FrontPoint Systems Ltd

So there we have it, the new line-up at the Department of Health.

Secretary of State - Alan Johnson MP
NHS and social care delivery and system reforms; finance and resources; strategic communications

Minister of State for Health Services - Ben Bradshaw MP
Finance including: Spending Review; Resource allocation and Financial policy; NHS Financial management; NHS Estates, Capital, Private Finance Initiatives (PFI) & Local Improvement Finance Trusts (LIFT); NHS Performance management; NHS efficiency
Policy & Strategy including provider policy, demand side reform, Payment By Results (PbR) policy & system architecture regulation
18 week patient pathway
System management & regulation and Professional regulation including the 3rd session Bill
Workforce Capacity
Commissioning capabilities & programmes
Commercial policy, solutions and procurement
Connecting for Health / NHS IT
Urgent Care & emergency care
Primary care
South West Strategic Health Authority (SHA)
London SHA

Ben Bradshaw is more of an unknown quantity with his brief covering NHS IT as well as PFI, Commissioning & the 18 week target. I guess he will be the one to watch.

Parliamentary Under Secretary of State for Health Services - Ann Keen MP
Healthcare quality
Patient Safety including Cleaner Hospitals / Healthcare Associated Infections (HCAI)
National clinical directors and programmes including: Cancer services; Cardiac services; Stroke services; Diabetes; Renal services
Dentistry and fluoridation
Partnership, experience & involvement
Optical
Chronic Diseases and long term conditions (including neurological)
Workforce including: Employment models and contracts; Education & careers; Pay; Nursing policy / Chief Nursing Officer (CNO) people strategy
Reconfigurations
Children’s health services and maternity
Yorkshire & the Humber SHA
North East SHA
North West SHA

At the very least Ann Keen can be said to have some knowledge of the state of affairs in addition to Ara Darzi though of course a clinical background is not a guarantee of sound judgement. But having sat on the Health Select Committee till now, she should atleast be able to display a grasp of workforce issues.

Minister of State for Public Health - Dawn Primarolo MP
Public health including Regional Public Health Groups (RPHGs), WHO and Children’s public health
Health improvement national programmes including: tobacco & smoking, alcohol, diet & nutrition, physical activity, drugs & drug treatment, obesity, sexual health, accident prevention, abortion, rural health, and Deep Vein Thrombosis (DVT).
Health Inequalities
Fertility, including IVF, Human Fertilisation and Embryology Authority (HFEA) and draft Bill, Regulatory Authority for Tissue and Embryos (RATE)
Food Standards Agency
Health protection including: Emergency preparedness; Scientific development; Pandemic flu; Immunisation; International health
International & EU business
Research and Development (R&D): National programme, R&D workforce, systems, Infrastructure, Innovation & Industry relations
Medicines & Pharmaceuticals industry including Medicines and Healthcare products Regulatory Agency (MHRA)
National Institute for Health and Clinical Excellence (NICE)
Departmental Management
West Midlands SHA
South East Coast SHA

We know all about Dawn from her time at the Treasury, thank you.

Parliamentary Under Secretary of State for Care Services - Ivan Lewis MP
Social care, local government & care partnerships, including: policy & innovation; finance; strategy; workforce; inspection; Partnering & alliances; Regional presence; Older people; Learning / physical disabilities; Disabled children
DH’s relationship with local government
Mental health including Child and Adolescent Mental Health Services (CAMHS)
Prison/offender health
Allied health professionals
Third sector including section 64 and social enterprise
Carers
Dignity & respect
Sustainable development
Equality & Human Rights
End of life care
Audiology
East of England SHA
South Central SHA
East Midlands SHA

An old hand at this, hopefully one capable of learning new tricks.

Parliamentary Under Secretary of State - Lord Ara Darzi
NHS Next Stage Review - Terms of Reference as announced

Hmmm, the fig leaf of respectability or something genuine?

Share This

The HSJ suggests that the delayed Commissioning Services Framework (ASCC) is finally happening with the official announcement due next week. It will be interesting to see just who made it onto the list but the possibility exists that the contract is not that important anymore due to the change in emphasis at the DoH.

And it looks like Leicester will not be getting a new PFI hospital after all with the collapse of a £921 million scheme.

The University Hospitals of Leicester Trust (UHL) has pulled the plug on its Private Finance Initiative (PFI) after a nine-week review of the project.

The trust had planned to spend £711m developing three sites in Leicester but the review showed costs would increase to an unaffordable £921m.

A total of £23m had already been spent preparing for the PFI scheme.

Atleast they took the decision now rather than going ahead with the plans in a fit a of bravado & saddling the people of Leicester with an unaffordable white elephant. Now to see if other trusts in a similar position gain the courage to do the same.

An interesting argument from a PCT PEC member regarding the importance of diversity assessments while commissioning. I’m glad to see someone applying their mind here instead of just filling in check-boxes. But it is action that is required, not just waffle.

This post from Hospital Phoenix hits the bulls-eye regarding the complicity of the Royal Colleges in dumbing down medical training.

While the midwives go to war.

Something from the BBC & Lancet.

Not to mention this surprising turn of events with Isoft ditching IBA at the altar to elope with Compugroup! Though with CSC having taken over all responsibility for the NPfIT contracts, the relevance to UK healthcare is reduced.

While this is an argument for increasing the priority allocated to sexual health.

And finally the official write-up of the work done by the NHS Service Delivery Organisation (SDO) that was covered here previously describes the importance of continuity of care to eventual outcome even where choice might have initially been seen to have the upper hand in the patients mind.

Patients need help with choosing which service mode and/ or practitioner will suit them best.

As far as I knew, that is what GPs do!

Service developments that make relational continuity less easy to deliver will impair patients’ experience of care, particularly those patients who have more complex problems. For these patients, informational continuity promoted through electronic record systems cannot substitute for relational continuity. And as the structure and range of services becomes more extensive, some patients may find increasing difficulty in negotiating for the aspects of care they prefer. A service is needed that is simple to use and allows for both convenient access and continuity depending on the patient’s preferences and needs.

And regarding the movement of services closer to home, there is a reiteration that not all is as rosy as it seems.

Our review broadly suggests that transferring services from secondary to primary care, and developing strategies to change the referral behaviour of primary care, may be effective in increasing the effectiveness and efficiency of outpatient services.
Relocating specialists in primary care and developing joint working arrangements between
primary and secondary clinicians have been of more doubtful value.
Although the evidence is still limited it does suggest that any initiative to move care closer to
home needs careful design and evaluation, as we cannot simply assume cost-effectiveness and high quality.

Many of the new models of care have been introduced to meet the important objective of improving patient access. However, those responsible for service improvement should be aware that they might face potential trade-offs between the goals of access, cost-effectiveness and quality.

And regarding the fashion for GPSIs, the message appears to be unequivocal.

The most important benefit to patients of GPSI services appears to be in terms of accessibility. The location of a GPSI service is crucial to maximise accessibility and convenience for as many people as possible. In the case of the first study, it appeared to provide care which was more accessible and preferred by patients, with no evidence of difference in clinical outcomes. These benefits were obtained at considerably greater
cost.

I wonder if policy-makers will take this into account, not to mention of course the above-mentioned commissioners?

Share This

Just what is happening in Scarborough?

The Scarborough and North East Yorkshire trust will shed 600 jobs under the proposals, which managers say are the only way to make “immediate and essential” cuts in their ballooning budget.

The trust, which is the biggest employer on Yorkshire’s North Sea coast, has accumulated debts of £20m, with a £7m deficit this year. It covers one of the largest areas of any NHS trust in the country and has a large, mostly retired, elderly population.

So just how do they plan to do this?

The finance director, Sandy Hogg, said the trust needed to save £15m immediately, and the trust had some leeway to close wards and reduce non-clinical support. Patients were staying in hospital for shorter periods and more health care was provided at home, which would help to maintain service provision with fewer staff.

I do not know the details of the situation in Yorkshire in detail but I can confidently proclaim this to be tosh. Provision of services at home will need an expensive short term investment in staff, not something that the trust are likely to do at the moment.

And how many interpretations can be placed on one report? It appears that the Healthcare Commission have managed that most difficult feat, creating something that everyone can quote to support their point of view.

The Healthcare Commission said it could not assess independent sector treatment centres because of a lack of data.

It said there were reassuring signs but called on ministers to rectify the “cock-up” which meant performance data was not comparable with the NHS.

I must remind readers here that a patient opinion survey is not a very reliable or useful measure of quality.

Anna Walker, the commission’s chief executive, said the contracts the Department of Health drew up with the private companies were not adhered to as the emphasis was on setting them up quickly to treat patients faster. Data collection was overlooked. She said: “I believe it was a cock-up. The contracts lacked clarity.”

I lean towards the cock-up explanation as well rather than conspiracy theory but when the faults have been predicted well in advance & stridently warned against, I find it rather difficult to excuse the strikingly poor performance. And is there no penalty for repeated & utter failures? Failing upwards maybe?

British Medical Association research carried out among its members found that 62 per cent of clinical directors working in NHS hospitals were concerned about the quality of care provided by the centres.

A quarter said medical notes were never made available and half reported patients who had developed complications needing emergency admission to an NHS hospital following operations in treatment centres.

And what is worrying is that the CD does not appear to be interested in collecting data to verify or refute this & other claims.

The FT spins the report as supporting the case for ISTCs.

But “they are not adequate for monitoring the quality of care given to patients”, said the commission, and more work was needed to ensure that in future data could be compared more easily. The same information should also be collected regardless of the part of the county in which patients were treated.

I could comment about KPIs & the curious lack of interest the Commercial Directorate has in them.

And when will the terms of the Wave 2 ISTC contracts be made public? Does anyone hear a “never”?

At least £1 million has been paid to a private health-care company for operations on NHS patients that have not been carried out, a leaked letter shows.

Derbyshire County Primary Care Trust has a £2.7 million contract with an “independent sector treatment centre” in Chesterfield to provide orthopaedic operations. But more than a quarter of the procedures paid for were never carried out because patients opted to go to NHS hospitals. Health managers have written to GPs trying to persuade them to send more patients to the Barlborough treatment centre, run by Partnership Healthcare Group.

While Liam Donaldson is wished an early retirement. Watching him dissemble on this Channel 4 clip is excruciating.

But he can have a drink at the nearest 24hr pub, hopefully one that does not contribute to these dismal statistics.

The proportion of alcohol-related attendances rose from 2.9 per cent in March 2005 to eight per cent in March 2006.

Alcohol-related assaults more than doubled from 27 to 62 and injuries connected to drinking almost trebled 44 to 129.

The number of patients who had to be admitted on to the wards rose from 24 to 71.

A worthwhile legacy to add to his accomplishments perhaps?

Share This

More from the Public Accounts Committee on that deal with Dr Foster.

Edward Leigh, MP, the chairman of the committee, said: “By pursuing its backroom deal with Dr Foster LLP, the Department of Health failed in its duty to be open to Parliament and the taxpayer.

“There was no fair and competitive tendering competition, as laid down in public sector procurement guidelines. And Treasury guidance on joint ventures between public and private sectors was ignored. Instead, the deal was handed to Dr Foster on a plate.

In addition the costs of KPMG, the consultants who advised the Information Centre on the deal, rapidly escalated from a figure initially estimated and contracted for £284,000 to between £1.75m and £2.5m, an extremely high figure on a relatively straightforward £12m deal.

Nice work!

And we are told that targets are to be “slashed”. Now just how believable is that? I wonder if this new chapter will be worth mentioning in a few months.

Improvements in services need significant initial investment before we get to high quality self-care for diabetics or other chronic conditions.

Besides which people accord a low priority to strokes based on their perceptions of what can be done to treat them. So increased urgency in treatment will translate to earlier presentations. After all, heart attacks used to be managed at home not so many years ago.

The Stroke Association poll of 2,000 people suggests 88% would react immediately if they lost a bank card.

This compared with 34% of people it suggested would wait 24 hours if they experienced facial or arm weakness and speech problems - symptoms of a stroke.

Just 33% of those polled were aware a stroke caused immediate brain damage. Experts say the findings are worrying.

Patients turning up at A&E to find very little done for them are unlikely to follow the well-meaning advice on TV.

Soothing words that have been betrayed flagrantly this year already with the MTAS recruitment crisis, which has scalped thousands of highly trained men & women.

Alarmed at so many posts being vacant on August 1, the Department of Health gives trusts two weeks to manage what the hugely expensive national competition failed to achieve in six months. Before August, trusts are ordered to find somewhere to shuffle 10,000 doctors for three months until the current crisis is past, and these doctors can then be quietly lost from the NHS for ever.

Maybe they should move into this field as interest in it seems to be growing.

Ten years ago a similar project provided telemedical care to the remote reaches of the Andaman & Nicobar islands from a hospital in Chennai, India. And it was a similar project aimed at providing support to A&E departments out of hours that was my first independent large-scale foray into medical informatics in this country. I’m glad to see that it is still of interest to some folks.

Share This

So now it is GPs who earn too much who are at fault for the problems faced by the NHS. Or so we are told after the recent attacks on consultants.

The government said it never anticipated doctors would make so much, with critics arguing the pay rise has contributed to health service deficits.

Really? I am sure that I can find evidence to the contrary. Not that Richard Smith is well placed to act as spokesperson.

And speaking of the quality of information, NHS Choices has featured here before.

The Times has a fairly good compilation of items from the professional press with coverage of MRSA in care homes, RFID tracking of surgical instruments, better working environments in the charity sector, a few home truths, the regulation of private prison healthcare facilities and the lack of information about the NHS Supply Chain as well as the new GP patient experience survey.

There are a few accurate comments too on the state of CfH i.e.

“The Government’s National Programme for IT (NPfIT) is, to date, overblown, ill-considered and hinders rather than helps progress. “

and on that security scare

“Bearing in mind the Home Office’s recent bungling track record, it’s easy to see how this could turn into a bureaucratic nightmare,” says a senior figure from the BMA. “We must remember that overseas doctors have been a vital factor in the successful running of the NHS.”

And having been intimately involved with transplants & consent for donation, I am not sure that this proposal will lead to any measurable benefit.

Sir Liam said the wishes of the deceased donor should outweigh those of their relatives but admitted that where the family expressed strong objections it would be difficult to go ahead and harvest the organs.

I would hope that this is effectively what happens anyway & the negative publicity involved from a population that has difficulty understanding the retention of pathology specimens is hardly likely to greatly increase donor numbers.

Is there a case for keeping healthcare out of the purview of local government?
Nicholas Timmins in the FT seems to think so.

This is bizarre. For two decades now both Conservative and Labour ministers have demonstrated that none of them trusts local government an inch. Local authorities have seen their powers in education, planning and much else removed, cribbed or constrained. They have been inspected, performance-managed and capped close to death. And administration after administration has failed to address the issue that really poisons the relationship between central and local government - namely local government finance and its massive over-reliance on central government funding.

Yet ministers who even now believe that local authorities cannot be trusted with big planning decisions somehow seem to believe they could do a good job of commissioning £90bn worth of NHS care.

Hmmm, I will concede his point but the argument that the reform agenda should be pushed forward slightly undermines his appeal. But this is the FT after all.

Share This

So how exactly is the Serious Fraud Office faring in its efforts to counter fraud affecting the NHS?

Operation Holbein is the codename for the SFO’s ongoing case against alleged price-rigging by manufacturers of penicillin and other generic drugs - a practice that is estimated to have cost the National Health Service as much as £2bn.

The SFO brought criminal charges against five companies - Goldshield, Indian giant Ranbaxy and three private businesses: Norton Healthcare, Kent Pharmaceuticals and Generics UK - last April. Nine company directors were also charged. The companies and the directors deny all allegations of collusion.

Though the fact that a number have settled civil action has to count for something. Atleast the USA seems to be more serious about it.

And the RCN keep up the pressure on the pay dispute.

More than half - 55 per cent - said they were too busy to deliver the level of care they would like, and almost a third - 30 per cent - said they would quit the profession if they could.

As for the paucity of services for allergy sufferers that is highlighted by the Times, GPs muddle through.

Pam Ewan, a consultant allergist at Addenbrookes Hospital in Cambridge and a member of the National Allergy Strategy Group, said that the NHS was still failing allergy sufferers at “a series of levels”.

“It is a massive epidemic, and the lack of provision is startling,” she said. “GPs are not well informed about allergy at all, but particularly about food allergy, and that is because they are not trained in it.

“So GPs have gained knowledge by self-learning or self-interest, then if a GP wishes to refer to a specialist he will have a problem because there is a very small number of these.”

People sneezing is apprently not a high priority.

I will try not to leave my SIM card lying around. I suppose wondering just how idiotic John Howard appears to be is also a crime?

Atleast the rest of Australia appears to have a heart.

Share This

The Health Service Ombudsman has seen fit to rail against that common failing of large organisations that have lost touch with their users, the unwillingness of staff to show initiative & prioritise the goal over the process.

Ann Abraham said that distressed patients and bereaved relatives were often left battling bureaucracy when “a bit of courage and common sense” was all it took to resolve simple issues.

Speaking ahead of publication of her annual report on the NHS, Miss Abraham said she was concerned that hospitals and GPs were not learning simple lessons raised in countless reports.

I don’t think that anyone will disagree but it is not just the NHS that faces this problem.

Latest figures show the total number of complaints rose to 138,000 by 2006, a rise of 5,000 on the previous year. Meanwhile, 8,000 unresolved cases were passed to the NHS inspectorate, the Healthcare Commission - more than twice the number it expected when it took on the role three years ago. On top of this, hundreds of complaints are going to the ombudsman’s office, with latest figures due out on Thursday.

Though it appears also that the estimation of workload by the bodies concerned was a little off, the same excuse that many other groups have used including PMETB who claim overwork to be the reason why their fees have trebled since inception just a few shot years ago.

Both watchdogs expressed concern that NHS staff are not dealing with complaints properly.

Miss Abraham told this newspaper: “We see some really appalling complaint-handling in the NHS, with no consistency at the front-line about what to do when people complain.

“Sometimes it is about people not taking complaints seriously. Very often when I look at cases, you can see a point where if someone had just shown a bit of courage, and a bit of common sense, and actually dealt with the situation rather than getting entrenched, and focusing on the bureaucratic process, it could have been sorted out.”

She said the NHS often left complaints to be dealt with by junior staff who did not feel “empowered” to show initiative.

“What you will see is if the target is to write a letter within 25 days, they will do that, but the letter doesn’t actually respond to the point being made. It would be better to miss the target, and resolve the problem,” she said.

Marcia Fry, the head of operational development at the Healthcare Commission said that its current audit of hospital complaints suggested more than a quarter of trusts made little effort to ensure that patients did not suffer worse treatment if they complained.

That would involve the use of initiative & the prevailing culture of targets actively discourages such events. I would however not hold out much hope for any lessons being learnt here.

The Independent suggests that Independent Sector facilities are substandard compared to the NHS on the basis of an expected Healthcare Commission report but misses the point & in the current climate feels it easier to tar all IMGs with the same brush. Perhaps some research might be in order.

Presentation plays a part, to be sure but if your facility is clean there is usually no need for the ostentatious display of cleaners as their results speak for them.

A report commissioned by the Department of Health (DoH) recommends an increase in “the visibility of cleaning staff” so that hospitals are “seen” to be cleaner.

It is understood cleaners may now have to wear distinctive uniforms, and work during the busiest times of the day, to make their presence more visible.

And get in every-ones way presumably? Perhaps Ipsos Mori could find something useful to do for a change.

That military covenant comes under scrutiny in the Independent. The services required simply do not get the same priority in the NHS & no amount of flag-waving will change that. Instead of improving the facilities of the NHS to meet that provided by the military hospitals, Whitehall decided to bring them down to the civilian standard & the current fuss is just the belated recognition of that fact.

Replacing a Rolls Royce with cut price services didn’t do much for quality we are told, though as a “not for profit” the new provider might be expecting some slack.

“We have pre-existing services which were described as very good, blue riband, Rolls-Royce, these were the sorts of expressions used, and they were replaced by more cut-price services.”

“I appreciate we all have to live within financial constraints. I think at this point there were other things that could have been done that would have been safer for patients.”

A pharmaceutical version of Payment by Results seems to be on the cards in the US, with interesting results.

Share This

Thankfully a slow day today with most papers catching up with yesterday’s news. Maybe more will happen later. But the Telegraph covers the RCN ballot for strike action that closes on the 6th of August. It will be interesting to see if the row will be defused before then.

The Independent covers the Lancet review of mental health provision.

In a special report to coincide with the passage of the Mental Health Bill last week, the journal says many aspects of mental health care are neglected. Access to psychological treatments remains “pitiful”, despite a ruling by the National Institute of Clinical Excellence (Nice) that cognitive behavioural therapy should be available on the NHS.

Anxiety and depression in children have risen by 70 per cent in the past 25 years and there are signs that the environment in which they are growing up is becoming more hostile. A survey by the Department of Health published last week found fewer people in England favour a more tolerant attitude to those with mental illness than in 1994. The journal says: “This opinion is unsurprising. Mental illnesses are not perceived to be as serious as physical ones, by the public and government alike.”

One in four people will be affected by mental illness at some point yet mental health services are the first to be cut when the NHS is in deficit. The journal adds: “Ultimately, turning the tide of stigma and neglect that faces many people with mental ill-health in the UK will require a substantial shift in public and ministerial attitudes.”

Share This

One of the major complaints against the “2 week wait” target has just got beefier this week with evidence published in the BMJ showing that it is delaying the diagnosis of cancer in a large number of women. It has long been pointed out that cancer does not come with a neat little label & the restrictive protocols used to justify these targets de-professionalise the GP’s involved & forcing them to refer for routine care patients that they might otherwise have prioritised for treatment.

The BMJ findings, after the researchers tracked every one of the 25,000 referrals to Frenchay breast care centre in Bristol between 1999 and 2005, indicate that the wrong women are being fast-tracked.

The researchers found the number of “urgent” referrals had increased by 42%, but the proportion with genuine breast cancer had dropped from 12.8% to 7.7%.

Meanwhile, the proportion of those with breast cancer who are not referred as urgent cases within the two-week rule but judged “routine”, waiting at least a month, has risen from 2.5% to 5.3%.

Non-urgent patients in the Bristol study waited 30 days but in other areas the wait is up to 17 weeks.

I have no doubt that similar statistics will emerge for other similar conditions & this episode also serves to illustrate the inadequacy of protocol based care.

It looks like it is not just me that has a problem with Ofcare as the Times reports on complaints submitted by a number of organisations on the similar merger of the Human Fertilisation and Embryology Authority (HFEA) and the Human Tissue Authority (HTA) into the Regulatory Authority for Tissues and Embryos (Rate).

Clinicians and researchers say that the remit of the new Regulatory Authority for Tissues and Embryos (Rate) will be so broad that it will lack the expertise it needs, while creating extra tiers of bureaucracy and expense. Its shortage of specialist knowledge will jeopardise public and professional confidence, and could even compromise its ability to oversee complex areas of medicine with implications for patient safety, the critics say.

Somehow I feel that comparing the new agency to Ofcom or the FSA was not a very smart move by the DoH.

More about the postcode lottery in the care of the elderly:

In March this year Derby City PCT was giving just seven people continuing care, a rate of 0.26 people per 10,000.

By comparison, Harrow PCT was giving 826 people continuing care - a rate of 41.75 per 10,000 people.

This is despite Harrow having 75,000 fewer people and a younger population.

And the Autistic spectrum disorder stories refuse to die away with an additional focus on adults. But why is it exactly that there has been such a rise in its prevalence?

The usual suspects are out to defend the Darzi plan for London.

It appears also that direct to patient ads, long expected, will be with us soon.

The £450,000 campaign marks the first time the private sector has advertised directly to NHS patients. Slots in local newspapers will tell readers that there is now “somewhere surprising you could go on the NHS: BUPA Hospitals”.

The campaign will run in two phases: the first will run immediately for three months; a second big campaign will start in autumn as BUPA Hospitals changes its name to Spire Healthcare following the £1.44bn private equity purchase by Cinven of the hospitals from BUPA.

And the NHS will perforce do the same creating a bonanza for the media but very little benefit to patient-care. Aah, the wonders of choice!

This at the same time as a touted recovery in the private health insurance sector

The number of individuals paying for private medical cover continues to decline. They fell by 2.2 per cent, down a quarter on the 1996 peak, to 1,097,000 policy holders. But strong growth - a 3.4 per cent rise - in company paid schemes, and a smaller increase in company self-insured cover, took total policy holders up to 4,188,000. About 7.4m people, or just over 12 per cent of the population now have some form of cover, although not necessarily a fully comprehensive policy.

It appears that the Health Select Committee is to hold an enquiry into MTAS having heard from the Tooke review. More as it becomes available.

And speaking of the fill rates so proudly announced by the DoH, the following makes for an interesting set of questions raised on DoctorsNet:

Also the figures look worryingly racist to me. Remember to be eligible the Junior IMGs needed to have HSMP – this means having worked for at least 8 months in a high salary job in the UK – usually these are doctors from overseas with good qualifications and skills and expertise gained from working in the UK.

Check my figures

9336 of 13600 UK Graduates got jobs = 69%
3264 of 13,600 non UK Graduates got jobs = 21%

i.e. three times more likely to get a job if a UK graduate – this may be sensible but does not look like EQUOL?

I would have to agree.

Not to mention that a third of the 2006 cohort of physiotherapy graduates are still looking for jobs nearly a year after qualification & with the 2007 batch about to graduate with the resultant increase in competition.

Share This

For the unnamed “security management specialists” who trot out complete garbage about the easy availability of dangerous viruses & chemicals in hospitals as well as the credulous reporters who recycle this stuff, just what formulaic Hollywood B-movie have you been watching lately?

It is difficult to call what was achieved on the crisis over appointments to medical training posts a victory as it was a defeat barely stretched into a draw but have we lost the wider war? Have the people responsible gotten away with the classic denial strategy, letting time deal with the problem?
Every mention of the debacle in the public arena refers only to the MTAS problems & dismisses it as a computer problem with no attention paid to the contribution of the MMC structures. Have the teeth been drawn from the protests & are people resigned to accepting whatever is dished out? Today we hear that it cost £1.9 million just for the website & structures with no estimate made of the other costs involved. When will the human cost of all this be calculated?

The London plans draw an early defence from the usual suspects with this letter in the Times.

And in other clinical snippets, the contaminated blood scandal, the true prevalence of HAI in Scotland & the improved thrombolysis rates within the golden hour get a mention.

From the US of A, Medicare seems to be having good results with its version of QOF. And Massachusetts appears to be doing well too with plans for universal healthcare coverage. But with healthcare being one of the prime issues of the 2008 elections, more ideas are likely to surface.

Share This