Saturday, 31 October 2009

Patients who wait too long will get private care on the NHS

By Tom Baldwin and Sam Lister

Patients who do not get the treatment that they need from the NHS within 18 weeks are to be given the legal right to free private care.

The Cabinet agreed this week that the legislation, placing maximum waiting times on the statute book for the first time, should be rushed through Parliament before the next election.

Cancer patients, in particular, will receive funding for private treatment if they have not seen an NHS specialist within two weeks of GP referral.

Downing Street says that the two legal rights, which will be unveiled in next month’s Queen’s Speech, are designed to entrench the dramatic reduction of NHS waiting lists over recent years — as well as allowing Gordon Brown to “throw down the gauntlet” to the Conservative Party in the election campaign.

With NHS budget growth likely to be sharply curtailed whichever party is in power, No 10 believes that the legislation will prevent waiting lists drifting back up.

“This will send a strong ‘no turning back message’ to voters,” a senior government source said. “David Cameron will have to decide whether he wants to repeal this measure and take rights away from patients.”

The Tories have promised to phase out all NHS targets, including those for waiting times, saying that patients should make “informed choices” about their care without hospitals being forced into a straitjacket of government regulation. “Labour always focuses on the process while we think what really matters is whether you are better after your treatment,” a Conservative spokesman said.

Patients are currently offered a choice from a range of NHS, independent and private provision only at the outset of their treatment. They are obliged to stick with that decision even when their treatment is delayed beyond the existing target time limits.

The new rules will allow people to switch to a different hospital, including those in the private sector, if they have been made to wait longer than 18 weeks for treatment by a specialist after seeing their family doctor.

When Labour policy documents published this summer first raised the prospect of a legal entitlement on waiting times, ministers had still not agreed on the timing of legislation and the enforcement mechanism.

The Queen’s Speech on November 18, setting out the Government’s legislative programme for the final months before the election, will promise that the measure for England and Wales will be in place within months.

Ministers plan to issue executive regulations that turn key waiting time pledges from the new NHS constitution into legally binding rights. Downing Street suggested yesterday that although parliamentary approval was not needed to amend the Health Bill, MPs were likely to be given a vote.

Draft legislation is understood to say that primary care trusts must monitor whether patients are languishing in the queue and inform them of their rights for alternative provision. The trusts will be required to “take all reasonable steps” to ensure patients are treated immediately either by the NHS or the private sector.

According to the latest figures from August, about 37,000 patients had not received treatment from an NHS specialist within 18 weeks of their GP referral. There are legitimate clinical explanations for some — and others are caused by patients cancelling their own operations to go on holiday — but officials believe that about half have been “failed by the system”.

Andy Burnham, the Health Secretary, told Cabinet colleagues this week that the new legislation would mean that underperforming hospitals would lose funding from patients going elsewhere and “act as a powerful challenge for them to raise their game”.

Jennifer Dixon, of the Nuffield Trust, said the plans could be seen as “Tory-proofing” the NHS. “It would not only give patients enforceable health care entitlements but it would also prevent managers and clinicians from controlling waiting times as a way of limiting demand and saving money,” she said. “In the past requirements to make financial savings often resulted in hospitals stopping routine surgery for a couple of months before the end of the financial year.”
Source: Times Online

Friday, 16 October 2009

Watchdog vows to get tough on NHS

One in eight NHS trusts has been told it must urgently improve the care it provides, by a new regulator publishing ratings on England's 392 trusts.

The assessments by the Care Quality Commission show a drop in the number of hospitals meeting basic standards in areas such as hygiene and safety.

But it also said more services than ever could be rated good or excellent.

From April, the CQC will gain new powers to be able to shut any of the 47 underachieving trusts down.

Rigorous assessment

The new commission, which took over the watchdog duties of the old Healthcare Commission earlier this year, pointed out a number of successes in its report.

These included what it called the notable achievement of most patients in England receiving hospital treatment within 18 weeks.

The government said this was the most rigorous assessment the NHS had ever seen.

NHS Ratings Health Minister Mike O'Brien said the report showed improving standards across the health service.

"We have transformed the waiting experience for millions of patients and now have the shortest waits on record. MRSA and C. difficile infections have been significantly reduced and over three quarters of GP surgeries are providing extended opening hours, giving patients greater choice and more convenient access to GPs."

But shadow health secretary Andrew Lansley said the report showed the government was unable to "turn round poor performers".

"Many staff are doing a great job in keeping up high standards but we cannot allow that to obscure the fact that there has been poor performance in some very important areas in the NHS, such as maternity and stroke services.

"And it is unacceptable that the number of patients who have had their operations cancelled has risen so sharply."

The CQC looked at every type of NHS trusts, including acute, mental health, primary care and ambulance.

More than half of primary care trusts were rated good or excellent, with many patients reporting being able to get an appointment within two days and services such as chlamydia screening for young people improving.

There were, however, significant regional variations, with trusts in London performing particularly poorly on patient satisfaction with appointments and opening times.

Fewer mental health trusts were rated excellent or good, and some struggled to meet new criteria on collecting data about services. Ambulance services also failed to perform as well as last year, but the CQC nonetheless praised the general response to emergency calls.

But much of the focus is on hospitals: fewer acute and specialist trusts were rated excellent, with more receiving an unimpressive fair grading.

Based on a system of self-reporting, there was a significant drop in the number of acute trusts fully meeting basic standards such as those relating to hygiene, child protection and training: this was down to 59% of all trusts from 69% last year.

Many also failed to meet new performance targets, such as the collection of maternity data to help improve services, and stroke care.

The number of operations cancelled rose for the second year in a row - equating to 63,000 procedures called off at the last minute for non-clinical reasons.

However a higher proportion are now being rearranged within 28 days of the original appointment, and the figure also reflects the much higher number of people now receiving treatment.

Waiting times for treatment have fallen to 18 weeks or less this year, one of the achievements highlighted by the regulator.

It also noted that 98% of the 19 million patients who attended A&E waited less than four hours, while rates of the infections Clostridium difficile and MRSA had both fallen by about a third - despite hospitals themselves reporting failings in hygeine.

While a number of trusts were singled out for praise - including the Royal Marsden, which has scored excellent every year for both quality and finance - the CQC said the focus now had to be on those which had performed persistently poorly.

Twenty trusts scored weak for overall quality, while 27 others have now never scored higher than fair for either quality or finance in the four years since the ratings system was started.

'Nuclear option'

Some particularly poor performing acute trusts were highlighted: Barking, Havering and Redbridge hospitals received a double weak rating, while the Royal Cornwall Hospitals NHS Trust was deemed weak for the fourth year in a row.

Maidstone and Tunbridge Wells NHS Trust - which saw a deadly outbreak of clostridium difficile amid serious hygiene lapses between 2004 and 2006 - was rated weak for the third year in a row.

The CQC said it intended to work closely with these 47 trusts to sort out their problems ahead of April next year, when it will gain the power to intervene in every trust, from dealing out admonishments to potentially launching prosecutions and closing services down.

"But that would be the extreme nuclear option for any regulator," said CQC head Cynthia Bower.

"Trust are aware of what their issues are, so none of this is going to come as a surprise to them.

"There is an ongoing process of debate to sort these problems out by April, no-one is just waiting around."

The King's Fund chief executive Niall Dickson stressed that overall the report showed the NHS appeared to be performing well, but that it was unfortunate the ratings did not shed light on why some did well and some badly.

"Patients served by the hospitals and other services that consistently rank at the bottom have a right to know why these organisations are not providing the quality of services that is expected from them.

"We need to understand whether the problems are managerial or structural, and what is being done to help them raise their game."

Source: BBC News

Watchdog gets tough with patients too according to The Telegraph

Tuesday, 13 October 2009

The devastating moment parents said goodbye to their son left severely brain-damaged by hospital blunders

This is the heartbreaking moment parents Johanne Rees and Krishna Govekar clutched their newborn baby boy for the last time, just minutes before being forced to switch off his life-support machine.

The parents said goodbye to son Arun, who had been kept alive for 10 days after his birth, after a catalogue of medical blunders left him severely brain-damaged.

The NHS was today ordered to pay the couple £160,000 compensation after midwives at the University Hospital of Wales (UHW), Cardiff, failed to spot the unborn child was in distress.

Ms Rees said today that she believed they would have had better care if she had given birth in her partner's home country of India.

During her ordeal one doctor even rejected Ms Rees' pleas that she had gone into labour, saying she simply needed the toilet.

The harrowing pictures, which were taken by another family member, were released through the couple's solicitor today to highlight their plight.

Ms Rees, 48, had been classed as having a 'high risk' pregnancy because she was aged 44 when she was due to give birth and had previously suffered a miscarriage.

Ms Rees had been admitted to the University Hospital of Wales in Cardiff 32 weeks into her pregnancy, in November 2005, with abdominal pains.

But she told how her labour was not properly monitored for more than two hours at. She said heart readings 'clearly showed' her unborn baby was in distress.

'I just couldn't understand why they weren't doing anything to help me and my baby,' she said.

'At my last antenatal visit I was told my baby was breech and I would need a caesarean section.

'It was a no-brainer - I knew my baby needed to be delivered urgently.

'I was screaming in agony and begging the midwives to get my baby out but they just left me.

'I couldn't believe it when a doctor arrived and said I wasn't ready to deliver but had probably eaten something that had disagreed with me and to try going to the toilet instead.'

An emergency caesarean was performed an hour-and-a-half later on a second doctor's recommendation.

Baby Arun was taken to the special baby care unit but had suffered irreversible brain damage.

The parents were not told the extent of their baby's health problems for five days. After spending four days with him they made the decision to switch off his life support machine.

Full article in Daily Mail
Also in Daily Mail: Boy, 10, awarded £7.1 million damages for birth blunders which left him brain-damaged

Monday, 12 October 2009

Nurse struck off by GMC for secretly filming neglect and abuse wins appeal

A nurse who was struck off the register for secretly filming care for the elderly at a Brighton hospital has won her battle to return to work.

The High Court approved a settlement between Margaret Haywood and the Nursing and Midwifery Council (NMC).

The striking-off order imposed in April this year will be replaced with a one-year caution, which means she can now work as a nurse.

Ms Haywood filmed at the Royal Sussex Hospital for a BBC Panorama programme.

Footage from Ms Haywood's filming was broadcast in July 2005 and showed examples of neglect, including an elderly patient sitting in clothes he had soiled the night before.

The Nursing and Midwifery Council found her guilty of misconduct during a fitness to practise hearing and she appealed in May.

Ms Haywood, from Liverpool, said she was delighted with the verdict.

"Losing my registration after 25 years as a nurse was devastating," she said.

"I have been overwhelmed and humbled by the patient and public interest in my case and would like to thank everyone who has supported me, including the Royal College of Nursing (RCN) for running my appeal.

Full article BBC News
Other posts on my other blog about Margaret Haywood

Some medical staff are struck off for secretly filming neglect and abuse in the NHS.

But Dr Gerry McCann, who is suspected of neglect and concealment of his own child's body, has the approval of the NHS to film - as long as it's for personal reasons.

And a doctor can work in the NHS even if suspected of paedophilia.

At Leicester Hospital, anyway.

Funny old world.

Well done Margaret!

NHS boss gave Birmingham Children's Hospital job reference for future fiancee

Oct 11 2009 by Jeanette Oldham, Sunday Mercury


THE boss of the NHS in England supplied two hospital job references for the woman who is now his fiancee, the Sunday Mercury can reveal.

David Nicholson, 52, recommended former assistant Sarah Jane Marsh, 32, for top posts at Walsall Hospitals NHS Trust and Birmingham Children’s Hospital. But the NHS chief executive, who earns £207,000 per year, has denied the pair were in a relationship when he gave the high-flyer his professional backing.

Last week, we revealed that the divorced father-of-two had become engaged to Ms Marsh, who was recently appointed chief executive of Birmingham Children’s Hospital (BCH).

The attractive brunette has risen to the top tier of the NHS only ten years after graduating with a Master’s Degree. Her first ‘temporary’ job after leaving university in 1999 was as a complaints co-ordinator for a telesales firm. But after enrolling on the NHS Graduate Trainee Scheme in 2000 she became assistant general manager for trauma and orthopaedics at Worcester Hospitals NHS Trust.


But Mr Nicholson denied they were lovers at the time in a statement to the Sunday Mercury. He said: ‘‘As a former employer, I agreed to provide a reference for a position at Walsall Hospitals NHS Trust and the Chief Operating Officer position at Birmingham Children’s Hospital. We were not in a relationship then. I did not provide a reference for the Chief Executive post at Birmingham Children’s Hospital.”

Sources close to the divorced NHS chief claim the romance started around Christmas. In his statement Mr Nicholson admitted they had enjoyed a romantic trip early in the year. He said: “We went on holidays over New Year 2009. It was a private holiday, organised and paid for by both of us. We were not on NHS business, nor was any part of the trip paid for by the NHS.’’


Patients had endured delays in treatment and sub-standard care, youngsters having been redirected to other services. BCH chief executive Paul O’Connor resigned in March, two weeks before the report’s publication.

Ms Marsh was then promoted to interim chief executive of the trust. Her permanent appointment to the estimated £155,000-per-year post was made at the end of June.

As part of his NHS package, Mr Nicholson receives an allowance to rent a flat in London.

Full article can be read in Sunday Mercury


More from Birmingham Childrens hospital:

A BIRMINGHAM hospital paid a PR company £16,000 for just 20 days’ work to handle the fallout from a damning report.

Birmingham Children’s Hospital chiefs brought in two senior media consultants from LTA Communications at a cost of £16,387 when the trust was faced with heavy criticism in a Healthcare Commission report a month ago.

They paid out the equivalent of £86 an hour on the crisis team – despite already having three press officers who work full-time and have a combined salary of at least £100,000.

The money mirrors the annual salary of a junior nurse.

Today, the dad of a baby who died at the hospital described it as “a pathetic waste of money”.

Businessman Ayaz Ahmed, from ­Moseley, whose daughter Alesha died in intensive care after waiting more than two weeks for a bed said: “Spending £16,000 on spin doctors is a pathetic waste of money when ill children can’t even get a bed they need.

“There is something fundamentally wrong with the NHS at the moment, no one cares about lives. I could look at the books and tell them exactly how they should be spending their money.”

He claimed: “They made millions in profit last year yet they want donations for new units and are wasting money like this.”

The figures were obtained under a Freedom of Information Act inquiry by the Birmingham Mail after hospital bosses refused to disclose the figure.

The consultants “advised” and managed press interest as the Foundation hospital came under fire for a catalogue of failings from a severe shortage of beds, causing 70 sick children to be turned away every month, and poor staff training which meant theatre nurses could not recognise surgical equipment.

Martin Salter, director of communications at the hospital, said: “LTA Communications assisted our in-house team with the huge amount of interest in the Healthcare Commission report. Their daily rates have been market tested and are considered to be excellent value for money.”

Birmingham News

NHS plan nearly killed my mother

Oct. 11, 2009 (United Press International) -- A woman says she rescued her 80-year-old mother from starving to death in Hastings, England, under a National Health Service end-of-life protocol.

Christine Ball, 42, said she fought for weeks with staff members at Conquest hospital in Hastings to have her mother, Hazel Fenton, removed from a plan used by NHS officials to ease the suffering of dying patients, The Sunday Times of London reported.

"My mother was going to be left to starve and dehydrate to death," Ball said. "It really is a subterfuge for legalized euthanasia of the elderly on the NHS."

After being admitted to the hospital with pneumonia on Jan. 11, hospital medics determined Fenton only had days to live and stopped providing the elderly woman with artificial feeding and antibiotics as part of the care plan.

The Sunday Times said Ball eventually convinced doctors to resume artificial feeding for her mother and the senior citizen was later relocated to a nursing home.

"Patients' needs are assessed before they are placed on the (plan). Daily reviews are undertaken by clinicians whenever possible," an unidentified East Sussex Hospitals NHS Trust spokesman said regarding the controversial plan.

Source: here

Thursday, 8 October 2009

Government Medicine Kills

Let’s compare America’s system with Canada’s and Great Britain’s.

By Deroy Murdock

As the Senate Finance Committee prepares to vote on its Obamacare bill, it would behoove senators to ask themselves why on Earth America should move even one inch closer to the government-driven health-care model that plagues Canadians and Britons. Thankfully, the Finance Committee bill lacks the government option for health insurance that sends liberal salivary glands gushing. Still, the bill is awash in mandates, regulations, subsidies, taxes, and plenty of other potential distortions that help make single-payer medical systems deadly.

That’s right. Deadly.

Compare America’s system with Canada’s and Great Britain’s. The latter are single-payer, universal health-care programs in which medical treatment is free at the point of service (Yay!), although citizens eventually pay for it through higher taxes (Boo!).

According to Organization for Economic Cooperation and Development data, there were 26.6 MRI machines in the U.S. per million people in 2004. In Canada, there were 4.9 such devices, while Britain enjoyed 5. For every 100,000 Americans, 2006 saw 436.8 receive angioplasties. Among Canadians, that figure was 135.9, while only 93.2 Britons per 100,000 got that cardiac procedure.

Maybe that’s why, among American men, heart-attack deaths in 2004 stood at 53.8 per 100,000. In Canada, 58.3 men per 100,000 died of cardiac arrest, while coronaries buried 69.5 of every 100,000 British males.

The fatality rate for breast cancer, according to the National Center for Policy Analysis and Lancet Oncology, is 25 percent in the U.S., 28 percent in Canada, and 46 percent in Great Britain.

Among those diagnosed with prostate cancer, 19 percent die of the disease in America. In Canada, 25 percent of such patients succumb to this disease. And in Great Britain — an Anglophone NATO member and America’s closest ally — prostate cancer kills 57 percent of those who contract it. That is triple the American fatality rate.

This chart presents additional examples of how Canadians and Britons needlessly suffer and drop dead, thanks to government medicine:

The Senate Finance Committee should sink Obama-Baucuscare and instead craft a patient-friendly, pro-market, limited-government approach to health-care reform. Perhaps some senators cannot fathom the Hippocratic Oath’s key insight: First, do no harm. If that’s Greek to them, here it is in language they understand: First, don’t kill your voters.

Deroy Murdock is a New York-based columnist with the Scripps Howard News Service and a media fellow with the Hoover Institution.

Thursday, 1 October 2009

Leicester Royal Infirmary doctor misdiagnosed hundreds of children over a 10 year period

Hospital 'sorry' for boy's death

The parents of a three-year-old boy who died after being given the wrong medication have received an apology and compensation from a Leicester hospital.

Royal Infirmary bosses have admitted Ryan Pitcher received "incorrect treatment" for epilepsy from Dr Andrew Holton, which led to his death in 1997.

Dr Holton misdiagnosed hundreds of children over 10 years at the hospital.

Ryan's parents Simon and Diane said concerns about Dr Holton should have been investigated earlier.

His parents, of Heather, near Coalville, described Ryan as "like a zombie" on the medication he was prescribed.

Investigations by the University Hospitals of Leicester NHS Trust found Dr Holton ignored the advice of other consultants, who said Ryan's dosage should be decreased.

Mother Diane said: "It's devastating really. How do you live with knowing someone's killed your child, made them suffer for years?"

A report by an independent NHS inquiry team in 2003 found complaints were first made about Dr Holton almost three years before he was suspended.

Fifty-two children died while Dr Holton was practising, but Ryan's is the first death linked to the consultant paediatrician's treatment.

'Landmark case'

He was allowed to retrain and is still working in medicine.

A hospital spokesman said: "Ryan's case was very complex and it was investigated extremely carefully.

"On the basis of expert evidence, the trust accepts that Ryan's treatment and medication were incorrect.

"The trust is deeply sorry for what has happened and has made an unreserved apology to Ryan's parents."

The amount of compensation agreed has not been disclosed. The trust declined to say how many other families affected had received compensation.

Robert Rose, the solicitor representing the family, said: "All the official reports that we've had up until today have indicated there were no causes for concern for those children that died whilst under the care of Dr Holton.

"This in a sense is a landmark case because it shows there are real causes for concern."

Source: BBC News