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Friday 19th December 2014

OnMedica

  • Andrew Lansley dubbed ‘worst health secretary’ in a lifetime.

    Andrew Lansley has won the dubious accolade of being named the ‘worst health secretary’ ever. Britain’s leading doctors and health experts chose Conservative MP Andrew Lansley, who served as health secretary from 2010 to 2012, as the worst Secretary of Health in their lifetime. Aneurin Bevan was named as the best. The results are drawn from an analysis* by The BMJ of replies to its weekly questionnaire, known as BMJ Confidential. Looking at the first 50 columns, journalist Nigel Hawkes scrutinised how doctors and academics answered 24 questions about such matters as their earliest ambitions, worst mistakes, guiltiest pleasures and pet hates. Asked to name the worst health secretary in their lifetime, 15 doctors named Andrew Lansley. Other health secretaries who were named included Enoch Powell, John Moore, Kenneth Clarke, Virginia Bottomley, Alan Milburn, Patricia Hewitt, and Jeremy Hunt. Andrew Lansley was the hands-down winner – no one else received more than one vote. Aneurin Bevan topped the poll for best health secretary, with 20 votes, followed by Frank Dobson with 9 votes, Alan Milburn and Stephen Dorrell (5 votes), Kenneth Clarke (3 votes), Barbara Castle (2 votes) ; and six more with one each: Enoch Powell, Kenneth Robinson, Richard Crossman; Patricia Hewitt, Alan Johnson, and Jeremy Hunt. The interviewees, who included presidents of the royal colleges, the then chairman of the National Institute of Health and Care Excellence, and four health tsars (national clinical directors), named their pet hates as lying, obvious answers, experts, risk averse bureaucracy, bullies, litter, worthiness, men who struggle to hear women, arrogance, self-pity, tinned tomatoes and many more.

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Open Democracy

  • "The biggest denationalisation of health services ever announced by a health minister" .

    The 1946 NHS Act transferred all voluntary, charity and municipal hospitals to the NHS. This was the nationalisation of hospitals. The British state finanically underwrote these hospitals, investing billions since in their rebuilding and extension, and giving us guaranteed continuity of service. As Nye Bevan said, the pre-war “patch-quilt of local paternalisms” with mutuals and friendly societies contributing to a "chaos of little or big projects" could not fulfil the NHS founding principles of providing a comprehensive and universal health service. The social solidarity that underpins the NHS is the fact that we – all of us – own the NHS and its hospitals. But now, more hospitals will be run “outside of the NHS” by “mutuals”, Cabinet Office minister Francis Maude told the Telegraph this week. He did not “see a line” he wasn’t prepared to cross, in terms of how many hospitals might be allowed to transfer out of the NHS. Assisted by health minister Norman Lamb and Kings Fund chief Chris Ham, Maude has already been quietly purusing this agenda - what one expert health commentator recently called “the biggest denationalisation of health services ever suggested by a health minister.” In July this year Norman Lamb and Francis Maude wrote to the chief executives of NHS Trusts and Foundation Trusts (FTs) asking them to consider joining the “Mutuals in Health” programme and offering a share of £1m for ten “pathfinder” trusts to investigate becoming mutuals. It was a policy that appeared to have been killed off back in 2011. The 2010 Coalition NHS White Paper announced the Conservative intention to end the concept of publiclly owned hospitals, suggesting that “As all NHS trusts become foundation trusts, staff will have an opportunity to transform their organisations into employee-led social enterprises that they themselves control.”

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Red Pepper

  • Deaf people to receive only one hearing aid – an insight into life after the NHS.

    This month Devon has announced that smokers and obese people will be denied all routine operations, and deaf people will get only one hearing aid. Caroline Molloy argues the end of the NHS is coming into focus and Devon is the canary in the coal mine. 'We constantly strive to improve services all in the best interests of the patient.. I sense a real optimism here in Devon because clinicians are inherently close to their patients… The patient must always come first...' So said the Chair of the new North East & West Devon Clinical Commissioning Group (CCG) Dr Tim Burke earlier this year, introducing the system the 2012 Health Act set up. So what does this optimistic vision look like on the ground ? Dr Burke’s CCG has just announced that obese people and smokers in Devon will be denied ALL routine surgery. The Royal College of Surgeons slammed the move as 'unacceptable'. Shoulder surgery will also be restricted for everyone in Devon (obese or not), as part of a package of cost cutting measures, with further cuts to be announced shortly. And deaf people will now only get a hearing aid for one ear, not two. Justifying the decision Dr Burke told us that 'second hearing aids show far lesser cost effectiveness than the first'. And that 'the CCG has a legal duty to live within its financial resources and the prioritisation of services is helping us to do that.'

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The Independent

  • NHS services cut in Nottingham after doctors quit rather than work for private firm.

    An NHS hospital has been forced to scrap highly rated services for patients with severe skin conditions including skin cancer after an “exodus” of senior doctors reluctant to work for a private-sector subcontractor. Nottingham University Hospitals Trust said it would no longer be able to provide acute adult dermatology, including emergency care, after losing six of its eight consultants. Five of those departing are understood to have left rather than transfer to Circle, a private healthcare company which won a contract to provide most of the local dermatology services last year. The closure of the service has raised concerns about the impact of privatisation on the NHS, with doctors worried about job security in the private sector. The trust lost out to Circle, despite warnings from senior doctors that they would leave rather than be transferred out of the NHS, the Health Service Journal reported. It is understood that the senior doctors who left were concerned over job stability at a private employer, and also had fears that a profit-driven provider would not offer opportunities for academic research or training. The trust has said it will stop providing acute dermatology services to new patients from early next year because of a lack of consultants. While Circle’s outpatient treatment centre will remain open, any patients with severe conditions will no longer be seen by a specialist at the hospital and may have to be referred elsewhere.

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The Guardian

  • Private firms on course to net £9bn of NHS contracts.

    Private health firms are on course to win more than £9bn of NHS contracts to look after patients as a result of the coalition’s ramping up of competition in the health service, research shows. Analysis by the NHS Support Federation, an independent campaign group, 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. They have won two out of three of the 195 contracts awarded by NHS bodies in England in the 19 months since that legislation dramatically extended the enforced tendering of services in the NHS. Those 131 contracts represent about half the value of the 195 deals that have been agreed. Researchers tracking the awarding of NHS contracts say that, if the private sector continues its 50% win rate by value, it will earn a potential £6.6bn more of the £13bn of other contracts which have been advertised but not yet awarded. That would result in private firms earning £9.2bn as a direct result of the changes ushered in by then health secretary Andrew Lansley’s restructuring of the NHS, which a cabinet minister recently described as the coalition’s biggest mistake. The £18.3bn of services tendered include more than £1bn worth of contracts for elective surgery, diagnostics (£1.2bn), community care services (£1.9bn), musculo-skeletal care (£785m), ambulance and patient transport services (£583m) and pharmacy (£558m). The Department of Health said the figures were misleading and only a small proportion of the NHS’s overall spending was in the private sector.

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The Telegraph

  • Hospitals and fire services will be run “outside the public sector” as the Conservatives dramatically shrink the state and cut costs, a senior minister has disclosed.

    Francis Maude, the Cabinet Office minister, told The Telegraph that services could be handed over to mutual companies owned by employers and other non-state bodies. He also warned that public sector jobs and wages would have to fall sharply to ensure the Government lives within its means. George Osborne, the Chancellor, has set out plans to reduce public spending to its lowest level since the 1930s, something which senior Conservatives believe will require fundamental changes in the role and responsibilities of the state. Mr Maude, who is drawing up plans for £20 billion of Whitehall savings by 2020, said that with the exception of defence and policing, every function of the state could potentially be done outside the public sector. But instead of “red-blooded commercial for-profit outsourcing” to big companies, services could be transferred to a range of “mutual, joint venture or hybrid” companies run by their staff. He said it would “give flexibility to evolve services around the needs of the user, which makes for a better outcome and saves money”. The National Health Service is already experimenting with transferring some “acute” services out of the public sector. Hinchingbrooke hospital in Cambridgeshire is run by a company jointly owned by its staff and private investors.

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HSJ

  • Exclusive: Service hit by staff 'exodus' after CCG transfers contract to Circle.

    One of the biggest teaching trusts in England has been forced to axe its once renowned acute dermatology service following an “exodus” of medical consultants following the transfer of their contract to private provider Circle. Nottingham University Hospitals Trust has confirmed it will cease to provide acute adult dermatology services – including emergency services – from February next year, due to a lack of staff. The workforce crisis comes after Nottinghamshire commissioners awarded Circle a contract that made it the main provider of dermatology services delivered across the trust and Circle’s Nottingham NHS Treatment Centre. The trust’s own bid for the contract was unsuccessful and the services were passed to Circle last year, despite warnings from the trust’s 11 dermatology consultants that senior staff would leave rather than be transferred out of the NHS. Prior to 2013, the consultants had all been employed by the trust under NHS contracts, but provided outpatient services and some surgery at the treatment centre under secondments. Under the new contract, most of the consultants faced moving to Circle under the transfer of undertakings protection of employment regulations, known as TUPE. A March 2013 letter from the consultants sent to Rushcliffe Clinical Commissioning Group, seen by HSJ, predicted the transfer would result in a loss of consultants “within a 12 month period” and noted Circle had experienced difficulty in recruiting consultants directly. They warned that this loss would mean “our patients are at risk, and teaching, training, research and the overall clinical service for our colleagues in Nottingham and regionally will suffer”.

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Thursday 18th December 2014

Yorkshire Post

  • Private hospitals to help ease NHS backlog.

    NHS England has agreed to commission a “significant range and volume” of planned care from private hospitals over the coming months. The commitment comes following the failure of a national push to clear NHS waiting list backlogs in recent months. The health body, as well as national health services regulator Monitor and the NHS Trust Development Authority (TDA) have promised to underwrite hospital trusts’ spending on referrals to private providers that they would not otherwise be able to fund. A Monitor spokesman said that £30m of as yet unallocated money from £250m set aside to ease waiting lists would be used to pay for approximately 30,000 procedures between December and March 2015.

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Guardian

  • Nick Clegg attempts to calm NHS worries over EU-US trade deal.

    Nick Clegg has moved to calm campaigners worried about the proposed EU-US trade deal – the transatlantic trade and investment partnership (TTIP) – saying the government would secure written guarantees that it would not threaten the NHS. The deputy prime minister said he would ensure the UK maintains its sovereign right to run the NHS, amid fears the deal could allow private US health corporations the ability to mount legal challenges over the right to bid for contracts. Clegg is among many politicians who have found the issue of the TTIP raised on the doorstep by potential voters following a huge grassroots campaign to raise awareness about possible problems with the deal. His intervention on the issue is in marked contrast to the rhetoric of David Cameron, who counts the TTIP deal as a major priority for Britain and the EU. The government has refused to exclude the NHS from the provisions of the TTIP on the grounds that it will not affect the health service at all. Campaigners fear that a controversial investor-state dispute settlement (ISDS) clause will allow private companies to sue the government bodies if they are prevented from making profits. Labour has promised to exempt the NHS from TTIP, saying the right of governments to legislate for legitimate public policy objectives should be protected effectively in any dispute resolution mechanisms.

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Tuesday 16th December 2014

Morning Star

  • A nefarious NHS agenda

    Government efforts to play down the proportion of NHS contracts in England snapped up by the private sector are disingenuous and intended to mask its nefarious agenda. But for British Medical Journal (BMJ) determination to use freedom of information legislation to expose reality, the public would still be in the dark. The Department of Health seeks to camouflage the scale of private-sector penetration of our national health service by insisting that private companies account for just 6% of NHS expenditure. However, the real scale of the danger emerges as the BMJ reveals that the private sector has won 41% of contracts awarded via competitive tender against just 30% for NHS providers. This is because of the different priorities of private and public health bodies. Public bodies care for sick people while private companies prioritise winning profitable contracts in the interests of their shareholders. Clinical commissioning groups (CCG) imposed on the NHS by a radical top-down reorganisation, which both the Tories and Liberal Democrats had pledged not to introduce, are pressed to award contracts on a best value basis. Not surprisingly, this works to the benefit of profits-first outfits prepared to cut right, left and centre to offer a lower quote. Ministers point to CCGs as putting doctors in charge of placing contracts, but most of this work is outsourced to shadowy and secretive “commissioning support services” that are immune to the Freedom of Information Act. The NHS is wholly funded by the taxpayer, so the public ought to be in a position to examine contracts to judge how their money is being spent. However, this doesn’t suit the interests of the privateers and their parliamentary representatives. We are constantly told that funding is tight and that all expenditure must be closely monitored, but that doesn’t apply to the rocketing employment of consultants by NHS England, more than doubling over the past four years to £640 million a year.

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Western Morning News

  • Government to end scandal of mentally ill teens being held in police cells.

    The Government will move to end holding teenagers with mental health illnesses in police cells following an outcry over a vulnerable 16-year-old girl spending two nights in custody in the far South West. Home Secretary Theresa May will this week publish a review of section 136 of the Mental Health Act, which allows people with mental illnesses to be detained in a police cell if there are no beds available in a hospital or psychiatric unit. The review will conclude that mentally ill children and young people should never be placed in police custody and adults should only be detained by police when their behaviour is so extreme that it cannot be managed elsewhere. The problem has been so acute in the far South West that Paul Netherton, assistant chief constable of Devon and Cornwall Police, lashed out on Twitter after a 16-year-old girl suffering mental health issues was held in a custody cell for around 48 hours because there were “no beds available in the UK”. Latest figures show that across Devon and Cornwall in the last 12 months, 750 mentally ill people – including 28 children – have been detained in police custody. The 16-year-old girl was eventually placed in an adult ward in Exeter. At the heart of the problem is a chronic shortage of beds in so-called “places of safety”. Former Labour Health Minister Ben Bradshaw, MP for Exeter, raised the issue in a House of Commons debate last week. He said: “It’s all very well for the Home Secretary to say she wants to ban this practice, but where will the children go when there aren't the secure beds available and private sector providers are allowed to turn them down ? There were 30 such instances in Devon last year because of the chronic shortage of accommodation and the Government’s chaotic commissioning system. Simply banning the police from getting involved won’t work if there’s nowhere else for the children to go. The Government collectively needs to address the underlying crisis in mental health services and in young people's services in Devon in particular, otherwise this will only be seen another bit of leadership posturing by the Home Secretary.” The House of Commons Health Select Committee, chaired by Devon Conservative MP Sarah Wollaston, one of the first to publicly criticise the practice, is investigating whether section 136 is being used inappropriately.

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Sheffield Star

  • Sheffield hospitals plan for new £30m cuts.

    Hospitals in Sheffield face the prospect of making another £30m of cuts next year, it has been revealed. Sheffield Teaching Hospitals NHS Foundation Trust will need to start making the savings from April as part of its annual efficiency savings target. But the trust, which employs around 15,000 people, said it believes the savings can be made without any adverse affect on services or needing to make compulsory redundancies. The trust says it has managed to break even or achieve a small surplus for the last 13 years. Recent money-saving initiatives have included the introduction of a new frailty unit for older patients to reduce the length of time they need to stay in hospital. Neil Priestley, director of finance, said: “Every year, each NHS Trust has to make circa four per cent savings by looking at ways to do things more efficiently. Sheffield Teaching Hospitals NHS Foundation Trust has a budget approaching £1bn and so for us each year this equates to between £25-£30m in savings.“

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Northern Echo

  • Investigation into private ambulance company.

    Insolvency practitioners have launched an investigation into the collapse of a private ambulance firm which suddenly lost a large contract with the NHS. Investigations are being conducted into the liquidation of private medical firm, Medical (Europe) Ltd which traded as North of England Ambulance Service. The company was used by the Yorkshire Ambulance Service (YAS) NHS Trust to bolster its ambulance cover in North Yorkshire, providing private ambulances and patient transport.The Northern Echo has seen documents which show that in January this year (2014) the YAS suddenly stopped using the company, forcing its revenue to decline almost overnight to less than a tenth of its original monthly income. The company was unable to continue and folded in August this year. Now the insolvency firm, Lines Henry, which is dealing with the administration of Medical (Europe) Ltd is looking into recovering its assets for creditors. It is also investigating whether its director Robert Arrand sold part of the company to a partnership he was involved in when Medical (Europe) was insolvent but before it was officially registered as in liquidation.A spokesman for Yorkshire Ambulance Service NHS Trust, said: “As a professional ambulance service we respond to the overwhelming majority of our emergency patients using our own staff and vehicles. However, when demand for our emergency service is particularly high, our own resources can be complemented by St John Ambulance and private ambulance service providers. This is common practice amongst ambulance services throughout the country. The North of England Ambulance Service was contracted by the trust on a fixed-term basis until the beginning of 2014. We have not used this company to provide private ambulance support since then.”

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Daily Mail

  • Voters 'oppose NHS in trade deal'.

    Most voters in the constituencies of the Prime Minister and Health Secretary are opposed to the NHS being included in a controversial new trade deal between the European Union and the United States, according to a new report. A poll of 2,000 voters in David Cameron's Witney seat and Jeremy Hunt's South West Surrey constituency, showed that four out of five didn't want health services to be part of the so-called Transatlantic Trade and Investment Partnership (TTIP). The Unite union said its survey showed "massive opposition" to the trade deal, which opponents have claimed will lead to the privatisation of NHS services. Unite general secretary Len McCluskey said: "Even in these Conservative constituencies there is massive opposition to the NHS being part of the US trade deal. David Cameron's and Jeremy Hunt's constituents expect them to act and veto the NHS from TTIP. The NHS unites this country, it is the single most important local issue for voters. The Prime Minister has cut himself adrift from public opinion by refusing to listen to the public. They are demanding that he veto the NHS out of TTIP. Unite has polled 17 Tory seats and in every case voters oppose the NHS being part of TTIP. David Cameron has claimed that there is 'no threat' to the NHS from TTIP. If this is true, why doesn't Cameron just remove the NHS from the trade deal ? Other countries have vetoed sectors from the trade deal. The Government has failed to give one decent reason why the NHS should be in this trade deal."

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Monday 15th December 2014

The National NHS Campaign

  • 999 Call for the NHS invites all NHS campaigners, activists, trade unions and concerned citizens to join us in a National Convention to Save the NHS.

    The idea for the 999 Convention for the NHS grew from the 999 Peoples March for the NHS which marched from Jarrow to London in August & September 2014. As the march made its way through 23 towns and cities, it united broad layers in defence of the NHS from trade unionists, councillors, politicians & health activists to pensioners groups, health campaigners and the local community. However, as the march passed through, the issues remain. NHS campaigning remains localised and fragmented. While there are many NHS campaigns and organisations at a national, regional and local level, there is not one united voice. The idea is to hold a ‘999 Convention for the NHS’ in January/ February 2015 bringing together campaigners from across the country to plan and coordinate days of action in the run up to the General election, putting the NHS at the centre of the General Election and preparing the ground for the fight beyond it. We want to unite all NHS campaigners and make the ground shake with protests, marches and direct action so the Tories lose and can never harm our NHS again. We want the mass protests in defence of hospitals in Lewisham and Stafford, united with the determination of the 999 Marchers, combined with the energy and direct action of UK Uncut and tax avoidance campaigners, occupying banks and blocking bridges to protect the NHS. The convention will be a chance to discuss the way forward, agree days of action before the General Election and organise a national campaigning body to continue to defend the NHS whichever party wins the general election. The convention is open to all who want to defend the founding principles of the NHS. Discussions have taken place with key figures from other organisations including KONP, National Health Action Party, and local NHS campaign groups who have already indicated support. An Initial meeting took place in Darlington on Saturday 13th December. There will be an open planning meeting in January 2015, and the idea is to have a full convention in February to give campaign groups time to get messages out to the public before the election. The conference is dedicated to organising national and regional events with one unified voice and to offer the opportunity for campaign groups to connect face to face and join forces in the fight to save the NHS.

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Our Kingdom

  • A culture of revenue and profit-driven performance incentives has too often been misaligned with the needs of the public who fund and depend on these services.

    Margaret Hodge MP writes on the Public Accounts Committee's new report on the contracting out of public services. The private sector delivers around £90 billion worth of complex services on behalf of the public sector – half of public sector expenditure on goods and services. We all expect these companies being paid for services by the taxpayer to have the highest ethical standards in their work. However, too often the ethical standards of contractors have been found wanting. It seems that some suppliers have lost sight of the fact that they are delivering public services, and should do so in accordance with public service standards. The case of G4S and Serco overcharging the Ministry of Justice for years on electronic tagging contracts was the starkest illustration of both contractors’ failure to work in the public interest and government failure to safeguard taxpayers’ money. G4S apologised to us for getting it wrong and Serco said the affair was ‘unacceptable and unethical; frankly, we are deeply ashamed of it’. We have examined similar cases where there are allegations of the misuse of taxpayers’ money. Serco’s altering of performance data on its contract for out-of-hours GP services in Cornwall is an unacceptable example. Two other G4S contracts have been referred to the Serious Fraud Office to investigate, and another Serco contract has been referred to the City of London police.

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The Guardian

  • NHS litigation claims double under coalition.

    Scale of clinical negligence claims is now unprecedented prompting claims that reorganisation has harmed patient care. 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. Such are the costs of dealing with the legal actions that the NHS has increased the amount of money it retains to deal with claims, up from £8.7bn in the first year of the coalition government to £15.6bn in 2013-14 – adding to the financial stresses within the service. The analysis, based on figures published annually by the NHS Litigation Authority, comes as NHS England revealed that 35,373 patients waited more than four hours for treatment in the first week of December. That number was 66% higher than the same period last year. Meanwhile 7,760 people were kept on a trolley for between four and 12 hours before a ward bed was found – up from 3,666. Amid a barrage of criticism on Friday, Dame Barbara Hakin, the national director of commissioning operations for NHS England, was forced to admit in interviews that the NHS was “under a huge amount of pressure”. “We are seeing far more patients than we ever have before,” she said. The Department of Health has insisted that the NHS was well prepared for winter and that an injection of £700m would pay for extra nurses, doctors and beds this winter. Labour said, however, that the figures on litigation should act as a warning. The health secretary, Jeremy Hunt, had previously admitted that a high number of litigation claims was a good indicator of poor care in the system. In a speech given at Birmingham Children’s Hospital in October, Hunt said standards in safety and quality of care must improve to reduce avoidable costs.

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  • Like everyone else, I’m spending the next week getting ready for Christmas.

    It’s busy: shopping, school plays, friends and family, the last-minute rush at work… What a weird time for the government to launch a consultation on arrangements for the transfer of commissioning responsibility for renal dialysis services from NHS England to clinical commissioning groups (CCGs). I mean: phew. That sentence alone is exhausting! Imagine, alongside the inevitable high jinks and hold-ups of the holidays, carrying out a comprehensive consultation about passing responsibility for dialysis services from NHS England to CCGs (regional groups of GPs) by 9 January. Everyone is in the same boat at the moment, right ? So much to do! So many distractions! Wouldn’t it be awful if the whole consultation period elapsed without most people knowing it had happened at all ? It’s worrying, especially as the amount of people needing dialysis (around 23,000) is increasing – some estimate that by 2018 it could be up to 40,000. The changes are due to kick in next April, and there’s a lot of debate about what impact they might have on patients. Supporters say services will become more efficient, but the National Kidney Federation and the British Kidney Patient Association have expressed deep concern. The BKPA argues that dialysis is a specialised area which should be the responsibility of renal experts (not GPs); that separating responsibility for dialysis and kidney transplant services could lead to poor co-ordination and that CCGs deciding not to prioritise dialysis in their area could create a postcode lottery. They have requested a delay to gain assurances that services will be safeguarded. An e-petition opposing the changes has 30,500 signatures.

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  • Jeremy Hunt under pressure over looming winter crisis in A&E.

    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. Labour has increased pressure on the coalition by demanding that Jeremy Hunt, the health secretary, tells parliament before the Christmas recess starts next Wednesday what he intends to do about the deteriorating situation. Official NHS figures revealed that record numbers of A& E patients across England – 35,373 – had to wait more than four hours last week for treatment. Only 87.7% were treated on time. The target set by government is 95%. NHS leaders fear the extra £700m Hunt allocated to help the service cope this winter will not be enough to head off potentially serious failings, especially if there is severely cold weather. The week to Sunday 7 December also saw a new all-time high of 7,760 patients forced to wait between four and 12 hours on a trolley to be admitted to a hospital bed from A& E. Waits of over four hours were up 66% on the same week in 2013, while trolley waits had doubled. NHS leaders blamed rising number of patients turning up at A& E and more needing to be admitted as emergencies. But Dr Mark Porter, the leader of the British Medical Association, the doctors’ union, said that the growing problems in A& E indicated that the health service as a whole could no longer cope.

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Hospital Doctor

  • Medical Innovation Bill is simply unnecessary.

    RCPsych understands and sympathises with the sentiment behind the Medical Innovation Bill, but regrettably cannot support it in its present form. We have significant concerns that the Bill in its current form is unnecessary, leaves the door open for irresponsible practice in the name of innovation (which could be detrimental to patients), and also fails to provide any mechanisms to promote good innovation for the benefit of patients. We note and respect the clear legal opinions of Sir Robert Francis QC as to why this Bill is unnecessary. The current law of negligence does not prevent responsible innovation and never has. The Medical Protection Society, which has extensive experience of issues of clinical negligence and advising doctors on ethical and medico-legal matters, has clearly stated it is not aware that a fear of clinical negligence claims is preventing doctors from being innovative. The Bill’s current provisions about the need for doctors to obtain the views of potentially just one ‘appropriately qualified’ doctor and ‘taking account’ of their views before undertaking innovation treatment are worryingly vague, and provide an insufficient safeguard for protecting patients against an unjustifiable risk of harm.

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London Evening Standard

  • London has three of 10 worst trusts for A&E delays.

    Three London hospital trusts were named today as among the worst 10 in the country for A& E delays, as figures showed the NHS under the heaviest winter pressure for a decade. A total of 436,229 people sought emergency help across the country in the week ending on Sunday — almost 30,000 more than the average for the same period last year. In west London, the trusts that run Northwick Park, Ealing and Charing Cross hospitals again fell far short of Government targets to see patients within four hours, adding further fuel to the row over the closure of two neighbouring casualty units in September. Severe delays were reported at the trust running Queen’s Hospital in Romford and King George in Ilford, where 76 per cent of patients attending the main A& E units were seen in time. The national target is 95 per cent. NHS England’s first “winter health check” of this year said more than 110,000 patients attending A& E were so ill they had to be admitted to hospital — about 5,000 more than a year ago. Nationally, 91.8 per cent of patients were seen in four hours, down three points on last year.

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Friday 12th December 2014

Open Democracy

  • Parliamentary watchdog: too often private sector contractors' ethical standards found wanting.

    A culture of revenue and profit-driven performance incentives has too often been misaligned with the needs of the public who fund and depend on these services. Margaret Hodge MP writes on the Public Accounts Committee's new report on the contracting out of public services. The private sector delivers around £90 billion worth of complex services on behalf of the public sector – half of public sector expenditure on goods and services. We all expect these companies being paid for services by the taxpayer to have the highest ethical standards in their work. However, too often the ethical standards of contractors have been found wanting. It seems that some suppliers have lost sight of the fact that they are delivering public services, and should do so in accordance with public service standards. The case of G4S and Serco overcharging the Ministry of Justice for years on electronic tagging contracts was the starkest illustration of both contractors’ failure to work in the public interest and government failure to safeguard taxpayers’ money. G4S apologised to us for getting it wrong and Serco said the affair was ‘unacceptable and unethical; frankly, we are deeply ashamed of it’. We have examined similar cases where there are allegations of the misuse of taxpayers’ money. Serco’s altering of performance data on its contract for out-of-hours GP services in Cornwall is an unacceptable example. Two other G4S contracts have been referred to the Serious Fraud Office to investigate, and another Serco contract has been referred to the City of London police. The legitimate pursuit of profit does not justify the illegitimate failure to conduct the business in an ethical manner. A culture of revenue and profit driven performance incentives has too often been misaligned with the needs of the public who fund and depend on these services.

    Read more ...

Hospital Doctor

  • Staff shortages affecting stroke services.

    Two reports published today from the Sentinel Stroke National Audit Programme (SSNAP) show that despite steady progress in the care of stroke patients in the UK, there are still major shortages of both nurses and doctors. This is worrying because research shows that death rates are lower when stroke wards have higher numbers of nurses, and death rates for acutely ill patients are lower when there are more doctors available at nights and at weekends. The organisational component of SSNAP measures the staffing levels, resources and facilities available in every hospital that cares for stroke patients acutely, and also published is the annual overview about the direct patient care element of SSNAP. This continuously measures the care provided to patients and has reported every three months since February 2014 on the RCP’s website. They are being published together to provide a full national and local picture of stroke care in the UK – The State of the Nation Report on Stroke services and care.

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  • Investigation reveals creeping NHS privatisation, A third of NHS contracts in England have been awarded to private sector providers since the service was reorganised in 2013, research suggests.

    Of 3,494 contracts awarded by 182 Clinical Commissioning Groups in England between April 2013 and August 2014, 33% went to the private sector. The information comes from Freedom of Information requests made by the BMJ, although it’s unclear how much the contracts were worth because CCGS wouldn’t disclose this information citing commercial sensitivities. The BMA said the figures show the extent of creeping privatisation in the NHS since the Health and Social Care Act was introduced. BMA council chair, Dr Mark Porter, said: “The government flatly denied the Act would lead to more privatisation, but it has done exactly that. “Enforcing competition in the NHS has not only led to services being fragmented, making the delivery of high-quality, joined-up care more difficult, but it has also diverted vital funding away from front-line services to costly, complicated tendering processes.” The BMJ investigation looked at different types of contract to provide NHS clinical services, including those awarded to a single provider without an open tender, those awarded via a competitive tendering process, and those awarded to multiple providers under Any Qualified Provider. Private sector providers were most successful at winning contracts awarded via competitive tender - 80 compared with 59 won by NHS providers. Private firms were also more likely to win smaller contracts on an Any Qualified Provider basis, for services such as diagnostics, audiology, and podiatry in the community. Porter added: “What’s worse is that there isn’t even a level playing field as private firms often have an unfair advantage over smaller, less well-resourced competitors, especially those from the NHS and social enterprises.

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Daily Post

  • Health campaigners put up signs calling for residents to oppose US firms in the NHS.

    Campaigners have slammed a proposed trade deal amid fears parts of the NHS could be “sold off” to US firms. A campaign group called the “People’s NHS Wales” distributed signs around Llandudno and called on Prime Minister David Cameron to use his European Union veto to block the deal. The group are opposed to the Transatlantic Trade and Investment Partnership (TTIP), a proposed trade deal between the EU and US which could allow US companies into public services such as the NHS. But Guto Bebb MP, whose Aberconwy constituency covers Llandudno, claimed that the deal would be “positive” for the NHS and urged Peoples NHS Wales to devote their energies to helping cancer patients in Wales instead. The campaigners who are trying to raise awareness of the proposed NHS “sell off” yesterday put up “Cameron estate agent” signs at homes in Norman Road, Ffordd Morfa and Cwm Place. They urged Llandudno householders to demand that Mr Cameron uses his European Union veto “to stop irreversible privatisation of NHS to US” in the TTIP. Sarah Murphy, of People’s NHS Wales, called for Llandudno residents to take a “collective stand against the irreversible the sell-off of their health services to America by raising ‘Cameron take our NHS Wales out of TTIP Estate Agency’ boards with the clear message to veto the NHS from the EU US trade deal called TTIP”. People’s NHS Wales say they have carried out similar campaigns throughout England, Scotland and Wales against the “behind closed door negotiations”.

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Brent and Kilburn Times

  • Top barrister to investigate impact of A&E closures on Brent residents.

    A top barrister has been brought in to investigate the surge in A& E waiting times following the closure of casualty units at Central Middlesex and Hammersmith hospitals. Michael Mansfield QC will head the probe which has been launched following the release of shocking statistics which showed patients waiting to be seen at casualty units at Northwick Park and Ealing faced the second longest waits in the country in October. Both hospitals are run by the London North West Healthcare NHS Trust (LNWH). The investigation has been commissioned by Cllr Muhammed Butt, leader of Brent Council, and his counterparts in Hammersmith & Fulham, Ealing, and Hounslow in response to concerns over hospital services in their respective boroughs. According to NHS figures just 67.8 per cent of A& E patients at both hospitals were being seen within four hours despite a government target of 95 per cent. Mr Mansfield, who represented the family of murder victim Stephen Lawrence, will look in depth at the impact the A& E closures have had on services and the implication further proposals including the closure of the maternity unit in Ealing Hospital will have on residents. The closures were a result of the controversial Shaping A Healthier Future programme rolled out across North west and West London by the NHS.

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Halifax Courier

  • Hospital Trust to slash jobs.

    Calderdale and Huddersfield NHS Trust has asked its staff to take voluntary redundancy as it struggles to find savings resulting from Government cuts. Trade union Unison - which represents many working within the NHS - has estimated that up to 400 jobs could be slashed from the current 6,000 staff. The Trust’s financial position is so serious that its Chief Executive Owen Williams recently admitted that it had been referred to its regulator Monitor as it was unable to find the required savings. Julie Hull, Executive Director of Workforce and Organisational Development at the Trust, said: “The Trust currently faces a number of significant challenges – service, structural and financial - which all impact on our workforce in terms of the way we work. “The Trust has launched a voluntary redundancy scheme to assist in responding to these challenges and the environment in which we operate.” Only staff who have worked for the Trust for at least two years on a continuous basis will be eligible for the voluntary redundancy scheme.

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The New Statesman

  • Since the government's reforms, a third of NHS contracts have gone to the private sector.

    In terrible news for David Cameron, and a gift to Labour, a third of NHS contracts awarded since the government's health reforms have gone to the private sector. The British Medical Journal analysed nearly 3,500 contracts awarded between April 2013 and August 2014, since the government's Health and Social Care Act kicked in last year, and found that 33 per cent of contracts had been handed to private sector providers. These contracts are awarded by the controversial Clinical Commissioning Groups established by the new health reforms, led by GPs, which have the power to influence commissioning decisions for patients and organise the delivery of services. Dr Mark Porter of the BMJ called the findings a demonstration of "creeping privatisation in the NHS since the Health and Social Care Act was introduced", and criticised the government, which he claims "flatly denied" that the reforms would amount to increasing privatisation.

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Thursday 11th December 2014

Independent

  • Management consultants are ‘making a killing’ from shake-up of NHS.

    Management consultants hired by the NHS are behaving like “racketeers” and “arms dealers” in times of war – making vast “spoils” from the Government’s reorganisation of the health service, a senior NHS adviser warns. Professor David Oliver found annual NHS spending on consultants had doubled from £313m in 2010 to £640m in 2014 – enough to run three medium-sized hospitals. This is despite a pledge by the former Health Secretary Andrew Lansley to “slash” consultancy spending at the last general election. Writing in the British Medical Journal Professor Oliver, who until last year was the Department of Health’s national clinical director for older people’s services, said such spending was wasteful and unnecessary. He called for NHS executives to be forced to justify all consultancy spending and explain why – given the number of “well-paid and experienced clinical and organisational leaders” such management skills did not exist “in-house”. “If these well-paid individuals lack the skills to solve most local problems in-house, or by learning from other NHS colleagues, perhaps they shouldn’t be leading at all,” he writes. Professor Oliver, president-elect of the British Geriatrics Society and a hospital doctor for 26 years, said he had “lost count” of the number of reports he had seen by management consultants in the NHS suggesting money can be saved and demand reduced “based on no credible peer-reviewed evidence”. He added: “Consultants often sell back the solutions offered to them by the staff they speak to. Or, in glossy reports, they tell service leaders what they want to hear when they haven’t the courage to take ownership of their own decisions. In times of war arms, dealers and racketeers profit from chaos. ‘Disruptive innovation’ has led to similar spoils for management consultants, with taxpayers’ money diverted from already struggling health and care services.” “Consultants have told me that their advice is not valued unless they charge at these rates,” he said. “Several times I have been offered obscene amounts to advise the NHS – when I say that I would do so for free, the offers go quiet.”

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BBC News

  • A third of NHS contracts awarded to private firms - report.

    A third of NHS contracts in England have been awarded to private sector providers since the service was reorganised in 2013, figures suggest. The information comes from a Freedom of Information request made by the British Medical Journal. Of 3,494 contracts awarded by 182 Clinical Commissioning Groups in England between April 2013 and August 2014, 33% went to the private sector. The government says the data is misleading. It's unclear how much the contracts were worth because the CCGS would not disclose this information citing commercial sensitivities. Private sector providers were most successful at winning contracts awarded via competitive tender - 80 compared with 59 won by NHS providers. Private firms were also more likely to win smaller contracts on an Any Qualified Provider basis, for services such as diagnostics, audiology, and podiatry in the community. Critics say the results are evidence of privatisation of the NHS. The government denies this. Dr Jacky Davis of Keep our NHS Public said doctors were being forced to tender out all work, and big corporations were best placed to win these contracts. Dr Mark Porter of the British Medical Association said: "These figures show the extent of creeping privatisation in the NHS since the Health and Social Care Act was introduced. The government flatly denied the Act would lead to more privatisation, but it has done exactly that. Enforcing competition in the NHS has not only led to services being fragmented, making the delivery of high-quality, joined-up care more difficult, but it has also diverted vital funding away from frontline services to costly, complicated tendering processes."

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  • NHS in 'dire straits' without migrants says top economist.

    The NHS would be "in dire straits" without migrant workers, one of the UK's senior economists has claimed. Stephen Nickell, who is on the board of the Office for Budget Responsibility, suggested 35% of "health professionals" came from outside the UK. Latest estimates suggest that more than a quarter of all UK consultants are not British nationals but the figure for total health staff is lower.

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Tuesday 9th December 2014

The Journal

  • George Osborne's cuts will damage public services warns Lib Dem peer.

    The Chancellor’s plans for massive cuts in public spending will cause “major difficulties” in a range of public services and could hit the NHS, a North East peer has warned. Businessman Lord Wrigglesworth, former Member of Parliament for Stockton South, said he believed voters had not yet grasped the scale of the cuts the Government was planning. Despite being a Liberal Democrat peer he expressed concern about cuts implied by the last week’s Autumn Statement, which included plans to eliminate the Budget deficit by 2018-19 and was signed off by both Coalition parties. And Lord Wrigglesworth warned that it may simply be impossible to reduce spending to this extent while still ring-fencing the NHS. So far, the Government has avoided cutting funding for the NHS and kept funding for schools roughly steady, but this has meant that cuts have fallen even more heavily on other services such as policing or local councils. Speaking in the House of Lords, the peer warned: “The forecast cuts in expenditure that have to come in the next Parliament are enormous, and I am not sure that people outside this House, or even in the House, have fully understood the scale of the proposed cuts, which we need to think about very hard. Inevitably it raises a question about the ring-fencing of all departments, particularly the National Health Service, if the cuts are to be sustained.” Analysis by official spending watchdog the Office of Budget Responsibility (OBR), published alongside the Autumn Statement, warned that the cuts required for Chancellor George Osborne to meet his targets would be higher than the cuts already introduced.

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The Argus

  • Campaigners calling for new GP surgery stage protest.

    Campaigners calling for a new GP surgery have staged a protest ahead of a meeting being held this afternoon. The Replace Eaton Place campaign is calling on health bosses to establish a new GP practice in east Brighton. The two doctors running Eaton Place Surgery in Brighton are due to retire and the practice will close at the end of February. It means the more than 5,000 patients on the surgery's books have to find alternative GPs in the area. Protestors say patients are already struggling to find a practice to accept them and some surgeries are awkward to get to.

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Friday 5th December 2014

Morning Star

  • Shady trade deal faces legal challanges.

    180,000 sign petitions against TTIP and CETA deals. Brussels bureaucrats face a legal challenge to two hugely unpopular free trade deals after campaigners went to court yesterday. More than a million people across Europe - including over 180,000 Brits - have signed a petition against the secretive Transatlantic Trade and Investment Partnership (TTIP) between the EU and US and the Comprehensive Economic and Trade Agreement (CETA) that links Europe and Canada. EU regulations say officials are required to review proposals and put them up for debate in the European Parliament. The news comes after a new YouGov poll commissioned by petitions website 38 Degrees revealed only 13 per cent of the British public supported the deals. The TTIP blueprints will give transnationals the right to sue European governments in pursuit of profits from public services. Labour has called for the NHS to be exempted from TTIP. So far, the European Commission has refused to review the proposals - but a European Court of Justice hearing may force its hand. World Development Movement director Nick Dearden said: "The European Commission is desperately fighting to prevent a critical debate from taking place about these trade deals with North America." And War on Want head John Hilary said: "Not only is TTIP predicted to cost at least one million jobs between the EU and USA, but it will also make it impossible for any future government to repeal the Health and Social Care Act and bring the NHS back into public hands.

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Open Democracy

  • Devon - the canary in the NHS coalmine?

    This week Devon has announced that smokers and obese people will be denied all routine operations, and deaf people get only one hearing aid. The end of the NHS is swimming into focus - unless we swim hard against the current. “We constantly strive to improve services all in the best interests of the patient... I sense a real optimism here in Devon because clinicians are inherently close to their patients… The patient must always come first…” So said the Chair of the new North East & West Devon Clinical Commissioning Group (CCG) Dr Tim Burke earlier this year, introducing the system the 2012 Health Act set up. So what does this optimistic vision look like on the ground ? Dr Burke’s CCG has just announced that obese people and smokers in Devon will be denied ALL routine surgery. The Royal College of Surgeons slammed the move as "unacceptable". Shoulder surgery will also be restricted for everyone in Devon (obese or not), as part of a package of cost cutting measures, with further cuts to be announced shortly. And deaf people will now only get a hearing aid for one ear, not two. Justifying the decision Dr Burke told us that “second hearing aids show far lesser cost effectiveness than the first”. And that “the CCG has a legal duty to live within its financial resources and the prioritisation of services is helping us to do that.” Chris Ham, head of the Kings Fund ‘think tank’, this week extolled again the virtues of ‘bilingual’ ‘clinical leaders’. Others might look at the gap between rhetoric and reality in Devon, and consider 'bilingual' a kindly euphemistic term for its 'clinical leaders'.

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Pulse

  • Cutbacks in social, financial and legal advice is making our patients ill, GPs warn.

    GPs are seeing a rising number of patients with concerns about benefits, debt and housing problems, a legal charity has warned. Out of over 1,000 GPs surveyed by the Legal Action Goup, two thirds said that in the last year the number of patients whose health would have benefitted from legal, financial or other specialist advice on social issues has increased. Over half of GPs also reported that patients were increasingly discussing housing difficulties during consultations, with the Legal Action Group pointing to Government cuts to social and welfare legal advisory services as a possible reason behind the rise. According to the charity, which promotes access to justice for disadvantaged people, almost half of GPs said that unless patients get access to this type of advice they will experience negative effects on their health such as stress, anxiety or hospitalisation ‘to a great extent’. In a report on the findings, the charity said: ‘We initiated the research because we had some limited anecdotal evidence that GPs had noticed an increase in patients who might benefit from legal or specialist advice on social and welfare law problems. We had no idea before obtaining the results just how extensively this opinion was held. GPs also clearly believe that not obtaining advice on social welfare law problems can have a negative effect on a person’s health, with 48% believing this is true to a great extent.’ It comes as GPs working in deprived areas have warned that they are especially badly affected by ongoing cuts to MPIG funding putting patients at risk of also losing healthcare access.

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HSJ

  • FTs' £92m spend on exit packages.

    Almost one tenth of foundation trusts’ entire £92.4m spend on severance packages last year was paid by a single provider, HSJ analysis reveals. Norfolk and Suffolk Foundation Trust paid out £8.8m in redundancy payments and other exit packages in 2013-14 - eight times its previous year’s severance bill but only slightly more than the £8.2m it paid out in 2011-12. Its severance bill last year included a £307,500 payoff to a director who had been made redundant - the highest payment to an individual in the country last year and one of three payments made by the trust that exceeded £200,000. The trust, which has an annual turnover of £216m, last year paid off 213 staff, 84 of whom had been made compulsorily redundant. The analysis also showed that Norfolk and Suffolk was responsible for more than 80 per cent of “non-contractual payments” that exceeded the employee’s annual salary in England. Under Monitor rules such payments must be declared in foundation trusts’ accounts. Of 106 payments made by all foundation trusts, Norfolk and Suffolk accounted for 88 – £5.6m of the £7m total. The trust’s finance director, Andrew Hopkins, said its large severance bills in 2011-12 and 2013-14 were the result of a merger and subsequent “major service redesign” that aimed to cut costs by 20 per cent. The trust was created from the merger of two mental health service providers in January 2012.

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Thursday 4th December 2014

BBC News

  • Ashcroft Centre anti-closure petition signed by thousands.

    More than 2,300 people have signed a petition calling for a women's mental health unit to be saved from closure. The Ashcroft Centre in Wicklewood, near Wymondham, Norfolk, could shut in March as the county council is not renewing its contract for beds. Harold Bodmer, from the council, said it would meet representatives from Julian Support, which runs the centre, later this week to "continue the discussion". Pip Coker, of Julian Support, said she hoped the centre could be saved. The online petition was launched two days ago after the county council said it would not renew its block contract for seven beds at the Ashcroft Centre, meaning the whole 14-bed centre could have to close. Beds are also kept for Norfolk and Suffolk NHS Foundation Trust patients. The county council would not accept a weekly rate of £650 per person and said it would only pay £593. Ashcroft Centre trustees said staff numbers would have to be cut to unsafe levels.

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Plymouth Herald

  • 750 mentally ill people, including 28 children, held by police in Devon and Cornwall in a year.

    750 mentally ill people, including 28 children, have been detained in police custody because of a shortage of hospital beds in Devon and Cornwall in the last 12 months. Figures from Devon and Cornwall Police reveal that in the 12 month period between October 2013 and September 2014, 28 children were arrested under the Mental Health Act in Devon. In the same period the year before, there were 31 children detained. The issue was propelled into the spotlight when Devon and Cornwall’s Assistant Chief Constable Paul Netherton raised the alarm on Twitter that a 16-year-old girl had to be detained in police custody for three nights because there were no free hospital beds in the country for her. Inspector Paul Morgan who works in the Local Policing and Partnership Dept at police headquarters, branded it one of the “biggest issues” facing Devon and Cornwall Police. Mental health services for those aged 17 and under are provided by Child and Adolescent Mental Health Services (CAMHS). Virgin Care is responsible for Devon Integrated Children’s Service, which has been responsible for providing CAMHS since April 2013. But although CAMHS is responsible for the first three levels of a care, mild – severe, it is not responsible for tier four, emergency cases. While CAMHS professionals respond to emergencies, NHS England is responsible for finding beds for the patient. The Northern, Eastern and Western Devon Clinical Commissioning Group commissions Virgin Care for tier three, but was unable to confirm how much of its budget it provides to CAMHS. Insp Morgan explained that the issue of police officers having to provide the front line response to mentally ill people, has been prevalent for decades but has been exacerbated by the lack of NHS funding allocated to providing alternative places of safety. Dr Peter Carter, chief executive and general secretary of the Royal College of Nursing, denounced the situation of mentally ill people being detained in custody due to a lack of beds as “appalling”. He said that despite a 30% rise in demand for beds, there has been a drop of more than 3,300 mental health nursing posts and a loss of 1,500 available beds.

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Tuesday 2nd December 2014

New Statesman

  • Labour accuses George Osborne of 'spin' over NHS spending.

    "I'm afraid there is no money" seems to be the unofficial tagline for George Osborne's Autumn Statement this year, echoing former Chief Secretary to the Treasury Liam Byrne's parting billet-doux to his successor in 2010. This is because the Chancellor doesn't seem to be planning to spend any new money on the funding announcements he will make tomorrow. Nowhere is this starker than on the NHS. He will give the health service a £2bn annual funding boost, but it has emerged that £750m of this spending is being reallocated from within the Department of Health itself. The rest of the money will come from the Treasury (£1.3bn), efficiency savings, and under-spending in other Whitehall departments. This shifting around and scraping of funds for the NHS makes the Tories vulnerable to Labour's strength on the subject. Labour is consistently trusted more than their opponents on the NHS, and it seems the party's consequential plan to make NHS the key battleground of the imminent general election is gaining some ground, much to the Tories' disadvantage. The party has been able to accuse Osborne of "spin", and the shadow health secretary Andy Burnham has said his plan was based on "proposing to recycle funds". Although the extra money has been welcomed by leading health figures, such as NHS England's chief executive Simon Stevens, the Labour party still seems to dominate the political narrative on the subject.

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Open Democracy

  • Privatisation: the gap between politicians and the rest of us.

    New analysis from We Own It shows just how big the gap has become between what the British public want for their public services and what Westminster wants. From Royal Mail to the NHS, privatisation of our public services is continuing apace. An outside observer might look upon these cynical sell offs and conclude that such a policy commands popular support. However, our new analysis has shown just how out of step Westminster politicians are with public opinion when it comes to who should be running our public services. This privatisation scorecard compares public opinion with party policy on a number of key indicators, including a commitment to a publicly-run and owned NHS, public ownership of our railways, and proper accountability for private companies that win public service contracts. The major parties are consistently found wanting. A huge gap has opened up between what the electorate wants—public services run for people, not profit—and what politicians are willing to offer. Privatisation has become the lazy default rather than a conscious choice, and represents the opposite of evidence-based policy making.

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Friday 28th November 2014

HSJ

  • CCGs poised to defy pharma by switching to cheaper, unlicensed drug.

    Clinical commissioning groups across England are mulling the use of an unlicensed drug which could save the NHS millions of pounds, HSJ has learned. Vale of York and Northern, Eastern and Western Devon CCGs are hoping to switch from Lucentis to Avastin for the treatment of age related macular degeneration, as are a number of other CCGs across the North East. While both drugs are closely related, Avastin is listed at a 10th of the price of Lucentis. The cheaper drug is licensed by the Medicines and Healthcare Products Regulatory Agency for the treatment of five cancers in their advanced stages, including breast and lung cancer but is not licensed for use in the eye. Controversy over its use to treat age related macular degeneration has raged for years. In 2012, Novartis which markets the drug in the UK, launched a judicial review of a primary care trust cluster’s plans to mandate its use. CCGs have revisited the issue after a Cochrane review concluded that use of the cheaper drug was safe. Vale of York chief clinical officer Mark Hayes told HSJ the main barrier to the routine use of Avastin in the UK was the General Medical Council’s code.

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The Guardian

  • More patients, fewer doctors – is the NHS facing a winter crisis?

    At Bradford Royal Infirmary’s A& E department, their usual 350 to 370 patients make a busy day. Several times this month, however, more than 400 patients have turned up in 24 hours, placing even greater strain on the hospital’s staff, beds and ability to cope. Last Saturday, they saw 414. That, staff say, is when busy becomes super-busy. But the way the numbers are creeping up, with more than 400 patients becoming a more frequent occurrence, super-busy could easily become their new norm, especially with winter just around the corner. This rising demand is not unique to Bradford, says Helen Barker, the hospital’s chief operating officer. “Everybody’s finding it really difficult to deliver on the 95% target [the NHS-wide duty to treat 95% of A& E patients within four hours of their arrival]. “We are all seeing continued high attendances and a significantly high level of admissions too.” Those extra 50 or so patients make it very hard to ensure there are enough beds available for all who need them. Usually the difficulties between November and March are followed by an easier spring and summer. But not any more. “We’ve not seen any reduction in patients arriving at A& E all year, really, so winter just feels like a 12-month phenomenon. We’ve not seen any let-up this year at all,” Barker adds. The numbers arriving at the hospital went up last winter from over 300 to more like 350 a day, and stayed up. Why is this happening ? She refers to “the acuity of patients” – medico-speak for how ill people are. Put simply, more patients are more unwell than before. “There’s an ever-growing demand from elderly patients. But we also have a lot of patients aged 35 to 60 who have breathing conditions, chest pains, heart problems, illnesses linked to their diet, such as obesity, which is causing diabetes, which leads to vascular disease, and includes those whose illness has been triggered by drinking too much, such as liver disease or malnutrition,” she adds. Bradford is managing this better than most. Major efforts to hire extra staff and use of “virtual wards”, in which patients deemed well enough remain at home are cared for by visits from health professionals rather than in hospital all the time, mean the NHS trust is coping – at the moment – with the increased pressures.

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Open Democracy

  • Lord Hunt’s selective quotations from the 1946 Act which founded the NHS, and from the Efford Bill currently before Parliament, do not hit their target.

    The actual text of Clause 1 of the Efford Bill that Lord Hunt quotes simply copies and pastes from the 2012 Act. It’s not restoring any duty. The Bill puts the Secretary of State back in charge but does not re-establish a duty to provide the listed health services. I see that the House of Commons library has just amended its briefing in this regard. Why does Lord Hunt not mention the all-important Clause 3 of the Bill and section 3 of the NHS Act 2006 ? Presumably, because he would then have to admit that the Bill’s Clause 3 would transform the 2006 duty to provide listed health services throughout England into a new duty to commission them, and with no geographical stipulation. There is also a slight concern is around the Bill’s approach to the notorious Section 75 regulations which do much to force competition onto local health bodies. The Bill repeals sections 72-80 of the 2012 Health and Social Care Act - some of the key legislation around the regulation of competition to provide NHS services. This is to be welcomed as a step in the right direction of reducing tendering procedures. But for the record, the Bill doesn’t actually “repeal… the Section 75 Regulations” – i.e., The National Health Service (Procurement, Patient Choice and Competition) (No. 2) Regulations 2013. It repeals rather the power to make more such regulations in the future. Presumably it is intended that they should be revoked, but this must be clarified. More worrying, there are concerns about what the Efford Bill would do regarding the EU/ US trade deal, which many including the BMA have identified as threatening the NHS. Lord Hunt says that “TTIP will not be ratified if it: ‘…shall cause any legally enforceable procurement or competition obligations to be imposed on any NHS body …. in any part of the health service.’” But the Bill doesn’t actually say that.

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Hospital Doctor

  • BMA says funding crisis will engulf NHS.

    Demand on services is now far outstripping supply, particularly in emergency medicine and general practice, leading to delays in accessing care, waiting time targets being missed and the unacceptable rationing of care. These are the views of Dr Mark Porter, chair of BMA Council, which he shared with the NHS Select Committee on funding for health care. Porter warned MPs that the health service is under unprecedented pressure, with many parts of the NHS now close to breaking point. He highlighted the need for a long-term, sustainable funding plan for the NHS and called for an end to the continued erosion of front-line staff pay which has made up billions of so-called ‘efficiency savings’ and means that pay is back at 2008 levels. Commenting on the state of NHS finances, Dr Mark Porter, Chair of BMA Council said: “The NHS is going through its tightest funding squeeze in half a century. While investment has stalled, demand on services is rising and a massive funding gap is opening up. “The NHS has reached a crossroads – it is a reflection on just how hard front-line staff are working that the quality of patient care has so far been protected, and indeed improved, despite years of underinvestment, but pressure on services is now at a critical point and cracks are beginning to appear. “For patients this means unacceptable waits for treatment, the worrying rationing of care and longer queues in our GP surgeries and emergency departments. According to recent figures, there were more emergency admissions to English hospitals in the second week of November 2014 than in any week in NHS history. Porter warned that integrating care will only achieve so much. “While greater integration of care, investment in preventative care and reforming the financially crippling PFI system are needed to deliver savings in the longer term, we cannot escape the fact the NHS is – at this moment – in dire financial straits. With the election looming there needs to be an urgent and honest public debate about what the NHS can afford to deliver with current levels of investment,” he said.

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The Guardian

  • Spending breakdown reveals how NHS England cash flowed to private firms.

    Tech firms, management consultants and private healthcare companies have received millions of pounds in payments from public funds in the first full financial year of the coalition’s new-look NHS, an analysis by the Guardian can reveal. Last week NHS England, the body which assigns £96bn to fund the health service, produced its first detailed report on all spending over £25,000 in the 12 months up to April 2014. Unlike other government departments, the health service has never published comprehensive accounts, and NHS England only acted after campaigners received 76,000 signatures over 48 hours in a petition organised by online activists 38 Degrees and transparency lobbyists Spinwatch. The dataset, which has more than 140,000 entries, illustrates how big business has become enmeshed in the NHS and how hundreds of millions of pounds were required to set up and run the new structures in the health service. The figures show that to “establish” NHS England cost £135m, with computer maker Dell receiving £3.6m and telephone provider Vodafone collecting £13.5m in a year. To run NHS England, which is headquartered in Leeds, for one year costs £350m. Firms with ties to the Tories did well. Care UK, one of the country’s biggest private health firms, received £112m from the NHS in a single year, 90% of which was for the provision of healthcare. The wife of the company’s former chairman John Nash made a personal donation of £21,000 to Andrew Lansley, the architect of the coalition’s NHS policy, to fund his office while in opposition.

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The Independent

  • The annual NHS bed crisis occurs with tedious predictability.

    Yet winter has a strange habit of arriving at around the same time every year. It's not difficult to predict – you just need a calendar. So I struggle to understand why it comes as such a surprise to those in charge of the NHS. The lack of planning and preparation for the inevitable winter stampede to Accident and Emergency departments is lamentable. And this year's crisis has started even before the really bad weather has set in, according to figures released last week. These show that the number of people who have had to endure trolley waits has more than doubled compared with this time last year. What's to be done ? The current political rhetoric is to blame GPs. They are to blame because people who find it difficult to get appointments go to A& E instead. This is a shameful game of scapegoating. The situation is far more complex. If anything, GPs should be applauded because they are seeing many more people each year, despite diminishing resources. Recent figures show that on average each GP in the country is providing an additional 1,450 consultations per year compared with five years ago. That's a productivity increase of about 10 per cent – pretty impressive, especially when you consider that nearly 11 per cent of the NHS budget was spent on GP services in 2005–06 and only 8.5 per cent by 2011–12. That's a cumulative loss of about £9 billion in real terms. Access to GPs is still unacceptably patchy but GPs are working flat out. There are problems but it's not solely the fault of GPs. No, the spiralling crisis in winter A& E departments is partly to do with cuts to emergency services, partly to do with poor out–of–hours access to GPs, and partly to do with increasing population and changes in demographics. Added to this are changes in immigration policy, which has made it harder for doctors from outside the EU – such as India – to come to work here. These doctors would often take the less attractive jobs, in inner–city surgeries and smaller hospitals for example, meaning that there are now serious shortages in some regions and some specialities.

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Thursday 27th November 2014

Western Morning News

  • In my opinion: The NHS has been a political football for too long.

    David Halpin writes: As someone who worked as a surgeon in our NHS for 40 years, I need to say again that the service is in peril. There must be no complacency. The NHS has been a political football for too long. Each administration, of whatever colour, has brought its own dogma to bear. Upheaval follows, and with each there is an increase in bureaucracy with a parallel increase in non-essential costs. There is an inverse effect on morale. I have said that the Health and Social Care Bill of April 1 2012 has been the biggest upheaval, and on the Richter Scale number 10. Readers need to be reminded that Mr Cameron promised, before the 2010 election, that there would be “no top down re-organisation”. We have it in spades. The cost was said by him to be £3bn but there is no way of measuring that. The real cost might be treble that. Some facts lie beneath my great concern. About 20% of general practitioner posts go vacant in the South West. Years before, there would be dozens of young doctors applying for any post down here. Good general practice is the bedrock of first class and economical medical services. A poll of 10,000 nurses one year ago, recorded that 67% would leave the profession if they could. England is short of several thousand midwives, and the same goes for district nurses. Nurses often serve patients beyond their set hours because the wards are short staffed. Their health and their morale is put at risk further by pay freezes and declining real earnings. What should the public be doing ? The first duty is not to lie down under this. It is our NHS which is priceless both in concept and reality. The second is to find out what is going on. Bodies like PPGs, Healthwatch etc have been set up under the Act but in my opinion they only give an illusion of involvement and empowerment. There is a new lexicon of vacuous phrases. The NEW CCG (you know what that is ?) – “Healthy People leading Healthy Lives in Healthy Communities”! At present these various bodies ‘interact’ with only a small minority of people and those are self selected. The third duty is to stand up with many others for our NHS. It is only by massive public involvement will common sense and economy be returned to the service.

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Open Democracy

  • Markets are the wrong medicine for our health services.

    The overwhelming weight of evidence suggests market-based reforms are bad for healthcare, finds the latest report by the New Economics Foundation. Government reforms of England's National Health Service (NHS) over the last three decades have transformed a democratically controlled public service into an open, competitive market. Despite political leaders regularly claiming to base their decisions on evidence, our new report finds no sound evidence to support these changes. England's 2012 Health and Social Care Act is the latest and most extreme move towards markets in healthcare. Large profit-seeking organisations, many of them based in the United States, are now winning more and more NHS business. A new trade agreement between the European Union and the United States (TTIP), due for completion next year, threatens to lock in private sector control of the NHS by inflicting heavy financial penalties on a future government trying to return health services to public ownership. The momentum towards an open competitive market has been widely opposed by professional bodies, including the Royal College of General Practitioners, the Royal College of Paediatrics and Child Health, and the Royal College of Physicians. Lord Owen has warned that the Health and Social Care Act could “create a fully marketised national health service”. Even senior Tories have called the Act the Coalition government’s biggest mistake. The costs of maintaining market mechanisms in the NHS have been conservatively estimated at £4.5 billion a year – enough to pay for either ten specialist hospitals, 174,798 extra nurses, 42,413 extra GPs, or 39,473,684 extra patient visits to A& E. Not many people know this. Two in three people polled by Ipsos MORI said they knew little about changes being made to the NHS. Neither the Conservatives nor the Liberal Democrats promised voters the Health and Social Care Act in their 2010 election manifestos. Most remarkably, the overwhelming weight of evidence suggests that markets are bad for healthcare. There is certainly no compelling evidence that market mechanisms or private ownership are more efficient or more likely to improve care for patients than a publicly owned, controlled and funded system. The prevailing narrative is that health services are not working under state control: strong medicine is needed to save the NHS and that means more markets and more private sector providers. And the more it falls prey to financial pressures, the more easily the NHS can be described as a failing public institution – a problem begging for market solutions. Noam Chomsky (among others) has noted that this is a standard technique of politicians bent on privatisation: “defund, make sure things don’t work, people get angry, you hand it over to private capital”. What are the alternatives ? Following the evidence, it appears that health services for all, according to need, not ability to pay, are best provided through collaborative, public provision where (to quote Gordon Brown in 2005) “dedicated public servants put duty, obligation and service before profit and personal reward”. Brown ignored his own sensible advice. Indeed, no prime minister in the last three decades has resisted the trend towards markets in healthcare; most have encouraged it. In the absence of supporting evidence, we can only conclude that today’s NHS reforms are driven by ideology: a set of ideas that shape policy and – in this case – favour competitive markets with multiple, profit-seeking providers, over public institutions that aim to serve the public interest.

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Tuesday 25th November 2014

Financial Times

  • NHS trust financing woes expected to boost private sector openings.

    Healthcare providers expect a significant increase in opportunities for the private sector as more NHS trusts fall into financial difficulty in the coming year.
    In a survey of more than 100 influential industry figures – including chief executives, investors and advisers – nearly 70 per cent said financial pressures on the health service will lead to a range of new business openings, while the vast majority also predicted an increasing number of NHS trusts will suffer economic hardship in the next 12 months. Independent providers say they have received a significant increase in business since the coalition government came to power in 2010, and now earn more than a quarter of their income from the NHS. But they say the pace of privatisation has proved disappointing compared with their initial expectations. The Healthcare Industry Barometer 2014, an annual study by HealthInvestor magazine and the law firm Nabarro, shows how the UK private health market is rebounding after being hit hard by the financial downturn in 2008. Despite this, not all ventures have proved profitable. The outsourcer Serco has faced losses on a series of contracts including a deal to provide community healthcare in Suffolk. Mitie, the FTSE 250 outsourcer, admitted last week that its new homecare business, which provides support for the ill, disabled and the elderly, was less profitable than expected and that it was struggling to recruit and retain sufficient numbers of care workers. The findings echoed research by the NHS Support Federation, an independent campaign group, which showed private health firms are on course to win more than £9bn of NHS contracts as a result of the coalition’s ramping up of competition in the health service. It found companies such as Care UK, Bupa and Virgin 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.

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The Cornishman

  • No replacement for Poltair beds six months after closure.

    Six months after the decision was taken to permanently close Poltair Hospital, it has been announced that its ten beds will not be provided elsewhere. The decision, publicised at the "Poltair Next Steps" stakeholder event last week, has been branded "a monumental error of judgement" by the former vice-chairman of the Royal Cornwall Hospitals Trust (RCHT). And campaign group West Cornwall HealthWatch says the "service is almost at breaking point, with no sign of an early improvement". But Peter Stokes, programme director for NHS Kernow, and St Ives' family doctor Dan Rainbow, who was involved with the Poltair consultation, say that the vision of an integrated health and social care service is beginning to take shape and that the loss of the Poltair beds has not had a negative impact.

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Daily Mirror

  • NHS strike: that 1% "pay rise" for nurses is actually a cut.

    They do life-saving work every hour of the day, but today doctors, nurses and other NHS workers have stopped because they say they're not paid enough. NHS workers are on a four hour strike to protest against the Treasury's decision not to give a 1% rise to all staff as recommended by a pay review body. A 1% pay rise doesn't seem like much - but half of NHS workers won't even get that. Earlier in the year the Treasury announced that public sector workers would get a 1% pay rise. But NHS staff who are set to get a progression pay increase - linked to seniority - will not benefit from the pay rise. This is around 600,000 people (over 50%) of NHS staff. The remaining will "benefit" from a 1% pay rise. And for those who do: a 1% pay rise is effectively a pay cut when you consider inflation.

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BBC News

  • NHS staff stage four-hour strike.

    NHS workers, including nurses, midwives and ambulance staff, have staged a four-hour strike in England as part of a pay dispute. They were protesting about the decision not to implement a 1% rise for all staff recommended by a pay review body. Members of nine unions walked out at 07:00 GMT in England and at 08:00 GMT in Northern Ireland. A Department of Health spokesman said it could not afford the rise without risking frontline jobs.

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Monday 24th November 2014

Hospital Doctor

  • Invest to transform the NHS into 21st century sustainable service.

    The next government has to invest to transform the NHS into a sustainable 21st century service. That’s the message from the Foundation Trust Network in launching its ‘Programme for the next Parliament’. It sets out what is needed from government, regulators, providers, commissioners and politicians to free and support the NHS to make the changes needed to continue providing excellent patient care. It also calls on the government to support an empowered and affordable NHS workforce with the right skills and in the right numbers. It must ensure improvement is owned and led by providers underpinned by regulatory assurance that the system is working in the best interests of patients and service users. And autonomous and accountable NHS providers must be enabled to drive new models of care in partnership with their local health and care systems. Five priorities are identified within each theme including multiyear funding and planning; staffing decisions to be based on local clinical judgements not blunt national targets; regulators being held to account for providing value for money; and higher standards being set for local and national commissioners. Chris Hopson, chief executive of the Foundation Trust Network, said: “At the recent party conferences and in the NHS Five Year Forward View, there was cross-party recognition that the combination of underfunding and rapidly rising demand makes it impossible for the NHS to sustain and improve the quality of care within its existing model. “We must transform how we deliver care but are running out of time to make these essential changes. This programme for the next Parliament gives our politicians and the NHS system leadership complete clarity on what’s required from day one after the election to enable the NHS to transform to meet 21st century patient needs.

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The Huffington Post

  • We Need a More Courageous, Robust Response If We're to Save Our NHS.

    Figures released this week show private health firms are on course to win more than £9billion of NHS contracts. This Friday, I'll vote for a Bill which seeks to challenge the stranglehold of privatisation on our NHS. That Bill - the National Health Service (Amended Duties and Powers) Bill, from Labour MP, Clive Efford - is a step in the right direction, and is welcome as such. The situation is grave and the Efford Bill gets the ball rolling. It stops short of what it needs to be (more of which soon) but it does step up the debate about the privatisation of our NHS. And not a moment too soon. The NHS is on the edge of being hollowed out into little more than a logo. There is good in Efford's Bill. The Health and Social Care Act 2012 (HSCA) fundamentally undermined healthcare in this country. It's been a costly, unnecessary and underhand waste of money, implemented by those who don't believe in a public health service but who do want to shrink successful public services to allow profiteers access to the £110billion a year NHS budget. This Bill would repeal the 'competition' sections of the pernicious HSCA 2012 - and I welcome its attempt to reduce procurement and tendering procedures. It also looks like it would revoke regulations that force commissioners to advertise new NHS contracts to the private sector (unless the services are only capable of being provided by a single provider). The 2012 Act united an extraordinarily broad coalition of opposition to its core purpose (being to permanently hollow out public provision in the NHS and instead create a cash cow for the corporate health sector) including the BMA, Royal Colleges, 38 Degrees - I worked closely with Liberal Democrat rebels and the Opposition on key amendments to the Bill.

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Yahoo

  • MPs warn on kidney dialysis plan.

    Kidney disease charities were "stunned" to have been told this week dialysis will no longer be a prescribed service on the English NHS from next year, MPs have heard. Labour's Madeleine Moon (Bridgend) said officials at the Department of Health revealed the "dangerous" decision in a meeting, and told the groups legislation would be put to MPs in February. Mrs Moon urged Commons Leader William Hague organise a ministerial statement by Health Secretary Jeremy Hunt to allow MPs to protest at the plans. Speaking during the weekly business statement, she said: "At a meeting in the Department of Health this week, kidney charities were stunned to be told that kidney dialysis was no longer to be a prescribed service and a period of consultation of six weeks would be held by the Department of Health. "And then a Bill would be introduced to Parliament during February and changes to CCG (clinical commission groups) commissioning will commence on April 1. Can we have an oral statement from a minister for the Department of Health so they can hear from MPs across the floor in this House what a dangerous decision that would be and how kidney patients will be placed at risk by that decision ?" Mr Hague replied: "I don't think there is any need for a statement because it is health questions within a few days. Next Tuesday (Mr Hunt) and the ministerial team will be here on Tuesday to answer questions so I think there is an early opportunity for you to pursue this issue."

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The Guardian

  • Number of GPs seeking to leave UK and work abroad doubles under coalition.

    The number of GPs applying to leave the NHS annually to practise abroad has doubled under the coalition, raising fresh concerns over its handling of the health service. The exodus risks exacerbating the current backlogs in GP practices and the pressures on A& E departments, according to the Royal College of GPs, which has warned that 600 practices may close in the next year due to poor recruitment and retention of staff. The most recent patient survey reports that one in four patients now wait a week or more to see their local doctor. New figures show that 529 GPs were issued in 2013 with a certificate of good standing, which allows them to practise abroad. That compares with 266 in 2009, according to figures provided by the General Medical Council. A spokesman for the Department of Health said that medicine was a mobile profession and that doctors often wanted to spend time travelling and gaining experience overseas before returning to the NHS. But last night the shadow health secretary Andy Burnham said that the increase in the number of GPs being issued with the certificates was a clear indicator of plummeting morale within the health service, as it struggled to deal with a burgeoning population amid tightening budgets. Burnham said: “The prime minister who promised to put GPs in charge of the NHS has instead presided over a crisis in general practice and a collapse in GP morale. This week’s misjudged GP ratings announcement has seen the profession’s morale plumbing new depths. “Cuts to the GP budget are placing intolerable pressure on services and forcing many GPs to move abroad or retire early in despair. People are already struggling to get GP appointments and things are set to get even worse.” The pressures on medical practices are largely a consequence of a changing demographic. The UK’s elderly population has grown 80% over the last six decades and is set to grow further. The number of people aged 65 and over is forecast to increase by 23% from 10.3 million in 2010 to 12.7 million in 2018, and to reach 16.9 million by 2035. A government report published last summer, Securing the Future GP Workforce, concluded that “there is a GP workforce crisis that must be addressed immediately”. The report states that the shortfall in GPs is “being compounded by increasing numbers of trained GPs leaving the workforce” and that “evidence is also emerging from the NHS information Centre that the GP workforce is now shrinking rather than growing”. Dr Maureen Baker, chair of the Royal College of GPs, said that current and prospective GPs were being put off from working in the NHS by 11-hour days. She said: “The mass exodus of GPs – driven by soaring demand and plummeting resources – is a clear and present danger to patient safety.

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Friday 21st November 2014

Daily Mirror

  • Revealed: The 21 private firms from India, Japan and America targeting £1billion NHS contract to manage patient medical records.

    Private firms from around the world are targeting a £1billion NHS contract to manage the personal medical records of every patient in the UK. Four IT companies in India, a tech giant in Japan, a US arms manufacturer and the world’s largest law firm are among 21 businesses in the frame, the Mirror can reveal. The 10-year contract is the biggest ever put out for tender by the NHS, after the Tory-led coalition decided to outsource primary care support services. Dave Prentis, general secretary of union Unison, branded our revelations “an absolute disgrace” and warned it could mean “handing over millions of patients records” to “huge worldwide firms”.

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BBC News

  • MPs to debate bill to repeal NHS 'privatisation' laws.

    MPs will debate a bill later which supporters say will roll back what they call the creeping privatisation of the NHS. The Private Members Bill seeks to repeal key parts of the government's 2012 reform of the NHS in England. Ministers say those reforms are saving the health service money, and they have no plans to repeal any parts of the legislation. The bill is backed by the major health unions, but is unlikely to become law. It is designed to repeal parts of the 2012 Health and Social Care Act that underpinned one of the biggest reorganisations of the NHS in England. Mr Efford, Labour MP for Eltham, says those reforms imposed privatisation on the NHS. "The NHS as we know it today will disappear if we continue to allow services to be forced out to private companies. It will seriously undermine the capacity of the NHS to provide services in the future, leaving us at the mercy of the private sector. This bill will halt the rush to privatisation and put patients rather than profits at the heart of our NHS."

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Open Democracy

  • Efford's "Save the NHS" Bill - does it do what it says on the tin?

    A private members bill that Labour say will “halt the rush to privatisation and put patients rather than profits at the heart of our NHS” is to be debated in parliament for the first time on Friday. Trade unions are urging MPs to “back the bill”, put forward by Eltham MP Clive Efford, whilst suggesting it is only “a start”. The Trade Union Congress says the Bill will “put patients’ needs before private profits and protect health services from privatisation”. It's supported by Labour affiliate, the Socialist Health Association, and by 38 Degrees. The Bill has also been given “qualified support” by the British Medical Association and a cautious welcome by Lord David Owen, a vocal critic of the Health & Social Care Act, who told OurNHS: "These are imaginative and constructive proposals that deserve not just a Second Reading but careful consideration in Committee. No small Private Members Bill can cover every important aspect of the NHS but this Bill gives us an opportunity to act quickly”. It appears to give the Health Secretary considerable power to determine what counts as ‘anti-competitive behaviour’ and what counts as an abuse of a dominant ‘market position’ within healthcare. It also gives the Health Secretary the power to decide just how much money Foundation Trusts should be allowed to make from private patients (currently capped at 49% of income) and adds some safeguards about patient detriment.

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The Independent

  • TTIP backlash: NHS needs protecting from US trade deal, says Labour.

    The NHS must be explicitly excluded from the controversial trade deal being struck between the EU and the United States, Labour will demand today, as David Cameron and European leaders face a growing backlash against the plans. The Prime Minister argues that the Transatlantic Trade and Investment Partnership (TTIP) could provide a £10bn boost for Britain and has promised to put “rocket boosters” behind efforts to clinch the deal. He has praised the planned agreement as “good for Britain, good for jobs, good for growth and good for the British economy”. However, more than 920,000 Europeans have signed a continent-wide petition against TTIP on the grounds it would cost large numbers of jobs, undermine consumer rights and environmental protection, as well as transferring power from elected governments to unelected international business corporations. Similar objections are also being raised against a parallel agreement between the EU and Canada, which is nearing completion. The surge in opposition across the EU to the huge trade deals, as well as in the US, coincides with a Commons debate today, in which Labour will demand a commitment for the health service to be excluded from the agreement. Critics claim the deal would leave the NHS vulnerable to takeover by American healthcare giants and undermine the principle of a service free at the point of delivery.

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HSJ

  • Exclusive: Multinational arms firm among those interested in £1bn NHS tender.

    Multinational companies including G4S and arms manufacturer Lockheed Martin are among those that have expressed interest in a £1bn contract to run GP support services outsourced by NHS England, HSJ has learned. NHS England issued a contract tender notice last week appealing for bidders to run primary care support services. The authority decided to outsource the functions last summer. With a contract value of £1bn over 10 years, the tender is one of the highest value single deals ever offered by the NHS. HSJ has learned that NHS England hosted a meeting in recent weeks for organisations interested in bidding for the contract. It was not attended by a single NHS owned organisation. However, among the companies that did attend were the weapons manufacturer Lockheed Martin, which makes the F-35 Joint Strike Fighter and the Royal Navy’s Merlin maritime helicopter, as well as supplying what their website describes as “ingenious IT solutions” to public sector clients including the Welsh government, the Metropolitan Police Service, and Golden Jubilee National Hospital in Scotland.

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Independent

  • TTIP backlash: NHS needs protecting from US trade deal, says Labour.

    The NHS must be explicitly excluded from the controversial trade deal being struck between the EU and the United States, Labour will demand today, as David Cameron and European leaders face a growing backlash against the plans. The Prime Minister argues that the Transatlantic Trade and Investment Partnership (TTIP) could provide a £10bn boost for Britain and has promised to put “rocket boosters” behind efforts to clinch the deal. However, more than 920,000 Europeans have signed a continent-wide petition against TTIP on the grounds it would cost large numbers of jobs, undermine consumer rights and environmental protection, as well as transferring power from elected governments to unelected international business corporations. Similar objections are also being raised against a parallel agreement between the EU and Canada, which is nearing completion. The surge in opposition across the EU to the huge trade deals, as well as in the US, coincides with a Commons debate today, in which Labour will demand a commitment for the health service to be excluded from the agreement. Critics claim the deal would leave the NHS vulnerable to takeover by American healthcare giants and undermine the principle of a service free at the point of delivery. British opponents say the so-called “investor-state dispute settlement” (ISDS) powers could enable American healthcare firms to take legal action if a UK government restricted private involvement in the NHS.

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Daily Telegraph

  • Labour NHS bill is 'misguided and disruptive'.

    Labour attempts to reverse Tory health reforms are “deeply concerning, misguided and disruptive,” a coalition of leading GPs have warned. In a letter to The Telegraph, the doctors urged MPs not to vote on Friday in favour of a bill which claims to repeal parts of the 2012 Health and Social Care Act, which put groups of GPs in charge of NHS budgets. Labour MP Clive Efford’s private member’s bill would reverse some of the changes introduced by then Health Secretary Andrew Lansley. Labour says the 2012 reforms have pushed a “privatisation” agenda, by promoting competition for NHS contracts. But a number of leading GPs, including those in charge of Clinical Commissioning Groups (CCGs), say those calling for the changes to be reversed are making “an ill-informed attack” on the doctors in charge of the system. In the letter, Dr Michael Dixon, chairman of the NHS Alliance, which represents GPs, and eleven other doctors, said that reversing the changes would be a “backwards step for patients” which would force a needless reorganisation of the health service. Last night Labour issued a statement asking Conservative and Liberal Democrat MPs with financial ties to private healthcare firms to stay away from Parliament. Clive Efford, shadow minister for sport, said: “The Bill takes a scalpel to the Coalition Government’s hated Health and Social Care Act and cuts out those bits that force services to be put out to tender - where the private sector can cherry pick the most lucrative services that yield the most profits. Our health service is not a market and this needs to end now before it is too late and the NHS as we know it ceases to exist.” The new bill would reduce the amount of income NHS hospitals could receive from the private sector and change the way the service is regulated.

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Thursday 20th November 2014

Uttoxeter News

  • Staffordshire NHS cancer service 'privatisation' moves a step closer.

    Several private companies have been shortlisted for what is believed to be the biggest outsourcing deal in NHS history. Twelve organisations, including two NHS hospitals, are in the running for £1.2bn of NHS cancer and end-of-life contracts across Staffordshire. Private bidders include Virgin Healthcare and US technology giant CSC. Union Unite and the organisation Cancer Not For Profit have said it could lead to the privatisation of the vital service.

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Brent and Kilburn Times

  • Maternity unit faces the axe under plans that closed Central Middlesex Hospital’s A&E unit.

    A maternity unit is set to be the next casualty of a controversial programme which led to the closure of the accident and emergency unit at Central Middlesex Hospital. Ealing Hospital will lose its maternity services under the Shaping a Healthier Future (SAHF) plans which were rolled out earlier this year. The plans, which also resulted in the closure of the casualty unit at Hammersmith Hospital, will also see Ealing Hospital stripped of its neonatal, paediatric and gynaecology departments. Last month, Ealing NHS Trust, which manages the hospital, merged with North West Hospitals NHS Trust, which looks after Central Middlesex, Northwick Park and St Mark’s Hospitals, to save £19million. The closure of the maternity unit comes six years after a £3million birth centre at Central Middlesex Hospital in Acton Lane, Park Royal, was axed just four years after opening due to a ‘lack of demand’. Ealing Hospital is claimed to have one of the highest birth rates in London leading to fears that other maternity units such as NPH could become too overcrowded with its closure.

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Daily Mirror

  • Tory cuts put 15,000 cancer patients in danger as they are forced to wait too long for treatment.

    More than 15,000 cancer patients’ lives have been put at risk because Tory-led NHS cuts have forced them to wait too long for vital treatment. Official guidelines say no one should wait more than 62 days to start care after an urgent referral by their GP for suspected cancer. Hospitals must meet this target in at least 85% of cases but new figures published yesterday by NHS England reveal it has been breached for the third quarter in a row. In total, 15,425 people told they have the disease between January and September this year then waited more than two months to start treatment. Experts warned the delays meant patients were being “failed” and were more likely to either die or see their condition rapidly worsen.

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Independent

  • International arms firm Lockheed Martin in the frame for £1bn NHS contract.

    Doctors have expressed dismay at reports that an international arms firm is considering a bid for a £1bn NHS contract to run GP support services in England. American defence giant Lockheed Martin was one of a number of private companies represented at a recent meeting hosted by NHS England, for those interested in taking over the contract, which largely involves administrative functions. G4S, whose handling of security at the London 2012 Olympics drew widespread criticism, also attended the meeting, as did KPMG and the US law firm DLA Piper. No potential NHS bidders attended, according to the Health Service Journal (HSJ). The contract, which is likely to be awarded early next year, is one of the biggest ever put out to tender by the NHS. Leading London GP Dr Louise Irvine told The Independent that it was “shocking” that an arms firm could be awarded such a major NHS contract, and warned that the company could profit from money “taken from front line care”. “[It is] just as shocking that no NHS organisation was allowed to bid to provide these services, which are mainly back office support for General Practice,” said Dr Irvine, who is standing the general election for the National Health Action Party. “NHS administration systems, with years of experience, are being displaced by organisations that have little or no experience in providing these services.” Dr Mark Porter, chair of the British Medical Association, said that the tender was “another worrying example of creeping privatisation in the NHS”.The 10-year contract is understood to be worth more than the current cost of running the services, which currently employ 1,600 people. Bidders have been told they will have to close some offices and invest in new technology, and should expect to bear some redundancy costs, the HSJ reported.

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Financial Times

  • NHS spending per patient to fall under all main parties’ pledges.

    The amount the NHS spends per patient would fall between £98 and £191 – a real term drop in spending of at least £5.5bn – by 2020 under the main political parties’ funding pledges, analysis reveals. The figures, based on NHS England’s own calculations, show that despite the ringfence applied to the service’s budget, spending – using health officials’ preferred measure of estimated patient numbers – has fallen £50 per patient since 2009. Under the Conservative party’s pledge to hold NHS spending in line with inflation, the fall per patient would be £191 from 2009 to 2020 – about the cost of one accident and emergency visit for a patient in England. Under the Liberal Democrats, funding would fall £174 per patient during the same period, while under Labour’s pledge it would fall £98 – about the cost of an outpatient appointment. The Financial Times worked on the figures with the health policy think tank, the Nuffield Trust.

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Guardian

  • Private firms on course to net £9bn of NHS contracts.

    Private health firms are on course to win more than £9bn of NHS contracts to look after patients as a result of the coalition’s ramping up of competition in the health service, research shows. Analysis by the NHS Support Federation, an independent campaign group, 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. They have won two out of three of the 195 contracts awarded by NHS bodies in England in the 19 months since that legislation dramatically extended the enforced tendering of services in the NHS. Those 131 contracts represent about half the value of the 195 deals that have been agreed. Researchers tracking the awarding of NHS contracts say that, if the private sector continues its 50% win rate by value, it will earn a potential £6.6bn more of the £13bn of other contracts which have been advertised but not yet awarded. That would result in private firms earning £9.2bn as a direct result of the changes ushered in by then health secretary Andrew Lansley’s restructuring of the NHS, which a cabinet minister recently described as the coalition’s biggest mistake. The £18.3bn of services tendered include more than £1bn worth of contracts for elective surgery, diagnostics (£1.2bn), community care services (£1.9bn), musculo-skeletal care (£785m), ambulance and patient transport services (£583m) and pharmacy (£558m). The Department of Health said the figures were misleading and only a small proportion of the NHS’s overall spending was in the private sector. But Dr Mark Porter, chair of council at the British Medical Association, said the deepening privatisation exposed by the figures proved that ministers had not told the truth when they denied that Lansley’s shakeup would produce more of it in the NHS.

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