutbacks. The shocking workload is revealed by a paramedic who said drivers are so overstretched there is a danger of them falling asleep at the wheel.
Quarter of CCGs face a deficit for 2014/15
Findings from a quarterly monitoring report by the King’s Fund show that of 47 CCG finance directors polled, 26% are concerned or very concerned that their organisation will fail to achieve financial balance in 2014/15. A total of 40% were concerned that their CCG could end the 2015/16 year in the red.
NHS contracting "..a disaster"
Colin Leys, honorary professor at Goldsmiths College, says competition regulations that are driving outsourcing adds to CCG expenses. Almost half see competition regulations as thwarting the best organisation of local services, CCGs have not been given the resources to manage contracts, monitoring performance, and enforcing the contract's terms.
17th April 2014
Challenge the lies about the NHS
The National Health Party has published a fact sheet that identifies the lies that are current about the NHS, like "we can't afford the NHS", of course we can; or "there are £20 billions of efficiency savings" - no they're just plain old funding cuts.
UK wasted millions on Tamiflu
The British Medical Journal is asking the drug maker Roche to release all its data on Tamiflu, claiming there is no evidence the drug can actually stop the flu. Research by the independent Cochrane Collaboration, a not-for-profit organisation that publishes systematic reviews in healthcare, found there was little evidence to support claims that Tamiflu could reduce the impact of a flu outbreak. "I suggest we boycott Roche's products until they publish missing Tamiflu data," the lead researcher wrote. ".. governments should take legal action against Roche to get the money back that was "needlessly" spent on stockpiling Tamiflu."
What it's like inside Serco
A Serco employee writes "staff are treated like schoolchildren and targets are more important than customer service." Customer service is repeatedly ignored because targets are seen as the biggest single priority. "We soldier on in the knowledge that we make a difference … to the profits."
Fewer hospital beds in UK when compared to almost any European country
A study by the Organisation for Economic Co-operation and Development found that among 23 European countries, the UK now has the second lowest number of hospital beds per capita.
10th April 2014
You would think we're terribly unhappy with the NHS, wouldn't you?
One of the impressions created by the government and the media was that the NHS was failing, it must have major reform. The latest Kings Fund survey was carried out over the summer of 2012, prior to the implementation of the Coalition NHS Act. It gives a picture of the public’s satisfaction with the way in which the NHS runs; it now stands at 61 per cent, the third highest level since the BSA survey began in 1983.
Identifiable patient data lost 3 times since 2009
A Freedom of Information request reveals that patient data security has been breached in four of the last five years, resulting in identifiable records being disclosed by the Government’s official information centre without authorisation or to the wrong recipient. Info-security web site summarizes the care.data scheme's checkered history.
Hunt's claim that GP contract caused A&E crisis is disproved
A report by the King’s Fund has said there was ‘no evidence’ that the change in 2004 to make out-of-hours provision optional for GP practices had led to an increase in A&E attendances. The report found that there was little way of knowing whether people attended A&E because they thought they would not be able to get an appointment with their GP.
7th April 2014
Is there any justification for NHS charges?
Lord Warner was given the oxygen of publicity recently by stating that NHS users should pay a £10 a month for the NHS. His report is published by right-wing think-tank Reform which is funded by the General Healthcare Group, the UK’s largest private hospital firm, and also other private health companies - Prudential, Legal & General, Scottish Widows, Aviva, Benenden insurance, Gen Re (reinsurer of health products) and US health insurance giant UnitedHealth. NHS consultant Jacky Davis says there's no financial, ethical or clinical argument in favour of upfront charges for the NHS. The most efficient and the fairest way of funding it is through progressive central taxation.
CCGs forced to put health services out to tender
New research by the Health Service Journal shows that 29.1% of the leaders of 93 clinical commissioning groups (CCG) which responded to a survey said they had opened up services to competition which they would not have done if they were not concerned about the impact of new Section 75 rules contained in the controversial Health and Social Care Act. They included contracts for out-of-hours GP care, older people's services, audiology, ultrasound and podiatry.
Virgin sleight of hand in Surrey community services take over
When employees are outsourced it's almost certain they will get poorer terms and conditions of employment, even though TUPE regulations are supposed to offer protection. This is partly due to later employer "arm twisting" but also because pension rights do not transfer, as long as another scheme is offered - which is always less beneficial. So how did Virgin manage to pull off the transfer of Surrey community services staff? Well, staff will remain in the NHS pension scheme, by being transferred to a social enterprise called VH Doctors. So the state will bear the cost of paying their pensions; nice to know that we're feather-bedding private interests in the privatisation of our NHS.
3rd April 2014
BMA renews call for Act to be repealed
The doctors’ union launched a campaign calling into question whether the coalition government’s reforms were working. At a cost of billions of pounds, said BMA chairman Dr Mark Porter, the reforms had increased bureaucracy, and ‘needlessly shook up the fabric of the NHS’ with very little gain.
Hunt accused of "control freakery"
The health secretary Jeremy Hunt has had a series of standoffs and rows with NHS leaders amid claims from senior figures in the service that he is an interfering "control freak" who is trying to manipulate it for political purposes.
24th March 2014
Unite - NHS is being sold to private sector
Unite's head of health says what mainstream media isn't saying, that the NHS is being sold off to private health companies. Behind this is ".. deep-rooted intention of the coalition to privatise large swathes of the NHS as quickly as possible". All this despite the only experience we have of NHS services being delivered by the private sector is that healthcare quality suffers.
BMA poll - 60% of GPs want to get out
GP leaders said the profession faced a ‘workload disaster’ and would be unable to cope with patient demand without serious support and investment from the government. In the past year, 57% of GPs said they had considered retiring early. Another poll, by the Royal College of GPs, found that a majority of the public backed higher investment to save primary care.
17th March 2014
RCN: "nurses take the blame"
Peter Carter, head of the Royal College of Nursing says that nurses have been scapegoats in scandals over poor quality care when the main problem is understaffing. Recommendations in reports that tend to get implemented are the ones . . . that don’t have resource implications while [those with] resource implications tend to disappear into the long grass over time.
Care UK dispute over outsourced care workers
Care workers who look after learning disabled people in Doncaster are in dispute with Care UK who want to impose new terms and conditions of employment. This is typical of outsourcing - a drive for profit at the expense of workers who were, even under local authorities, hardly the best paid. Care UK, according to Unison, want to slash wages by up to 50%.
GP practices excluded from services unless they are federated
An online Pulse survey has found another example of how big business is favoured over traditional providers. GPs are being excluded from contracts for services they have traditionally provided unless they are part of a federation, A Freedom of Information Act request to CCGs across England found that contracts, including enhanced services, in some areas were being offered only to GPs working in networks, covering services such as drug misuse and population health services, as well as evening and weekend opening. The opening up of these services is driven by cost saving and will result in poorer quality of service, as we have seen in the care industry.
13th March 2014
Do the concessions to Care Bill mean anything?
The controversial clause that will allow special administrators to close neighbouring hospitals has been passed into law. The lack of consultation that was the substance of the challenge over Lewisham hospital's A&E closure; the challenge was upheld in court. It is claimed that there were concessions conceded in the Care Bill but others are not convinced.
Do you believe Nicholson - is he just another voice of doom?
According to Sir David Nicholson, the outgoing head of NHS England, billions of extra funding will be needed for the NHS to help push through "painful and unprecedented" changes during the next parliament. The NHS will need to "..ditch its outmoded reliance on hospital-based treatment and switch to a new model of community-based care."
10th March 2014
Health data releases to be published
The Health and Social Care Information Centre (HSCIC) will issue a report detailing all the data it has released and the legal basis behind those releases. Health officials in charge of a national database for hospital records are to publish a list of every organisation that has had access to the data.
A&E medic says it's 'Like a war zone'
Being a doctor in accident and emergency has at times resembled being a medic in a war zone. She says she has worked as a doctor in various conflicts and yet some of my most stressful moments, facing a tidal wave of pressure, have happened closer to home, in Queen's hospital, Romford.
GPs under pressure due to funding cuts
The Royal College of GPs has warned that patients will fail to get a GP appointment on more than 34m occasions in England this year because funding cuts are affecting services, the new chairman of the college Dr Maureen Baker, said: "GPs and practice nurses can't keep doing more for less now that funding for general practice in England has slumped to just 8.5% of the NHS budget."
Lack of clarity in the new public health body
Response procedures in public health emergencies are confused because of a lack of clarity over the responsibilities of Public Health England, and those of other health organisations, a report by the House of Commons health select committee said.
3rd March 2014
Hunt: care.data information will not be sold to insurance companies
The Secretary for Health is to legislate on the care data programme to appease some of the concerns that have been raised about the scheme. Hunt plans to provide "rock-solid" assurance to patients that confidential information will not be sold for commercial insurance purposes, the Department of Health said. There is widespread unease, allied to the NSA revelations about the granting access to personal data to government.
Coalition benefits assessment threatens patient-GP relationship
The BMA says that GPs are being asked for information that they should not be required to provide. Claimants are being encouraged by the Department of Work and Pensions or its contractors to directly approach practices for information. The BMA said that the work capability assessment process did not adequately assess patients in a fair and proper manner and ‘as a result causes unnecessary distress for claimants’.
27th February 2014
Who have our medical records been given to?
The health and social care information centre (HSCIC), set up to run the database of patient records has already given access to outside organisations. In a Health Select Committee meeting HSCIC's director of information and data service promised to publish all of its data requests and releases outlining which bodies have received patient information, and why. This revelation comes on top of the organisation's announcement of a 6 month delay in the scheme to upload GP records.
Three quarters of GPs say care.data should be "opt-in"
A survey by online medical website Pulse reveals that 75% of GPs in the survey believe that NHS England should abandon the ‘opt out’ system of patient consent used in the controversial care.data scheme before records are extracted in the autumn.
Mid Staffs Trust to be dissolved
Jeremy Hunt announced that the Mid Staffs Foundation Trust will be dissolved, with Stafford Hospital coming under the University Hospital of North Staffordshire trust, and its sister hospital in Cannock Chase becoming part of the Royal Wolverhampton hospitals trust. Should we think again about the idea of Foundation Trusts? Does running the NHS on business lines make the focus on finances a distraction to providing healthcare? Should we allow Foundation Trust managers to pay themselves what they choose?
NHS death rates 'should be ignored'
The most-widely regarded measure of hospital patient safety, the hospital standardised mortality ratio (HSMR), which compares the expected rate of death in a hospital with the actual rate of death, and the summary hospital-level mortality index (SHMI), which covers deaths after hospital treatment and up to 30 days after discharge, should be ignored. That's the main finding by professor Nick Black, who was asked by the NHS to see whether they are an accurate indicator of poor care. His review is not due to be published until December, but he told the BBC the most established method of measuring mortality appeared to have no value.
24th February 2014
Hospital medical records sold to insurance company
Just at the time when the care.data scheme has been postponed owing to a lack of public trust, so it emerges that the medical records of every NHS hospital patient in the country have been sold for insurance purposes, Medical records have been used with information from credit ratings agencies, such as Experian, to calculate insurance premiums. Phil Booth, from privacy campaign group medConfidential, said: “The language in the document is extraordinary; this isn’t about patients, this is about exploiting a market.......the question is why is the NHS prepared to hand this data over?”
Ben Goldacre: "Care.data can save lives"
Bad Science and Bad Pharma author Ben Goldacre gives his assessment of the medical data sharing scheme. I am not convinced that "The data will be "pseudonymised" before release to any applicant company, with postcodes, names, and birthdays removed." What use are health records without knowing the age and location of the patient? They won't tell us exactly how the data is held and how it's released to private companies - this is precisely the main stumbling block that promotes deep suspicion.
GP funding cuts create A&E crisis
The crisis in A&E is exacerbated due to patients being unable to get appointments at their local surgeries. The Royal College of GPs has said almost 11% of the NHS budget was spent on general practice in 2005, compared with 8.5% in 2011, resulting in ptients failing to get a GP appointment when they are unwell on more than 34m occasions in England this year.
Rise in NHS Foundation Trusts in deficit
A study of NHS foundation trusts in England has found the number of those in financial trouble has nearly doubled in a year from 21 to 39. Monitor, which regulates England's 147 foundation trusts, also found 18 trusts missed a target that 85% of suspected cancer patients start treatment within 62 days.
20th February 2014
Care.data launch postponed
Amid criticisms of poor communication on how it will benefit us, the fact that we have to opt out rather than in and can we trust private companies with our confidential medical information, the care.data launch has been postponed. Dr Louise Irvine, London GP and MEP candidate for the National Health Action Party, said: ‘It would have been reckless of NHS England to press on with the care.data plan given the serious concerns about the security of patient information'. Tory MP David Davis MP, said that the new database would be “a honeypot for hackers”.
Public should be consulted on CCG decisions
All CCG decisions would be put out for consultation by Health and Wellbeing Boards under plans to increase ‘public debate’ over how NHS resources are allocated, says Labour leader Ed Miliband. He said: ‘The problem with the current approach is that it creates a dynamic of decisions taken behind closed doors, lacking legitimacy, with little public debate about the real reasons a change is being proposed.
17th February 2014
NHS England admits care.data risks to privacy
The Privacy Impact Assessment by NHS England suggests that the risks of hacking and identification of patients patient confidentiality could be undermined by the new medical records database. It says the scheme could damage public confidence in the NHS and result in patients withholding information from doctors out of fear it may not be kept confidential. The Royal college of GPs has warned of a crisis of confidence in the new patient database.
Care.data will allow police access without informing GPs
Care.data will enable police to access a patient’s medical records without GPs ever knowing, if required as part of a serious crime investigation, it was claimed today. As it stands, police would need to obtain a court order then approach their GP to obtain a suspect’s record. However, after the introduction of care.data they will be able to seek data without seeking permission.
A&E doctors paid £3K a shift
Staff shortages are forcing health trusts to pay locum medics. On at least 2,300 occasions last year, locum doctors were paid in excess of £1,000 to plug the gaps in rotas at crisis-hit A&E departments. The sums included fees paid to agencies, which usually take around 15 per cent of the bill.
M&S boss drafted in to advise on NHS leadership
Former Marks and Spencer chair Sir Stuart Rose has been appointed by the Department of Health to advise on attracting and retaining top managers in the NHS in England. Health secretary Jeremy Hunt, announcing the appointment today, said this would help ‘transform the culture’ in under-performing hospitals. No announcement was made about the salary he'll be on. I wonder how many nurses his salary would cover.
14th February 2014
Damage that care.data will impose
Copying patients’ private medical data without their specific consent goes against everything ever taught about medical confidentiality and information governance. But Dr Chris Lancelot identifies the principles that should be behind it.
Top GPs warn of London crisis
The London Assembly’s health committee heard evidence on GP services from Londonwide LMCs’ chief executive Dr Michelle Drage and chairwoman of NHS England London’s transforming primary care board, Professor Clare Gerada.
10th February 2014
MP - GPs face bullying over care.data opt outs
MP Rosie Cooper said GPs in her constituency have spoken of the pressure they had been put under to ensure that large numbers of patients did not opt out of the care.data programme, which will see GP patient records shared nationally, including private companies, for the first time. A number of MPs have signed a motion calling for a House of Commons debate on the care.data programme.
Cycling could save NHS £250 million
The NHS would save £250m a year if one in 10 journeys were made by bicycle, according to a study commissioned for a campaign for government to treat cycling more seriously. Cambridge University researchers concluded that if cycling made up 10% of all trips, as against the current figure of about 2%, the nation would also gain the combined equivalent of more than 1m years of healthy living over a decade due to lower rates of inactivity-related illnesses.
6th February 2014
NHS England: "we should have been clearer about the care.data scheme"
Drug and insurance companies will from later this year be able to buy information on our medical records, if that is, we don't opt-out. Now NHS England has said it should have been clearer about how patients can opt out of the controversial scheme. The issue is that private companies will be able to buy our medical information for their own commercial purposes, so there are powerful arguments in favour of opting out.
Government amends clause to the Care Bill
Changes to clause 118 of the bill will now ensure NHS staff affected by reconfiguration at neighbouring hospitals would be properly consulted. Campaigners have warned that the clause would give new powers to special administrators appointed to overhaul struggling NHS trusts, allowing them to recommend changes to services outside of the geographic area they are assigned to, like the Lewisham proposals that were defeated in the High Court. However, whether a special adminstrator need not consult the public, which was the issue that caused Hunt's defeat over Lewisham, is not clear.
3rd February 2014
NHS facing a financial crisis
The Telegraph reports that of the 145 hospital trusts in England 44 per cent of them expect to end the year in deficit, with a combined “black hole” of more than £330 million between them.
NHS rationing on the increase
A survey by GPonline found 71% of 315 GPs believe local rationing of treatments or services in their area has increased since April 2013. GPs reported increasing difficulty accessing community nursing care, counselling services and treatments such as cataract surgery and IVF.
"Alarming" culture of bullying within the NHS
David Prior, chairman of the Care Quality Commission, warns of an “alarming” culture within the NHS. He discloses that one in four staff have reported bullying, harassment or abuse from colleagues and managers, while whistleblowers are ostracised.
NHS data grab presents a crisis for GPs
GP online says that since the inception of the NHS, GPs have been the trusted guardians of their patients’ most private medical information. But in just a few weeks, all that will change. Next month, the NHS will begin extracting and storing huge amounts of patient data from GP records for the first time under the care.data programme, and then linking it to data from secondary care.
30th January 2014
40% of GPs to opt out of data scheme
A survey by Pulse reveals that a substantial number of GPs are so uneasy about NHS England’s plans to share patient data that they intend to opt their own records out of the care.data scheme. Care.data will extract patient records from all GP practices, and linked secondary care data, and allow researchers and private companies to access it.
GPs could face investigation if patients opt out of data sharing
Under the care.data scheme, see article above, patients have the right to withhold their data, but they must make an appointment with their practice to do so. GP practices cannot choose to opt-out. Health minister Dr Daniel Poulter failed to rule out penalising GP practices with a higher-than-average proportion of patients opting out of new NHS data sharing arrangements.
Call for a register of doctors interests
A letter in the BMJ contrasts how citizens can access MPs’ central register of their financial conflicts of interest, yet patients cannot find out whether their doctor has a financial conflict of interest. Signed by 15 doctors and academics, it calls on the GMC to set up a central registry of doctors’ competing interests, and says the current system of self declaration “is variable, opaque, and unreliable” and that “there is a need for change”.
'Named GP' scheme in disarray
Plans to rollout ‘named GPs’ for all elderly patients from April have been thrown into confusion after a minister’s suggestion that practices could devolve responsibility for co-ordinating care to district nurses. Health minister Dr Daniel Poulter said GPs may be the best placed person to fulfil this role, but in ‘most instances other professionals are likely to be better suited to take on the care coordination role’, including district nurses.
27th January 2014
90% support free healthcare principle
A Patients Association survey reveals nearly all respondents believe the NHS should be free of charges;75% felt that those who had paid for private diagnostic tests should not be moved up the list above those waiting for the tests on the NHS; less than half think those who paid for a private procedure should get their follow up treatment funded by the NHS.
Lewisham campaigner standing as MEP candidate
Lewisham GP Dr Louise Irvine, a leading campaigner for a group that defied health secretary Jeremy Hunt over plans to downgrade Lewisham hospital, will be running in the European elections, as a candidate for the National Health Action (NHA) Party.
NHS relies on immigrants
The Institute of Public Policy Research says that 11% of all staff for whom data was available and who work for the NHS and in community health services are not British. The proportion of foreign nationals increases for professionally qualified clinical staff (14%) and even more so for doctors (26%), prompting the BMA to observe that without the contribution of non-British staff, "many NHS services would struggle to provide effective care to their patients".
23rd January 2014
Private hospitals allowed to cash-in on the NHS
Owing to the winter surge in demand NHS will farm patients out to private hospitals. Do you think they will take the patients with more complex needs? What will happen when things go wrong? A private hospital recently quoted £13000 for a standard knee replacement....is this good value for our NHS funds?
A&E funding rule relaxed
Hospitals are to receive more money for treating patients admitted as emergencies after NHS bosses relaxed a payments system which critics say has wrongly denied A&E units an estimated £500m a year. It just goes to show that the NHS budget is protected under the Coalition, once McKinsey all the firms involved in tendering in the commercial market have had their share.
Northampton Healthcare Foundation Trust pulls out
The Trust has decided to withdraw from bidding for Cambridgeshire and Peterborough Clinical Commissioning Group’s contract to create an integrated acute and community pathway for older people.
NHS waiting time data for elective surgery 'unreliable'
Patients in England cannot rely on information on waiting times for non-emergency operations, such as knee and hip replacements, The National Audit Office (NAO) has said. After reviewing 650 cases in seven trusts the NAO found it was unable to discern whether this was deliberate, but overall the practices concealed delays rather than over-recorded waits.
20th January 2014
Hunt undermines trust in GPs
In a poll for the Guardian, four in five family doctors say they believe Hunt is deliberately seeking to undermine trust through a series of sometimes trenchant attacks on them, and some complain that they are being used as "political scapegoats".
Patient data will be sold
Drug and insurance companies will from later this year be able to buy information on patients, including mental health conditions and diseases such as cancer, as well as smoking and drinking habits, once a single English database of medical data has been created. There will be no way for the public to work out who has their medical records or to what use their data will be put.
NHS111 call summaries "useless"
‘Simplified’ Post Event Messages (PEMs) were rolled out by NHS England this month, but GPs on the ground are struggling to notice any difference from the old-style summaries which were, in some cases, nine pages long for one patient.
16th January 2014
Private firms win 70% of NHS contracts
The NHS Support Federation analysed contracts for clinical services awarded between April and December 2013 and found that 70% of them were awarded to private firms. This is not surprising. The NHS is not in the business of contract winning, it's a publicly-run universal healthcare system...or perhaps was intended to be! It isn't skilled at marketing, that would be a waste of money. CCG's are now presented with slick presentations by commercial organisations making wonderful promises keen to get their hands on NHS funds; it's now a competitive market.
GP questions hospital closure law
In response to the Lewisham high court decision that supported campaigners against the government's intended closure of A&E and maternity, our Health Secretary has put forward a clause 118 in the Care Bill currently going through parliament that would give new powers to trust special administrators to recommend changes to services outside of the geographic area they are appointed to. A GP has written an open letter, that you can sign, to highlight the change; the clause will allow an administrator to ignore local opinion.
The legal fighting over NHS contracts has started
Just as predicted by critics of the NHS Act, energy and funding is now being spent on litigation concerning the winning of NHS contracts. Shouldn't the energies of people running our NHS do exactly that - run our health services, not have time and money spent on court cases? Will infighting of this sort improve the NHS – isn’t it an empire building side show?
6th January 2014
NHS budgets cuts: food quality suffers
Food bills have been reduced by more than two thirds in certain NHS trusts, with some hospitals now spending as little as 69p on each meal, according to official figures.
Official - Over 7000 medical staff made redundant since election
It is disclosed that the £20 billion "efficiency" savings, are not at all efficient. Dr Mark Porter, chairman of the British Medical Association, said forcing the NHS in England to make £20bn of "efficiency gains" by 2015 at a time of rising demand for healthcare was wrong and damaging.
NHS leaders ask for criticism of the NHS to stop
In a letter to the Guardian the leaders of 10 medical institutions, among them the Royal Colleges of GPs, Nursing, Physicians and Midwives) have demanded an end to what they describe as relentless criticism of the service which exaggerates the extent of poor care and sees GPs and hospital doctors "unfairly bashed" for problems beyond their control. This is clearly aimed primarily at Health Secretary Jeremy Hunt who has dished out intense criticism of NHS and its workers.
GP leaders - "Charging fees will not help"
Pressure on emergency departments would not be reduced by charging patients, the GPC and RCGP warned. More funding for GP practices to expand capacity would be more likely to reduce pressure on A&E, they suggested.
30th December 2013
Doctors fear for sexual health services
Representatives of the UK's hospital doctors and sexual health specialists have written to every local council in England strongly advising them not to put services that provide contraception and diagnose sexually transmitted infections (STIs) out to competitive tender.
Coalition plans to divert funds to wealthy areas thwarted
The health secretary wanted to remove deprivation from the formula used to share England's NHS funds, but NHS England has opted to give all 211 CCGs rises of at least the rate of inflation both next year and in 2015-16, and give those serving the most deprived places extra money to help cope with the demand caused by ingrained health problems.
NHS reforms cost millions in legal expenses
Responses to freedom of information requests received from 190 of the 211 CCGs showed that 76 had paid to use competition lawyers, spending a combined total of over £5 million.
Migrants to be charged for A&E
The government is expected to announce that foreigners coming to Britain will be charged for emergency treatment on the NHS for the first time as part of a clampdown on health tourism. But visits to GP surgeries will remain free. The BMA says "..the system of administering the new charging system will end up actually costing more to run than it collects in revenue."
Winter crisis imminent
Hospitals are facing growing problems as winter pressures loom, with more missing the A&E treatment target, more patients being admitted as an emergency and bed closures on the increase. In a further announcement it's revealed that the pressures of working in overcrowded A&E units have led hundreds of doctors to quit the NHS for Australia, according to research that underlines how a medical brain-drain is exacerbating the struggle to retain emergency department staff.
Chairman of NHS England's dismay at Hunt
Sir Malcolm Grant reveals his frustration at attempts by the health secretary, Jeremy Hunt, to micro-manage Britain's health service. Grant said that difficult decisions would need to be made to avoid a £30bn black hole in the budget by 2021. Among the changes, he said, was a need for a significant reduction in the number of NHS hospitals offering specialist services, such as treatment for cancer.
Care home bosses jailed
Social care, largely run by local authorities before the 80's, is now run as a profit making industry. Care home scandals are now common place; the owners of this home were jailed for neglect. The home suffered from chronic understaffing and even the most basic care procedures were neglected. Might our NHS go the same way?
19th December 2013
Hospital closure regulations "rushed through"
The BMA called on Health Secretary Jeremy Hunt to backtrack on plans to give greater powers to a trust special administrator that would enable the closure of hospitals regardless of public opinion The changes form part of the Care Bill, introduced owing to the government's high court failure to close A&E and maternity at Lewisham hospital. The government appealed the decision in the High Court but lost precisely because it hadn't consulted the public.
NHS funding shift from the poor to the rich
Almost £1 billion will be diverted from England's poorest areas to its richest. This is the result of a new formula for the distribution of England's NHS budget approved by NHS England on 17th December. The north of England and London would lose a significant chunk of their NHS funding, with the cash going to the south, Midlands and east of England. MPs from poorer areas of the country fear it will exacerbate already stark health inequalities between rich and poor. You will notice that NHS England's announcement of the new formula doesn't mention that the impact of poverty in the hand out of funds has been reduced.
Primary care is the key to relieving the pressure on hospitals
The essence of this article is that good primary care, i.e.community-based GPs and nurses, is the key to reducing demand in hospitals. Of course we shouldn't ignore the fact that the squeeze on hospital budgets has contributed greatly to hospital crisis.
16th December 2013
Public have no confidence in private providers
The public is turning against the NHS’s use of private providers to deliver care, even when the care remains free at the point of delivery, a recent poll has found. Ipsos Mori asked 1,009 people if they agreed with the statement: ‘As long as health services are free of charge, it doesn’t matter to me whether they are provided by the NHS or a private company.’ It found that 47% of people disagreed with this statement, an increase of 11 percentage points on the number of people who disagreed when asked in February 2011.
Serco loses OOH contract in Cornwall
Serco has agreed to the early termination of its contract for out-of-hours GP services in Cornwall after the company left the county short of doctors. You will have read earlier in this blog (14th October) that Serco falsified figures on its performance 252 times, making it look better than it was. Serious failings in the service only came to light thanks to whistleblowers.
1000 CQC visits finds 10 with serious failings
This is the true picture of GP surgery inspections as announced last week. But the media, the BBC included, prefer dramatic stories of maggots and out of date medicines for the sake of attention-grabbing headlines.
A&E miss 4 hour targets, it's just a "week on week variation"
The NHS in England has missed its four-hour A&E waiting time target for the first time this winter. 94.8% of patients were seen within four hours compared to 95.6% the week before. The target is 95%. NHS England chief operating officer Dame Barbara Hakin said "last week was the busiest so far this winter". But it's going to get busier. Note also the government spin in this article by BBC health jouno Nick Triggle. Throughout the passage of the NHS Bill he constantly referred to the Bill as "providing local control" of the NHS, and giving patients choice; never did he mention the word "privatisation". That's BBC balance for you!
NHS consultants to work weekends
Consultants’ contracts will be rewritten so that they can no longer refuse to work at weekends, the medical director of the NHS has said. Sir Bruce Keogh said that the changes will be made to ensure consistent standards of care seven days a week.
12th December 2013
A&E hand-over delays
This BBC story, fueling the string of bad news about the NHS, highlights the increasing wait in the hand-over of patients from paramedic to A&E responsibility. Meanwhile the government tries to adopt a position of "something needs to be done, and we're doing it! That's why we brought in the Health and Social Care Act". But why are our hospitals under so much pressure? Is the solution to privatise NHS services? Could it be that the NHS is suffering because there are 20000 nurse posts unfilled, because of the £20 billion budget reduction due to the banker-created economic crisis? Or the NHS111 service that the public rightly doesn't trust?
It's job cuts that harm patient care
A survey of nurses, midwives, paramedics, and social care staff carried out by the union Unison, which represents nearly half a million health sector workers, found that nearly two thirds had experienced staffing cuts in their department in recent months. 55 per cent said they believed cuts had “significantly impacted on patient care and safety”.
GP-led dementia service wins award
The Memory First initiative in Staffordshire cut waiting times from two-and-a-half years to just four weeks by bring consultant-led care into the community and allowing patients to manage their care plan on a smartphone. So reconfiguration can take place without the automatic assumption that it's outsourced to private health companies like Virgin or BUPA.
9th December 2013
Rationing in hip and knee replacements
Data from health analysis firm Dr Foster highlighted the effects of recent austerity, with some operations at their lowest level for several years. The number of knee operations has been rising steadily since 2002, against a background of an increasingly ageing population, but fell for the first time last year.
Whatever happens it's not Jeremy's fault
Amid accusation that it's all GPs' fault that cancer patients aren't being referred quickly enough, a GP in Cumbria fights back. It is down to NHS guidance. He said, "For the last five years [governments] have introduced what are called referral management schemes. These weasel words actually mean applying pressure on GPs to reduce referral of their patients to specialists to save NHS expenditure. In some cases these schemes offer a financial incentive to lower referral rates. In the same article a surgeon suggested that [the Coalition's NHS Act] had made the situation worse.“As a specialist who has been receiving referrals from family doctors for 20 years, I have not noticed any decline in GPs’ caring or clinical skills. What, however, is patently obvious to most consultants is the increasing pressure on GPs not to refer their patients to hospital."
A&E waits on the increase - A winter crisis looms
Data for ambulance services show the patients' wait from paramedic to A&E handover is increasing, and these figures are for the three months up til October. The next two quaters are likely to be worse.
5th December 2013
Food poverty is now a 'health emergency'
Food poverrty is now such a big problem that it should be seen as a "public health emergency", says a group of leading public health figures. In a letter to the British Medical Journal, six leading public health figures warned poor nutrition could lead to a host of problems. There are reports that people are struggling to feed themselves. The numbers of people relying on food banks has tripled over the last year.
Rotherham CCG refuses to bow to competition rules
The CCG asserts that practices have been saved from re-applying for their local enhanced services, worth £616,000 in total including an anticoagulation service, an aural care service and a blood-monitoring service) under Any Qualified Provider. It argued that competition was not needed as only practices could guarantee the safety and quality of their services.
2nd December 2013
Towards whole person care
There are so many opinions on reform of the NHS, driven by conflicting perspectives and ideologies. The principles of Andy Burnham's "Whole person care" are persuasive but don't make good election slogans, according to Jacky Ashley in the Guardian. A report by the Institute of Public Policy Research on the subject details the principles of Labour's approach more clearly.
1000 care home residents die of thirst
The private care industry has failed our elderly; more than 1000 care home residents have died of thirst or while suffering severe dehydration over the past decade, Now the market-driven reforms look set to create a similar path to that of the care industry, as reduced funding drives down quality of heathcare.
28th November 2013
NHS to launch Trip Advisor style web site
The NHS is to set up a patient feedback website, styled after the popular travel site TripAdvisor, to allow patients to post complaints online, including those containing potentially derogatory comments about medical staff, and show hospitals' responses to them in real time.
Robert Francis is new Patients Association president
The man who led the public inquiry into the Stafford Hospital scandal has agreed to become president of the Patients Association, promising to do all he can to rid the NHS of bad care.
25th November 2013
First there's £20 billion cuts, then there's a scramble for sticking plasters
The NHS is heading for a winter crisis so the Coalition are panicking, It was plain that the NHS could never afford the £20 billion cuts, which has resulted in 6000 nurses losing their jobs and 20000 nursing posts remaining unfilled because hospitals couldn't afford to fill them. Now the government is apparently "pulling out all the stops" ....lest the NHS turns into an election issue.
Hospital cuts stopped because GPs said "no"
Surrey Downs CCG surveyed all GPs, including salaried and locum doctors, across its 33 practices about plans to downgrade A&E and maternity care. More than 74% of GPs opposed plans to downgrade Epsom Hospital, which is part of Epsom and St Helier University Hospitals NHS Trust. So CCGs can say "No, we're not going to make cuts, medical opinion is against it". It follows that they could say "shouldn't we consult doctors, and patients, before we privatise NHS services?"
Is our NHS going the same way as social care?
Under the Tories in the 1980s local authority care homes were compulsorially sold to the private sector. Since then, with minority exceptions, the quality of social care has spiralled downwards, with many stories of neglect and private care companies folding, the notable example being Southern Cross. Now a CQC report tells a story of A%E departments being choked with half a million elderly people a year are being unnecessarily admitted to hospital as emergency patients because of stark failings in community care, Alas it's likely that privatisation will force a similar fall in healthcare quality on the NHS.
21st November 2013
Hunt orders hospital to publish staff numbers but not staff ratios
Health secretary Jeremy Hunt has ordered NHS trusts to publish the staffing numbers in each ward. Additionally the National Institute for Health and Care Excellence (Nice) is required to draw up a "toolkit" suggesting minimum staffing levels in wards according to the size of ward, acuteness of patient illness, age profile and other factors. But he does not insist upon mandatory minimum nurse to patient ratios.
Private health companies challenge CCG decisions
Ther government hopes to promote CCGs forming groups for the commissioning of some health services. But apparently this is contrary to competition rules and so private health companies are considering legal challenges This is despite the Government’s claims that its competition regulations, set out in Section 75 of the Health and Social Care Act and based on European competition regulations, will not affect moves towards integrated working.
18th November 2013
Will the new GP contract relieve the impending A&E crisis?
There's no doubt that the Coalition government is fire fighting NHS problems, fearing it will be a major election issue in 2015. So the question we should consider is will the new GP contract, with over-75s being designated a GP, reduce pressure on A&E departments? It seems that GPs themselves don't think so. Will part-time GPs (there are a lot of them) have responsibility for over-75s? What happens when a GP is on holiday? How does this differ from the current set-up for over 75s?
Are NHS trusts solely responsible for the state of care in our hospitals?
We know that owing to the banking crisis and the resulting £20 billion NHS cuts, that 20000 nurses posts are left unfilled. Yet we hear in the press that hospitals are rapped over failings, or that a new inspection regime will target poor care. So hospital trusts are in the government-created bind of reduced funding on the one hand and greater inspection demands on the other. But shouldn't central government be in the spotlight too? The Health and Social Care Act removed the Secretary of State for Health's duty to provide a national heath service, so all in all, governments have created NHS problems but have washed their hands of them.
14th November 2013
NHS111 actually increases demand for urgent care
Data from the pilots of the NHS 111 urgent care line showed a measurable increase in the numbers of emergency ambulances sent to patients and may be responsible for increased activity in the urgent and emergency care system, a BMJ Open study has concluded. The study found that there was an increase of 2.9% in emergency activity in the NHS 111 pilot sites compared with the non-pilot sites.
Is this a solution to the A&E crisis?
At least 100 accident and emergency units will offer reduced levels of service and patients will have to travel further for expert treatment under the biggest shake-up of NHS casualty departments in 40 years. Under the system up to 70 of England’s 170 casualty units will be designated as “major emergency centres” which treat the most serious conditions and injuries. The remainder will deal only with less serious injuries. This comes amid a report that around 12,000 patients spent at least 12 hours lying on trolleys after being admitted to A&E last year.
Biggest outsourcing firms paid £4000 million of our taxes
A report by the National Audit Office reveals that more than £4bn of taxpayer funds was paid out last year to four of Britain's largest outsourcing contractors, Serco, Capita, Atos and G4S, prompting concerns that controversial firms have become too big to fail. A significant proportion of outsourced contracts will be in the NHS. The report estimates that the four groups together made worldwide profits of £1.05bn, but paid between £75m and £81m in UK corporation tax. Atos and G4S are thought to have paid no tax at all.
Nursing cuts are putting patients at risk
Patients are being put at risk because NHS hospitals are functioning with 20,000 fewer nurses than they need, ministers have been warned in a new report. As many as one in six nursing posts at some hospitals are lying vacant, according to evidence obtained in freedom of information responses gathered by the Royal College of Nursing (RCN). Across the NHS in England, a total of 19,526 full-time nursing posts are unfilled as a result of the Whitehall-ordered drive to save £20bn by 2015 in "efficiency gains",
11th November 2013
Nursing poll shows NHS is "being plunged into peril"
A survey of more than 3000 nurses by trade union Unison shows the “major barriers” to delivering top quality patient care are staffing levels (85%), “unreasonable” workloads (72%), stress (36%)and service cuts (69%). “The NHS is being plunged into peril by government cuts and falling staff numbers coupled with an increasing demand for health services,” said Christina McAnea, head of health at Unison.
Tory cabinet millionaires - now Hunt is the richest
Jeremy Hunt, the Secretary of State for Health, is set to become the richest member of the Cabinet after it emerged that he is in line for a £17m windfall from the imminent sale of his own company. Hotcourses, an education listings service he co-founded before he became an MP, is believed to be close to a deal to be bought for £35m by the private equity firm Inflexion. See this article for a list of all the Tory cabinet millionaires.
Paramedics told, don't take patients to A&E
Paramedics will be told to take fewer patients to hospital as part of radical reforms of the NHS to be unveiled this week. Sir Bruce Keogh has said extra money and “outsourcing” of some services to the private sector will be used to attempt to head off an immediate crisis. Hey Bruce, this is exactly how we got into this mess!
Closure of walk-in centres fuelling A&E crisis
One in four NHS walk-in centres, set up in the past decade to improve patients’ access to urgent health care, have been closed since the election, a Monitor report has found, amid a mounting crisis in accident and emergency care. The report shows that the number of patients turning to walk-in units has almost doubled in eight years, with seven million visits in 2012-13, compared with less than four million in 2004-05. Many of the 185 remaining walk-in centres, which usually provide seven-day services, are run by private health care firms, while others were run directly by the NHS.
7th November 2013
A&E overcrowding may cost lives
The College of Emergency Medicine's president, Dr Cliff Mann, said "...if you have overcrowded emergency departments then the mortality rates for patients going through that department increases." His intervention in the debate over how to relieve the pressure on A&E units comes amid warnings that the NHS could be facing its toughest winter ever. The government must provide effective alternatives to A&E for patients without acute severe illness or injury seven days per week and at least 16 hours per day.
How to reduce pressure on A&E
"The government must develop long-term and short-term strategies to address the staff shortages across the NHS, and invest in systems and measures that direct patients to the service or setting that is right" says GP Dr Kalash Chand, deputy chair of the BMA's GP committee.
Competition rules blocking NHS progress
The competition process is obstructing efforts to improve patient services, Chris Hopson, chief executive of the Foundation Trust Network has warned. He has written to Health Secretary Jeremey Hunt urging him to look again at the competition rules and processes. He continued "NHS providers are having to spend huge amounts of money and time, on lawyers, accountants and economists, trying to satisfy the regulators – the Competition Commission, the Office of Fair Trading and Monitor".
NHS Chief - "NHS bosses deserve six figure salaries"
Sir David Nicholson says senior NHS managers should get salaries in excess of £100,000. Do you think so? Do any of our CEOs and bankers deserve the astronomic salaries they get? He went on "...it was wrong to constantly "denigrate" those at the top of the NHS, and blamed the constant reorganisations of the health service for the rising bill for managerial pay."
4th November 2013
CCGs slash the use of management consultants
The online health website Pulse reveals that GP commissioners are shunning management consultants and have dramatically cut NHS spending on external support since CCGs assumed full budgetary responsibility in April. Figures obtained under the Freedom of Information Act from 141 CCGs across England show an accumulated spend of £5.66m since April on consultancy firms. How many of the 6000 nurses who lost their jobs since 2010 could be re-employed with £5.66 million?
How much has your CCG spent on management consultants since April?
141 CCGs, out of 212 across England, were asked for the amount it has spent on management consultants since April. Click here to see if your CCG was one of them.
NHS managers landed £1 million redundancy only to be re-employed
The couple were among around 50 senior staff to receive more than £100,000 to leave their jobs as the NHS was restructured this year under the Tories' NHS Act. However the scale of the settlements, and the fact that a dozen of the executives quickly found new jobs in the health service, drew fierce criticism. Deputy chairman of the British Medical Association Dr Kailash Chand described the payments as a “kick in the teeth of over 6,000 nurses” who have lost their jobs.
31st October 2013
Hunt loses appeal against unlawful Lewisham closure
The Health Secretary has suffered a humiliating defeat in the Court of Appeal after a ruling, that his plans to downgrade Lewisham hospital were unlawful, was upheld. However, he has been accused by a senior oncologist of trying to sneek through changes which would give him greater powers to force through changes to local health services.
Ealing and Charing Cross A&Es to be retained, but others downgraded
A&E departments in West London will be reorganised, Ealing and Charing Cross hospitals will retain their A&E departments but Hammersmith and Central Middlesex hospitals will lose theirs. It is said that senior doctors in the area had supported the changes.
Study finds medical tourism generates millions for NHS
Medical tourism is a lucrative source of income for the NHS, according to a major new study by the London School of Hygiene and Tropical Medicine and York University. The research contradicts many of the assumptions behind the government's announcement that it will clamp down on foreigners abusing the health service. See links for 24th October below.
Devon doctors pulls out of talks with Serco
The social enterprise which runs the out-of-hours Devon service has withdrawn from talks with Serco, A CQC report in 2012 found Serco had failed to meet quality and safety standards. The firm failed to employ enough skilled staff to meet the needs of patients. Local MP Andrew George (Liberal Democrat, West Cornwall) has said Serco should ‘hand back the keys if they can't do the job’ and called for the service to be ‘reintegrated’ with the rest of primary care by the CCG.
CCGs urged to back GP-led services to avoid tendering
More CCGs should copy a West Midlands group that plans to award enhanced services worth more than half a million pounds to GPs without putting them out to tender, the chairman of the GP committee of the BMA has said.
24th October 2013
New NHS chief might bring US-style NHS
Christina McAnea, Unison's head of health, says the new NHS chief, Simon Stevens, a former advisor to Tony Blair who is currently an executive for a US private healthcare firm, could introduce an American-style service paid for through insurance contributions. Why ever do we look to the US for leadership on healthcare? ....Shouldn't it be the other way round?
BMA - "No evidence that health tourism is a burden on NHS"
The BMA deputy chairman writes that convincing evidence does not exist that the cost of people coming here for healthcare is a significant burden on the NHS. In fact this argument may simply be a distraction from the NHS's real issues which are 6000 nursing jobs lost since 2010 and, under the Coalition's NHS Act, an increasing proportion of the NHS budget goes to non-medical expenses, e.g. management consultants and the financial and legal costs of commissioning.
Care firms pay less that the minimum wage
The Low Pay Commission has been told that HMRC has identified 120 care providers for investigation because they are suspected of paying their workers below the minimum wage. To cut costs care companies were in "increasing numbers" hitting on a number of tactics, such as not paying for travel time between visits. Two points occur - I wonder how much the directors of the care home companies are paid, and should local authorities have been forced to sell their care homes to the private sector under Thatcher in the 80's?
21st October 2013
GP-led group likely to take over Serco's failed OOH service
Devon Doctors, a GP-led social enterprise set up to provide out-of-hours care is talking with Serco on running Cornwall's out-of-hours service. A CQC report in 2012 found Serco had failed to meet quality and safety standards. The outsourcing firm failed to employ enough skilled staff to meet the needs of patients, see 14th October below.
How UK benefited from immigrant doctor
A GP lambasts the Coalition government for introducing charges for non-UK NHS patients, by the example of his immigrant father, a medic who volunteered for the Royal Army Medical Corps during WW2, and provided 45 years of service to primary care in South East London.
Government is trying to sneak through a law to close hospitals
The government is trying to push through a last minute change to the law to make it far easier to shut down A&E departments and hospitals without full consultation. Amendments to the Care Bill due to have its third reading in the Lords today, give the government or Monitor the right to order any hospital they like to ‘reconfigure’ - in other words, close - with little consultation, to benefit neighbouring struggling hospitals. The move comes after Jeremy Hunt’s failed attempt to hastily close much of Lewisham Hospital and redirect its patients to neighbouring South London hospitals in financial difficulties.
Police cars forced to be used as ambulances
The scandal of police cars being seconded to do the work of overstretched ambulance staff has been revealed in a leaked log of incidents compiled from around the country. Officers have had to step in after being told on bank holidays of a seven-hour wait for ambulances, according to the document compiled by officers.
17th October 2013
NHS risk log shows problems were expected
Risk logs relating to the roll out of the new non-emergency 111 service published by NHS Commissioning Board, now NHS England, show it expected problems that could put patient safety at risk.
Elderley betrayed by Coalition on social care costs
Thousands of pensioners will be forced to sell their homes to pay for care despite Government promises to the contrary, it has been claimed. The Coalition was accused of betraying the elderly by introducing a means test for access to a flagship scheme designed to prevent anyone having to sell their property while they are still alive to pay for care either residential or in their own home.
Warning of NHS mental health crisis
The mental health service in England is in crisis, according to a leading psychiatrist, as new figures show many trusts are running at full capacity. More than 1,500 mental health beds have been closed since April 2011, representing a reduction of 9%, an investigation found.
14th October 2013
Private US healthcare firm donates £17K to Tories
The Hospital Corporation of America (HCA) is the world’s largest private hospital group, runs several units in London, and holds contracts to run NHS services. It donated £8,500 to the Conservatives in August 2010 and a further £8,500 in September 2011.
The competition rules kick in - CCGs under investigation by Monitor
So the rules haven't been rewritten, as we were promised. It seems CCGs must go to the market, if that is, Spire Health's allegations are unheld. Two CCGs have become the first to face a Monitor investigation over breach of competition rules after being accused of directing patients away from the local private hospital. The competition regulator has opened an investigation into whether patients were disadvantaged by the way non-emergency hospital services were purchased by Blackpool CCG. We will follow this case with interest.
Serco attempting to offload troubled Cornwall OOH service
Private contractor Serco is looking to pass on its troubled GP out-of-hours service in Cornmwall to a subcontractor. If you read this blog regularly, you'll know that Serco operation of Cornwall's out-of-hours service was called "sub standard" by the parliamentary Public Accounts Committee after it was found to have falsified figures on its performance 252 times. The committee chairman Margaret Hodge said "It's absurd that the government contracts with one company, which can't cope and misleads us all, and the company then just hands the job over to another."
NHS England imagines there's a magic wand abroad
Just as the Coalition has blind faith in the private sector, resulting in the Health and Social Care Act, so NHS England imagines there's wonderful healthcare ideas out there that we must copy. All health workers know that, primarily, we must start by funding frontline services properly.
10th October 2013
Tory MP forgot he was paid £50K by Circle
Conservative MP and ministerial aide Mark Simmonds has apologised for failing to make clear an interest when speaking in favour of the NHS reforms. The MPs’ register of interest shows he is paid £50,000 a year as a strategic adviser to Circle Healthcare. Mr Simmonds told MPs he wanted to apologise for “inadvertently” failing to declare his interest. Should someone who financially benefits from a private health company be allowed to influence and vote upon the privatisation of our NHS?
Essex GP stands up for his patients right over their data
Essex GP Dr John Cormack wrote to the Health and Social Care Information Centre (HSCIC) to argue that simply putting up posters in waiting rooms and making leaflets available did not go far enough to offer patients the chance to opt out of having data extracted from GP systems. He said he wants to get the active "...permission of my patients for their confidential medical records" to be accessed by private companies. You will have seen from this blog on 11th August, see below, that private companies and researchers are now able to access data from GP records for £1,
7th October 2013
Labour promises to repeal the NHS Act
Labour’s shadow health secretary Andy Burnham has promised that the party will repeal the Health and Social Care Act in ‘the first Queen’s Speech’ if elected. In an attack against the recent rhetoric of the Department of Health and the health secretary, he accused the Government of ‘spinning’ against its own health service.
Burnham criticises the BBC's coverage of Manchester march
Labour shadow health secretary has asked the BBC Trust to review the extent and quality of the corporation's coverage of the TUC demonstration against cuts and NHS privatisation. The march coincided with the opening day of the Conservative party conference in the city. He said "By any reckoning, this was a major national protest and it seems to me that the BBC's coverage did not reflect this,"
Harmoni gets the boot from out-of-hours service
City and Hackney CCG has awarded a four-year contract to a not-for-profit GP group, City and Hackney Urgent Healthcare Social Enterprise (CHUHSE), to run its out-of-hours care. CHUHSE bid for the service earlier this year but in March 2013 current provider Harmoni’s contract was temporarily extended. A recent CQC inspection of Harmoni North Central London which covers the City and Hackney contract found ‘there were not enough qualified, skilled and experienced staff to meet people’s needs’. The current out-of-hours care deal with Harmoni is worth £4.8m a year, but the contract awarded to CHUHSE is worth £6.4m a year. City and Hackney CCG said: ‘There is confidence that the funding gap will be mitigated by the reduction in A&E activity over the course of the contract."
Coalition wages war on doctors' and nurses pay, but not City bosses
The government has asked that "...any pay increase is withheld next year, unless doctors sign a new deal, under which more of them would work “out of hours”. Any award which is agreed for 2014-15 should be deferred and not paid out until reforms are agreed, Doctors are paid well, but nothing like the vast amounts "earned" by City people. Osbourne said that such schemes are "unfair". Now I'm all for applying fairness to pay, so shouldn't we start with CEOs and bankers? In a separate move Hunt has angered unions by urging the two independent pay review bodies that set earnings for the NHS's 1.3 million workforce to cancel the 1% rise due in April 2014, even though the chancellor, George Osborne, has previously said it is affordable.
Primary care got almost £1 billion less since election
The coalition put £400m less into GP services last year than Labour's final year in office, despite family doctors struggling to meet growing patient demand for appointments, family doctors say. General practice received £943m less across the coalition's first three years because an increase in spending under Labour was not sustained, according to research by the Royal College of General Practitioners (RCGP).
A&Es failing to meet targets has tripled in a year
A total of 39 departments failed to meet the target of seeing 95% of patients within four hours between July and September, according to NHS England data. This compares with 14 units during the same period last year.
Hospitals face unexpected £500 million cuts, so expect more nursing job losses
Despite the government's pledge to protect frontline services with real-terms increases in funding, Monitor, the NHS watchdog, has proposed that in 2014-15 hospitals should be paid 4% less for operations than they were the previous year. While hospitals were braced for a cut of about £1bn in funding, the Foundation Trust Network, which represents all 160 hospital trusts in England, calculates that Monitor is now asking for another £500m in savings – roughly £3m from each trust.
30th September 2013
Burnham - "One health team working around the patient"
Labour's Andy Burnham gave details of his plans for the NHS after the next election. He set out radical plans for whole-person care and integrated services, He said "Let’s extend Bevan’s vision to the whole person.....NHS values were under the 'most audacious attack ever' and the Coalition government was creating an 'American healthcare system'. He also promised to repeal the Health and Social Care Act in the first Queen's speech of a 2015 Labour government.
Hunt - "There are more Mid Staffs out there"
Jeremy Hunt plans to give greater power to the Care Quality Commission that would reveal more hospital disasters. How does he know? Perhaps it's because the effect of under-funding NHS front line services, owing to introducing expensive commissioning services requiring lawyers and management consultants, and of course reducing the nursing work force by 6000 jobs since the election, is that hospitals can't cope. So Jeremy plans to keep the bad news about the NHS rolling in, I guess because he imagines it's good for Tory re-election chances ....or is it?
30 NHS trusts "set for deficit"
A report by the NHS Trust Development Authority says that 30 trusts are exected to be in deficit by the end of this financial year. It said the figures reflected falling income for services and a reduction in bailouts from other parts of the NHS. So why did Hunt hand back £2000 million of NHS funding to the Treasury?
26th September 2013
Labour - give local government a greater role in commissioning
Andy Burnham, speaking at the party’s annual conference in Brighton, said local government should be given a bigger role in commissioning health and social care to bring back accountability. He added "I don’t support GP domination or control of commissioning, because in the end, I don’t think there is enough there to secure the public interest."
Hospital staff bullied into providing poor care
A survey by the Chartered Institute of Personnel and Development has found that fewer than three out of five health workers would be confident to raise concerns about the quality of patient care to senior management A quarter of doctors and surgeons and a third of nurses have been bullied into behaving in ways they believe are bad for patient care. Note: there were accusations of a culture of fear and bullying at Mid Staffs Hospital.
A&E peak arrives early
The flood of patients into A&E has seen waiting times rise across London, leaving almost 10% of people waiting for more than four hours in the biggest hospitals. Normally this level of long waits in the NHS in London does not occur until well into December. The emergence of the document, leaked to the Health Service Journal, follows the recent disclosure that the Royal London hospital in Whitechapel could not admit even emergency patients for two days earlier this month.
4000 care homes allowed to break the law
The Care Quality Commmission (CQC) has turned a blind eye to the failing, even though its chief executive has admitted that said such homes are far more likely to be putting vulnerable people at risk. Each care home should have a registered manager accountable for the quality of services; yet there are 3900 without one.
Majority of contracts now put out to full competitive tender
GP commissioners have put three quarters of all new contracts out to competition since taking over in April, potentially opening up huge swathes of the health service to take-over by the private sector. Figures obtained by Pulse reveal that 63% of the contracts offered by CCGs since April were put to full competitive tender and 9% out to Any Qualified Provider. The figures are the first to show the effect of the controversial section 75 regulations on the procurement of new services by CCGs since they came into force in April. Contracts offered to AQP are restristed to 39 defined services to providers on the NHS England AQP list of providers, But CCGs can also offer a contract completely open to competitive tendering, by any provider.
23rd September 2013
2 tier NHS hospitals doing more private work
Thanks to the coalition's NHS Act NHS hospitals can now earn 49% of their income from private patients. Now NHS patients are going to the back of lengthening queues.
NHS is struggling to make the £20 billion cuts due to the bankers crisis
The NHS is struggling to make £20 billion cuts caused by the lack of proper banking regulations (which of course is still not in place). A Kings Fund report found that 56% of trusts who replied said there was a high or very high risk that the national savings target would be missed.
NHS executives' exorbitant pay
A Guardian exclusive finds that Sir David Nicholson, who headed the SHA in charge during the Mid Staffs Trust crisis,and is now NHS chief executive, earns the most – £211,249. Five executives earn more than £180,000, including Prof Sir Bruce Keogh, the high-profile national medical director, whose salary is £190,000-£195,000.But executive pay isn't solely an issue for the public sector. We have to buy our food, have a bank account, buy petrol all from private organisations who pay their senior managers massively. We have no choice but to engage with companies who endulge in such greed. So let's take issue with all excess, not just that in the public sector.
Mental health services are 'stretched to the limit'
Mental health services have always been seen as an easy target for cuts. They somehow fall under the radar of public scrutiny and so in the recent round of cuts have suffered disproportionately. Now a report by the Mental Health Foundation says that mental health units run by both the NHS and independent sector providers have begun to run out of beds. I can see the headline now "Mental health nurse failed to medicate mental patient!" says coroner.
19th September 2013
Hunt told to stop claiming the NHS is failing
Head of the Royal College of GPs tells our secretary of state for health to cease running the NHS down. She said there is no evidence for his claim. The only evidence we have is that politicans, both New Labour and Coalition, are failing us and our NHS. Think of recent political meddling, and you come up with monery-wasting interventions - Foundation Trusts (Mid Staffs is one of these), ISTCs, Darzi Centres, over-management, targets, and of course the Health and Social Care Act.
Kings Fund chief "NHS problems could wreck coalition election chances"
Ministers could face a deepening series of problems in the NHS, including cancelled operations, rising waiting lists and worsening financial problems, says professor Chris Ham, chief executive of the King's Fund.
Private care fails so social workers face disciplinary
An 81-year-old widow was found by a district nurse suffering from dehydration and starvation nine days after Agency Carefirst24 was shut down. She died in hospital two weeks later.The private care company responsible for visiting Foster four times a day to feed and care for her, was raided by the UK Border Agency earlier this year after allegations that the firm was employing illegal immigrants. The company was subsequently closed down. Now Surrey social workers are taking the flack.
Time to give Harmoni the sack?
The GP-founded not-for-profit City and Hackney Urgent Healthcare Social Enterprise (CHUHSE) is to make a fresh bid for out-of-hours services in the area..Current provider Harmoni's contract was due to end in March 2013, but was extended for a further nine months. You will remember that Harmoni admitted running the out-of-hours service with no doctors.
So when you hear that the NHS budget is protected....
....remember that this is where it goes. The abandoned NHS IT system has cost £10 billion. Note: 6000 nurses jobs have been lost since the Coalition came to power.
More money to be spent on NHS management
A £10m scheme due to be announced today by Jeremy Hunt aims to ape the success of a generation of headteachers who have helped to turn around failing schools. It will offer the "brightest and best" candidates a 10-month crash course in how to run hospital trusts and other important parts of the NHS. The new super-managers will be provided with a two-month intensive business course at top UK and US universities as part of their training. You can't make it up, can you?
9th September 2013
Report warns of impending A&E crisis
In a survey conducted by the NHS Confederation, the body which represents every part of the health service, senior staff said they believed the pressures on their wards will be even worse than last year's difficult winter. A prolonged period of cold, a rapid increase in seriously ill patients arriving at A&E or a lengthy norovirus season would be "all it would take to bring many departments to breaking point".
BBC Survey - A&E understaffed by 10%
The survey finds that there are over a thousand posts unfilled, with London being the worst with four trusts bearing the largest proportion. A&E services came under extreme pressure last winter and the government's four-hour waiting time target was regularly breached. An RCN poll found nine out of 10 nurses working in acute and emergency care believed current pressures on A&E services were putting patients in danger.
4th September 2013
Serco's alleged fraud - police called in
The issue surrounding the fraud is not specifically about the NHS, but Serco is involved in bidding for NHS contracts, and it's been found wanting. It was the company that falsified data on its performance (no less than 252 times) and was accused by the Public Accounts Committee of "substandard" out-of-hours care in Cornwall. So the culture of the company is of interest to us. If fraud is proven then it clearly ought not to be regarded as an organisation fit to run NHS services.
Mid Staffs NHS Trust to be prosucuted
This issue is the death of a patient in its care. Now do you think, like me, that prosecuting the trust and attempting to punish the organisation that provides health care for the area is the correct response? Presumably if found guilty the trust will have to pay a hefty fine and pay huge costs, impoverishing the local community. Doesn't culpability lie with board members and possibly senior staff, more concerned with maintaining their foundation trust status i.e. cutting costs and hitting targets, (and ignoring those who spoke out)? In fact doesn't Mid Staffs demonstrate that health trusts being turned into so-called foundation trusts, is, as an idea, just plain wrong? Public service should be primarily concerned for those in its care, not management, status and the bottom line.
Two thirds of nurses considering resigning
Morale amongst nurses, sapped by under-staffing, cut backs and constant government criticism, is at an all-time low. A Royal College of Nursing (RCN) survey of 10,000 staff found that 62% had thought about leaving over the last year because they were under so much stress in their job.Sixty-one percent felt unable to give patients the care they would want to because they were too busy, while 83% believed their workload had increased in the last 12 months.
"Never" NHS errors double in a year
A "corner cutting" culture in the NHS, due to the £20 billion NHS budgets cuts, cause errors to double. And a further pressure on budgets that diverts funds from front line services is caused by the Coalition's NHS Act. Non-medical expenses now account for an increasing proportion of total NHS funds, due to redundancies resulting from the top-down reorganisation and a complex commissioning procedure, involving contract bidding, legal and financial overheads.
26th August 2013
Hunt hands £2000 million back to the Treasury
An exclusive in Pulse Today reveals that the Department of Health is giving part of its budget back to Osbourne. So 6000 nurses jobs have been lost since 2010, causing bed-shortage and a resulting A&E crisis, and the DH hands £2000 million back to the Treasury. Clearly Hunt's priority is cutting services rather than ensuring quality healthcare.
Hunt - "employment flexibility needed," but why no offer of support?
Our health secretary of state says a change of attitude towards working carers was needed to face up to the issues posed by Britain's rapidly ageing population and an impending "dementia time bomb". Does it occur to you that the very person responsible for health and social care ought to be offering solutions, like financial support for carers, rather than simply repeating a well-known issue?
Private care firms and zero hours contracts
This article exposes the hypocracy of Hunt's hand-wringing in the link above. Private care firms, get round minimum wage regulations by not paying carers for their travel time between patients' homes. Does he really think that employers, who have taken advantage of employment deregulation to maximise profit, will respond to his headline-seeking?
The £1 billion redundancy bill for the Coalition's NHS reforms
In the past year nearly 1,000 employees, formerly working for PCTs that were abolished under the Act, have received six-figure exit deals. So when you hear that the Coalition is protecting the NHS budget from cuts it's important to realise that a much higher proportion now goes on non-medical overheads like this.
Being open and honest about NHS funding
The NHS Confederation is a body representing organisations that provide NHS services, so I guess now has private health firms in its membership. As a result it avoids taking issue with government policy, possibly even welcoming it. Anyway, this document tries to say that increasing NHS budgets is not an option. Why not? What better use of public money is there than to care for our citizens? Are free schools or Trident more valuable than providing good healthcare of all?
Selling NHS blood plasma company "too risky"
Labour peer, a former health minister, has warned that the sale of a UK blood plasma company to a US private equity firm endangers the supply of life-saving products.
Restrictions on migrants' access to healthcare will cost more than it saves
An organisation called Doctors of the World UK, part of the international humanitarian organisation Médecins du Monde, gives some stark warnings over the public health consequences of requiring GPs to charge for care.
19th August 2013
The longest NHS waiting lists for 5 years
The referral to treatment waiting lists which have hovered around 2.5 million patients in recent years reached 2.88 million in June, the highest level since May 2008. The figures were released in a report by the regulator Monitor, that warned that some trusts were cancelling non-emergency procedures to deal with a higher load of emergency cases.
The NHS: free and caring or a market commodity?
“A free Health Service is a triumphant example of the superiority of collective action and public initiative applied to a segment of society where commercial principles are seen at their worst”, wrote Aneurin Bevan. Quite simply, if you care about the NHS then be invigorated by this article in The Lancet, on the one hand, and infuriated that the medical profession didn't do enough to oppose the Health and Social; Care Act. A quote from it "..one might be forgiven for thinking that the current Coalition Government views the NHS as a failing bank or business".
Shortage of midwives until 2026
Calculations by the Royal College of Midwives, despite Coalition pledges to improve maternity care amid a continuing baby boom, suggest that the gap between the number of midwives the NHS in England needs and the number it now has will not be closed until 2026
15th August 2013
Charging for GPs will cost more in the end
Zara Aziz, a Bristol GP, makes the case against charging for GP visits. Many people would go less often for minor illnesses and, instead, use self-help therapies. There is a significant danger that cost would deter the most vulnerable people from attending, especially early on in their illness when medical interventions could be more successful and cheaper in the long run.
GPs have safety fears over their A&E
Three neighbouring CCGs - Barking and Dagenham, Havering and Redbridge - are going to investigate the emergency care at Barking, Havering and Redbridge University Hospitals NHS Trust, owing to‘long-standing concerns about performance’ and more recent staff shortage concerns highlighted by the trust.
GP practices pressured to house private providers
GP practices have been warned not to be pushed into letting any qualified provider firms (AQP) use their premises. They may not be able to charge them for it.
Wales to go ahead with alcohol and tobacco regulation
Minimum prices for alcohol and standardised tobacco packaging will go ahead in Wales if ministers have the legal powers required. The Scottish Government is also moving ahead to implement the standardised tobacco packing and minimum alcohol pricing. Clearly the relevant industries don't contribute to the party funds of the Welsh and Scottish governments.
NHS 111 call centre scripts to be simplified
Following complaints that scripts take 30 minutes on the phone, and then patients are often told to go to A&E, NHS England has decided to ditch the complicated NHS 111 call summaries in favour of a simplified system. Could always have medically-trained staff taking calls, as NHS Direct used to have, but then there's no profit for those private companies now running 111.
11th August 2013
Berwick Report - Why no minimum staffing levels?
Dr Kailash Chand wonders why, despite the report making the point that low staffing levels are the major cause of virtually all the NHS's recent difficulties, it doesn't specify minimum levels of nursing and medical staffing levels? I wonder why too....??
The £500 million bailout for A&E better spent on GPs and nurses
You would think from the headline (see "A&E in crisis" below 8th August) that the money will be spent on more doctors and nurses in A&E - I certainly thought that this is what is meant. But no, read Claire Gerada's (chair of the Royal College of GPs) piece on where the money's going.
Did you know that private firms will be able to access you health records?
Private companies and researchers will be able to access data from GP records for £1, under plans revealed by NHS England to radically reduce the cost and boost the availability of information about patients available outside the NHS.
Do the constant headline-grabbing announcements from Hunt persuade you?
One day Jeremy says this, or this, or plans to do this, or demands that. Does it persuade you that the NHS, as a comprehensive publicly-funded healthcare system that is (or was?) the best in the world, (check the evidence), remains in safe hands? Or do you think that it's being destabilised by being cut up into little pieces and the juiciest bits being fed to the profit-hungry private sector?
8th August 2013
The Berwick Report
This report, commissioned by Cameron following recent NHS crises, was conducted by Don Berwick, co-founder of the Institute for Healthcare Improvement in Boston, Massachusetts, and a former head of Medicare in the US. It's interesting how it was headlined by different news media. I listened to the BBC radio news which emphasized his recommendation of a new offence for "wilful neglect". The Telegraph headlined it on this point too. But really the main thrust of the report was that the blame games that have led to the vilification of staff at hospitals such as those in Mid Staffordshire must end and be replaced by a new culture of openness. So the BBC and the Telegraph have used his report to continue the very thing he's saying must stop.
Healthcare cannot be sold like an Ipad
In a personal piece Dr Kallash Chand provides his critique of the Coalition's policy of fragmenting and privatising the NHS. He points out where private companies see big money to be made "...for big private corporations the real money is in safe, elective procedures, like hip, knee, heart or cataract surgery, not routine visits to the GP/hospital outpatients, or looking after older, chronically ill or mentally ill patients." The commissioning system under the NHS Act "..makes it easy for private providers to cherry pick tasks to ensure they maximise their income and overall profit from the NHS while minimising their costs."
A&E in crisis
It's reported that some hospital A&E departments are close to collapse. If they are like this in summer, then come winter when the elderly suffer, collapse is assured. So Cameron has given £500 million. Perhaps just some of the 6000 nurses who have lost their jobs since the election might be re-employed, but it's not nearly enough.
1st August 2013
Victory for Lewisham campaign
The High Court yesterday ruled that Hunt had exceeded his powers in ordering a closure of Lewisham Hospital's A&E and the downgrading of its maternity unit. This is a major embarrassment for the health secretary and a huge a victory for the London Borough of Lewisham and the Save Lewisham Hospital campaign, a community-based group made up of and supported by patients, community groups, GPs, hospital doctors, nurses, other health professional, and Millwall FC.
30th July 2013
NHS 111 - Did you see Channel 4 Despatches last night?
If you didn't then read this article. The new non-emergency helpline is being run on the cheap, to the extent that the old public NHS trust, NHS Direct, that used to run it, has said it will pull out. Such are the funding restrictions placed on organisations involved in the new service that call handlers are not medically trained and read a series of questions from a computer script, often taking up to 25 minutes, and provide health advice on the basis of the answers they enter.
29th July 2013
"NHS111 is unsafe"
The new non-emergency phone line provided by pirvate healthcare firms was found to be unsafe by an undercover investigation. A manager at a call centre in Dorking run by private company Harmoni – which manages a third of 111 contracts in England - was secretly filmed and said: "We had a very bad service. Still realistically on the weekends we still are unsafe. We don't have the staff to deal with the calls that are coming in."
A&E crisis: shortage of consultants
More than 80% of accident and emergency units do not have enough consultants on duty for the 16 hours a day that is regarded as necessary to give patients high-quality care, MPs say.
Kings Fund: NHS facing chronic staff shortages
The NHS is facing such chronic shortages of GPs, nurses and specialists in elderly care in the next few years that patients may not get the care they need, a Kings Fund report warns. Deepening gaps in the service's workforce are so serious that bosses may have to rip up longstanding national pay agreements in order to attract key staff, risking confrontation with the health unions, Of course they could always divert cash currently going to management consultants and to the profits of private healthcare firms to genuine NHS frontline services.
It's all the nurses fault.....
Two Stafford Hospital nurses who falsified A&E discharge times have been struck off the nursing register. But no criminal charges brought against Mid Staffs board members and senior managers, in charge during the period that saw the unnecessary deaths of hundreds of patients.
Drugs companies overcharging the NHS
The Telegraph exposes how the prices of more than 20,000 drugs could have been artificially inflated, with backhanders paid to chemists who agreed to sell them. The taxpayer is thought to have lost millions of pounds.
Bullying culture at the Care Quality Commission
The full extent of the bullying culture within the Care Quality Commission has been revealed in an internal report, which talks of fear and harassment, often in a drive to reach targets.
23rd July 2013
Cameron strategist's firm briefed against NHS
The lobbying firm founded by the Tories' chief election strategist Lynton Crosby advised private healthcare providers on how to exploit perceived "failings" in the NHS, according to a leaked document obtained by the Guardian. For "perceived failings" read stories slanted to show the NHS in a bad light in the rightwing press, and smear campaigns as immediately below.
22nd July 2013
Apology for Tory smear campaign
If you read the "Hunt accused..." post below, you'll be interested to read of the apology made by Sir Bruce Keogh to Andy Burnham the shadow health secretary over the Tories' "political operation" to use Keogh's report into the death rates at 14 hospital trusts as an attack on Labour's record. Keogh told Burnham that he was sorry about the smear campaign led by Conservative MPs and officials in the days immediately before and after publication of his report.
"Mr Cameron, why are you privatising the NHS?"
We must constantly challenge the government over its plans to privatise the NHS; we all know that's there's no evidence that privately provided health services are better. There's increasing evidence that private providers drive primarliy for profit, not for healthcare for all - see numerous examples below. So, please do as this woman is doing, she challenged Cameron at a public event about the real agenda behind the NHS Act. So write to your CCG or local newspaper to challenge plans to offer contracts to private providers.
MPs - Staff shortages are the real cause of A&E crisis
A report, from the Health Select Committee of the House of Commons, will say that patient safety is being put at risk by staff shortages, leaving people in need of critical care in the hands of junior doctors. The result is that "A&E departments are in crisis”, it says, and the NHS’s new 111 helpline has failed to improve the situation.
NHS plasma company sold to owners of Burger King
After the CJD crisis the government of the day decided to have its own supplier, PRUK, to regulate quality and safety itself. Now the Tory-led Coalition has sold off the NHS-owned company supplying safe blood plasma on which thousands depend to Bain Capital, a private equity group that also owns Domino Pizza. I urge you to fight this madness - write to your MP or complain to your local paper.
17th July 2013
Hunt accused of using hospital deaths for political point scoring
Doctors have accused Jeremy Hunt of trying to "make political capital out of patients' deaths" after the Keogh report into 14 hospitals with high death rates uncovered "mediocrity" rather than a disaster on the scale of Mid Staffs. They said that his political briefings to the media before the report was published "... had unjustifiably frightened patients and relatives, demoralised staff and undermined the public's confidence in the service."
16th July 2013
Low staffing = high hospital death rates
Evidence considered by Sir Bruce Keogh, NHS England Medical Director, discloses that all bar one of the 14 trusts with high death rates had a lower ratio of nurses to patients than the national average. So, the main finding is not the absence of private involvement, or the fact that its publicly run, or no competition, or some notion of business acumen (whatever that is), but low staffing levels. At least the Telegraph, amid all its critical articles on the NHS, highlights the real problem.
MPs - "Be tougher" on private providers
A House of Commons Public Accounts committee report says that the Cornwall PCT failed in its task of overseeing its contract with Serco for out-of-hours primary care. ‘Even when it knew that Serco had falsified performance data, the PCT did not fine the contractor or terminate the contract,’ the report said. Could it be that PCTs were just too cosy with private companies and failed to manage the NHS on our behalf? Are CCGs going to be any different? Have Specsavers got a contract in your area exclusively for easily-prescribed age-related hearing loss? Is that not tailoring a contract to suit private sector profit, leaving the expense stuff to the NHS?
The sensible way to fund the NHS by Jacky Davis
Amid the trailing of suggestions that we have to start charging patients for NHS services, here's a must-read article on how to properly fund the NHS; an NHS brought to its knees by the coalition.
11th July 2013
NHS Funding - calls for charging begin
The Institute of Fiscal Studies predicts that if the current rate of NHS funding continues there would be a £30 billion shrtfall by 2021/22. What this doesn't explain is the increase in non-medical expenses that recent years have seen. Starting right back in 1991 with the purchaser-provider split, which the Commons has said hasn't worked, then New Labour brought in management consultants and the private sector and now we have the Coalition's NHS Act that introduces a market, with legal, financial and administrative overheads. So the budget is expanding owing to these non-medical expenses but is front line healthcare capacity increasing? And Shirley Williams initiates the call for the introduction of NHS charges. It's all so predictable isn't it.
65 reasons to love the NHS
This amusing piece is worth a read just to endulge the wonder of the survival of a universal, comprehensive free healthcare system in this world of mad marrket-fundamentalism that is today's society.
Cost of redundancies alone due to NHS reforms - £1.1 billion
Of course this isn't the only cost or the reorganisation resulting from the H&SC Act. Around the coountry CCGs are spending millions on employing management consultants. So no wonder the the IFS (see above) is predicting a shortfall.
Public Accounts Committee - Serco provides a "sub standard" OOH service
The private provider that has a numerous million pound contracts for government services is attempting to take over NHS services and proving the point that private companies put profit first and patient care second.
24th June 2013
Even the BMA has its Conservatives
The BMA conference is to debate the introduction of patients paying for NHS services. Advocates of charging within the BMA (they as usual are hospital consultants) claim it would help the NHS continue to provide a comprehensive list of agreed basic services and cope with the tight budgets. Whereas some believe that not only is a comprehensive health service a fundamental right of all, but that it can and should be afforded - it's only the absence of political commitment that will deny it. .
It has been known for years that the CQC was not fit for purpose
So the scandal of Morecombe Bay baby deaths finally highlights what medics have been saying for years, yet have been ignored - that the Care Quality Commission (CQC) is not fit for purpose. It has neither the organisational culture nor the resources to prevent healthcare failure. Note, yet again this is a scandal involving a Foundation Trust, in this case University Hospitals of Morecambe Bay NHS Trust. Foundation Trusts, being empowered to sell-off land and buildings, to break national pay agreements and act more like vulture capitalism than healthcare organisations, focus on finances and targets to preserve their FT status.
17th June 2013
Report into emergency care review published
The review, led by NHS medical director Sir Bruce Keogh, looked at all kinds of urgent and emergency care including walk-in centres, telephone advice lines and minor injury centres and concludes there is pressure throughout the system. It stated there should be a much simpler 24/7 system. This follows the BMA saying it refuses to accept that the 2004 GP contract changes are the cause of the recent A&E crisis.
Review of children's heart surgery destroys confidence in reconfiguration
The Independent Reconfiguration Panel's report into children's heart surgery found that the review had failed in its objective of recommending a safe, sustainable and accessible way forward. This has created a lack of confidence in NHS service reconfiguration.
Surgeons can opt out of league tables
The value of the NHS league table for surgeons has been cast into doubt after it emerged that consultants can opt out of the system that rates their individual performance. NHS England conceded that they could legally refuse to hand over performance data, including how many people die in their operating theatres, under the Data Protection Act. Won't tables create a climate in which surgeons are less likely to operate where, even though surgery is required, there exists a high risk of failure?
Extensive use of gagging orders in NHS
The scale of the use of orders that stop employees speaking out became clear when requests under Freedom of Information showed that at least 52 staff have been silenced using the orders since 2008, at a total cost of £2million. NHS CEO Sir David Nicholson, who is retiring next year, was accused of misleading Parliament after he told MPs he did not know how many of the orders had been signed.
10th June 2013
NHS must change says managers and charities
A coaition of health service managers and charities says changes "..are needed to rescue the NHS from sometimes disastrous failures and a vicious spiral of badly planned responses to financial pressures," Now there is a good case in reconfiguring hospital services because a) specialist regional centres might offer more effective care for certain services, and b) it could be that some hospital services can be more effectively provided in primary care settings. But, there must be incontravertible evidence that this is the case by peer-reviewed research and/or pilot schemes before such reconfiguration happens; not some political ideology that insists that "it must be the case that this is a change for the better".
Hunt announces fundamental review of A&E care
Health secretary has sought to defuse the row over the crisis in A&E by announcing a fundamental review of emergency care, Earlier the King's Fund warned that waiting times for A&E patients had hit a nine-year high and the number of people waiting more than four hours to see a doctor had almost doubled since last year. Hunt blamed the 2004 GP contract changes for the A&E crisis, see 23rd May below, even though the A&E crisis started just recently.
New guidance from Monitor says rules will not always force competition
NHS competition rules will not force GP commissioners to go out to tender for every service according to draft guidance published by Monitor, the organisation designed to enforce competition under the new NHS Act. My cynical response is "just the profitable ones then?" But hey, we'll watch the outcomes of CCG commissioning very closely.
3rd June 2013
Hospital waiting times getting longer
Waiting times for treatment and the rationing of care have worsened and will get worse still because of the NHS's £20bn savings drive, health service bosses have warned. A survey of leaders of 185 NHS organisations shows that 64% also believe that patients' experience of the NHS will suffer,
GP tells Hunt "don't blame GPs for disastrous Coalition policies"
GP Paul Hobday refutes Hunt's claim that the A&E crisis is due to the removal of out-of-hours responsibility from local GPs. "Why is it government policy to let private companies buy and run GP surgeries on the cheap, using locums who are rarely seen again? Why did they introduce the NHS 111 service before it was ready?"
Monitor to investigate Walk-In centre closures
PCTs were required to open at least one Walk-In primary care clinic in 2008/9, but lots of them have closed - although it's not known how many. Some moved into A&E departments. Monitor said that it launched the review to understand why the closures in England are happening and if they are ‘in the best interest of patients’.
GPs threaten to quit commissioning role
Some GPs have pulled out of involvement with their local clinical commissioning groups (CCGs) because they could not spend enough time with patients while also helping run the groups. Dr Clare Gerada, chair of the Royal College of GPs, said the difficulty of reconciling patient care with new managerial duties in their local CCGs meant it was "inevitable" some GPs would pull out of the CCGs.
23rd May 2013
Hunt gearing up for a fight with GPs
He blames the new GP contract for the A&E crisis, despite 5000 nurses having been sacked since 2010 and the abolition of NHS Direct replaced by the disastrous privatised 111 helpline, and now, today, he's going to unveil plans for GPs to be responsible for out-of-hours again, and for a new inspection regime. Doctor's leaders accuse Hunt of spouting "anti-GP rhetoric", as a cover for his own failings.
Sir David Nicholson to resign
The head of NHS England, Sir David Nicholson, who was chief of the Strategic Health Authority responsible for Staffordshire Hospital at the time of its crsis, is to resign.
20th May 2013
Harmoni admits running OOH service with no doctors
The now private out-of-hours service for City and Hackney, Harmoni, admitted there were no doctors at an emergency GP centre. Harmoni took over the out-of-hours service in 2010 under an interim arrangement which was extended in February without a tender process. Hackney GPs who formed a not-for-profit organisation were blocked from bidding for the contract. A recent CQC inspection of Harmoni North Central London which covers the City and Hackney contract found ‘there were not enough qualified, skilled and experienced staff to meet people’s needs’. Ed - "Why do we not have some oversight of decisions made about our health services? Where are the headlines decrying privatising our NHS?"
NHS threatened by US trade deal, warns Lord Owen
Lord Owen has warned that an EU-US trade deal contained ‘no plan to exclude arrangements for healthcare in its different forms in England, Scotland, Wales and Northern Ireland’.The deal raised fears of ‘investment protection being extended to the whole raft of private health contracts in the UK, that American health care companies and consultancies expect to be awarded to them in the next few years’. ‘Such protection could have the effect of health contracts being virtually retained in perpetuity,’ he added.
10 occasions when Labour has promised to repeal the NHS Act
Dr Eion Clarke, on his Green Benches website, lists the top ten occasions when either Andy Burnham or Ed Miliband has promised to repeal the Health and Social Care Act.
The running down of NHS Direct caused increase in A&E attendance
In the dying days of NHS Direct, as it was preared for privatisation under the disastrous 111 helpline, it referred an extra 120,000 patients to accident and emergency departments in its last year, compared with the final 12 months of the Labour government. This appears to offer an explanation for at least some of the huge increase in people attending A&E departments. The coalition had been running down the NHS Direct service, about 40% of whose staff were nurses, since announcing in summer 2010 that it was to be replaced by a 111 helpline run by private call centres.
The care of a million elderly "at risk" from Care and Support Bill
The heads of 38 leading charities including Age UK, the Alzheimer’s Society, Scope and the British Red Cross, have warned that the Care and Support Bill, which, the Coalition claims, will usher in a cap on the cost of care to prevent people being forced to sell homes. However, Labour spokeswoman Liz Kendall says the costs involved in the average stay in a care home will not exceed the £72K cap, so many elderley residents won't get any support.
16th May 2013
A&E crisis prompts call for overahaul
The College of Emergency Medicine has called for GP support at A&E departments. It says that a major overhaul is needed in how emergency care is delivered and urges a big expansion of what it calls "co-located primary care services" – especially GP services and urgent care centres – to look after between 15% and 30% of those arriving as emergency cases and now the Red Cross is having to prop up England's emergency care system.
Foundation Trusts are immune from intervention after whistle-blowing
The pledge made by Sir David Nicholson, head of NHS England, to intervene if he "caught a whiff" of organisations not providing support to whistleblowers, was thrown into doubt by a letter he wrote immediately after making the pledge to the Commons Select Committee on Health. He said in the letter to former NHS employee that he could not help because a "legal process" had been concluded and that his hands were tied because foundation trusts are "separate legal bodies" from the Department of Health, Note: Mid-Staffs Trust was, and still is, a Foundation Trust, and all hospital trusts under the new NHS Act will be forced to become Foundation Trusts.
13th May 2013
Private OOH service not staffed by doctors
A whistle-blower has said that Harmoni, a private out-of-hours service covering 250,000 patients, is using senior nurses when doctors cannot be recruited to work the shifts. In times of extreme staffing shortages there has been just one advanced nurse practitioner working overnight in North Somerset, the Daily Mail said. Locum doctors have been flying in from Europe, or driving from elsewhere in Britain to perform back-to-back shifts round-the-clock. Terminally-ill cancer patients have waited eight hours for a doctor to visit them at home and administer pain relief; and foreign doctors with a poor grasp of English have been used to plug gaps in the rota.
New 111 helpline is "seriously flawed"
Doctors say lives have been put at risk, with desperately-ill patients left waiting hours for help while ambulances have been dispatched to trivial cases. Last weekend it emerged that 22 serious incidents are being investigated in connection with the line, including three deaths.
Woman starves to death after care agency's immigration raid
When Carefirst24 was raided by immigration authorities, suggesting it was using foreigh staff illegally for very low wages, it closed down. This resulted in the death of Gloria Foster, 81, a frail widow with dementia. She was entirely dependent on four daily visits from carers, who fed her, helped her get out of bed and gave her medicine.
3/4 of nurses say Mid Staffordshire scandal could happen again
In a Sunday Mirror the poll of 2,000 nurses, 40% said on their last shift there were not enough staff to provide a safe level of care. The Safe Staffing Alliance (SSA), a group that includes the Royal College of Nursing, Unison and the Patients Association, says wards often have just one registered nurse looking after eight patients. This ratio could be regarded as the minimum acceptable of staffing when it in fact puts patients at risk.
Councils fear big cuts in public health funding
The Department of Health has confirmed that the body that plans future budget allocation, the Advisory Committee on Resource Allocation (ACRA), is looking at the public health funding formula. Councils across England fear their public health funding for 2015 could be cut by up to 85%, while others face increases of up to 48%. The chairman of Hackney Council's health and wellbeing board Jonathan McShane warned that some enhanced services could face the axe because councils are now only mandated to provide five services. These include sexual health, health checks and the national child measurement programme. Smoking cessation, obesity or public mental health services are not covered and could be at risk.
9th May 2013
It's official, NHS emergency care is in crisis
What all A&E nurses have been saying for some time has been officially acknowledged by the regulator, the Care Quality Commission. Since 2010 over 500 nurses have been sacked. Despite all the clap-trap about efficiency savings and running hospitals "smarter", this has the effect of reducing the number of beds - as well as morale - in our hospitals. Result - no places for emergency patients to feed through to. Of course the new privatised 111 call handlers, because they're not medically trained, saying "go to A&E" doesn't help!
Where next for campaigners after Section 75 regulations?
Despite our wonderful campaign in which peers were deluged with letters and emails, and the LibDems voting with the Tories, the dreadful regulations ensuring all NHS services must be offered to the private sector. were passed. So what do NHS campaigners do now? This article, by Caroline Molloy, offers some guidance.
111 service investigated for "serious incidents"
NHS England, the new name for the NHS Commissioning Board, are investigating claims that some patients have suffered harm, and even died, as a result of problems with the replacement for NHS Direct, the new telephone advice service, that in some areas has been privatised. Since its launch patients in some areas have faced long waits for their calls to be answered and further delays before a call handler rings back to advise them. Others have been given wrong advice, with staff shortages and poorly-trained staff blamed. Hospitals say problems with 111 partly explain a surge in demand for A&E services.
NHS stops referring to private hospital after damning report
The Mount Alvernia hospital in Surrey, run by BMI Healthcare, one of Britain's biggest private healthcare providers, agreed to suspend surgery earlier this week after the damning Care Quality Commission (CQC) report. Care failures cited by the CQC report included a surgeon who operated without gloves in blood-stained shirt sleeves, and a child who was not seen by a paediatrician for seven hours despite his condition deteriorating.
2nd May 2013
Culture of fear prevents whistle blowing
Research by the RCN demonstrates that when staff come forward as whistleblowers they are intimidated to keep them quiet. 5,277 (64%) of the 8,262 nurses surveyed by pollsters ICM for the RCN had raised a concern, mostly about unsafe staffing (48%) or patient safety (21%). But 24% said they were discouraged or warned off taking any further action by managers or colleagues.
Were nurses really to blame for Mid Staffs?
Previous entries on this blog, see 28th March below, have tried to emphasise that contrary to headlines about the Francis Report and particularly what our PM and his health secretary had to say, the real culprits were the Board and senior staff. Here's an article from The Telegraph underlining that point; to quote "One idealistic junior nurse, who complained repeatedly that standards were dreadful, was threatened and silenced." To reiterate exactly this point take a look at this video by a speaker at the RCN, it will make you impassioned about nursing, and angry that they are carrying the bedpan for genuine political responsibility.
15th April 2013
10 ways the Tories destroyed our NHS
Dr Eoin Clarke explains, with evidence, how the Coalition government has destroyed the NHS, from handing £7 billion of NHS budget to private profiteers, axeing 5000 nursing jobs, closing walk-in centres and ambulance stations and, despite government spin, there's a real-terms fall in NHS expenditure. All this before the privatising of the NHS Act gets going.
Patients warn government - hospital surveys are a waste of time
Cameron's "friends and family" survey of hospitals is regarded as unnecessary by the public and should be dropped. Under the prime minister's plan, patients and staff will be able to score every hospital and GP in England on whether they would be happy for their loved ones to use the service.
11th April 2013
Thatcher began the privatisation of the NHS
Dr Kailash Chand, BMA deputy chairman, writes in GP Online that Thatcher brought in the concept of the internal market and fundholding in the NHS. Her big idea was the creation of a market within the NHS so that some parts of the organisation would become providers selling their services to the others, the purchasers. This separation of purchaser from provider - the purchaser/provider split - was the key feature. The result was that the entire NHS started fragmenting, with each hospital in competition with the others. Primary and secondary care were put in an adversarial position.
Outgoing NHS scientific adviser says homeopathy on the NHS "is mad"
In an article in the Telegraph professor Sir John Beddington criticised the Government for ignoring his advice against the use of homoeopathic remedies by GPs and NHS run hospitals. He retired as chief scientific adviser to the Government on April 1, and expressed his frustration that ministers had continued to allow taxpayers money to be used to fund such treatments despite them having “no scientific basis”.
Chair of NHS Alliance says 50% of hospital work should be in community
The NHS Alliance, an organisation of PCT and some clinicians, supported the move for private companies' involvement in the NHS. Now its head, Michael Dixon says that much hospital care could be done in the community. He was taken to task in letters to the Guardian by GPs Oliver and Green. The problem with this debate is that we are quite rightly suspicious of moves to reduce hospital care. It could be a cynical attempt to reduce the care available on the NHS, just as localism was used as a justification for private companies' involvement in the health service. However, there could be a case for some hospital work to move to primary care, provided there is evidence-based proof that it's cheaper and more effective. Needless to say, there has never been clear unequivocal evidence that NHS services provided by the private sector are either cheaper or more effective than that their equivalent by the publicly-run NHS; in fact, quite the opposite. See a multitude of examples in this blog.
8th April 2013
'Momentum building' in opposiiton to Section 75 regulations
The Labour peer leading the fight against the so-called revised Section 75 regulations has tabled a 'fatal motion' to defeat the passing of the regulations that will ensure that all NHS services are put out to tender, thus ensuring that the private sector has the pick of our health service. I don't want to dampen your anticipation, but 'fatal motions' rarely work.
A&E departments across the country are failing
Professor Alysson Pollock says David Cameron's recent attack on migrants' use of NHS services diverts attention from the real story of what is happening to our accident and emergency services. A&E departments are serially failing to meet their targets, primarily due to staff cuts as hospitals trusts attempt to achieve Foundation Trust status, something all health trusts must do under the NHS Act.
NHS hospitals are gearing up to attract private patients
Under the new NHS Act hospitals can give up to 49% of their beds to private patients. There used to be a limit on private patients income - that limit was abolished under the Act. Hospitals are seeking a radical increase in revenue from the treatment of private patients as their budgets come under pressure since the government can cut NHS budgets. Under the Act there is no longer a "duty" to provide a national health service, something the Secretary of State for Health always had from 1948 until now. So NHS patients go to the back of lengthening queues.
3rd April 2013
Hunt drops key Francis recommendation on the rights of the patient
The Telegraph reports that Health Secretary Jeremy Hunt has quietly omitted a key point from the Mid Staffs report. Robert Francis, the inquiry chairman, said that one of his top priorities was for the NHS constitution to be rewritten, making it explicit that “patients are put first” and “everything done by the NHS should be informed by this ethos”. But the redrafted constitution, quietly released a few days ago simply states that the health service will “aspire” to put patients first.
NHS 111 roll-out postponed due to fears that it's not fit for purpose
The commencement of non-emergency advice phone 111, the replacement for the NHS Direct, has been aborted amid fears that lives could be put at risk. 111 contracts have been offered to private companies like Harmoni (see "Privatised OOH service "wholly inadequate", 4th March, below). To maximise profit the service will be staffed by non-medically trained staff, who despite this will decide whether to refer cases for emergency call-out. The BMA said "“The whole idea was that this was meant to be NHS Direct “light”, but this is so light it is in danger of floating away. You cannot do this without doctors and nurses."
NHS Act is a threat to doctor-patient relationship
Dr Mark Porter, chairman of the ruling council at the British Medical Association (BMA), said doctors were worried that their role undre the new Act in deciding which patients got access to which treatments, as a result of the formation of 211 GP-led clinical commissioning groups (CCGs) across England, would prove divisive and unpopular. GPs would be at risk of being seen as "agents of the state" who are implementing government cuts.
4 hour A&E target now being missed
The NHS is now not meeting even the watered-down target of 95% of petients being seen in 4 hours (it used to be 98% before the last election). The Department of Health data emerged just after the East of England ambulance service took the unprecedented step of erecting a tent to treat patients.
EU/US trade talks threaten NHS
Trade talks quietly taking place between the US and the EU could see England's NHS tied into a privatised model semi-permanently. Yet this deeply concerning backdrop to the Coalition's deplorable NHS privatisation has received scant media attention.
Perhaps the NHS should have had a PR department....
Was this the fundamental error in Bevan's plans? In our privatised world where via advertising companies tell us how wonderful they are, the NHS should have been trumpeting its successes, as in patient satisfaction scores in Commonwealth Fund research. Now here's more research that suports just how good the NHS is...or was. The Kings Fund report that the annual British Social Attitudes survey reveals that satisfaction with the NHS now stands at 61%, the third highest level since the survey began in 1983. So why the need for reform?
28th March 2013
38 Degrees' legal opinions on S75 regulations rejected by government
The online campaigning group 38 Degrees obtained a legal opinion that regulations, referred to as 'Section 75' regulations but titled NHS Procurement, Patient Choice and Competition (No. 2) Regulations 2013, will promote NHS privatisation. The government in its formal response has rejected this claim; this despite the fact that the revised regulations still state that "commissioners can only award contracts without competition if they can show no other provider could offer the service." If a CCG awards a contract to the NHS without offering to tender and private firms would like to bid, then the CCG risks a dispute over its assertion that other providers were not capable of offering the service. But would a CCG risk the possibility of expensive litigation? No, the effect is that all services will be offered in a bidding procedure. So the private sector will take what it wants, leaving the publicly-funded NHS the rump.
Compare Hunt's response to Francis to the real thing
You probably have got the main issues that Hunt has prioritised in his response to the Mid Staffs crisis - aspiring nurses will have to work as healthcare assistants first. But Francis said the primary responsibility for the deaths lies with the Board. The Board were singularly focused on maintaining its Foundation Trust status. But instead of questioning the wisdom of Foundation Trusts and whether they are good for our NHS, Hunt has simply barred the individuals of the Mid Staffs Board from running an NHS orgainsation. The real issue is managerialism and targets - are they good for our NHS?
BMA calls for a delay in NHS 111 implementation
The doctor's union has written to the government urging a delay in bringing in the replacement for NHS Direct. The BMA said that in several pilot areas the service was completely unable to cope with call volumes or suffered severe IT failures. It said patient safety was being put at risk.
25th March 2013
GP contract changes and "chaotic reforms" putting lives at risk
The General Practice Committee (GPC) of the BMA calls for a halt to the chaos caused by changes to doctors' contracts, the disruption wrought by the government's NHS reforms and the roll-out of NHS 111, the replacement for NHS Direct.
More smoke and mirrors as Hunt obscures the real Francis Report message
On Tuesday 26th March Health Secretary Jeremy Hunt will unveil his response to the report into Mid Staffs. He won't say, as he should, that the catastrophe was caused by excessive managerialism - a focus on finance and targets rather than real healthcare. He will say that he's going to relieve hospitals of the duty for collecting scores of different sets of data. Data collection is important to treat individual patients and to run a national healthcare system, so it may have to be collected whether or not there exists a responsibility in law to collect them. But he will try to make his announcement sound as if the government are saving the NHS, instead of applying more of the same problematic philosophy.
More evidence that the NHS is the best healthcare system... so why the reforms?
Do you remember Cameron's claim at the last election that cancer care in the UK was the worst in Europe? In fact due to the rate of improvement in NHS cancer care, if allowed to be funded as it has been in recent decades, it would be, in just a few years, the best in Europe. More evidence emerged in a report by Cancer Research UK. Young cancer deaths have halved over the last 40 years.
21st March 2013
GP practices forced to join their CCG against their will
Two practices have been forced to join their CCG by the NHS Commissioning Board against their wishes, in a move GP leaders say makes a mockery of Government claims the new bodies reflect implicit GP support for their reforms. The NHS Commissioning Board used its legal powers to force two practices in Essex to become members of NHS Basildon and Brentwood CCG and NHS Thurrock CCG.
18th March 2013
Foundation Trusts more likely to miss A&E waiting times target
A report by Monitor, the orgainsation that will ensure that competition rather than collaboration underpins the operation of the NHS, says that 32 of the 88 trusts that missed their A&E target are foundation trusts. The target for A&E waiting times says been watered down by the Coalition government from 98% to 95% of patients must being seen within a 4 hour wait. Under the Coalition's NHS Act all trusts will become foundation trusts. Foundation status gives greater operational freedom to the trust - it can sell its assets (land, buildings etc.), break national pay agreements (always downwards it seems) ..... and be so concerned with finances, e.g. Mid Staffs, that it misses A&E waiting times?
Commissioning Board gives CCGs full marks for GP engagement ....really?
CCGs have been given an almost complete clean bill of health from the NHS Commissioning Board in their engagement with member practices, despite claims from LMCs (Local Medical Committees) that they have a way to go to ensure shared values with their member practices. Here in Brighton 74% of GPs who responded to a survey said "no more privatisation" - engagement would seem to imply that the Brighton CCG will follow suit. But will the CCG members take notice of local GPs? Could it be that GPs with interest in private health firms have got themselves onto CCGs? See "Conflict of interest fears of GPs with private healthcare involvement" 14th March.
14th March 2013
Bereaved mother blames privates involvement for son's death
The mother of a seven week old baby who died as the result of inadequate out-of-hours care by Harmoni, now owned by Care UK, has vowed to fight commercialisation of the NHS. The child developed into pneumonia that went untreated despite repeated calls and visits over the course of five days to the out-of-hours service run by private contractor Harmoni.
Leaked letter reveals the real intentions of government's NHS policies
The Academy of Medical Royal Colleges says that ministers appear to have reneged on previous agreements with the profession, by attempting to force through parliament new rules that would greatly expand the role of private operators across the NHS. The body expressed grave concern that the government is planning to privatise large sections of the NHS by stealth – in breach of previous promises to doctors to limit the role of the private sector.
Rewritten rules still threaten enforced privatisation
Lord Hunt has said that not all services need to be offered to the private sector, but the redrafted regulations still state that commissioners can only award contracts without competition if they are certain no other provider could offer the service. RCGP chair Professor Clare Gerada said: ‘I still cannot see a circumstance where you would only have one potential provider. If there is one legal challenge, CCGs will be scared'.
Government adviser admits GPs do not have faith in reforms
For the last 18 months, DH commissioning adviser Edna Robinson has produced a report every six weeks for NHS chief executive Sir David Nicholson based on feedback from clinicians. She warned that grassroots GPs remain to be convinced about NHS reform.
Conflict of interest fears of GPs with private healthcare involvement
One in three GPs on CCG boards have private healthcare interests. Overall 426 (36%) of the 1,179 family GPs on a board of one of the 211 clinical commissioning groups (CCGs) in England have an interest in for-profit firms. The rules say that those GPs with private interests cannot vote on the award of a contract to their private company. But why not insist that GPs cannot have any private healthcare involvement if they sit on Clinical Commissioing Groups?
4th March 2013
Royal Colleges say ministers have reneged on promises about the NHS Act
The Academy of Medical Royal Colleges says that ministers appear to have reneged on previous agreements with the profession, by attempting to force through parliament new rules that would greatly expand the role of private operators across the NHS.
GP leader says "GPs will walk unless commissioning rules are changed"
The Government must change the wording of its rules over the use of competition, or risk GPs deserting the entire clinical commissioning process, says the leader of the organisation representing CCGs. Dr Michael Dixon, interim president of NHS Clinical Commissioners, said the rules risked forcing commissioners through expensive procurement processes and opened them up to expensive legal claims.
RCGP leader says competition rules must be scrapped
In a letter to health minister Lord Howe, RCGP chairwoman Professor Clare Gerada demanded a meeting with the government to discuss NHS regulations. Dr Gerada wrote: ‘It is clear to us that, as they currently stand, the regulations will be interpreted by CCGs as requiring services to be put out to competition."
Privatised OOH service "wholly inadequate"
The private company, Harmoni, who run the out-of-hours service in North London was critcitised by a coroner at the inquest of a seven-week-old baby boy died while in the care of the privatised GP service. The baby previously fit and well, died last November, having contracted a routine cold which developed into a lung infection that went untreated.
28th February 2013
NHS Act: Section 75 regulations set to privatise the entire NHS
Perhaps you haven't heard of these regulations or don't know the details. Well this parliamentary briefing by Keep Our NHS Public explains all. Despite lots of assurances from Lansley and Cameron, all of which are documented here, the NHS Act is about privatisation. It is true that Hunt says he's going to rewrite them to assure LibDems. But we've heard this before somewhere - no doubt he's listening as well.
Hospitals increasingly missing cancer treatment targets
Hospitals and other providers are judged against a national DH target that 85% of patients should wait no longer than 62 days to begin treatment after urgent referral for suspected cancer from their GP. But in the last three months of 2012, hospitals in England missed this target in patients with lung, gastrointestinal and urological cancers, although they surpassed it for breast and skin cancers.
Commissioning Board says GP co-ops should do out-of-hours
Setting up cooperatives to cover out-of-hours services should be incentivised so GPs regain ownership, according to NHS Commissioning Board deputy medical director Professor Steve Field. It's interesting that the NHSCB is saying this, promoting cooperatives that is.
80% of third wave of authorised CCGs face restrictions
Eighty percent of CCGs authorised by the NHS Commissioning Board still face restrictions on their independence just six weeks before they take over from PCTs. All but 33 CCGs in the first three waves have been authorised with 'conditions' - meaning they were unable to meet in full the 119 criteria for authorisation set out by the NHSCB, and will face additional checks on their work. A total of 56 third-wave CCGs were authorised with conditions, including five that could be forced to work with staff appointed directly by the NHSCB to oversee improvements because of the severity of their failings.
21st February 2013
Regulations make it impossible for the NHS to remain publicly run
The Health and Social Care Act was the primary legislation, but most of the real effect of new laws come with regulations slipped out quietly. This article demonstrates what the Act was really about. "The new regulations effectively close down the possibility of awarding a contract without competition, saying that this can only occur in very exceptional circumstances." The new regulations grant Monitor sweeping statutory powers as a regulator to intervene and enforce competition.
Doctors hit back over Lord Howe claims
The GP committee of the BMA has replied to the assertion by the Tory lord, see 14th February below, that 2013 is going to be "..the best year for the NHS". The chairman of the committee said that "..every GP knows it's going to be tough".
Cameron: "Someone must take the blame"
But not the man in charge of the Mid Staffs board at the time, who Cameron has promoted to be chief of the NHS under the new Act. Of Sir David Nicholson, the PM is said to have"...retained full confidence in Sir David." Yeah, that's right, take it out on staff who were following Nicholson's orders.
18th February 2013
Mid Staffs: "hitting targets and balancing books squeezes out quality"
This article emphasises the real message of the Francis Report that the hospital board were more concerned with targets and finance than real healthcare issues. "The culture was that if targets were met and the books balanced, then the hospital had done its job." The overwhelming message we get from media reports of the Francis Report, check out this morning's Telegraph headline showing a picture not of a suited manager but a nurse, is that it was down to failings of individual care staff members.
Government downpaying low income in poverty measurement
This article is not specifically about health news except that the poor need healthcare more owing, in no small measure, to their genuine poverty. But such is the dominance of the government's agenda to paint the poor as feckless skivers rather than victims of a banker-created economic crisis, that makes this article worth a read.
"Swathes" of public health funds chopped
A survey has found that primary care organisations have cut millions from public health campaigns like stop smoking services. Under the NHS Act public health has moved from the NHS to local councils. Despite government statements about ring-fencing it from financial constraints imposed on municipal funding, fears are that councils will impose further cuts despite reports of an obesity crisis that demand public health campaigns to change children's diets and get them exercising.
14th February 2013
GPs urged to back demand for transparency in private provision
BMA deputy chairman Dr Kailash Chand said GPs should put pressure on their MPs to sign an early day motion (EDM) put forward by Labour MP and health select committee member Grahame Morris. Private providers often hide behind so-called "commercial confidentiality". The EDM demands that private health providers are subject to Freedom of Information requests as are publicly run NHS services.
Tory lord thinks 2013 is going to be "the best year for the NHS"
Earl Howe, who was the government enforcer who drove the Health and Social Care Bill through the House of Lords thinks this. Do you agree? Read the press report that follows this one, and then ask yourself again. Perhaps he means the best year for private health corporation profits.
NHS directors think quality of care is declining
A Kings Fund survey of finance directors found that one in three finance directors of NHS organisations in England believes quality of care has worsened in the last year. They point to the coalition's NHS reforms and an accompanying high turnover of senior staff for the apparent drop in care quality. A half of all local council leaders of adult social care said care had declined in the last year.
A&E waits are "highest for a decade"
A Kings Fund report, presumably the same one as in the above item, found from October to December 2012 more than 232,000 patients waited more than four hours. That is a rise of 21% compared with the same period in 2011 and the highest figure for those months since 2003. A&E doctors blamed a combination of rising pressures and staff shortages, i.e. budgets cuts.
Nicholson ignored warnings that "patients were in danger"
The sacked head of United Lincolnshire Hospitals Trust, chief executive Gary Walker, said "I want David Nicholson to be held to account. I warned him that this was going to happen. I warned him that Lincolnshire was going to become the next Mid Staffordshire. He didn’t investigate those concerns, and now look what’s happened". The trust is one of five being investigated for high mortality rates following the Francis Report into Mid Staffs.
11th February 2013
CQC 'cannot guarantee it won't spot another Mid Staffs'
A Telegraph report quotes David Prior, a former Tory MP and recently chair of Norwich and Norfolk Universirt Hospitals Trust, as saying that the CQC "...at this time, we can’t give a guarantee that we would spot another problem similar to Stafford."
Mid Staffs used to justify reforms
The Francis Report has been portrayed as if the scandal at Mid Staffordshire Hospital had nothing to do with managers' preoccupation with their Trust's finances rather than than care of patients; a point brought home by Polly Toynbee in the Guardian, and in a report in the Morning Star.
The growing opposition to NHS privatisation
The Morning Star reports that across North-West England and London especially, people are showing their outright opposition to private firms involvement in their NHS. In response the Greater Manchester Health Emergency open conference will be held on Saturday February 16 from 12-4.30pm at the Friends Meeting House, Mount Street, Manchester.
7th February 2013
Francis Report: who is to blame?
The Guardian gives a summary of the organisational failures, primarily with the board of the Mid Staffordshire NHS Foundation Trust. It's worth noting here that the trust achieved foundation status in 2008. Foundation Trusts are " ...not directed by government...are free to keep surpluses and borrow to invest", and can dispose of hospital sites or excess land as it sees fit. The theory is that freedom from government oversight improves healthcare; which of course is the spin that has been attached to the new NHS Act.
Francis Report: Cameron thinks target pay for nurses is the answer
Our prime minister's response to the Francis Report is to imply that the failures of Mid Staffs were down to the personal failures of nurses, so performance pay is the answer. So David, despite Robert Francis QC clearly saying that "..that almost all the organisations within the NHS, both in and around the hospital and nationally, failed to some degree...", your solution is to ignore organisational failure and to imply it was a failure of the individual's on the care front line? For a reaction that aligns with Francis's conclusions see "What Francis has done is expose a new unhealthy, managerially obsessive culture".
Despite failings Harmoni is awarded the OOH contract
This blog reported, see 17th December, on the failures of a private company, Harmoni, in running Hackney's out-of-hours GP service. The contract was reviewed and a local GP-led group submitted a bid, but the PCT decided to stick with Harmoni.
4th February 2013
GP leader of Lewisham campaign considers litigation after Hunt decision
Dr Louise Irvine says legal action to counter Hunt's decision to downgrade Lewisham A&E and its maternity unit is a possibility. The successful demonstration last month was supported by thousands; "25000 people don't just melt away" she said.
Lewisham CCG leader may resign over A&E decision
Is the Health and Social Care Act really about giving control of the NHS to local doctors? So why is Hunt deciding the fate of Lewisham hospital when local doctors are in revolt about the threat to its A&E? The chair of the Lewisham CCG may resign over Hunt's decision. Should Lewisham take the financial hit for the PFI debts of another trust? Shouldn't the government take responsibility for encouraging such stupid financial deals?
31st January 2013
Some CCGs face having staff imposed upon them by Board
The outcome of the second wave of CCG authorisations has resulted in the NHS Commissioning Board possibly imposing its own appointed staff on to CCGs as a condition of their authorisation. CCG have to be authorised by the NHSCB, a procedure CCGs must pass to be allowed to operate,
Monitor claims that the use of competition is up CCGs
Chairman of Monitor, the organisation who's duty is to ensure that competition exists in the NHS, says that the use of competition is for ther individual CCGs to decide. But this may be a clever tactic, because he goes on to say "...as long as competition is used fairly" ......Guess who's job it is to say whether it's "fair" or not?
Are private health firms to be given tax breaks as well?
Is Monitor going to allow private health corporations off corporation tax, or any other benefit, to achieve what it calls a "Fair Playing Field". See Monitor's chairman's letter in the Guardian.
14th January 2013
Americans are "sicker and die younger"
A damning report into the health of US citizens ought to be read by those who in the US's recent debate on healthcare reform claimed that they don't want so-called "socialised" medicine. The report by the National Institute of Health compared the health of its citizens with those of 16 developed countries and found that the US does badly in nine specific areas. Amongst them are the highest infant mortality rate, the highest rate of adolescents pregnancies, the second highest HIV rate, the highest obesity rates and of course highest homicides.
GP demands a meeting with Hunt over Lewisham A&E closure threat
A GP leading the campaign to "Save Lewisham Hospital" has demanded a meeting with Jeremy Hunt over the report on the financial crisis into PFI debt laden South London Trust. It recommends the amalgamation of two hospitals, causing the closure of Lewisham's A&E and maternity departments. But Lewisham Hospital isn't in South London Trust's area. Why should the people of Lewisham suffer because the board of a neighbouring trust were stupid enough to employ the financial trick of buying hospital buildings on future income?
House of Lords: NHS reforms unlikely to improve healthcare
A committee was doubtful that the NHS reforms in England would enable more people to be treated outside of hospital or tackle the issues of an ageing society. Well when the NHS's non-medical costs will rocket because of financial and legal bills introduced by Lansley's Act, what else would you expect?
17 hospitals have dangerously low staffing levels
The Care Quality Commission has said that 17 hospitals have been issued with warnings that they did not have enough staff “to keep people safe and meet their health and welfare needs”. Jeremy Hunt, the Health Secretary, said there was “no excuse” for hospitals not to provide adequate staff". So Jeremy, please explain, you make cuts in the NHS budget and then complain when there's not enough staff in hospitals? I know, let's get rid of management consultants like McKinsey!
9th January 2013
CQC does not command public confidence
The Commons health select committee has said the purpose of the Care Quality Commission is to be seen by the public as a guarantor of acceptable care standards in all institutions of care - homes, clinics and hospitals. The CQC was established in 2008 by the combination of 3 regulatory organisations but has failed to command respect from professions and public. A report by the health committee states that it has a long way to go.
Why doesn't the report say what caused South London's financial crisis?
A special administrator's report on PFI-debt ridden South London Healthcare NHS Trust has caused an angry response from doctors and patients. It recommends "dissolving" the trust and merging one of South London's PFI hospitals at Woolwich with nearby Lewisham, but Lewisham is not part of the South London trust and would lose its A&E in the merge. South Lodon Trust has 3 hospitals, two of them rebuilt using PFI.
Uncoordinated NHS reforms risks to public health
Health and Wellbeing Boards set up under the NHS Act are putting in place inadequate organisational structures that may impair public health improvements, said Professor Chris Bentley, giving evidence to the commumities and local government select committee of the Commons.
7th January 2013
1 in 5 CCG board members have conflicts of interest
A Pulse exclusive shows that more than one in five CCG board members have financial interests in private healthcare providers exposing them to possible conflicts of interest when commissioning services. An investigation of the registered interests of nearly 900 CCG board members’ shows that 23% are directors, owners, partners or shareholders in private healthcare providers, or have a family member with an interest in a private healthcare provider
Burnham repeats that he would repeal the H&SC Act
In a video interview with GP Online Labour's shadow health minister says that a Labour government will keep CCGs but get rid of part three of the Act, the compertitive regime, and restore a collaborative NHS. He also called for an 'honest' debate about funding and said that Labour will make the NHS a major issue at the next election.
NOA report reveals rationing of healthcare in more than half of trusts
A National Audit Office report on how the so-called "efficiency" savings are affecting the NHS shows that hospitals in certain areas have stopped offering elective treatments for smokers or people above a certain level of obesity, while in others cateract patients are being forced to wait until their eyesight deteriorates further before being allowed surgery.
Astrnomical price-tag of the NHS Commissioning Board
A Sunday Express exclusive reveals that the new NHS Commissioning Board, which officially starts in April, will cost £527million a year to run. It flies in the face of Government promises that sweeping NHS reform would spell an end to “top down bureaucracy”, and is "...made up of layer upon of layer of managers, with middle-ranking bosses netting salaries four times the national average and those at director level commanding wages higher than the Prime Minister." It has already asked for extra funds in the 2013-14 budget because of “additional staffing requirements”. Original estimate of 3,500 staff has now almost doubled to 5,900.
"A ventilator not avaliable" - report on death in private NHS clinic
A man who's sister, who was previously in good health and who died from complications following a knee replacement, urges NHS Hertfordshire to close its privately-run treatment centre. The Surgicentre in the grounds of Stevenage's Lister Hospital is run by Carillion, formerly part of Tarmac. It has already been investigated over potential failings in the cases of six patients who suffered irreversible sight loss after treatment. Local doctors are advising patients against having procedures done at the centre,
AQP gives over 100 private firms NHS contracts
Department of Health figures show that private firms like Virgin and Specsavers are cashing-in on the NHS Act and will be providing basic NHS care, such as physiotherapy, dermatology, hearing aids, MRI scanning and psychological therapy. As predicted by opponents of the Act the NHS is fragmenting as the number of providers increases dramatically. The BMA's GP committee chairman warned that private providers would start advertising to attract and retain patients, and that NHS organisations would have to follow suit in order to remain viable. Some local hospital services would go out of business in the face of competition under AQP.
20th December 2012
Poverty removed as a factor in funding
The NHS Commissioning Board has removed poverty as a means of distributing NHS funds. Poorer people, by virtue of their work (or lack of it), lifestyles and housing, have a higher need of health services, so this used to be reflected in the NHS funding formula. But poverty will no longer be a factor in the way the Coalition government, in the guise of the NHS Commissioning Board, will share out the NHS budget.
A personal account of the corporatisation of primary care
A patient's point of view when The Practice plc, the UK's largest operator of privatised NHS GP practices, took control of a surgery in Camden. The Practice plc was acquired by American healthcare giant United Health, and this 82 year old's local surgery was closed down.
NHS trusts heavily involved with private providers
Freedom of information requests to more than 100 NHS trusts revealed hospitals were spending millions of pounds buying beds in private hospitals. This marketisation of healthcare presents ethical issues for the NHS. For example, the Sheffield teaching hospitals NHS foundation trust has spent on average £1.3m annually for the last three years at BMI's Thornbury hospital, yet at the same time the NHS hospital's medical director, Michael Richmond, had a private clinic at the Thornbury.
What exactly will Labour's policy to the NHS be at the next election?
You won't be surprised that it's not formulated yet, but this article by Labour's shadow health minister for care and older people starts to consider this issue. Should Labour say "we will reinstate the old structures?" or should it say "we will leave the NHSCB, CCGs, Healthwatch and all the other bodies as they are?"
17th December 2012
Private out-of-hours service accused of "putting patients health at risk"
Harmoni, originally a doctors cooperative but now a private company recently bought by Care UK, stands accused of risking lives because cuts have lead to excessive workload of appointments. Medics critical of the company allege it has cut costs to the point of making the service unsafe. In one case a seven-week-old baby with a suspected respiratory infection died despite repeated calls to the service over several days,
Former Tory chief to be chairman of the CQC
As predicted in this blog, see 3rd December, a former deputy chairman of the Conservative party is to head the Care Quality Commission. David Prior is currently chairman of the Norfolk and Norwich University Hospitals NHS Foundation Trust. Dame Jo Williams had resigned in September following her role in the attempted sacking of a fellow board member.
AQP private providers outnumber NHS by two to one
A Pulse exclusive reveals that private companies outnumber NHS providers by two to one under the rollout of AQP across the country for community and mental health services. Official DH figures show that 87 providers have qualified under AQP and are now able to provide services across England, of which 38 were from the independent sector and just 26 were NHS.
13th December 2012
Doubts over NHS "efficiency" savings
The National Audit Office has questioned government claims that it has made £5.8 billion savings this year, towards the £20 billion 2015 target. It could only verify £3.4bn of the £5.8bn efficiency savings supposedly achieved by the NHS in England in 2011-12. While savings made under the Nicholson Challenge are meant to be recurrent, £520m of the £5.8bn alleged savings were non-recurrent, and so "the NHS will have to find replacement savings in future years",
AQP causes GP appointments overrun
Having to explain the options that Any Qualified Provider gives to patients is causing pressure on GP's time. Acording to BMA "The reality is that for the vast majority of patients simply want a good local service and "choice" in political terms is not high on their agenda, and it therefore is rarely raised by many patients."
Commissioning is becoming 'smothered'
Are GPs really signing up enthusiastically to the constitution of their CCG? wonders Dr Kailash Chand.
10th December 2012
Ali Parsi to stand down as Circle chief
Circle, the company that took over the running of Hinchingbrook Hospital from a PFI debt-laden trust, reports that its founding merchant banker Ali Parsi is standing down as its chief executive.
CCG constitutions gags their GPs
Online medical publication Pulse reports that hundreds of GPs are being asked to sign legal agreements that prevent them from saying anything about their CCG in public. The BMA says in response doctors should be ‘free to say what the hell they like’.
Responses to media reports of poor nursing
Ex psychiatric nurse Jo Brand says nurses are not to blame, they are an easy target - it's rotten management that's the problem. Whereas the Guardian's Ellie Mae O'Hagan says it's politically expedient to blame substandard NHS care upon cold-hearted staff rather than disastrous health policies. An interesting first paragraph of this article tackles the politically-relevant way that problems in publicly-owned services are framed as opposed to stories in privately-owned industry. In addition, Guardian letter writers come to nurses' defence.
Privacy campaigners wary of Cameron's plans for DNA database
David Cameron will this week unveil plans for a DNA database capable of storing every British citizen's DNA records. Genewatch claims anyone with access to the database could track an individual using their DNA and then identify their relatives. The coalition is expected to allow people who do not want their data stored to "opt out", which will go some way to alleviating concerns from human rights groups.
6th December 2012
Coalition claims on NHS spending rebuked by watchdog
The UK Statistics says Cameron and Hunt are wrong to say that under the Coalition NHS spending has increased. In a letter to Health Secretary Jeremy Hunt, the chairman, Andrew Dilnot, said a detailed analysis of the best-available Treasury data suggested real-terms health spending was lower in 2011/12 than in 2009/10.
Private consultancy firms paid millions by CCGs
An On-line Pulse exclusive reveals that clinical commissioing groups have paid millions to management consultants to prepare for commissioing. So this explains why NHS spending is "increasing" and yet patients are waiting longer for healthcare.
3rd December 2012
Two tier health service may be on the way
The Nuffield Trust says that if the NHS budget is frozen and savings are not possible then it will lead to "..the rich being able to pay for essential care rationed because of austerity policies". Jeremy Hunt has said he cannot make any promises about whether the NHS budget could be ringfenced.
Half the population think taxes should rise to protect the NHS
A poll by Ipsos Mori for the Nuffield Trust found that one in two wanted to “increase taxes in order to maintain the level of spending needed to keep the current level of care and services provided by the NHS”.
Hospital consultant says there's an admissions crisis
Dr Andrew Goddard, a director of the Royal College of Physicians, says "If you talk to doctors in this country they would say that the system is straining to burst, particularly in winter, but now it's increasingly happening the rest of the year."
Tories want another Tory to become head of CQC
Former Conservative deputy chairman David Prior is Jeremy Hunt's preferred candidate for the chair of the Care Quality Commission. The Secreatry of State has invited him to speak at a health select committee meeting and then will decide. Hmm....
BMA fears legal action over patient pledge cards
The BMA has been advised that GPs could be open to legal action if they encourage patients to complete pledge cards that asked for their healthcare not to be provided by private firms.
Hunt says competition has an important role in the NHS
He reveals what he really thinks of the NHS in saying that competition will make sure "...we don’t have complacency, that there is innovation, that we have a system that is open to new ideas and the independent and voluntary sectors can help create that spur to innovation." Funny, but he doesn't say that competition will make sure the NHS is open to fragmentation and cherry picking by health corporations.
29th November 2012
Cameron's "sham" listening exercise
Website Social Investigations reveals how private health firms were working with Downing Street during the "pause" to ensure new legislation went ahead, even though there was supposed to be a "listening exercise". There was no "pause" as the government claimed at the time nor a temporary halt to its efforts to introduce more competition within the NHS through its controversial health and social care bill.
"Cracks are beginning to appear in the NHS" - Kings Fund
A Kings Fund report reveals that there "..are huge risks, particularly in ensuring that quality of care does not suffer with the further financial squeeze. The stakes for patients could not be higher".
26th November 2012
Support for the reforms take a dive
An Ipsos Mori poll, reported in online Pulse, says 7 in 10 people interviewed thought cuts and the involvement of the private sector will mean that the NHS will get worse. 43% said they expected the Government’s reforms to make things worse, compared with 38% in last December’s survey. An interesting and repeatable summing up of the Coalition reforms in a comment to this article, referring to the role of GPs under the Act, is that GPs are "..a conscripted messenger, not the architect."
CCGs to inherit multi-million pound debts from PCTs
CCG leaders are likely to be saddled with multi-million pound deficits from April next year, despite previous Government assurances they would not inherit legacy debts, reports Pulse. The NHS Commissioning Board revealed it is looking again at the issue of CCG debt. It is due to make an announcement in early December to clarify what will happen to any deficits or surpluses left over by PCTs. Earlier this year ministers were continuing to insist debts would not be passed on to CCGs.
Patient choice overridden to divert patients to ISTC
Pulse reports that NHS Swindon has attracted fierce criticism because its referral management centre, the organisation that now ntervenes between GP and hospital in the refarrel process, has overridden the patients selection and referred to their ISTC.
NHS Commissioning Board outlines how CCGs should make cuts
NHSCB official says that cuts made by CCGs in so-called "service re-design" must be evidence-based, that is, "...backed by evidence of patient engagement and clinician input".
The revolving door from government to lobbying
Sean Worth, who was No 10's adviser on NHS privatisation until June, became a part-time strategic adviser to MHP Communications last month. The firm's clients include the Priory Group, which sells mental health care services to the NHS; Laing O'Rourke and Interserve, construction firms with hospital private finance initiative interests; and private equity firm Hg Capital, which owns care home operator Voyage Group.
22nd November 2012
ITV's Exposure programme: The effect of removing the private income cap from NHS hospitals
A 'must watch' TV programme, it demonstrates how hospitals are gearing up for more private patients with exclusive up-market wings for those rich enough to pay. The NHS Act has removed the low limit on how much revenue a hospital can take in private income, now it can have up to 49% of beds occupied by private patients. The progamme follows the case of the death of a breech baby due to the obstretician being called away to a straight forward birth involving a private patient.
Individual Funding Requests increase
Where a doctor considers a medical procedure, which is not normally available on the NHS, is warranted, s/he makes an IFR to the local PCT. So the number of IFRs can be seen as a measure of NHS rationing; when the range of NHS healthcare is restricted so the IFRs will increase. An exclusive piece by GP Online establishes that IFRs increased by 19% between 2010-11 and 2011-12.
Women are under-represented
A GP Online article demonstrates that top jobs are not occupied by women within the professional medical bodies. The facts are; a total of 46% of GPs are women, but just 21% of GPC members and 24% of UK BMA council members are women. At the Royal College of GPs, 31% of council members are women.
19th November 2012
NHS job cuts are harming care say nurses
The number of nurses being laid off is so critical that the NHS's ability to care is under threat, says the Royal College of Nursing. The loss of more than 6,000 nursing posts in England since the coalition took power in May 2010 means the NHS "is sleepwalking into a crisis", the nurses' union claimed.
Launch of the NHS Action Party
A political party dedicated to opposing NHS privatisation has been launched by medics unhappy with the involvement of the private sector in the NHS. Drs Richard Taylor, who woh a West Midlands seat in 2001, and Clive Peedell, a consultant oncologist, say they will put up candidates against Cameron, Lansley and Osbourne, and pro-market Labour politicians too.
Did you see Dispatches "Getting Rich on the NHS"?
The Channel 4 programme focused on Virgin Health's involvement with a surgery in Northamptonshire. Patients say that when Virgin took over from the NHS seeing a doctor became a challenge, the clinic became far too reliant on locum GPs and the company was not keeping its commitment to provide extended hours access to doctors. Whereas in Teeside Virgin runs sexual health services. It repeatedly missed targets on the numbers of people screened for Chlamydia and an internal memo revealed staff were asked to take home testing kits to use on friends and family to help make the numbers up. See also the Bureau of investigative Journalism article on the programme.
Private company provision in NHS is growing
For certain conditions private companies now provide one in five procedures in the NHS. Private companies, mainly through ISTCs, now carry out 17% of hip replacements (11,500 operations), 17% of hernia repairs (9,000) and 6% of gall bladder removals (3,000) annually in England. Their share of NHS patients grew rapidly between 2006-07 and 2010-11 after Labour's promotion of "so-called" patient choice. Ed - my wife had a knee replacement at an ISTC, but there was no choice. This is where all knee replacements for the hospital trust are carried out. Take or leave it!
16th November 2012
GPs will quit CCGs if red tape not cut
Bexley GP Dr Howard Stoate, the former Labour MP for Dartford and chairman of the Bexley CCG said a 'heavy touch' approach from the government risked killing the NHS reforms. If the CCG could 'get through authorisation smoothly', GPs' optimism could be restored, he said. 'It depends how the government wants to play it. If the government wants a light touch, it can work; if it insists on a heavy touch, it will kill it.'
Poor data collection will risk public health
You may know that one of the many criticisms of NHS Act was that it will undermine public health due to poor health data collection. Well now the chairman of the UK Statistics Authority, Andrew Dilnot, has written to Jeremy Hunt to say exactly this. He says that unless problems with official health statistics were addressed, it may be difficult for the current reforms to improve services. Yeah, this, privatisation and all the other issues with the Act!
12th November 2012
Government contracts handed out without querying promises
Public Accounts Committee says contracts are handed out to firms that have "over-promised and under-delivered". Chairman Margaret Hodge saya she has a list of contracts where "the taxpayers are too often left paying the price when companies fail to run public services properly." Her comments come after Circle, the private company brought in to save PFI debt-laden Hinchingbrooke hospital, was found to be more than £2 million behind in its plan to turn it around.
PFI debts are crippling NHS services throughout the country
The Public Accounts Committee reports that the government will have to hand out an estimated £1.5 billion to health authorities crippled by PFI debts. Problems of increasing waiting times and rationing of services are bound to get worse.
GPs have become millionaires over sale of out-of-hours service
The purchase of Harmoni, reported here on the previous news, see below, has made its former GP owners very rich. Harmoni was originally a GP cooperative started in Harrow in '96. It won the contract to run the non-emergency phone line 111, but the unsuccessful bidder, Care UK, has now bought the company.
8th November 2012
All CCGs have applied for authorisation
Every clinical commissioning group in England have taken the first step in gaining authorisation from the NCB (NHS Commissioining Board). There are 3 outcomes; first is 'authorised', the second is 'authorised with conditions' and the third is 'established but not authorised'. Isn't "localism" wonderful?
Harmoni, the firm chosen to run the non-emergency 111 phone line, bought by Care UK
Care UK was beaten in the race for the government contract to run the 111 phone operation by Harmoni, a firm that started as a Harrow GP cooperative in 1996. Now Care UK has bought Harmoni, the successful bidder. So the firm not thought good enough to run it ..... is now going to run it. That's the thing about the competitive market - you always get the best!!
Private firm running NHS hospital could make £31 million
Circle, set up by former Goldman Sachs banker Ali Parsi, is the firm that now runs Hinchingbrooke NHS hospital after the Cambridgeshire NHS Trust became PFI debt-ridden. It has now been estimated by the National audit Office that Circle could make £31 million in the next decade if it meets its target of paying off the £40 million debt. The hospital already has some empty wards, more are expected to follow if the target is to be met.
5th November 2012
NHS usage of the private sector increasing
Data from the NHS Information Centre shows that NHS funded operations by the private sector increased in a year by 10%. Labour spokesman siad "...the government is hell-bent on opening up the NHS to private companies to pick off thousands of operations". Cameron said he wants to turn the NHS into "... a great business opportunity" and we're seeing just the start of this.
Cameron underbriefed about NHS reforms
If you believe what Michale Portillo is reported to have said, and I leave that entirely to you, then Cameron did not realise the full extent of the NHS reforms. If this is true then surely Cameron is not in control of his prime ministerial brief, and then why did he replace Lansley with arch-right winger Hunt? Does it add up? I'm not convinced.
Patient choice is "a mockery"
The general practice online publication Pulse says for GPs it boils down to Choose and Book, the government system that is plagued with problems. Choice is trotted out as the cover for privatisation. But do patients want choice? Where's the evidence? There isn't any, patients want good local services.
1st November 2012
Osbourne's raid on the NHS
Health Service Journal reveals that under the Coalition the Department of Health has returned nearly £3 billion to the Treasury, despite the NHS having £20 billion of cuts.
29th October 2012
Hospital privatisation is possible outcome for PFI debt-laden South London NHS Trust
A report by a 'special administrator', Matthew Kershaw, appointed to investigate the financial difficulties of the hospital trust states 'without action the trust, already losing £1m a week, would accumulate a deficit of more than £240m by the end of 2015'. The financial difficulties are the result of PFI debts; the South London NHS Trust runs three hospitals, two of which, Princess Royal in Bromley and Queen Elizabeth in Woolwich were built by PFI. This year alone the trust will pay £61m in charges and interest, nearly 15% of the trust's turnover, and the final PFI payment is not due until 2032, The report by Kershaw has cost £2 million!!
QOF overhaul attacked by BMA
The chairman of the GP committee of the BMA said government plans to change QOF were 'politically motivated'. Introduced in 2004 as part of the General Medical Services Contract, the Quality and Outcomes Framework is a voluntary incentive scheme for GP practices in the UK, rewarding them for how well they care for patients. The QOF contains groups of indicators, against which practices score points according to their level of achievement. The chairman, Dr Laurence Buckman, said the plans would introduce 'unworkable targets and siphon off cash for "politcally-driven" enhanced services'.
Safegaurding alerts issued for patients moved from Winterbourne View
Many patients who were moved from the care home that was the subject of the Panorama investigation have since had safeguading alerts raised for them. Safeguarding alerts allow the reporting of possible abuse of vulnerable adults.
25th October 2012
If it's about localism then DH must relinqush control to GPs
Chair of Bexley CCG and former Labour MP Dr Howard Stoate said GPs’ hearts sink when he explains the bureaucracy his CCG has to undergo to be authorised by the NHS Commissioning Board (NHSCB). "On the one hand, localism is the watchword, and on the other hand command and control and centralism is very much the way it is being driven.....If the government want a light touch, it can work, if they insist on a heavy touch, they will kill it."
Commissioning CEO: "Next 6 months incredibly hazardous"
The head of 2 CSUs (Commissioning Support Units) - what PCTs used to do before the Act - also said "...if GPs viewed colleagues working on CCGs as 'going to the dark side', then the CCG had failed."
CCGs look for advice from management consultants
PricewaterhouseCoopers revealed this week it is now working with around 100 CCGs, while KPMG is working with 50 CCGs and Capita around 40. The companies are providing a mixture of short-term support to CCGs and commissioning support units on areas such as governance and authorisation, alongside longer-term advice on how to meet the daunting £20bn efficiency challenge set by the Government’s QIPP agenda. So up go non-medical overheads to the NHS. Do we really need such people to tell us how to run our health service?
22nd October 2012
Cost of implementing NHS reforms rises by £300 million
In a written ministerial statement Jeremy Hunt has admitted that the cost of implementing the Health and Social Care Act is in excess of £1500 million. This includes redundancy costs due to the dismissal of staff who worked for PCTs of £630 million. Increasingly the adminstration of healthcare will be farmed out to management consultants and private companies under new rules laid down by the government. The lunatics are definitely in charge!
BMA considering supporting an opt out of private healthcare under the NHS Act
BMA Council has agreed to explore a plan to produce and promote ‘patient pledge’ cards, which would allow patients to ask their GP to refer them only to publicly-run NHS services, providing the quality of their care would not be compromised, and where an alternative publicly-provided NHS service is available. Private health companies have slammed it, so it must be a good move.
A political party set up to fight NHS reforms recruits members
National Health Action, the political party set up by doctors to ‘stop the destruction of the NHS’, has opened its doors to members. The party, set up by hospital consultants Clive Peedel and Richard Taylor will be officially launched next month. It is calling for the repeal of the Health and Social Care Act and will be putting up 50 candidates in carefully selected general election seats as well as standing in local elections.
15th October 2012
PCTs instructed to privatise services
A Labour Party survey has found that a quarter of PCTs have put services out to Any Qualified Provider following dictat by the government. The survey showed that of the 398 services offered out to AQP, 110 services (27.6%), there was no intention by the PCT to change the provider before the government instructed them to do so.
Government's NHS rationing disproportionately affecting the elderly
A study by the Royal College of Surgeons shows an effect of the government's £20 billion budget cut-back is that older people are denied vital surgery for cancer, hernia or joint replacement. The NHS imposes "cut-offs" based on "age discrimination" using "outdated assumptions of age and fitness".
NHS chief fears reforms will "end in failure"
Sir David Nicholson, head of NHS Act's National Commissioing Board, the body that will oversee the work of commissioning of local doctors, says high-profile, politically driven changes almost always end in disaster. He believes competion "...is very effective when it is used as a rifle shot to deal with specific issues rather than a carpet bombing." However, he failed to support his opinion that competition in healthcare works by citing research that supports his assertion that health systems run on competitive line are better than those run as a public collaborative system, as the NHS was before the new NHS Act; this because there isn't any. See Commonwealth Fund research.
8th October 2012
Judicial review launched after Virgin takeover of Devon services
A Devon mother has launched a judicial review of Devon County Council and Plymouth and Torbay PCTs decision to award a contract for children's services to Virgin Healthcare. The mother, whose children use the existing service, is seeking a judicial review of the decision to award the £132m three-year contract to a firm in the private sector, claiming the authorities failed to properly assess the impact. In July GPs in Devon expressed their view that the founding principles of the NHS were under threat due to the imminent involvement of private health providers.
GMB fights Plymouth Hospital Trusts over lowering wages
The health union GMB said the Trust is going the "wrong way" over its plans to solve its financial difficulties. The Trust plans to bring in regional, which is seen as a pseudonym for lower, wages as disclosed in a leaked document seen earlier this year.
Study shows £800 million spent by government on private consultancy firms in this parliament
Research by Dr Eoin Clarke PhD shows that this sum comprises more than £400m of auditing contracts that have been agreed with private consultants to check the accounts of the new CCGs. In addition, there are the sums spent on 'hit squads' sent into 9 Foundation Trusts and 1 PCT that will make KPMG & McKinsey more than £20million.
4th October 2012
Labour vows to reverse NHS privatisation
Labour's shadow health secretary stated in a conference speech that a Labour government would "...reverse the rapid privatisation of NHS hospitals". Andy Burnham said that hundreds of contracts worth £250 million have been signed in just this week. He said he was against a market in NHS services but not private companies.
Serco to run community services in Suffolk
The private company that runs ferries, electronic tagging of offenders, the Early Warning Missile Defence System at Fylingdales, education support services in Bradford and a host of other government services is to take over community health services in Suffolk. In a £140 million deal Serco will run community nursing, specialist nursing, community hospitals, speech and language therapy and specialist children’s services. As a result pproximately 1,400 members of staff have transferred to the new service, which is now called Suffolk Community Healthcare.
Jeremy Hunt says NHS budget may be cut after next election
The new government Health Secretary said the Conservatives might not protect the £110 billion NHS budget as they did before the last election .....ed - did they? He said it might not be realistic to protect the NHS budget "..we would have to look at the economic situation."
1st October 2012
NCB refuses to overhaul contracts with private providers, despite GP service being traded
The board set up under the NHS Act that will oversee the work of commissioning groups has refused to revise APMS (Alternative Provider of Medical Services) contracts. In 2008 American giant United Health won a contract to run the Camden Road surgery. In 2011 it then sold the contract to another firm, The Practice plc. A year later it shut down, forcing 4700 patients to re-register with other GPs. A report in June this year by Camden council said "..primary care by GPs should not be a commodity traded in the private market" but the NCB has refused to amend contract rules.
How the BBC betrayed the NHS
A report by Open Democracy found in the two years building up to the government’s NHS reform bill, the BBC appears to have categorically failed to uphold its remit of impartiality, parroting government spin as uncontested fact, whilst reporting only a narrow, shallow view of opposition to the bill.
Serco takeover of path lab 'led to clinical and financial failure'
Documents obtained by Corporation Watch under the Freedom of Information Act detailing the running of path labs for Kings College and St Thomas's hospitals reveal 400 clinical incidents including mishandling and losing samples. An £800 million ten year deal involving Serco, a company that specialises in contracts for government services,resulted in the hospitals being forced to lend money to GSTS, the company running the labs.
27th September 2012
Cornwall's out-of-hours fiasco deepens
Serco, the leading private contractor to the government, has admitted that it presented false data to the NHS 252 times on the performance of its out-of-hours GP service in Cornwall.
CCGs plan to limit role of private sector
Some CCGs have taken legal advice and are using the principle of local control and adding clauses to their constitutions that will reject the imposition of AQP, "Any Qualified Provider", the Lansley Act's wording that permits NHS services to tb awarded to the private sector.
"Closing hospitals could improve care"
According to a Royal College of Physicians professor, this would allow hospitals to specialise and to move to 7 day a week organisations.
26th September 2012
Number of frontline nurses falls dramatically
The number of NHS nurses and health visitors has fallen by over 5000 since the coalition took power in 2010, official figures show. Despite ministerial pledges to protect the frontline 700 positions were lost in June alone.
Tory Party Donors benefit from NHS privatisation
More than £10,200,000 has been donated to the Conservatives by people who have since gained NHS contracts. Since the Conservatives came to power, Tory Donors have been handed more than £4,000,000,000 in contracts.
NHS rationing is forcing patients to go private
More patients are going private because the NHS is increasingly cutting back on providing a range of treatments, Dr Clare Gerada, chairman of the Royal College of GPs, said it was “incontrovertible” that increased NHS rationing was behind the increase in going private, a trend she described as “very sad”.
Private health contractor admits presenting false data
Private firm Serco, the leading private contractor to the government, has admitted that it presented false data to the NHS 252 times on the performance of its out-of-hours GP service in Cornwall. The revelation raised wide-ranging concerns about oversight of contracting services and has prompted calls for a review of contract.
6th September 2012
Jeremy Hunt is controversial appointment as Health Secretary
Jeremy Hunt's views on abortion and homeopathy have made him a controversial figure to appoint as Health Secretary. Mr Hunt has voiced support for the NHS paying for homeopathy and voted for the abortion limit to be halved.
Health warning over army of NHS 'temps'
NHS trusts are increasingly employing key clinical staff on 'zero hours' contracts which threaten to turn parts of the reformed service into an army of "temps".
NHS rationing is putting health at risk, says doctors' leader Mark Porter
the new British Medical Association's chair of council, says cuts and rationing of drugs may harm patients because of growing rationing being imposed to save money.
30th August 2012
NHS logo used to bolster health companies' profits abroad
The NHS has been the model for healthcare around the world, but under Lansley's Act Alysson Pollock demonstrates how scrupulous health corporations are using the logo to "...front up their unethical, fraudulent and inequitable activities".
Government sends in lawyers and accountants to find savings created by PFI debts
Seven health trusts struggling with PFI repayments have Department of Health officials sent in to find savings to renegotiate contracts.
Private firms asked to help run PFI indebted South London Trust
Private firms like Virgin, Serco and Circle will be invited to bid to run the trust losing £1 million a week because they owe so much to PFI firms .......like Virgin, Serco and Circle - the lunatics are definitely in charge!
Lansley's obesity policy criticised by his own public health adviser
Professor Simon Capewell, who served on Lansley's Public Health Commission while in opposition criticises Lansley's Responsibility Deal as "a pantomime" and said the plan to work together with manufacturers to introduce voluntary cuts to fat, sugar and salt levels in food was like "putting Dracula in charge of the blood bank".
23rd August 2012
Class divide in health widens
A report by the Kings Fund finds that the number of people engaging in risky life style activites falls, but those who do are more likely to have no educational qualifications. The report covers the years 2003 and 2008, a time when the Labour government invested heavily in public health schemes. But would the divide have been greater without these schemes?
Private providers likely to escape toughest regualtion
Following the publication of Monitor's draft guidance it's clear that private health companies will avoid the most stringent regulation. It is likely that mental health provision will be the service that will be offered to the private sector and charities would struggle to find finance to support cessation of their services. Yet another reason why the market isn't suited to our NHS. Note, you need subscriber access to read this article.
Very few patients have registered under 'near work' scheme
The Patient Choice Pilot Scheme lets patients register with a GP practice near their workplace. The scheme piloted in Manchester, Salford, Nottingham and 3 PCT areas in London has not attracted many patients.
20th August 2012
Number of older people living with cancer set to treble
A report based on research by Kings College London says that by 2040 the number of over 65s living with cancer will increase from 1.3 million, as now, to 4.1 million. The biggest increase will be in women with lung cancer. Whereas at present 13% of older people have cancer, by 2040 25% wil have the disease.
Dilnot's £35K cap on social care revived
Lansley indicates that despite having shelved the proposal as too expensive last month, the government is now having a rethink. The Dilnot Report proposed that the maximum anyone should pay towards their care in old age should be £35000.
13th August 2012
Patients lost sight after NHS private clinic treatment
Six patients have suffered irreversible damage to their sight becaue of a lack of proper aftercare following eye surgery at a private clnic run by Clincenta, an operation run by Carillion, the construction firm formerly opwned by Tarmac. It is feared that many more people may similarly suffer after treatment for glaucoma and retinal deterioration. The CQC is investgating the Hertfordshire clinic and local GPs are warned not to refer their patients there.
8th July 2012
Cameron raids NHS funds
The PM is accused of hypocracy after he took back £1400 million of unused NHS budget. Money earmarked for health spending and which the Departemnt of Health chose not to spend was raided by George Osborne. The move was condemned by the Kings Fund, doctors and Labour's Andy Burnham.
Financial austerity used to dismantle the state
So says Dr Gabriel Scally who was employed by the Department of Health as regional director of public health in the South West. He has resigned to fight the government's health policies. He said "I think there's a very deliberate policy across all of the public sector to roll back the achievements that have been made in this country since the second world war – including the NHS – and that financial austerity is being used to pursue an agenda aimed at dismantling the state."
Telehealth - saves lives but not money, so will it happen?
While the full report is delayed, a study indicates that home monitors save lives. But the gpvernment's initial expectations of saving money were too optimistic.
How PFI is crippling the NHS
Professor Allyson Pollock argues that the underlying cause of health trust mergers, reductions in hospital beds and private take-overs of hospitals is Private Finance Initiative debt.
3rd July 2012
More concerns over Serco's health provision
The well known private security firm is facing fresh worries over the health services it provides in Cornwall. The Guardian reports that there are new allegations being made against the company - it is already being investigated by the Care Quality Commission for previous complaints about its care. The new allegations relate to levels of staffing over the Jubilee weekend, with one terminally ill patient waiting six hours for an emergency prescription - by the time a doctor had answered the call the patient had died.
Midwife numbers falling short
A survey by the Care Quality Commission has found that one out of seven of the 141 trusts that provide maternity care don't have the recommended level of midwives, which should be in a ratio of one midwife for every 28 births. This is due to the fact that 4.8% of midwife posts are vacant.
27th June 2012
Drugs and alcohol services being carried out by voluntary sector
There is concern amongst substance misuse experts and trade unions over the transfer of services for treating drug and alcohol addiction from the NHS to voluntary groups. Dr Clare Gerada, chair of the Royal College of GPs, said that 'we are taking services backward'.
South London Healthcare Trust in £150m debt
The trust is to be put in to 'special measures' by the Department of Health over its £150m debt, largely due to a £2.5bn PFI scheme to rebuild two hospitals, which this year cost the trust £61m. A second trust, the Barking, Havering and Redbridge Trust, has been warned that it could be the next trust to go through this process.
21st June 2012
"NHS [is a] supertanker heading for an iceberg"
Research by the NHS Confederation, an organisation of NHS commissioners and providers, finds that half of the 252 health chiefs in the study think that the effect of the reductions in health budgets is that the "quality of care will reduce over the next 12 months".
NHS healthcare is now being rationed
Research reveals that more than 90% of primary care trusts are applying some sort of threshold to limit the number of patients qualifying for medical treatment, despite having been referred by their GP. For example, some are restricting GP referrals for bariatric surgery to BMIs over 50; another restriction is allowing cataract eye surgery on just one eye.
Non-urgent care number 111 increases GP workload
A report into pilot schemes for the new non-urgent care 111 number, which can be manned by call handlers who are likely to be non-medics, finds that the service will increase GP visits, A&E attendance and ambulance call-outs.
6th June 2012
More allegations in Serco scandal
The level of care that Serco is providing to the people of Cornwall is facing further scrutiny, after it has been alleged that only one after hours GP was available to cover the whole county, from midnight to 8am on the night of the 29 May. It has also been claimed that a new system for dealing with phone calls, which replaced trained nurses with staff following a computer generated script, led to people waiting for more than 3 hours for advice.
Supporter of Lansley's health reforms de-registered vulnerable patients
A practice which was run by one of the most prominent supporters of the health reforms, Dr Charles Alessi - who is now the chair of the National Association of Primary Care, has been found to have de-registered patients who were among the most vulnerable in order to save money.
An NHS investigation revealed that last year the Churchill practice in Kingston had let go 48 elderly and disabled care home patients who required high levels of care, as these patients were among the most costly to provide for. The NHS issued a breach of practice notice for removing patients 'predominantly for financial reasons'.
With money becoming an ever more important factor in our healthcare after the latest reforms, could this be a sign of things to come?
29th May 2012
Serco scandal highlights lack of accountability
Jackie Davis identifies the lack of public accountability that will accompany the NHS changes under Lansley's health service reforms, highlighted by the Serco scandal in Cornwall.
28th May 2012
Scandal emerges over Serco out-of-hours contract
Concern has been expressed as long ago as 2007 about Cornwall's contract with Serco. Now the Care Quality Commission has been forced to investigate allegations of under staffing at Serco and the downgrading of the urgency assessment of phone calls to the service. This follows the death in 2010 of a six year old who died of appendicitis after being told by the service to go to bed.
Calls for investigation into mental health deaths
A doctor whose wife, herself a mental heath campaigner, died in a London hospital, is campaigning for an investigation into the high number of deaths of mental health patients. It is thought that the high number of deaths should be put under greater public scrutiny.
24th May 2012
Lansley to favour south by switching NHS funding from deprivation to one based on age
Research from Durham University shows that the founding fundamentals of the NHS are further eroded as Lansley proposes to switch funding distribution based on deprivation to one based on age of residents. For example, this will take £90 million from Knowsley on Merseyside, whereas the leafy shires are likely to see a significant increase.
Funding cuts are depriving those in dire need of cataract surgery
RNIB research has found that patients unable to drive or read are being denied surgery owing to NHS funding cuts, and cost the NHS more in the end,
21st May 2012
Unpaid jobseekers to work as hospital nurses
Sandwell and West Biurmingham Hospital to extend its work experience scheme in which unpaid jobseekers will deliver patient care.
Doctors trained to do the Government's NHS cuts
A doctor reports that his hospital management training course is really about making doctors the scapegoats for government cuts.
Lansley's intentions for commissioning support services revealed
Such is the privatising motives behind the NHS Act that, what PCTs used to do comparatively cheaply, will become free-standing commercial organisations selling their services. The chaotic picture of health service management that is emerging is a one of uncertainy and escalating risks.
National Health Action Party launched
Former MP who in 2001 won the parliamentary seat of Wyre Forest, campaigning to save the A&E department at Kidderminster Hospital, has agreed to become joint leader of a new political party.
17th May 2012
Possible legal challenge over veto of risk register
The damning report by the Information Commissioner of the coalition's refusal to publish the risk register for the Health and Social Care bill has been followed by former shadow health secretary's statement that he hasn't ruled out the possiblility of requesting a judicial review.
14th May 2012
Over 61000 jobs lost in community care
The Royal College of Nursing says that more than 61000 jobs have been lost or put at risk since April 2010. A dossier of evidence shows that health services outside of hospitals are close to collapse. General Secretary Carter said that cuts to district nursing are a false economy because it keeps patients with long term illnesses, particularly the elderly, out of hospital.
Queens speech: Lack of social care bill "unforgiveable"
Richard Vize says there's a failure of leadership at the heart of the government's proposed legislative programme. Social care is in dire need of comprehensive reform, but George Osbourne has blocked it.
10th May 2012
NHS Act Risk Register will never be published
Government exercises the rare right to refuse to publish the Health and Social Care Bill Risk Register. So the public will never know that under the Act there will be no ministerial accountability for the NHS, a fragmentation of services, a postcode lottery of services, in fact an end to a comprehensive National Health Service.
Public sector workers strike over pensions and cuts
400,000 Health workers, civil servants and police are expected to strike today over government cuts.
Eastern European parents fly home because of increasing NHS waiting lists
Strathclyde University study shows that while many came here expecting to improve the prospects for their children, NHS waiting lists have forced them to return to their home countries.
3rd May 2012
Revealed - How Circle will profit from the first NHS privatised hospital
Circle, the private equity backed firm given the contract to run Hinchingbrooke Hospital, will take the first £2 million annually of any surplus that the hospital trust makes. Surpluses over £2 million are shared. What are the chances when the NHS has to make £2000 million cuts, that the hospital trust will have a surplus of more than £2 million? So contrary to the impression given with the fanfare surrounding Citrcle's take over, probably all profits will go to Circle and the only way the heavily-indebted trust can break even is by cutting services to the people of Cambridgeshire.
UK spending on healthcare steadily increased between 1997 and 2010
The most recent data for NHS spending released by the Office of National Statistics shows that spending on the NHS rose steadily between 1997 and 2010. But paradoxically, owing to growth ouststripping the NHS budget, fell in 2010 as a proportion of GDP.
30th April 2012
Waiting times up
A report by the Patients Association shows that waiting times for a range of elective surgery has increased by 6% between 2010 and 2011. For example, the average wait for knee replacement rose from 88.9 days to 93, and for hernia surgery from 70.4 to 78.3.
NCB to have powers to stipulate CCG support staff?
Draft regulation, to be discussed soon, shows that the NHS National Commissioning Board will have powers to control the support services that Commissioning Groups employ. The wording of the 6 criteria demonstrate a leaning towards management consultants, and say that the NCB will have powers to ".. determine the most effective source of support" and will have the option of "...placing a representative on the CCG governing board". The NCB could "make full alternative arrangements for commissioning.". Lansley's plans for the heirarchical relationship between the NCB and CCGs are becoming clearer.
NHS trust to enter the luxury hotel market
Cambridge University Hospital Foundation Trust, clearly keen to demonstrate the "merits" that foundation trust confers, plans to build a huge hotel in its grounds with a commercial partner. So the principle that all managerial consultants preach that underlies outsourced privatisations, that you must focus on your core activities, doesn't seem to have been fully appreciated.
HSC Act inhibits public health data collection
Under the Health and Social Care Act public health data collection, says a report from the BMJ. Health reforms are informed by evidence based on data collected on defined geographical areas, but now this will be based on the shifting populations attached to GP practices.
16th April 2012
Members of APGH revealed to hold financial links to private healthcare companies
Key members of the self proclaimed `impartial` Associate Parliamentary Group for health have been revealed to hold financial links to companies involved in private healthcare. The organisation is one of the preferred sources of information on health as used by parliament, a group that holds a list of members from the private healthcare world.
Glasgow University to head Parkinson's study
A doctor at Glasgow University is to lead the biggest study into the cause of Parkinson’s disease. Dr Kieran Breen, director of research and innovation at Parkinson’s UK commented “This vital new study will help us fill in some of the gaps in our knowledge”.
The Academy of Medical Royal Colleges has turned on Number 10 over their failure to tackle obesity endemic
The academy demands tougher and more direct measures, and calls on Andrew Lansley to ditch the government’s inherently flawed approach. Charlie Powel, campaigns director of the children’s food Campaign has commented that “Andrew Lansley should act on this excellent set of robust recommendations, but his track record suggests that he will once more ignore the advice of our best medical experts”
11th April 2012
Mass doctors' strike in the pipeline
NHS managers have drawn up plans to cope with the first ever mass walkout by doctors. If a ballot is returned in favour, services will be withdrawn, with the exception of urgent and emergency care. The strike ballot is "the latest sign of the increasingly hard line being taken by the BMA in its opposition to the health bill"
Andy Burnham has set out labour's defence of the NHS
Andy Burnham has laid out a practical five point programme regarding the damage control and defence of the NHS. He asked NHS leaders to resist the encroachment of charges and restrictions based on lifestyle choices as well as the `postcode lottery`. He has promoted collaboration over competition, and urges a resistance against market destabilisation, asserting that "A vote for labour in May's elections is a vote for the NHS"Hospital cuts given the go ahead
Cuts proposed by Bridport community hospital have been given the green light after councillors decided they would not have a substantial impact. This comes despite the community health campaign's persistant opposition to the changes, which, backed by a 11,000 strong petition, vowed to try to force a judicial review.
New cancer vaccine tested on humans