It never just rains
There appears to be a veritable deluge of healthcare related stories today.
The BBC continues looking at the problems with cancer treatment & radiotherapy with an investigation that shows up-to 10% of new equipment sitting idle in hospitals because of a shortage of staff.
A report by the Royal College of Radiologists, commissioned by Five Live, found 10% of machines in the 60 UK centres were not being used.
The total cost of the machines is £150m, with some of the funding coming from lottery money.
The Royal College of Radiologists’ vice president Michael Williams said services have improved, but that they still are not up to scratch.
“The present radiotherapy service is inadequate. People are reluctant to admit how bad the situation is because they say it’s a lot better than it was,” he said.
Problems in the provision of Mental health services get a closer look in the Guardian, with reference to the politically incendiary Mental Health Bill which the government is attempting to push through for a second time.
The bill, the biggest reform of mental health legislation in 50 years, contains controversial measures to empower the authorities to section - or lock up - patients considered to be a threat to the public more easily, and to give psychiatrists the power to incarcerate those considered to be ill. It was strongly criticised during its first reading in the Commons and then lambasted as ‘draconian’ by the House of Lords. The government insists it will get its legislation on the statute book. Those politicians opposed say that they will do their best to defeat the new rules.
Tempting as it is to lay all the blame for the disintegration of the mental health system at the government’s door, Turner believes the public must acknowledge its own culpability. ‘The lack of empathy and sympathy for those suffering mental illness has created the perfect environment for the government to make us into their Cinderella service, which they chip away at, at every turn,’ he said. ‘Every family in the land has someone troubled by mental illnesses and everybody knows someone who has been there. Before your readers rush in to judge us for our failures, they should ask themselves how many people they have let slip quietly away into the night, embarrassed by their predicament, or scared by the things they are saying, or bored, and a few months later heard of that same person’s hospital admission or suicide.’
There is also a look at the backlash against homeopathy
‘The basic problem is that several Primary Care Trusts (PCTs), the local bodies which pay for NHS care, have stopped, or drastically reduced, their funding of treatment at the RLHH,’ said Dr Ian Fisher, personal homeopath to the Queen and clinical director of the Royal London Homeopathic Hospital in an open letter. ‘If too many PCTs stop funding, the hospital may be forced to close. We are already having to cut our services. PCTs have generally justified their decisions by claiming that scientific evidence of effectiveness for homeopathy and other complementary therapies is lacking.’ Twenty-five hospitals from London and southern and eastern England have already either stopped sending any patients to the RLHH or agreed to fund only a handful, Fisher warns.
The Telegraph highlights the early launch of the Extended Choice Network for Orthopaedic patients undergoing joint replacement (hip or knee) surgery who will be able to choose any hospital in the country from July.
The policy will be backed by a £15 million government website showing how hospitals compare on MRSA rates, waiting times, and cleanliness. The website, due to launch in the summer will also allow all patients to look up their conditions in a medical library, with information kite-marked by experts.
Patients are currently able to choose from four local hospitals and any of 34 “foundation” hospitals or 15 privately run centres, with the government promising all patients a choice of any hospital by next April. On Wednesday, the Health Secretary, Patricia Hewitt, will announce that orthopaedic patients will be offered full choice nine months’ early, allowing them to travel to any site in England if they do not want to use local services.
The NHS will pay the travel costs of patients opting for hospitals far from home.
The Guardian has more details:
The new system allows people who need a referral to a hospital for treatment to find out more about different trusts, such as their star rating, the distance to their home, car parking facilities and the waiting times for surgery. Different conditions will also be described so that patients can find out about particular treatments or operations, and there will be access to some medical data, such as the hygiene rating and its MRSA infection rates, which is becoming crucial to patients’ perception of a hospital’s safety.
It will also look at the number of ‘revision’ operations a team of surgeons does, which is where patients have to be readmitted after the first operation. Prospective patients will also be able to look at the results of patients’ surveys, which broadly show the satisfaction rates for different hospitals.
But the site will not allow patients to pick one particular specialist for their operation. Instead, patients are referred by their GP to a particular group, such as a team of orthopaedic surgeons, and it is the doctor who will select which patient he or she sees, depending on their clinical need.
I am afraid that this is another scheme that merely returns the situation to that existing before 1997. And the numbers of people taking this up are going to be low. When a patient is advised surgery, what is important that they know are the competence of the surgeon, details of the procedure & success rates and the regimen involved in aftercare in addition to factors of convenience. Star ratings are a poor substitute for advice from a GP who knows the situation. But then the choice of surgeon (being able to refer to a particular surgeon) is being taken away from everyone by stealth.
I have to concur with Dr Hamish Meldrum, the chairman of the British Medical Association’s GPs’ committee, who accused the Government of “focusing on trendy window-dressing” rather than accepting that most people want a good local hospital, and advice from a trusted GP.
Patientline comes in for more stick in the comment section of the Guardian.
Ofcom, the telecoms regulator, investigated these exorbitant charges and we were delighted when, last January, it recommended that something be done. It found other entertainment services on the wards - such as paid-for TV - were being subsidised by these high call charges. For that reason, it said, this had to be investigated by the Department of Heath, which oversees the contracts with companies such as Patientline.
But did the Department of Health do anything? Apparently not. It says it is still ‘working closely’ with the company to find a way to reduce incoming call charges. But in the meantime Patientline has hiked up the price of outgoing calls instead. Its justification? It is not making any money, it says.
Ofcom won’t get involved as it says it is bound to end up referring the issue back to the Department of Health. So what is the Department of Health doing? Absolutely nothing. It says pricing arrangements with companies such as Patientline are between the company and the local NHS trust. It also says that the restrictions on the use of mobile phones in hospital wards have been ‘relaxed’ and that people can now use them if they do so sensibly. But, despite this, plenty of hospitals will not allow patients to call from their own phones.
Carol Sarler carries the maternity torch:
Patient choice, perhaps the craftiest currency in the political purse, was jingle-jangling for most of last week as Patricia Hewitt announced that, by 2009, all pregnant women would be able to choose a home birth. ‘Clearly,’ she said, as she always does say, ‘far more women out there would like to have home births.’ Equally clearly, if you listened to her language, she would like far more women to have them, too.
There was lots of ‘more’ and ‘increase’ and ‘priority’ and ‘guarantee’ and ‘gold standards’; there was a big up for areas ‘delivering’ (her pun, not mine) 10 per cent, rather than the national average of 2 per cent of their births at home. In short, this was a woman carefully choosing positive words of promotion. Among the words wholly absent from the rhetoric, however, were ‘risk’ and ‘danger’. Which, under the circumstances, is puzzling.
While the Telegraph carries the new head of the Royal College of Nursing ripping into the record of the govt on the NHS.
The Prime Minister has allowed the NHS to plunge into crisis by becoming trapped in a “parallel universe of spin”, according to the new head of the Royal College of Nursing.
In a blistering attack on the Government’s running of the health service, Dr Peter Carter, the RCN general secretary, said cuts in jobs, services and training were catastrophic for the country and a “personal tragedy” for the Prime Minister.
Dr Carter, who will address his first RCN annual conference next week, said Tony Blair should admit Labour’s administration of the NHS had gone “fundamentally wrong”. He said Labour’s track record on the health service was far worse than that of the Conservatives, even though Mr Blair had poured in record funds.
Dr Carter, a former hospital trust chief executive, told The Sunday Telegraph: “I have never seen so much money go into the health service and I have never seen so much money wasted.
“It is a tragedy. It must be a personal tragedy for Tony Blair. In the recesses of his mind, he must be saying: ‘What the hell has gone wrong?’
“In the 1980s and ’90s finance was extremely tight but you did not get the crisis we have seen in the last two years. Nurses are saying to us ‘we ain’t going to vote Labour’. They aren’t saying who they will vote for, but it will be interesting to see what happens in the Scottish, Welsh and local elections.”
He urged Mr Blair to “stop getting caught up in spin and a parallel universe, which only looks at the success stories, and acknowledge that this has gone fundamentally wrong”.
The Guardian also has an audit of Blair’s time in office.
Health
The factsThe NHS has enjoyed the biggest increase in funds of all the public services, with spending up from £34bn in 1997 to just over £94bn this year. Staff numbers have risen, with 20,000 more consultants and GPs and about 70,000 more nurses. The number of people on waiting lists for operations has fallen by 384,000 since 1997. Output, in the form of number of people using the service, has increased by about 3 per cent a year. The drugs bill has risen 13 per cent. 118 new hospitals and 188 GP clinics have been opened or are being built. There has been a 75 per cent increase in the number of emergency ambulance calls. The number of hospital beds has fallen by 15,000 but there is more day-case surgery.
The analysis
When Tony Blair first came to power, the health service was not his immediate priority. It took a spate of people dying on the waiting lists and terrible headlines to achieve a volte-face in 1999, when he pledged to bring health spending up to the level in the rest of Europe.In 2000, the government announced the biggest rise in NHS expenditure and put 1p on national insurance to pay for it. With it came a host of Treasury-driven performance targets such as shortening the waits in casualty departments. Some of the targets had perverse effects, however, and ended up putting pressure on other parts of the service.
Cancer and heart disease have seen the most investment. Maternity care and mental health have not enjoyed the same largesse. The big failure has been to tackle the rise in chronic diseases linked to unhealthy lifestyles.
Blair was adamant that the health service should offer patients more choice, and so allowed private companies to come in and compete with the NHS to provide quicker treatment but this has destabilised some of the NHS. There is enormous uncertainty among managers over which hospitals will survive the next two years as private units take more of their patients.
Of the extra billions, 43 per cent has gone into extra staff and pay rises, probably at too fast a rate. Surveys suggest that people are broadly happy with their healthcare and still very supportive of the NHS, but large areas of dissatisfaction remain.
The huge rise in hospital-acquired infections such as MRSA, the lack of time patients have to talk to their doctor, the fact that there are still very long waits for services such as psychotherapy, remain issues. GPs are under pressure not to refer patients to hospital for financial reasons. Many doctors, like managers, feel battered by the constant changes and reforms.
Jo Revill, Health Editor
This survey says pretty much the same thing.
On the National Health Service
Very good 2%
Good 12%
Average 25%
Poor 27%
Very poor 30%
Don’t know 4%