More trouble
More trouble at the Commercial Directorate of the Department of Health with the revelation that Nuffield Hospitals has pulled out of the West Midlands ISTC programme.
Nuffield Hospitals, the not-for-profit private hospital operator, has pulled out of negotiations to provide operations for NHS patients using mobile operating theatres in the West Midlands.
The move is a setback for the Department of Health’s drive to get up to an extra 250,000 patients a year treated in private sector facilities through a second round of independent sector treatment centres (ISTCs).
Some 13 schemes have reached preferred bidder stage but it is now nearly two years since they were first announced, with none having yet reached financial close. Nuffield cited costs and delays in concluding the deal as the reason behind its decision.
The move comes as most of the companies bidding for the second wave of ISTCs now say privately that they do not believe the programme will reach the government’s original - and repeatedly confirmed - target of spending £550m a year to treat 250,000 patients annually. Most now expect it to add up to only £350m.
I hope that the DoH uses this as an opportunity to review the entire programme, not jump headlong into a deal with the alternate bidder. There is increasingly an unacceptable concentration of work in limited hands, based on very sketchy evaluation & a flawed tendering process.
The letters column of the Times has consultants writing in to vent about the Public Accounts Committee report:
Despite the evidence of independent surveys showing that the average consultant worked 50 hours a week, he boasted hat he would get more work out of us by “imposing†a 40-hour week. Either Mr Milburn is mathematically challenged or, more likely, his socialist preconceptions would not allow him to believe that consultants really did work that hard. The result was inevitable, and we are now under pressure to reduce our hours in order to bail out cash-strapped trusts.
Until 2003 I was working 55-60 hours per week and being paid for 37.5 hours. With the new contract I am paid to work 52 hours and still work 55-60 hours.
And we still talk about increasing productivity & hear nonsense from the govt’s pet healthcare advisers about negatively incentivising doctors to work harder by cutting their pay.
It appears that staff aggrieved by Agenda for Change are suing to alter it:
Unison, the largest public sector union, said that a new pay and grading system, dubbed Agenda for Change, was under threat from claims lodged by a number of health workers against North Tyneside primary care trust and health unions.
Solicitor Stefan Cross, representing the workers, says that Agenda for Change failed to end pay discrimination and continued to protect the earnings of male union members at the expense of women.
Karen Jennings, responsible for health workers at Unison, said: “Agenda for Change involved detailed discussions between NHS employers, the government and all 20 health unions and organisations. At every stage of the negotiations expert and legal advice was sought and given, making this challenge even more bonkers. It is a disgrace that ‘no win no fee’ solicitors should attempt to wreck a pay system that has resulted in 90 per cent of women getting a better deal.”
I am not too sure about this. I have heard from a lot of people from different backgrounds that AfC is not being applied properly & that a number of professions have actually lost out.
But when this is taken into consideration, the recent NHS Pay Review Body decisions look very suspect:
The two-year pay settlement for teachers in England and Wales could be reviewed because of rising inflation.
The independent body which advises the government has asked for its permission to reconsider the current pay deal. Ministers are considering the request.The settlement, with 2.5% rises last September and next, included scope for a review if inflation were to pass 3.25%. The headline rate is now 4.8%.
Just how then are 0% rises anything but a pay cut & no wonder nurses & other staff are prepared to strike.
The risk of multiple pregnancies with IVF is looked at by the Times:
About 50 per cent of twins need special care at birth. In 1975 there were 6,000 twins born annually. Now the figure is 10,000. This rise is caused almost entirely by IVF. A quarter of IVF pregnancies result in multiple births, ten times the natural rate, largely because clinics implant more than one embryo to increase success rates.
Assisted reproduction combines desperate parents with private clinics whose fortunes depend on success rates, and that means implanting multiple embryos and more multiple births. This results in more babies needing NHS special care and fewer staff to go around. If the staff to baby ratio were higher, lives could be saved. A recent study indicated that if each baby in specialist care received one-to-one treatment, the incidence of deaths could be cut by 48 per cent.
Quite a few leaps in the article but the one thing that is not mentioned is that in most countries with a single embryo policy, multiple cycles of IVF are funded by the state but here in the UK getting on the list for even one cycle can be a struggle.
There is a review of the current state of dentistry & of dental insurance plans in the Financial Times.
So when the government announced reforms last April to the way that dentists operate that were designed to help more people gain access to an NHS dentist and so encourage more regular visits to the dentist, health officials welcomed the idea.
But one year on from the implementation of the new contract, the British Dental Association has declared that the most radical shake-up in NHS dentistry for more than 50 years has failed.
Dentists complained that meeting these targets put undue pressure on them and one in 10 dentists did not sign the contracts, resulting in a loss of around 2,000 dentists from the NHS.
The effect of this exodus is that more people have struggled to find an NHS dentist and have moved to private practices, and are having to cope with the accompanying higher charges. The cost of a dental crown could be almost double the NHS charge.
Between 2001 and 2005 spending on private dentistry in the UK jumped from £1.45bn to £3.07bn.
No one seems to be learning the lesson that ignoring the professionals is a recipe for failure.
The differential pricing of cochlear implants is to be the subject of an OFT inquiry with the postcode lottery also making an appearance.
The cochlear implant costs £12,563 in the UK compared with £7,770 in Sweden.
Nottinghamshire PCT says that the case for a second implant is unproven, though children in other areas now routinely receive two.
“The evidence for bilateral implants is there; colleagues in Finland can’t believe that we would only offer one. Two ears are clearly better than one.”
Among the pharma related issues in the news, the battle for Boots finally gets under way in earnest:
The board voted to recommend a formal £10.90-a-share bid from the private equity group Kohlberg Kravis Roberts and Boots’s deputy chairman, Stefano Pessina, at a board meeting late on Thursday night. The bidders had proposed to pay £10.60 but were forced higher when the Alliance Boots board told them that Terra Firma was planning a £10.85 offer. Their new bid is £900m more than KKR first offered six weeks ago - and £3bn more than most City analysts thought the company was worth before either bid emerged.
Less than four hours after Alliance Boots and KKR announced they had reached a deal, Terra Firma, run by the financier Guy Hands, and his partner, the Wellcome Trust, slapped an even higher proposed bid on the table, of £11.26 a share. That bid is subject to Hands’s team completing due diligence and is not yet a formal offer.
The concentration of pharma distribution continues apace inspite of the OFT inquiry:
Alliance Boots yesterday defied regulators by signing a second exclusive drug distribution deal, in a move that gives it control over the delivery of nearly a quarter of the UK’s medicines.
The deal with AstraZeneca, the UK’s second-biggest pharmaceuticals company, was condemned by critics yesterday as a “nail in the coffin†for smaller wholesalers. Under the agreement, UniChem, the drug wholesaling arm of Alliance Boots, and AAH Pharmaceuticals, part of the German drug wholesaler Celesio, will be the sole distributors of AZ’s prescription medicines to doctors, pharmacies and hospitals.
The tie-up with AZ comes seven months after Unichem signed an exclusive distribution deal with America’s Pfizer, the world’s biggest drugs group, triggering an investigation into the drug wholesale market by the Office of Fair Trading (OFT).
And finally in another demonstration of just how money is made, Astra Zeneca shoot themselves in both feet:
Documents have surfaced on industry insider websites allegedly describing illegal drug marketing practices and AstraZeneca has since launched an investigation into the activities of several employees.
Mike Zubillaga, who was regional sales director for AstraZeneca’s Mid-Atlantic Business Center in Wayne, Pennsylvania, was quoted in a internal newsletter saying: “I see it like this: there is a big bucket of money sitting in every office. Every time you go, you reach your hand in the bucket and grab a handful. The more times you are in, the more money goes in your pocket. Every time you make a call, you are looking to make more money.”
Unfortunately for Mr Zubillaga, who was intending to motivate his sales staff to sell more cancer drugs, an industry blogger got hold of the newsletter from a whistleblower and published the comments, sparking an online debate about the ethics of drug companies.
Concern was raised after another comment from Mr Zubillaga in the same newsletter appeared to highlight a more serious issue. He allegedly appeared to be suggesting sales staff should counter-promote drugs, which is selling by comparing another company’s drug, a practice prohibited in the US.
Peter Rost, a former marketing executive at Pfizer, who first posted the newsletter on his “whistleblower” blog two weeks ago, wrote: “AstraZeneca lacked the internal controls to make sure the truth didn’t get out, and now they are trying to show they are holier than thou, by firing the guy who said what everyone knows to be true … Instead of a reprimand, AstraZeneca created a sacrificial lamb to cover the corporate rear end.”
I wonder if No Free Lunch get a boost in membership from this.
April 24th, 2007 at 9:50 am
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