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Tuesday 28th April 2015

Get West London

  • 'Save our NHS' petition presented to Hounslow election candidates.

    A 'Save our NHS' petition signed by nearly 600 people in Feltham & Heston has been presented to local parliamentary candidates. The petition calls on candidates to do everything they can to protect the health service should they be elected as MP for the area. It says that includes opposing privatisation, ensuring there is sufficient funding and keeping the NHS out of TTIP (Transatlantic Trade and Investment Partnership) to "protect it from US health corporations". More than 600,000 people nationally have signed the petition on the campaigning website 38 Degrees, including 594 in Feltham & Heston and 1,554 in Brentford & Isleworth.

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London Evening Standard

  • Nurses plan protest outside St Thomas’ Hospital in pay dispute.

    Nurses are planning to stage a protest outside St Thomas’ Hospital this week in a dispute over proposed pay cuts. Members of Guys and St Thomas’ Unite (GSST) will demonstrate outside the hospital in Westminster Bridge Road on Thursday after proposals were made to cut unsocial hours pay rates. It is understood NHS England plans to introduce a seven day working week for nurses, which would mean the current system of unsocial hours payments would be scrapped.An online petition set up by an NHS nurse Abi Smith calling on the Department of Health to scupper the plans has gained more than 137,000 signatures.

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BBC News

  • Election 2015: Plaid call for a 'truly national NHS'.

    Plaid Cymru has pledged to end the postcode lottery it says patients in Wales can face in getting new medicines on the NHS. It is calling for a "truly national health service" with plans to create a new drugs and treatment fund and a national panel to approve requests. Plaid Cymru said drugs and treatments not ordinarily available to NHS patients should be approved by a national panel. Leader Leanne Wood said many patients were currently forced into "difficult circumstances" to get the treatment they needed. "Plaid Cymru believes that the NHS should be a truly national health service, the ability of a patient to access a new treatment or medicine should be based upon how effectively it will treat their condition, not upon where they live," she added. The party said it would cover the increased spending by establishing a ring-fenced budget funded by the Pharmaceutical Price Regulation Scheme rebate payments Wales receives every year.

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Guardian

  • Cross-party support for NHS bill 2015.

    David Owen writes from the House of Lords: Your editorial (23 April) is too kind to David Cameron. It is Downing Street spin you have fallen for, that he “neglected to read Andrew Lansley’s wild NHS overhaul until emergency surgery became necessary”. The Institute for Government and King’s Fund report by Nicholas Timmins, Never Again ?, makes it abundantly clear that Cameron was deeply involved at every stage as opposition leader in developing that policy, deliberately hid the policy from the electorate and, in private to Conservative MPs, still denies as prime minister that there has been any substantive change made by parliament and it is all about presentation. That is why Labour and the SNP, together with the Green party, Plaid Cymru and any willing Lib Dem MP must reinstate a recognisable NHS operating throughout the UK by replacing the Health and Social Care Act 2012 with the cross-party National Health Service bill 2015.

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Monday 27th April 2015

Get West London

  • 'Save our NHS' petition presented to Hounslow election candidates.

    A 'Save our NHS' petition signed by nearly 600 people in Feltham & Heston has been presented to local parliamentary candidates. The petition calls on candidates to do everything they can to protect the health service should they be elected as MP for the area. It says that includes opposing privatisation, ensuring there is sufficient funding and keeping the NHS out of TTIP (Transatlantic Trade and Investment Partnership) to "protect it from US health corporations". More than 600,000 people nationally have signed the petition on the campaigning website 38 Degrees, including 594 in Feltham & Heston and 1,554 in Brentford & Isleworth. Local campaigner Nijam Rahman said he had invited all five candidates in Feltham & Heston to collect a copy of the petition outside Holy Trinity Church, in Hounslow High Street, on Wednesday (April 22). He said Liberal Democrat candidate Roger Crouch, UKIP's Peter Dul and Labour's Seema Malhotra all attended, but Green Party candidate Tony Firkins had been unable to make it and Conservatives Simon Nayyar had declined the invitation. The issue is particularly close to Mr Rahman's heart as he gave up his job to help care for his mother Rohmun, who had been in hospital after she had a stroke. He said she was at West Middlesex Hospital for six months until her death last December, aged 78, and he was disappointed with how she was looked after.

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The Guardian

  • Far more NHS contracts going to private firms than ministers admit, figures show.

    Profit-driven firms have been winning far more NHS contracts than ministers admit and privatisation has increased significantly under the coalition government, the latest evidence shows. Two new sets of figures, detailing who is being awarded contracts to provide NHS clinical services, both challenge the government’s claim that only 6% of the service’s budget goes to private firms. Contracts monitored by the NHS Support Federation campaign group show that private firms won £3.54bn of £9.628bn worth of deals awarded in England last year – a win rate of 36.8%. And responses from GP-led clinical commissioning groups (CCGs) to a Labour freedom of information request reveal that private firms have been winning 40% of contracts CCGs have put out to tender, worth a total of £2.3bn, only slightly fewer than the 41% awarded to NHS bodies. Labour also claim that NHS patients have had to endure longer waits for treatment as NHS hospitals have increasingly maximised their income from private patients, the number of which has gone up by as much as 58% since 2010. The NHS will end up as “a two-tier service”, with those paying privately being prioritised over other patients, unless action is taken to reverse the trend, the party claims.

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Telegraph

  • Patients are being forced to endure stays of up to two days in Accident & Emergency departments amid a growing crisis as NHS beds run out.

    A Telegraph investigation discloses that the number of hospitals admitting to A& E delays of at least 20 hours has doubled in just one year. The figures show that this winter, one in three NHS trusts recorded times at least this long – with some patients stuck in casualty units for as long as 46 hours. The previous year, one in six trusts had patients whose time in A& E exceeded 20 hours, the Freedom of Information disclosures show. Charities said the revelations were “alarming” and “extraordinary” and evidence of a growing crisis, with hospitals now regularly running out of beds as they became crammed with patients. Levels of “bed-blocking” reached a record high this winter, with rising numbers of elderly people stuck on hospital wards because of a lack of social care services to help them at home. Latest published figures show hospital occupancy levels reached a record high in the last three months of last year - at 89.5 per cent. The recommended safe maximum is 85 per cent, to reduce the risk of infection, but some hospitals reached levels of 99.5 per cent in the run-up to Christmas, it can be disclosed.

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The Independent

  • NHS hit by stealth cuts of £2bn as tariffs received for medical procedures are reduced.

    Hospitals across England have suffered a “stealth cut” amounting to more than to £2bn since 2010, because of reductions in the amounts paid to fund standard medical procedures, according to new research. Tariffs – the prices paid to hospitals to treat patients – have been reduced in the past five years, a trend medical experts say “is making a mockery” of government claims that the NHS has not suffered cuts. One in four “elective procedures”, such as treatments for kidney stones, asthma, blood poisoning and diabetes, have had their tariffs cut by more than 40 per cent since 2010, according to an analysis of 698 procedures by the False Economy think tank, commissioned by the TUC and Unison. Unlike Scotland or Wales, where hospitals are paid through local contracts with health boards, English hospitals are subject to a system of national tariffs. Looking in more detail at almost 130 different NHS procedures, researchers found that between 2009/ 10 and 2014/ 15, hospitals suffered a net income loss of £70m due to cuts to tariffs. Some treatments for conditions such as leukaemia, asthma and sickle cell anaemia, have been cut by 85 per cent – amounting to thousands of pounds being cut off the amount given to treat an individual patient. The amount given for treatments of health problems such as glaucoma and tuberculosis has been reduced by more than 70 per cent. Hospitals have also had the tariffs for some treatments for diabetes reduced by almost two-thirds, while the amount they are given to treat kidney stones and septicaemia has been cut by more than half.

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Friday 24th April 2015

Pulse

  • Opening general practice to private providers 'may have worsened patient care'.

    Traditional models of general practice continue to provide the best patient care while APMS providers seek to transfer costs to secondary care through higher numbers of referrals and exception reporting, new research has found. A study published in Journal of the Royal Society of Medicine found that APMS practices provided worse quality care than practices on GMS or PMS contracts, even when the demographical differences such as age and deprivation were taken into account. It concluded that opening up the NHS to competition from private providers ‘may have even led to worse care’, and calls on commissioners to hold APMS practices to the same standards as GMS and PMS practices. The study comes as Pulse reported last year that NHS England said it would replace all closed practices with APMS contracts, a vow they seemingly backtracked on, but there remains a drive to increase numbers of APMS practices. GP leaders said that the opening up of general practice to competition has been an ‘unmitigated disaster’. The researchers intended to look at the effect of allowing new entrants, including private companies, into the primary care market under APMS contracts in 2004. The study identified a total of 347 current APMS providers, 4.1% of the 8,300 GP providers in England, and assessed their performance across 17 national quality indicators drawn from the GP patient survey and QOF. The results showed that APMS providers performed significantly worse across 13 out of the 17 indicators (p=<0.01 in each) in each year from 2008/ 09 and 2012/ 13, and were significantly worse than traditional general practice in three out of the five years for a further two indicators.

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The Huffington Post

  • Why are the media allowing themselves and the public to be hoodwinked by the Tory pledge to fund the NHS?

    In his Five Year Forward View, the chief executive of the NHS Simon Stevens says the NHS faces a £30billion spending gap by 2020 and even with efficiency savings of £22billion, that leaves an £8billion shortfall PER YEAR by 2020. If spending must increase each year to reach an extra £8billion a year by 2020 that is a cumulative amount of £20 billion over five years. Read the Conservatives' election manifesto. [p 38], and it's crystal clear that they are pledging the £8billion over the course of the next Parliament and not annually by 2020. That is only £8billion cumulatively - far less than the £8billion per year by 2020 that Stevens said was the very minimum needed to adequately fund the NHS. First the manifesto sets out what the Tories have achieved in this parliament: "We are set to increase health spending by more than £7billion above and beyond inflation in the five years since 2010." So that's clarification of what they say they've spent over the course of the full five years of this parliament, not per year. The manifesto goes on to say: "We will implement the NHS's own plan to improve health care even further - the Five Year Forward View. Because of our long-term economic plan, we are able to commit to increasing NHS spending in England in real terms by a minimum of £8 billion over the next five years. Combined with the efficiencies that the NHS Forward View sets out, this will provide the funding necessary to implement this plan in full". It couldn't be clearer that the £8billion pledge is over the course of five years, not per year.

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The Conversation

  • Tax-based financing of the NHS is better than the alternative.

    There should be a move to consider abandoning the NHS as a tax-funded health system offering comprehensive care free at the point of use, a recent article on The Conversation argued. Malcolm Prowle proposed “looking, with an open mind, at alternative funding options”, notably charges and health insurance models that “operate perfectly well in other European countries”. Prowle supports his claims by citing his own study funded by the Association of Chartered Certified Accountants. This study assessed the sustainability of 11 healthcare systems in Australia, Abu Dhabi, Canada, England, France, Germany, Ghana, India, Malawi, New Zealand, and the United States. The study’s primary source material was an unspecified number of interviews conducted with a “finance professional working in the healthcare sector of a particular country or an academic commentator working in the healthcare field”. We cannot conclude that health insurance models “operate perfectly well” in other European countries on the basis of a handful of interviews conducted in England, France and Germany. But the study doesn’t draw this conclusion anyway. Prowle misquotes his own report which says that “health insurance schemes work satisfactorily”. This is some distance from “perfectly”. Nor does Prowle’s assertion match what other research tells us. Rather than interviewing a few finance professionals and academics, it is far better instead to ask people who use the health system whether they think it works well or not. This is what the Commonwealth Fund did in its 2010 health survey. Between 1,000 and 3,500 people from 11 countries were asked if they believed their health system worked well, required fundamental change or needed to be completely rebuilt.

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The Independent

  • Private sector providers of GP services being outperformed by traditional practices.

    Private sector and other alternative providers of GP services in the NHS do not do as well as traditional GP practices, an expert analysis has found. Since 2004 for-profit companies such as Virgin Healthcare and Care UK, as well as voluntary organisations and social enterprises, have been able to win contracts to provide GP services. Now research carried out at Imperial College London has found that these providers perform worse than typical surgeries on 15 of 17 key indicators – such as patient satisfaction, diabetes control and keeping patients out of hospital. Experts at Imperial said the study could “inform the debate about the growing role of the private sector in the NHS”, but supporters of private and voluntary providers in the health service said the study did not necessarily compare like-for-like GP practices. The study, published in the Journal of the Royal Society of Medicine found that 347 of the 8,300 general practices in England are run by under ‘alternative provider medical service’ (APMS) contracts.

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The Guardian

  • NHS 'will miss £22bn efficiency savings target', says thinktank.

    The NHS is highly unlikely to make the £22bn of efficiency savings it has agreed and so is likely to need the next government to give it even more than the £8bn extra a year it has already asked for from the Treasury, the King’s Fund warned on Thursday. The thinktank’s gloomy prognosis is based on a survey of the views of finance directors of hospital trusts and other NHS organisations, amajority of whom voiced deep pessimism about the target. Last October Simon Stevens, the chief executive of NHS England, committed the service to plugging £22bn of the expected £30bn gap in its finances by 2020 through productivity gains of 2% or 3% a year between now and 2020. Since then the Conservatives and Liberal Democrats have promised to provide the other £8bn by 2020 from government funds, though Labour has refused to do the same. “It’s quite possible that the NHS will miss the £22bn target by quite a long way and therefore require much more than £8bn in additional funding. That’s a realistic possibility”, said Richard Murray, the King’s Fund’s director of policy. The £22bn target was “looking increasingly unlikely” because more hospitals had ended up in the red since Stevens first outlined the deal in the NHS Five Year Forward View, his blueprint for ensuring the service’s future, Murray said. “It’s not impossible that it will be met. But at the moment it’s more likely that the NHS will miss it than hit it,” he said. Sixty-nine of the 93 finance heads at NHS trusts questioned said there was either a high or very high risk of the NHS in England failing to achieve the £22bn. Only six thought there was very little or little risk of failure, while 18 put it at 50/ 50. Among 40 finance directors at GP-led NHS clinical commissioning groups, which between them spend £69.2bn a year on patient care, 27 said there was either a high or very high risk of the NHS not making the productivity gains Stevens wants to see. Thirteen others put the risk at 50/ 50, while none identified little or very little chance of failure.

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Thursday 23rd April 2015

The Lincolnite

  • Campaigners to stage protest in Lincoln to ‘save the NHS’.

    A local campaign group are taking to Lincoln High Street, calling on MP candidates to protect the NHS from privatisation and funding freezes. The protest has been coordinated by independent campaign group 38 Degrees and is the second Lincoln demonstration in the months before the general election. The national group is hoping to gain as many signatures as possible in order to convince MP hopefuls to commit to extra NHS funding and protection from TTIP trade deals. So far, the Lincoln petition has gained over 1,200 signatures. David Babbs, executive director of 38 Degrees said: “We want Lincoln MP candidates to see that the best way to win votes is to pledge to save the NHS from privatisation and funding freezes. Every candidate needs to realise that cutting NHS funding, or handing it over to private companies, is a huge turn off for voters.”

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Borehamwood Times

  • 'Anxious, devastated and disgusted' - births at private maternity unit suspended.

    Nearly 30 pregnant women have been left in a “panic-stricken limbo” after discovering they would not be able to give birth privately. Many mothers-to-be discovered that they would not be able to have their babies at under private care at Watford General Hospital after a link was posted on social networking site Facebook. The decision to suspend births was made by the hospital after a Care Quality Commission inspection and affects 27 mothers who are due to give birth after May 1.The mothers who paid for their baby’s birth up front were all reimbursed as soon as the news broke via a statement on West Herts Hospital NHS Trust’s website and went viral on Facebook. They feel they have not been given adequate warning to make alternative arrangements. Professor Tracey Carter, chief nurse, said: “We were pleased to welcome the Care Quality Commission (CQC) into our hospitals last week for their planned inspection. As is common with visits of this type, the CQC team has given us some immediate feedback and, as a result, we have made changes to the way we do some things. We have also chosen to suspend our small private obstetric service – allowing our maternity team to focus on our NHS patients."

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Public Finance

  • NHS facing ‘biggest challenge’ as finances worsen.

    The NHS is facing the biggest financial challenge in its recent history during 2015/ 16, the King’s Fund has warned, with both mounting deficits and worsening performance. In its quarterly monitoring report, the think-tank said it now seemed certain that hospitals and other NHS providers in England overspent their budgets in 2014/ 15 by more than £800m – despite nearly £900m extra being provided by the Treasury or moved from capital budgets. According to the regular survey undertaken for the report, almost 60% of finance directors at hospital trusts said they were dependent on additional financial support or had drawn down their reserves in 2014/ 15. The King’s Fund concluded that the financial outlook for 2015/ 16 was even gloomier, with two-thirds of hospitals concerned about staying within budget over the next year. Performance is also deteriorating, the King’s Fund stated, with accident and emergency performance at its worst level since 2003 – 8.2% of patients waited longer than the four-hour target in the final quarter of 2014/ 15.

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Tuesday 21st April 2015

Open Democracy

  • Bring back the NHS - a night hosted by Sir Ian McKellen.

    On the 7th May we vote in the General Election and on the future of the National Health Service. This Friday, 24th April, Bring Back The NHS will see those who know the health service best cut through the hubbub of election campaigning and remind the electorate and their candidates just how important an issue it is. Successive changes over the last few decades, most recently with the 2012 Health and Social Care Act, have fundamentally eroded the founding principles of the NHS. The NHS is no longer national: the direct, democratic responsibility of the Secretary of State to provide healthcare has ended and huge privatised contracts are spreading quickly and fragmenting quietly. It is no longer about health: trusts are competing for contracts rather than cooperating with neighbouring trusts, and senior health staff are distracted from patient care by the financial worries the marketplace and commissioning have given. And it is no longer about service: competition threatens to break up integrated clinical care, while the profit imperative, not the needs of the public, increasingly determines the availability of health provision. Bring Back the NHS is a non-party political evening, hosted by Sir Ian McKellen and bringing together an impressive array of powerful messages and entertaining speakers. From the experiences of those at the frontline of the NHS and firsthand testimony from patients and carers; to the efforts of campaigners and the insights of scientists and academics. This line-up offers a clear message for the election - that no matter who wins, we want the next government to bring back a health service that fully reflects its founding principles.

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Pulse

  • SNP vows to fight for increased NHS spending across the UK.

    The Scottish National Party would fight for increased NHS spending and against privatisation across the whole of the UK, its leader has vowed. Launching its election manifesto, Scottish first minister Nicola Sturgeon said the party would lobby for an increase in the NHS budget of £24 billion by 2020/ 21, the largest spending promise yet. Under SNP plans, this would be funded by the scrapping of the Trident nuclear weapons programme, releasing £100bn to invest into areas such as health and education. Of this, £24bn should be spent on the NHS across the UK, £9.5bn above inflation, including £2bn in Scotland, Ms Sturgeon said. Ms Sturgeon added that the SNP would also fight privatisation of the English NHS, saying: ‘I also give a commitment today that SNP MPs - in order to protect Scotland’s budget - will vote against any further privatisation of the NHS in England and we will back any moves to restore it to a fully public service.’

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Independent

  • The biggest US-EU free trade agreement in history is advancing behind closed doors.

    Secret negotiations between the US and EU for the biggest bilateral trade agreement ever negotiated resume on April 20 in New York. The talks are attracting increasing criticism as activists guess at the proposals while politicians keep the details behind closed doors. The Transatlantic Trade and Investment Partnership is a massive new trade deal, expected to be completed in the next few months, that would cut tariffs on imported goods between the two powers while standardising safety rules. Critics say it could reduce European safety standards and allow the privatisation of services such as the NHS. But we cannot sure, because the negotiations occur behind closed doors. One of the reasons we do know a bit about the contents of the agreement is due to a leaked draft from February. The draft contained a clause stating the EU reserves the right to adopt or maintain any measure with regard to the provision of all health services that receive public health funding or State support in any form – words the government said will protect the NHS from privatisation. The Labour party and the Scottish Green party have said that the language of the clause is too vague to guarantee protection. They are calling for the NHS to be named in the text as exempt.

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Daily Mirror

  • Hospital bosses get £35m in pay rises while frontline NHS workers struggle to pay bills.

    Hospital chief executives received £35 million in pay rises, despite unprecedented pressures on NHS spending, it was reported tonight. An investigation found bosses enjoyed pay hikes of 6%, well above those of frontline staff. Some executives earned more than £1 million last year, while directors at a handful of the worst-performing hospitals received pay packages of up to £5,000 a day, it was reported. A total of 47 hospital bosses pocketed more than £400,000 last year - putting them in the same pay league as top City traders, the Daily Mail found.

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Guardian

  • Labour claims study shows Tories back further NHS privatisation.

    Labour has released research that claims to expose widespread support for the introduction of NHS charging and privatisation inside the Conservative party. A survey of Tory councillors who were asked about future funding of the NHS shows that more than a quarter appear to support further charging and privatisation. Responses from 115 Conservative councillors in the dossier include claims that they back charges for GP appointments and other NHS services, and increased privatisation plans for cutting the NHS. Some appeared to call for an insurance-based system of healthcare to replace the NHS or for another reorganisation led by the private sector, Labour claimed. A total of 26 agree with introducing charges for NHS services, a further 12 support privatisation or increased use of the private sector, while six want to make cuts to the NHS, the dossier says. Nick Hurst, a Tory councillor for Stroud district council, is quoted in the survey saying: “There are a number of areas where the NHS should not trespass. Gender re-alignment for instance must be a private matter. IVF, while desperately traumatic for some, has to be an issue the NHS should leave to private clinics. So, my bottom line is that healthcare, like education, is too important to be left to politicians to use as a political football. It should be taken out of government interference and run as a business by a commission.”

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Monday 20th April 2015

On Medica

  • While the political manifestos published this week address some concerns raised by NHS leaders, key issues around finances, workforce, social care and stability, remain outstanding.

    This is the message from the NHS Confederation, which has published a comparative analysis of the different political parties’ views. As part of its analysis, the NHS Confederation has looked at whether the manifesto promises made by each party, match the commitments called for by the NHS Confederation and 22 other leading health and care organisations in their 2015 Challenge Prescription for the Election. Last year, 23 leading organisations across health and care, including the NHS Confederation and Medical Royal Colleges, produced the 2015 Challenge Manifesto, laying out seven challenges politicians could address after the election. This was followed in February with The 2015 Challenge Prescription for the Election, which called on all political parties’ general election manifestos to do the following: Prioritise reducing preventable illness and maintaining wellbeing across all public services, and set out how local areas’ efforts on this will be supported. Detail concrete plans to make mental health services as accessible to people as physical health services by the end of the next Parliament. Commit to adequate funding for health and social care – including transition funding to enable service change – and the next Government must begin to deliver on this in its first budget and spending review. Commit to providing the stability and consistency required for local areas to continue to make progress on vital work to reshape care. The principles of the Five year forward view have secured broad support and the next Government should support their implementation as well as avoiding yet another top-down, large-scale structural reorganisation of the administration of the NHS.

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NHS For Sale

  • The government is currently going through a consultancy period where they are trying to push through an NHS reform bill.

    Rumours abound that the Conservative Party are using this bill to open up the NHS to the private sector as compensation to private healthcare companies who donated to the Tory party during their election campaign. Health Secretary Andrew Lansley said: "Claims that we aim to privatise the NHS amount to nothing more than ludicrous scaremongering. We have made it crystal clear, time and again, that we will never, ever, privatise the NHS. This week, emails emerged revealing that up to 20 hospitals are being earmarked to be run by foreign firms. Meanwhile, a vital legal obligation of the Secretary of State to deliver comprehensive public services across the country is being removed by, erm, the government. We, the Space Hijackers, have never trusted the government - regardless which colour tie they happen to be wearing. We’re particularly distrustful of the ones in the blue ties. While all this backroom scheming to unpick all of Nye Bevan’s good work in establishing the world’s largest single-payer healthcare system was taking place, we thought we'd take the debate to the streets.

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Red Pepper

  • Fingers in the PFI.

    Twenty years on from the introduction of the private finance initiative (PFI), Dexter Whitfield examines the effect it has had – and how it’s set to get worse under new Tory plans. Step into any recently built school or hospital in the UK nowadays, and the chances are that, despite its nominal status as a public amenity, it will be owned by and have been built by the private sector, as a private finance initiative (PFI). PFI was introduced by the Conservative government in 1992 and New Labour turned it into the only public investment show in town during 1997-2010, using it to keep the cost of building projects off the public books. It contributed a good many shiny new assets for the public sector. But like many boom-time aspects of the British economy that revolved around easy credit, PFI’s star has fallen post-crisis as the liabilities side of the public balance sheet has come into sharp focus, highlighting the mountain of debt and punitively high interest repayments with which the public sector is now saddled. The time should be ripe to abandon this flawed model, but instead it is being rebranded. PFI infrastructure projects have had a turbulent time under the coalition government. It abandoned the £55 billion Building Schools for the Future programme in July 2010, scrapping 715 planned projects. Then the public accounts committee weighed in with a highly critical account of profiteering in the sale of share stakes in PFI project companies, and expressed major doubts concerning value for money. The coalition’s austerity programme also imposed severe constraints on infrastructure investment. The year-long Treasury review of PFI, commencing in late 2011, led to more delays and uncertainty on top of those caused by the financial crisis. Meanwhile, bank debt had become more difficult to secure and pension funds, insurance companies and other investment funds were cautious about filling the gap, because they rely on stable, long-term investment. The volume of European infrastructure projects reaching financial close in the first half of 2012 was the lowest recorded in the past decade. The capital cost and number of signed contracts in the UK in 2012 is forecast to fall back to its 2009 level, a third of the pre-crisis rate. Despite this decline, the Treasury still identified 39 UK PFI projects in schools, hospitals, highways and waste management with capital costs of £5.4 billion (and total costs of about £21.5 billion) in procurement at March 2012. And while new-build project deals have slowed down, speculative trading of shares in public-private partnership (PPP) projects have mushroomed and offshore infrastructure funds had little problem raising equity for the activity.

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The Independent

  • NHS struggling to monitor the safety and efficacy of its services outsourced to private providers.

    The NHS is struggling to monitor and assess the safety and efficacy of services it has outsourced to private providers, according to a report published this week. Local clinical commissioning groups (CCGs) now spend 16 per cent of their care budget in the private sector and need to manage, monitor and enforce some 15,000 contracts with private providers. A growing number of the contracts are with large multinationals and companies backed by private equity, of which only seven have been terminated due to failings, a report by the independent think-tank Centre for Health and the Public Interest (CHPI) discovered. It said the abuse at Winterbourne View Hospital, which was run by Castlebeck Care until it went into administration, and Serco’s out-of-hours primary care contract in Cornwall, which was taken back by GPs in February, were just some of the high-profile cases where the NHS failed to manage contracts with private providers effectively. The CHPI sent Freedom of Information requests to all 211 CCGs, seeking information about how they monitor contracts with private providers. Only 12 either did not record the information or did not answer. Its report, “The Contracting NHS: Can the NHS Handle the Outsourcing of Clinical Services”, found that 60 per cent of CCGs surveyed did not record how many site inspections they undertook, or were unable to say how many they had done. Of even greater concern is the fact that 12 per cent had not carried out any site inspections.

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Friday 17th April 2015

Sturdy Blog

  • The NHS Shortfall in Funding; Suddenly An All-Party Issue.

    It has been interesting to observe how the former head of NHS England, David Nicholson’s, warning over an NHS “financial hole” has become big news in the context of the election. And how it has been framed. BBC News have declared it an “all party issue” and they are neither alone nor original in that respect. It seems to be “the line”. All the parties will have to sit down and explain how they will deal with it. Remarkably little focus has been spared for how we got there. Five years of an entirely unnecessary and costly reorganisation, the underfunding, the sacking of “useless managers”, the farming off of lucrative services to private companies of friendly donors, the decline of performance and results – all forgotten. It’s everyone’s problem now. And in a way it is, because it is a situation the consequences of which we all must suffer. But in another way it is not. To those of us who have been screaming “Save Our NHS” for the last five years it came as no surprise. As early as 2012 the UK Statistical Authority had to rebuke the government for “misleading boasts” that they had increased health spending, when they had not. In June 2014, senior Tories, including Stephen Dorrell, a former Conservative health secretary, Sarah Wollaston, a Tory MP, and Paul Burstow, a former coalition health minister, warned David Cameron that he needed to increase spending by as much as £15b over five years “if you don’t want the system to collapse during the course of the next parliament”. In October 2014 Rob Webster, chief executive of the NHS Confederation, warned David Cameron of an impending NHS funding crisis.

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Open Deomcoracy

  • BMA backs principles of NHS Reinstatement Bill to save NHS from destruction by market forces.

    As politicians squabble over NHS funding figures, the British Medical Association's Council has backed the principles of radical legislation which would get the costly 'market' out of the NHS. The stated policies of the British Medical Association are to end the market in health care, oppose the purchaser provider split, and to reinstate the Secretary of State’s duty to provide universal health care throughout England. The BMA has made its position clear - not only in its general election briefings but in full page advertisements where it has declared that its doctors support a “publicly funded, publicly provided” NHS. The BMA has now gone as far as setting out the principles of the legislation it would expect to see after the election. On 11th March 2015, the BMA’s Council completed its examination of two sets of legislative proposals on the NHS set out in Private Member’s Bills laid before the House of Commons. The purpose of its examination was to analyse two bills - the NHS (Amended Duties and Powers) Bill, presented by Labour MP Clive Efford and supported by 11 Labour MPs; and the proposed NHS Reinstatement Bill subsequently presented – on 11th March 2015 – as the NHS Bill 2015 by Green MP Caroline Lucas and supported by 11 Liberal Democrat, Labour, SNP and Plaid Cymru MPs. The BMA Council established a large working group, of which I was a member, to identify which proposals in the Bills were in line with and would further BMA policies. In response to the reports of that working group the Council unanimously agreed to support legislation which furthers implementation of strong and clear policies of the Association concerning: Restoration of the Secretary of State’s duty: to to provide and secure provision of services in accordance with the National Health Service Act 2006 for the purpose of the comprehensive health service that it is his or her duty to promote, and to to provide listed services throughout England under section 3 of that Act,

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Open Democracy

  • Why £8bn is a zombie figure that won't save the NHS.

    As the former boss of the NHS slams politicians for not addressing the financial 'black hole', will the pledged £8bn merely be used to pump prime further privatisation and cuts ? The introduction to a series examining the parties' NHS manifesto pledges. The NHS electioneering has so far been dominated by arguments about whether the Tories 'unfunded' £8bn pledge is better than Labour's 'funded' £2.5bn pledge. But this morning David Nicholson – the old boss of the NHS – weighed into the argument with a bombshell. He told the BBC that in any case £8bn won’t be nearly enough to save the NHS from entering a period of “managed decline” with ever-lengthening waiting lists. Nicholson is not alone – the Health Foundation said much the same earlier this month. And the British Medical Association has just warned that unless the funding gap is filled, a "pay NHS" could be on the way. Nicholson has now joined the fray, criticising politicians for making election pledges of a 24/ 7 NHS (Tories) and more staff (Labour) and “talking about extra services” but refusing to talk about the “financial hole”. Nicholson calls for politicians to be more honest with the public about what “big decisions” might be in the pipeline (of which more in a moment). But he himself is only pointing out the basic arithmetic. Most experts – including the NHS’s new boss, Simon Stevens – have said the projected NHS funding shortfall is more like £30bn a year by 2020. So even £8bn of new money leaves £22bn a year still to be found from somewhere.

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Keep Our NHS Public

  • Greater Manchester Association of Trades Union Councils ( GMATUC ) called a mass NHS emergency protest rally to protest against the devolution of the Greater Manchester NHS Budget, called “Devo Manc”, without public scrutiny.

    An emergency resolution passed by GMATUC stated in part, “ As trade unionists we can only suspect that the break up, dismemberment, rationalisation and further privatisation of the NHS in England ( under the banner of public service reform) is precisely what it’s all about, and being hurriedly imposed to avoid any such thorough examination, scrutiny and proper public debate of the issue.” The motion ends by calling for a referendum on ALL the Greater Manchester devolution issues. On 27th February 2015 Chancellor George Osborne, and the chief executive of NHS England Simon Stevens held a press conference to announce a “Memorandum of Understanding” for “Devolution of health and social care in Greater Manchester” ( GM ). This marked a deal to parachute in a £6bn pooled health and social care budget, direct from the Treasury to a new GM Strategic Health and Social Care Partnership Board – in shadow form from April 2015, and statutory by April 2016. This board contains leaders of 10 Local Authorities ( LAs ) ( 12 Clinical Commissioning Groups ( CCGs) and representatives of NHS England ( NHSE ), as well as providers and voluntary organisations. This deal came as a complete surprise to everyone but a few top council leaders, such as Sir Howard Bernstein and Sir Richard Leese, who had secret negotiations with Osborne for six months and then persuaded the 10 LA leaders ( 8 Labour ) to agree. Members of the public, NHS staff, trade unions, and Members of Parliament, had no idea.

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Thursday 16th April 2015

BBC News

  • NHS finance problem being ignored, says former boss.

    The NHS is facing a "substantial financial problem" which politicians are ignoring in the election campaign, the former head of the service says. Sir David Nicholson, who retired last year, told the BBC the NHS in England was accruing large deficits which would become "crystal clear" later this year. But he said instead of talking about how to address these, politicians were focusing on expanding services. He said the situation caused him "very great concern". In an interview for BBC Radio 4's Today programme, Sir David - who ran the NHS in England for eight years - said that because there was an election period, the NHS was unable to publish the latest report on its financial position. But he said it was "pretty clear in the NHS that there is a substantial financial problem, particularly in the hospital sector" which would become "crystal clear" in the autumn.

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Daily Mirror

  • NHS crisis: Unison's patient safety fears as tired nurses having to work extra hours.

    Patients are being “put in danger” as a third of nurses do hours of unpaid overtime after finishing their shifts. They are “too busy” to leave, face staff shortages or fear wards would be “unsafe” if they left, said health service union Unison. One in three nurses do more than their contracted hours, with more than 7,000 still working more than two hours after they should have gone home on an average day. The vast majority do overtime for free with NHS Trusts accused of becoming ‘over-reliant on nurses’ goodwill’. But the report by Unison warns that by staying so late to help out colleagues, tired staff are actually putting patients at increased risk of harm either by making mistakes or by missing key signs and symptoms.

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Tuesday 14th April 2015

Daily Mirror

  • NHS crisis: Damning report reveals nurses are too stretched to feed and care for patients.

    Patients are being denied pain relief, food and water due to NHS cuts, a damning report has revealed. Disturbingly, 65% of nurses said the sick are missing out on basic care because of the chronic understaffing. It shames the Tories – who have slashed the health budget by £20billion – as they launch their election manifesto. The Patients Association said the Unison report filled it “with horror”.The report by health service union Unison showed 42% of nurses were caring for eight or more patients on the day they were surveyed. Even more worryingly, 38 of the staff revealed they were forced to look after more than 20 patients each. The Nice guidelines on safe staffing levels stopped short of being classed as an edict on absolute maximums. But the vast majority of nurses – 88% – told the study team they support the creation of national rules specifying exactly how many patients each nurse should have at any one time.

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Daily Mail

  • Private firms getting up to 100% of profits from hospital parking: Companies walking away with millions patients wrongly believe is being invested in vital treatment.

    Private firms are profiting from extortionate hospital parking fees paid by NHS patients and relatives, an investigation has revealed. The companies walk away with millions of pounds that the public has been led to believe is invested in vital treatment and care. Nearly half of hospital trusts hire private firms to run their car parks and collect fees of up to £4 an hour. Depending on local arrangements, these firms take anything from a tenth to 100 per cent of the money made each year.

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Yahoo News

  • Thousands Petition Against Privatisation of NHS Cancer Care.

    More than 60,000 people have signed an online petition against the privatisation of cancer care. A Memorandum of Information obtained by the website Open Democracy last month revealed the proposed privatisation of NHS cancer treatment services in Staffordshire. If implemented, the proposal would see cancer care for some 800,000 patients handed over to a “prime provider,” that can be a private company. The campaigners behind the petition wrote, “There’s no justification for privatisation on this scale, ordinary people in Staffordshire haven’t been properly asked what they think, and if this deal goes through, we’ll be stuck with it for 10 years – and it could open the door for sweeping privatisation of our NHS across the country.”

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BBC News

  • Epsom and Helier could be replaced under new hospital plan.

    NHS bosses are considering plans to close two hospitals in Surrey and south London and build a new 800-bed centre. The new hospital in Sutton is one of three options put forward by consultants commissioned by Epsom and St Helier University Hospitals Trust. The others are to build a new hospital on either the St Helier site in Carshalton or the Epsom site. The trust said it was committed to retaining both hospitals for at least the next five years. The proposals were revealed by management consultants who held a conference call on a commuter train after meeting the trust chief executive Daniel Elkeles. The call was heard and recorded on a mobile phone by a BBC London reporter. Sandra Ash, of the Keep Our St Helier Hospital campaign, said she was shocked there were new plans to close it.

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Independent

  • Patients must show passport to use NHS or pay more than £2,000 in 'heath tourism' crackdown.

    Foreign women could be charged more than £2,000 to give birth in a NHS hospital as part of a government crackdown on “health tourism”. Tighter regulations that came into force earlier this month require foreign nationals to show passports, visas and proof of residency including rental agreements and employment contracts to receive free care. People classed as "ordinarily resident" in the UK do not have to pay but there are fears over abuses of the system by foreign nationals flying into to use the NHS. Announcing the changes in February, the Department of Health claimed they would help recoup up to £500 million spent on treatment for migrants, tourists and former residents every year by 2018. A think tank warned last year that the charges would put the British public at increased risk from infectious diseases, including HIV, because vulnerable migrants would be discouraged from seeking treatment. Thousands do not seek the care they need because they fear it will affect their immigration status or expose them to NHS fees, the cross-party group Demos said.

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Monday 13th April 2015

Huffington Post

  • Jeremy Hunt's Woolly Answers Over The Tory £8bn NHS Promise Aren't Going Down Very Well.

    Health secretary Jeremy Hunt has been accused of "making stuff up" after he seemed unable to explain how the Tory party would meet today's commitment to invest at least an extra £8 billion a year into the NHS by 2020. Despite saying the announcement was a "significant moment in the history of the NHS", Hunt seemed rather hazy about where the £8 billion would actually come from, prompting a BBC Breakfast host to ask "Do you make this stuff up as you go along ?" The health secretary spoke about the manifesto plans in a raft of media appearances on Saturday and was slammed by critics for evasive answers and implying that "confidence" in the economy would fund the pledge. Asked where the money would be coming from on BBC Radio 4's Today Programme, Hunt said, "Well, it's the right question to ask, because.. It's the obvious question to ask, because you haven't said so far," replied presenter Mishal Husain. "No, we have absolutely made it clear," Hunt responded. "We inherited an economy that was looking into the abyss, we've turned that around, it's the fastest-growing economy in the G7, it's creating 1,000 jobs every single day. Those jobs are paying taxes, the companies, the new companies that are being created are paying taxes, and it's on the back of.." Hunt replied. "Right, so it's based on an assumption, then," Husain fired back, "an assumption that the economy's going to grow to the point that you'll be able to afford this by 2020 ? On more than an assumption," Hunt said, saying annual spending on the NHS has risen over £7 billion in real terms during this parliament and he was "absolutely confident that we can put about the same again."

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The Independent

  • A million elderly people lack basic social care as unprecedented funding cuts leave struggling NHS to pick up the pieces.

    The number of elderly people who need help with basic tasks, but have been left to struggle by an unprecedented withdrawal of state-funded social care, has hit one million, experts believe. The leading charity Age UK estimated last year that 900,000 people in England between the age of 65 and 89 have unmet social care needs, but experts at the charity now believe the figure is closer to one million. Caroline Abrahams, Age UK’s chief executive, said that the issue of social care was the single most important issue for elderly voters going into next month’s election. But she warned it was not being talked about enough and had been put in “the too-difficult box” by politicians. The reason for that, Ms Abrahams said, was, in part, because most of the current crop of top politicians may be “too young” to have seen the impact of social care cuts on their own parents. Forty per cent cuts to government funding for local councils, which provide the bulk of social care, have had a devastating impact on elderly people, leaving hundreds of thousands struggling with basic tasks. New figures from Age UK reveal that more than 250,000 people who would qualify for help in the home because of difficulty getting up and down stairs are getting no support. Figures released by the charity in January show that 500,000 who need help with washing get no support, and nearly 600,000 who require assistance with dressing are struggling alone.

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  • George Osborne refuses to answer how Tories will fund £8bn NHS pledge 15 times in excruciating interview on The Andrew Marr Show.

    George Osborne repeatedly refused to say yesterday where the Conservatives will find the extra £8 billion they have promised to plough into the NHS if they are returned to power. During a sharp tempered exchange on the BBC’s Andrew Marr show, the Chancellor was challenged 15 times to say whether other public services, including the police, defence and local government, would have to face extra cuts to pay for this latest promise. He ducked the question every time, saying that the proposal was part of a “balanced plan” and pointing out that NHS spending had risen during the five years of a Conservative led coalition government. The latest Tory promise has created an unusual situation in which the Conservatives have outbid Labour in the amount by which they have promised to raise health spending. When Ed Miliband was invited to match the Tories’ promise, he seemed reluctant to do so, though Labour have said they will employ an extra 3,000 midwives. He has accused the Tories of promising to pay the NHS with an IOU. The Conservatives have also promised to cut the deficit faster than Labour had said they would, and have opposed Labour’s plans to raise extra tax by reintroducing the 50p tax rate and by ending the ‘non-dom’ tax status, and today the Conservatives have added a promise to raise the threshold for inheritance tax to £1 million. This has left observers wondering how they can pull off the treble of lower taxes, less government debt, and a higher NHS budget.

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HSJ

  • 63 CCGs take control of primary care budgets despite serious misgivings.

    Sixty-three clinical commissioning groups have taken on fully delegated responsibility of their primary care budgets despite serious concerns raised by some groups, HSJ has learned. One CCG that had been approved by NHS England to take on delegated commissioning of primary care dropped out before the new powers were due to take effect last week, but NHS England has not revealed the name of the group. HSJ also understands that City and Hackney CCG had been conditionally approved to take on delegated commissioning in 2015-16, but it will now not be taking on the new responsibilities this year. Commissioners were given only two weeks to sign delegation agreements with NHS England and finalise potentially complex legal arrangements for taking control of their primary care budgets, HSJ revealed last month. Several CCG leaders said they were concerned about the lack of time they have to prepare to take on their additional responsibilities. NHS England issued a letter, seen by HSJ, to all CCG accountable officers late last month to “clarify and offer assurance” following concerns raised by some groups about the terms of the delegation agreement. The letter said the organisation “received a number of queries and concerns from CCGs about the delegation agreement”. It was signed by NHS England director of commissioning strategy Ian Dodge and Blackpool CCG chief clinical officer Amanda Doyle, who is also co-chair of NHS England’s primary care co-commissioning programme oversight group. “Some of these queries have been points of clarification, whilst others have been concerns about the implications of certain clauses,” it added. CCGs’ worries related to when and how they would be allowed to use the termination clause, amendments to the delegation agreement, changes to delegated funds, liabilities for losses, legal claims and monitoring. The letter also revealed that NHS England was still finalising a service level agreement with CCGs around staffing. NHS England would be “updating the delegation agreement to address the main concerns CCGs have”, it said. CCGs would also not be required to “undertake anything for which NHS England is not already responsible”. Dr Doyle, who is also co-chair of NHS Clinical Commissioners, told HSJ: “We are delighted that 63 CCGs have now started commissioning primary care with full delegated budgets. “We are really pleased that we were able to work through all the issues CCGs raised [and are] working with NHS England to get those sorted out. [It’s] been a lot of work.”

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Friday 10th April 2015

Hospital Dr

  • The new chairman of the first hospital in the NHS to be run by a private company has said he cannot rule out department closures.

    Hinchingbrooke Hospital, in Cambridgeshire, has now returned to NHS management after Circle pulled out of its 10-year contract in January. The hospital was placed in special measures after a Care Quality Commission (CQC) report. Chairman Alan Burns said he would be looking at the “viability of services”. But he said his immediate priorities were to oversee “a smooth transition” from Circle back to NHS management and to get the hospital out of special measures. Mr Burns, a retired NHS chief executive, was appointed to chair the new NHS board running Hinchingbrooke, by the NHS Trust Development Authority. He said there was a “a very good sustainable future” for the hospital.

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The Guardian

  • Ways to right the coalition wrongs of NHS reorganisation.

    The letter from 140 health professionals (8 April) clearly identifies the problems the NHS has experienced in recent years. Key to the future is the issue of funding. The NHS accounted for less than 4% of GDP in its early years and this has risen to more than 9% now, with a particularly steep increase under Labour from 1997. Such increases have led to concerns regarding the system’s sustainability. But this reflects a complete misunderstanding of the nature of the healthcare system. Decades ago the American economist William Baumol defined certain sectors as being “handicraft industries” (health, education, the performing arts) that were disproportionately reliant on people rather than machinery, and as such with limited productivity gains. Elsewhere, productivity gains are more easily attained and goods become cheaper (such as the laptop I am using to write this). Technological developments in healthcare have been immense and we should always try to do things efficiently, but as any economy develops we should expect to spend proportionately more on the healthcare system. The good thing is that this is affordable because other “goods” are getting relatively cheaper. What is required is the political will to maintain and increase healthcare funding and less emphasis on trying to produce a system built on commercial values.

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  • When you step out of the NHS for a year, as I have, the inefficiencies, difficulty in getting appointments, and disgruntled patients fade into insignificance.

    Working as a doctor in Kolkata in India, a city where poverty is endemic and healthcare scarce, provides a new perspective on the NHS. I now see how a publicly funded healthcare system creates an optimal environment for ethical decision-making. Nowhere is this more apparent than in end-of-life care. In West Bengal there is no government palliative care policy or funding, so services rely on charitable organisations and private hospitals. Dr Dam is a palliative care doctor who has established his own NGO. He says referral rates are low and “oncologists have this attitude of ‘not letting go’ of their patients”. He argues that this is due to misconceptions about palliative care and economic factors including consultation fees, benefits from pharmaceutical companies and financial rewards for investigations. The Indian healthcare system is one of the most privatised in the world and is largely unregulated. A recent report in the BMJ by Dr Gadre, from Kolkata, exposed the extent of malpractice. He interviewed 78 doctors and found that kickbacks for referrals, irrational drug prescribing and unnecessary interventions are commonplace. In corporate hospitals doctors are pressurised to generate profit by performing unnecessary operations or procedures such as angioplasties. This undermines a fundamental medical ethic of “first, do no harm”. It is alarming that doctors “succumb to the pressures and get involved in these rackets”, as Gadre puts it. Those who do practise ethically cannot sustain their careers in these institutions.

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HSJ

  • District general hospital gives up standalone FT bid.

    A district general hospital has become the latest organisation to abandon plans to become a standalone foundation trust. Princess Alexandra Hospital Trust in Harlow, Essex, is now looking to become an integrated care organisation and is investigating both “horizontal” and “vertical” integration with other health bodies. The development was revealed in a paper presented to West Essex Clinical Commissioning Group’s board at the end of last month. It is the first time an NHS body has said publicly that the £177m-turnover organisation would not viable as a standalone FT. The report said: “Strategic review work carried out by [the trust] in conjunction with PwC concluded that a standalone route to foundation trust status is not achievable. Instead, the trust needs to undertake structural reform aligned to the underlying causes of its sustainability challenge.” It is not clear if the “vertical integration” mentioned in the document refers to the trust merging with a larger trust or with primary care and other local services. In the minutes of the trust’s January board meeting, chief executive Phil Morley said: “In its present form it [is] not financially viable and was becoming clinically unsustainable.” A trust spokeswoman told HSJ today that it “sees a possible future for delivering better healthcare and sustainable services through becoming part of an ‘integrated care organisation’”. She added: “Although early days, we are making a joint commitment [with local partners] over the next six months to test how this might work in practical terms, with a view to pursuing this as a viable long term model of care.” In April last year chair Douglas Smallwood indicated that he still wanted to pursue FT status. He said: “I think it is important that we can show that we can pass the test as well as secure the benefits of the increased self-determination it brings. In particular, striving for FT status is an important demonstration of ambition around quality.”

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  • Patients suffer 'harm' due to treatment delays.

    Performance: One patient could have suffered ‘serious harm’ because of a delay in receiving elective treatment caused by a large backlog of patients waiting for operations at Barnet and Chase Farm hospitals. A review by the Royal Free London Foundation Trust, which took over Barnet and Chase Farm hospitals in July, has found that one patient may have suffered “serious harm” and 39 “moderate harm”. The review has so far looked at 7,174 patients who have now received treatment. It will continue until all the patients who were waiting over 18 weeks have been treated. Barnet and Chase Farm Hospitals Trust discovered a large backlog of patients waiting for elective treatment last year. The Royal Free London has worked with commissioners and NHS England to put together a plan for treating these patients. The trust’s review concluded that one patient “may have experienced serious harm” and 39 patients had “potentially” suffered “moderate harm”, according to a report in the March board papers. There were also 68 patients who may have suffered “low harm”. Patients who are still in the backlog can be expected to be treated “within 18 months” after the data is validated. However, the trust hopes to reduce this waiting time. A review of the 33 patients in the backlog who had since died indicated that “no patient died as a result of waiting for more than 18 weeks for a procedure”. The trust has outsourced 1,541 patients to private providers since July last year, predominately for endoscopy and ear, nose and throat treatments. It has also scheduled extra outpatient clinics at weekends and extra theatre lists. HSJ asked the trust about the progress made in treating long waiting patients and if any patients would receive compensation for suffering harm due to waiting for treatment. A trust spokeswoman said: “When the Royal Free London acquired the former Barnet and Chase Farm Hospitals Trust, it inherited a waiting list in which waiting times were unknown. A key priority for the expanded trust has been to address this issue in close collaboration with our local commissioners and NHS England.

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Thursday 9th April 2015

BBC News

  • Coalition 'has undermined NHS', doctors say in letter.

    The government has "undermined and weakened" the NHS in England, a letter signed by 140 doctors says. The letter - published in the Guardian - said the coalition's approach has been characterised by broken promises, cuts and destructive legislation. And it warned the squeeze was "hitting patients" with pressures growing on A& E units and hospital waiting lists. But the Conservatives rejected the claims - and suggested it had been orchestrated by Labour. The letter was organised by Dr Clare Gerada, a Labour member and former chair of the Royal College of General Practitioners, but she denied the party had had any input into it. Signatories include Sir George Alberti, who worked as an emergency care tsar under Labour, Dr Laurence Buckman, a London-based GP and former senior member of the British Medical Association, and Prof John Ashton, a retired director of public health and president of the Faculty of Public Health.
    Dr Helena McKeown, a GP from Wiltshire and Liberal Democrat councillor, also signed the letter. The letter said: "The NHS is withering away and if things carry on as they are then in future people will be denied care they once had under the NHS and have to pay more for health services. As medical and public health professionals our primary concern is for all patients. We invite voters to consider carefully how the NHS has fared over the last five years." In particular, the letter went into detail about the government's reforms, saying they had led to a "rapid and unwanted expansion of the role of commercial companies".

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GP Online

  • Private firms could take temporary control of practices at risk of closure.

    Private firms and community providers could be handed temporary control of practices at risk of closure under plans being drawn up by NHS England.A framework agreement for interim primary care is being developed by the commissioning body’s South region to maintain GP services when a practice is at risk of closure. A document from NHS England South said it is looking for experienced, CQC registered, GP providers, federations and multispeciality providers to to join the framework and be able to take over practices on a short-term basis. Examples given include where a single-handed GP dies or retires at short notice, putting the future of the service at risk. The document said: ‘General medical services will be purchased from the suppliers on the framework using APMS contracts and, where necessary, after mini competitions between interested framework providers.’

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Manchester Evening News

  • Mental health patients taken to private clinics hundreds of miles from Manchester at cost of £7m.

    Hundreds of mental health patients are being taken to private clinics up to 260 miles from Manchester due to a shortage of NHS beds. Acutely-ill people have been transferred to clinics as far away as Darlington, Harrogate, London and Bristol for emergency treatment more than 670 times since 2013. Many have stayed away for weeks while undergoing treatment at a huge cost to the NHS in Greater Manchester. Bosses at the Manchester Mental Health and Social Care Trust have paid more than £7m for beds at clinics, including the Priory in Altrincham, since 2011. Senior psychiatrists, health unions and mental health service users have all expressed concerns about the practice. One patient has told the M.E.N. she was sent back to Manchester in a taxi after spending three weeks being treated in Harrogate, North Yorkshire.

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ITV News

  • Politicians should 'stop playing games with NHS', GPs say as they reject seven-day surgery plans.

    Doctors across the UK have urged politicians to "stop playing games with the NHS" as a major survey of more than 15,000 GPs revealed the vast majority are against plans to open practices seven days a week. Some 94% of GPs polled were against having to open their surgeries every day of the week - though 51% said they felt practices should offer some kind of extended hours. It comes after Conservative leader David Cameron pledged that a Tory government would guarantee access to a GP seven days a week by 2020 should they be voted in come May 7. The survey was carried out by the British Medical Association.

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West Yorkshire Examiner

  • Plan to close Huddersfield Royal Infirmary's early pregnancy unit edges closer.

    A plan to close Huddersfield Royal Infirmary’s early pregnancy unit is to be discussed by councillors. Mums-to-be who need scans and treatment during the early weeks of pregnancy may have to travel to Calderdale Royal Hospital in Halifax in the future. Hospital chiefs say the main reason for the move is to improve patient experience. But the report also says that both Huddersfield and Calderdale’s early pregnancy units are “under-utilised” and could be combined at the more modern facilities in Halifax. It is not yet known if the merger would cause job losses. The plan to move to Halifax comes seven years after maternity services were controversially switched from HRI to Calderdale and amid a wider ambition to shake-up all hospital services. The trust has previously revealed ambitions to merge services, including A& E, in its controversial restructuring plans.

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Tuesday 7th April 2015

Pharma Times

  • UK public support raising taxes to fund NHS.

    Protecting the NHS budget is high on the public priorities list, and the majority of people back raising taxes to secure its cash pot, a new survey of nearly 1,800 adults by Ipsos MORI for think-tank the Health Foundation has revealed. Eighty-five percent of respondents said the NHS should be protected from spending cuts, reflecting a much stronger feeling than for other public services such as schools (49%) and elderly care (45%), and defence (18%). Almost 60% said they back tax increases as a means of maintaining current levels of NHS spending, care and services, while just 21% said they want to see spending reductions in other services to protect the health budget. Health leaders are warning that by 2020 the NHS budget gap will have swelled to £30 billion unless efficiency savings of £22 billion can be generated and the Treasury streams an extra £8 billion a year into the system.

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Sunderland Echo

  • Union takes action after staff axed in Sunderland health shake-up.

    A union is set to take legal action against health bosses after three Wearside workers were left facing the dole queue. The nutrition and obesity service staff, all working with people in Sunderland, are caught in the middle of a jobs wrangle between two health trusts. Earlier this year, a deal was struck to transfer a wellness contract from South Tyneside NHS Foundation Trust to its County Durham and Darlington counterpart and Neca (the North East Council for Addictions). But uncertainty surrounded the future of those employed in the nutrition and obesity service over whether or not they would be included as part of the transfer. As the new contract was set to begin, the three workers turned up at County Durham and Darlington NHS Foundation Trust headquarters, but they were told that there were no jobs for them. The County Durham trust insists the staff were informed there would not be roles for the trio once the services were transferred, but their bosses in South Tyneside argue that the agreement was that all workers would be kept on. Now the dispute is set to trigger legal action, with Unison set to take the issue to an employment tribunal.

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Walsall Manor Express and Star

  • 50 jobs to go at Walsall Manor Hospital in £10.5m cuts.

    Walsall Healthcare NHS Trust is looking to claw back cash through its cost improvement plan for 2015/ 16. As part of its annual plan the equivalent of 48 roles are expected to be lost, although health bosses insist the overall number of staff will increase due to the agreed investment in nurses.

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Financial Times

  • NHS faces bigger than expected financial ‘black hole’.

    The National Health Service is facing an even bigger financial “black hole” than politicians and health leaders have acknowledged, following a sharp fall in productivity revealed in an analysis of official data for the Financial Times.
    The research, carried out by the Health Foundation, an independent think-tank, shows that despite an inflation-protected budget, hospital productivity tumbled from 2012 as the NHS prepared for, then implemented, a contentious structural shake-up that stripped out layers of management and handed budget control to clinicians. Government pressure on hospitals to hire more nurses following a 2013 inquiry into a care scandal at a Staffordshire hospital further hit financial performance as many NHS institutions hired agency staff, substantially inflating the health service pay bill, the analysis found. The findings will fuel the general election debate over the coalition’s management of the NHS and suggests whichever party forms the next government may confront an immediate imperative to inject more money into the health service.

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Friday 3rd April 2015

Hospital Doctor

  • Experts doubt election pledges on GP access.

    As the general election in the UK approaches, experts are questioning whether the political party promises on access to general practice are likely to be achievable. Tom Cowling and colleagues at Imperial College London say pledges on the GP workforce “are unlikely to be achieved within a parliamentary term” and guarantees of an appointment within 48 hours “may prove unrealistic”. Access to general practice is a prominent issue in national policy debate ahead of the 2015 UK general election in May - and the two main parties, Conservative and Labour, have both made bold pledges on this topic, write the authors in The BMJ. For example, the prime minister has declared that everyone in England will be able to see a general practitioner between 8 am and 8 pm, seven days a week, by 2020 if the Conservative Party is re-elected to government. The government also plans for an extra 5,000 GPs and spending an additional £2bn on the frontline of the English NHS next year (currently there are 40,000 GPs and spending is £115bn). Meanwhile, the Labour Party aims to guarantee a GP appointment within 48 hours, a policy recycled from past Labour governments. Labour also intends to recruit 8,000 more GPs. But the authors point out that the problem with access “has not been precisely defined; nor has the evidence behind pledges been made clear”.

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Red Pepper

  • Mythbuster: Health warning.

    By repackaging privatisation as ‘reform’, the government has tried to sell voters the idea of dismantling the health service. Jacky Davis exposes the main marketing myths behind the NHS giveaway. Myth: The NHS is inefficient and unaffordable – it can’t go on like this International studies have consistently shown the NHS to be one of the most cost-effective health services in the world. In 2014 the Commonwealth Fund study ranked it highest overall based on quality of care, access to care, efficiency and equity. Among the 17 countries considered, the US healthcare system was among the least efficient and effective. If we are agreed – and most people are – that the state has a role in providing health care, then the NHS is doing a good job with our money. And politicians who claim we can’t afford the NHS must answer the question – if we can’t afford the most cost-effective health service in the world what can we afford ?

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HSJ

  • New foundation trust slips £10m into the red.

    St George’s University Hospitals Foundation Trust has seen a steep decline in its finances and is expecting to report a £10m deficit for 2014-15. This comes two months after Monitor awarded the trust foundation trust status. The regulator had already delayed the trust’s application in December because of concerns over its finances. The trust’s March board papers show the financial position has worsened rapidly, and up until December the trust was expecting to deliver a surplus. The trust is now planning for a deficit up to £30m in 2015-16. A spokeswoman for the trust said this was a “working assumption rather than a firm plan”. The trust has imposed “very rigorous controls” on spending with immediate effect, including asking managers to cut bank and agency staff spend by 40 per cent. A spokeswoman for the trust said that staff have been told that if they have any concerns about the cuts affecting patient safety to discuss them with their department leadership team. Equipment and supplies orders will be “strictly limited”, according to a note to all staff from chief executive Miles Scott. Support from non-clinical services, including estates, IT and domestic services will be “tightly controlled” and “some service developments and capital expenditure will be delayed”. Mr Scott said: “Over the winter we have experienced extreme operational pressures resulting in increased costs and also reduced income from planned activity. This has been made worse by national funding changes, for example in education and specialised services.” St George’s received £2.1m in Project Diamond funding in 2013-14, according to NHS England figures. This funding is given to London trusts to cover the higher costs of specialist work in the capital. However, the fund may not be available to trusts to cover 2014-15. The March papers show a year to date deficit of £9.5m, which is £14.8m off its year to date target of a £5.3m surplus.

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Pulse

  • GP out-of-hours providers have been thrust into competition with practices over a ‘limited pool’ of GPs to work on Easter Saturday after NHS England announced incentive schemes to keep practices open.

    This comes as medical leaders reported variable uptake to local enhanced services created at short notice in response to a call from NHS England for GP practices to open for a three-hour shift over Easter in a bid to prevent a repeat of the Christmas holiday A& E meltdown. A Pulse investigation showed that between a sixth and a third of practices were taking up LESs specially created for the weekend in areas where financial incentives were offered, while out-of-hours services will be left to tackle the whole burden elsewhere.GPC deputy chair Dr Richard Vautrey said that in Leeds, where he is assistant medical secretary on the LMC, ‘around 20 practices’ will be opening at some point of the bank holiday weekend. He said: ‘This scheme is supported by additional funding for those who have volunteered to take part and also links to the extended hours scheme that one of the CCGs has developed which new long-term funding they’ve invested in general practice.’ But other GP leaders warned that the one-off payment incentives coupled with smaller indemnity costs incurred when operating from the practice rather than through out-of-hours were having the unintended consequence of drawing GPs away from working out-of-hours shifts this weekend. Devon LMC medical secretary Dr Mark Sanford-Wood said: ‘The main concern locally is that the offer may actually precipitate destabilisation of out-of-hours services. ‘Our local out-of-hours provider Devon Doctors on Call is proud that its services are largely delivered by local GP partners. Of course, if these people can earn better rates of pay for working in more protected circumstances within the structure of their own practice then they are likely to plump for that and avoid out-of-hours work over Easter which is always very difficult.’

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Thursday 2nd April 2015

Cumbria News and Star

  • Cumbrian nurses and care assistants asked to pay back wages.

    Nurses and health care assistants in Cumbria are being asked to repay hundreds of pounds – after allegedly being overpaid. Concerned NHS workers across the county have contacted their union, after being hit with repayment notices and given just 30 days to repay. The Royal College of Nursing (RCN) northern region has revealed it is consulting its lawyers after being contacted by members in Cumbria and the north east. It claims some nurses and health care assistants have received demands for repayment of more than £1,000 for alleged overpayments dating back six years, and yet have only been given 30 days’ notice to arrange repayment. Greg Canning, senior officer for the RCN, said: “It seems curious to say the least that all of a sudden we are seeing a flurry of employers claiming that they have overpaid their staff for the last six years, and we have as yet seen no evidence. Equally, there seems to have been no assessment of whether there are examples of nurses and health care assistants being underpaid by the employer too. We’re concerned that this is just an attempt to save money.” The News & Star understands that the union has received calls from all NHS trusts in the county.

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BBC News

  • Privately-run Hinchingbrooke Hospital returns to NHS.

    The new chairman of the first hospital in the NHS to be run by a private company has said he cannot rule out department closures. Hinchingbrooke Hospital, in Cambridgeshire, has now returned to NHS management after Circle pulled out of its 10-year contract in January. The hospital was placed in special measures after a Care Quality Commission (CQC) report. Chairman Alan Burns said he would be looking at the "viability of services". But he said his immediate priorities were to oversee "a smooth transition" from Circle back to NHS management and to get the hospital out of special measures.

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Sheffield Star

  • NHS England block closure of Sheffield surgery.

    An under-threat Sheffield surgery may come under new management after national NHS bosses said it should not close. Practice managers in charge of the Beighton Health Centre had consulted on plans to close the site in order to retain service levels at its sister surgery in nearby Sothall. They said proposed funding cuts for the next four years would cut almost a quarter of their income and make it impossible to keep the same level of service at both sites. More than 600 patients took part in a consultation organised by the Sothall and Beighton Medical Practice last year, with 64 per cent in favour of closing Beighton Health Centre on Queens Road to allow for longer opening hours at Sothall Medical Centre on Eckington Road. But that idea has been rejected for now by NHS England, with a new consultation due to start on whether a different provider should be found to run things in Beighton.

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Guardian

  • NHS spending inefficiently on non-permanent staff, says thinktank.

    The NHS should train more staff rather than spending around £2.5bn a year on locum doctors and agency nurses, a thinktank has suggested. Civitas, a cross-party thinktank, said a larger pool of dependable permanent staff would also enhance workforce stability and patient safety. The subsequent increase in competition for jobs would also help fill less desirable roles such as those in A& E departments and general practices. The report from Civitas said that agency nurses cost in the region of £24 to £29 an hour, equivalent to between £47,000 and £56,000 a year, while the salary for an NHS band 5 nurse is between £21,478 and £27,901. The typical charge for a consultant from an agency is £1,760 a day, equivalent to a pro-rata salary of £459,000. Civitas reported that, since the salary of an NHS consultant is between £75,249 and £101,451, four consultants could be employed by the NHS for the price of one agency staff member. The report said that as well as the financial drain of using non-permanent workers, it is also a safety issue if there are major difficulties with finding enough contracted staff.

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Wednesday 1st April 2015

Open Democracy

  • The privatising cabal at the heart of our NHS.

    The battle is on for the future of the NHS. Apparently. Ed Miliband came out hard, declaring he will ‘put patients before profits and stop the privatisation’. David Cameron’s camp countered with a commitment to fully fund the next wave of NHS reforms. Like pro-wrestling, it’s a good show, but a phony fight. How can you tell ? Just look at the players sitting round the table. Let’s start with former Labour Health Minister and arch-reformer, Alan Milburn, a man who has since made a personal fortune from working with private health firms. When Milburn was in charge of the NHS from 1999 to 2003 he pushed through many of the ‘reforms’ that the Conservative party have merely accelerated. His team at the time consisted of policy advisor Simon Stevens; private secretary Tony Sampson; and media advisor, Andrew Harrison. Where are they now ? Simon Stevens' journey is well known. He left the NHS in 2004 and spent a decade learning how the American’s do healthcare at US giant, UnitedHealth (at first Stevens was put on selling UnitedHealth services to European health systems, then became Vice President and lobbyist for the whole UH Group). Stevens was described in the Financial Times as “a key architect, along with Mr Milburn and Mr Blair – to whom he went on to serve as health adviser – of the reforms that for the first time broke up the NHS monolith, introducing privately run treatment centres.” In 2014 Stevens returned to the UK to share his wisdom as Chief Executive Officer of the NHS. He is the man currently running the show. Maybe less well-known is that Milburn’s private secretary, Tony Sampson, was also drawn to UnitedHealth. From 2005 to 2013, Steven’s former close colleague was UnitedHealth’s chief lobbyist in the UK. What’s hardly known at all is that Milburn’s other aide, Andrew Harrison, has also long been in the employ of UnitedHealth. Harrison is head of health at lobbying firm Hanover, which has lobbied for UnitedHealth since at least 2007. So, that’s the whole team – Stevens, Sampson, and Harrison – all lobbying for UnitedHealth for the best part of a decade. And today we’re surprised that UnitedHealth is in line to pick up billion pound NHS contracts ? Milburn’s seat also opens up the table for venture capitalists Bridgepoint. Bridgepoint has investments in Care UK, which calls itself ‘the UK’s largest independent provider of health and social care’. From its care home roots, Care UK now runs over 50 NHS services, and has been bidding for huge contracts.

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Socialist Worker

  • Austerity is fuelling NHS crisis—but bosses plan even more cuts.

    David Cameron last week pledged to bring in a “truly seven-day NHS”, if the Tories get back in—by smashing health workers’ pay structure. The plan to bring in seven-day working was first proposed last October by NHS England boss Simon Stevens in his Five Year Forward View. It was drafted after he admitted the health service is facing an £8 billion black hole. Now bosses want to get more out of workers for less. Tory health secretary Jeremy Hunt said that he would give the NHS an extra £8 billion—but only while cutting it by a further £22 billion. Bosses will have to dismantle workers’ pay structures in order to bring in seven-day working. The Department of Health has submitted evidence to the pay review body which includes the option to scrap unsocial hours pay altogether. There’s nothing wrong with seven-day working in the NHS. But the Tories’ plans are about smashing health workers’ pay and creating a more “flexible” workforce with fewer rights.

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ITV News

  • Hinchingbrooke Hospital is handed back to NHS.

    Hinchingbrooke Hospital is being handed back to the NHS to run it from today. It comes after the private company 'Circle' which ran the trust, ended its contract there. Bosses say there will be no noticeable change or disruption for staff or patients. Hinchingbrooke was the UK's only privately run NHS Trust, until the company running it decided to end its contract earlier this year.

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Warrington Guardian

  • Pensioner quizzes PM over NHS and fears hospital will be 'bankrupt'.

    AN 86-year-old governor of Warrington Hospital made the Prime Minister squirm after questioning him over the what will be done to limit the impact agencies are playing on the NHS. Alfred Clemo, who is also a treasurer at the Older People's Forum, quizzed David Cameron in Westminster in the pre-election event hosted by Age UK. Mr Cameron pledged to protect pensioners' benefits, the health budget and state pension but struggled to give Mr Clemo a straight answer when asked about what will be done to limit the effects agencies are having on the service. "The hospital is going further and further in to debt - the main thing causing it is the money being given to agencies," said Mr Clemo. "When the hospital gets busy they need agency staff to help out but the agency is fleecing the hospital. David Cameron was fudging the question - he tried to blame it on the management and I took it as an insult as we have a very good management team at Warrington, it is nothing to do with that. The NHS trains nurses and doctors but then agencies come along and offer them twice the money - if you come along and offer that then people will take it." Mr Cameron was jeered in front of more than 200 pensioners at the event urging for the leader to implement changes. NHS spending on agency staff has now tripled to £1 billion in two years and Mr Clemo fears the worst for Warrington Hospital if measures are not brought in.

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Daily Mail

  • Your secrets for sale: Now the NHS is in the dock after it's revealed details of patients who bought prescriptions online are sold off.

    Thousands of users of an online prescription service have had their data sold without their knowledge, a Mail investigation can reveal. Their names and addresses have been handed to companies that target the sick. Many of the patients used the Pharmacy 2U service because they were disabled or too ill to travel to their nearest surgery. Others used the firm’s online doctor consultations. Pharmacy 2U, which is the country’s leading NHS approved online pharmacy, even gave the patients’ email addresses, dates of birth and date of their last prescriptions to a marketing firm. MPs said the company was putting thousands of patients at risk and should face a police probe. The revelations come amid a growing outcry over the Mail’s reporting on how sensitive medical and financial data is being sold to conmen and criminals. Today we can also reveal that: NHS dentists are buying data on patients in order to try to sell them treatments; Payday loan brokers are passing on the financial details of vulnerable people who have been refused cash – leading to them being targeted by conmen; Schools are buying information on teenagers’ parents from a data firm already exposed for selling medical details; The Department for Business paid an unscrupulous data firm up to £15,000 in public money to help them target small business owners.

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BBC News

  • Clegg urges major parties to 'come clean' on NHS funds.

    Nick Clegg is challenging David Cameron and Ed Miliband to show how they would find the £8bn NHS bosses in England say is needed to preserve services. The Lib Dem leader threw down the gauntlet as he pledged to spend an extra £3.5bn over six years on mental health. Conservatives say they have cut red tape to invest in NHS staff. Labour would halt privatisation of the NHS. Last year Simon Stevens, head of NHS England, said there was an £8bn-a-year funding gap between what the NHS gets and what it needs. Mr Clegg said the Lib Dems would meet the shortfall from £2bn already allocated in the Autumn Statement and by closing some of the reliefs on capital gains tax and the Conservative shares for rights scheme.

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Monday 30th March 2015

The Lancet

  • Will politicians be architects or destroyers of the NHS?

    In the history of the UK’s National Health Service (NHS), The Health and Social Care Act 2012 will go down as the most egregious act of vandalism against the people of England. During its passage through Parliament, David Owen called it the “Secretary of State’s Abdication Bill”, because the legislation removed the Secretary of State for Health’s responsibility for, and duty to provide, an NHS throughout England. The Act’s destructive effect is being felt in all political jurisdictions. But it has fallen to Owen, a peer in the House of Lords who describes himself as an independent social democrat, to take on the mantel of Nye Bevan, the founding father of the NHS. A veteran politician, Owen has served as Labour health minister and foreign secretary, and led the Social Democratic Party in the 1980s. In The Health of the Nation, Owen returns to grass roots politics in his account of the People’s Commission in Lewisham, south London, and the Save Our Surgeries campaigns to stop NHS hospital and general practice closures in 2013–14. He documents the tenacity of local campaigners and NHS staff and patients to stop closures of their hospital and community services, which were driven by the high costs of servicing private finance initiative (PFI) debt. The fight went to the High Court where the people won; they won again when the UK Government appealed against the decision. Owen explains how the costs of the PFI debt repayments combined with budget cuts are the engine for NHS hospital, general practice, and community closures across the country. He outlines how privatisation is opening up health services to international markets and making public services vulnerable to trade treaties and legal challenges from multinational investors. As a former doctor, he fears the dismantling of the NHS will see a return to public health tragedies on a scale not seen since before World War 2.

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Open Democracy

  • The 'ninja' NHS privatisers you've never heard of...

    ”Despite our warnings about the risks... no one has been held accountable for the consequences.” That was the fierce criticism last week from watchdog Margaret Hodge MP and her Public Accounts Committee of the failed flagship privatisation of Hinchingbrooke hospital. No-one can hold Circle Holdings accountable. On the day inspectors gave the hospital they were running, the worst rating for ‘caring’ of any hospital in the country, the firm announced they were giving up and walking away, three years into the ten year contract. The Committee concluded that the deal was an expensive experiment that left taxpayers to pick up the bill. But who cooked this deal up in the first place ? And have they learnt their lesson ? Step forward, the Strategic Projects Team (SPT), a shadowy organisation initially set up within the NHS to design the Hinchingbrooke deal. And no, they don’t seem to be in apologetic mood. ”Change is a combat sport.” So said Strategic Project Team co-founder, Stephen Dunn, at this week’s SPT anniversary celebration. For six years, these ‘change-makers’ have been, in their words, ”supporting the brave” and ”encouraging the timid” to reform health services and hand them over to the private sector. That’s to say, roaming around England’s health service looking for things to privatise. ‘Change from within’ is SPT’s tag line. Today, though, SPT is having trouble defending its record, which may explain why they are in fighting mode.

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  • Cameron's biggest broken promise on the NHS.

    Virgin Care have won a £280 million contract to run NHS healthcare in East Staffordshire, it was revealed today. Virgin will now provide (or sub-contract to other providers of its choice) healthcare services for 6,000 frail elderly people and around 38,000 people with long term conditions such as diabetes or heart disease. The decision - along with other big pre-election privatisations - appears to contract David Cameron's pledge in November 2014, when he told the BBC "It's our National Health Service. It's in the public sector, it will stay in the public sector. That's not going to change." In fact there is evidence that despite government denials, the pace of NHS privatisation is accelerating. Commenting on the latest Virgin takeover, Clive Peedell, leader of the National Health Action Party, told OurNHS: "This is yet more evidence of the increasing privatisation of the NHS which adds weight to the findings of a recent BMJ editorial, which quoted research from Oxford Economics showing that in the first 3 years of the coalition, the value of outsourcing had increased from £6.9bn in 2010 to £12.2bn, equivalent to 10% of the NHS budget." Local health commissioners, East Staffordshire CCG, explained the decision, telling the Health Services Journal that without the contract it would be unsustainable by 2018 and overspend its allocation from NHS England by £10m. The decision follows a KPMG report highlighting the ‘distressed local health economy’. Quite how Virgin will deliver the service cheaper than the NHS is unclear.

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The Conversation

  • State of the Nation: ten things we’ve learned about the NHS under the coalition.

    Coming in to the 2010 general election, most people thought that the NHS was in a good place. After significant under-investment over many years, the 2000s witnessed nearly a decade of sustained growth, extra staff, a significant focus on key clinical priorities (such as cancer, mental health and heart disease), greater emphasis on joint working with social care, a modernisation of buildings and infrastructure and – perhaps most impressive of all – a radical improvement in waiting times and access. If someone had said in 1997 that waits would reduce from around two years in some instances to routinely under 18 weeks, most commentators (ourselves included) would have said it was impossible. And yet this is precisely what was delivered – public and patient satisfaction with the NHS was high and international comparisons were starting to look much more favourable. If ever there was a time for evolution rather than revolution, it was 2010. With hindsight, this makes the massive (and arguably unnecessary) upheaval of then health secretary Andrew Lansley’s reforms even more tragic. Rather than building on what was working well and focusing on further improvement, the 2010 Liberating the NHS white paper threw this all up in the air, introducing an almost completely new system which still few people understand and most think can’t possibly work. The NHS is also undoubtedly feeling the strain of an ageing population, rising need and demand, significant financial challenge and a workforce that is overloaded and weary of change. Unlike in 2010, healthcare will be a key electoral battleground this May – and all the signs are that this debate will be adversarial and bad-tempered. In thinking through how we got from the 2010 inheritance to now, here are ten things we didn’t know then but certainly know now.

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