Lewisham Hospital Closure Quashed at High Court

On 31 July 2013 Justice Silber found that Secretary of State Jeremy Hunt M.P. had acted unlawfully when he ordered the ‘downgrading’ of  the A&E and Maternity Departments at Lewisham Hospital. The judge quoted the National Health Services Act 2006 as the legislation that made Mr Hunt’s actions illegal.  The idea of one trust bailing out another seems to have been Mr Hunt’s undoing.

BBC TV and national newspaper coverage of the story was almost non-existent.  Apparently the Zimbabwe election and a Top Shop T-shirt showing an illegal image of Rihanna was judged as more important by national news media than the lives potentially saved by keeping Lewisham Hospital’s A&E open.

Mental Health Primary Care Plans for Ealing Cause Uproar

At a poorly publicised and poorly attended West London Mental Health Trust (WLMHT) meeting in Ealing Town Hall on 23 July 2013 mental health primary care plans for Ealing were revealed.

Ealing GP practices are to be financially ‘incentivised’ to offer mental health primary care services.  If they decline this offer, mentally ill patients at those practices will be deprived of primary care services.  WLMHT says that GPs will be given training in mental health primary care ‘this summer’. WLMHT admitted that this training had not yet started.  Only passing reference was made to resourcing challenges. Estimates of cuts to the NHS NW London mental health services are £43 to £54 million by 2015.

The few mental health service users and carers who attended the meeting expressed their disapproval.  Members of the Ealing Clinical Commissioning Group (ECCG) were on hand and they attempted to placate users and carers, but to no avail.  One service user savagely bemoaned the annihilation of the John Connelly Ward secure and successful mental health services at St Bernard’s Hospital.  She clearly had little or no confidence in moving the ‘setting of care’ from a secure, dedicated mental health hospital to GPs’ surgeries and her own front room.  No engagement has been attempted with service users, and the John Connelly Ward users wanted the ward to be re-opened.

This whole farrago exposes one of the flaws in the setting up of the NHS in 1948.  GPs should have been engaged as NHS employees way back then. The spectre in Ealing of GPs  – independent traders – electing not to provide mental health primary care is outrageous and very dangerous.  However, the NHS has no statutory requirements to insist that GPs should provide these services.

What a very worrying shambles.  Why is the NHS so unwilling to engage with its local communities during the formative stages of plan making?

My own experience of GPs and mental health issues is that the majority of GPs are not interested in dealing with mental illness.

Dedicated Government Press Campaign to Destroy our Public NHS?

Never in my lifetime can I remember such a relentless ‘headline’ campaign attacking a public service as the one now taking place on the NHS.  Every day newspapers, radio and TV are dominated by lead stories which expose, embarrass, denigrate or ridicule NHS staff, organisations, performance, outcomes, deaths, care standards, statistics, etc, etc.

No doubt there are regular failures in other public services, such as law and order, public housing, child protection, health and safety, not to mention private health care.  However, those involved in other public service failures must be delighted that they are not being pursued by a dedicated press campaign to expose their failings. When are we going to be asked if we would recommend Ealing Police Station to a friend?

‘Death Rates’ Explained

To quote ‘Private Eye’:

‘The Hospital Standardised Mortality Ratio (HSMR) represents the number by which the deaths in a particular hospital exceed the number that would have occurred if the hospital had had the national death rate for each age, sex and diagnostic group etc. for which adjustments are made.’

HSMR cannot be used to determine precise numbers of deaths.  However, the HSMR can alert managers and regulators to a potential problem or problems.

Sir Bruce Keogh’s review of 14 NHS Trusts with high HSMR rates is seen by many informed observers as being of value.  For the Coalition Government to use the review as a weapon to attack the Labour Party is pathetic. Keogh’s plea for NHS inspections to be carried out by doctors somehow got lost in the political crossfire.

NHS Good News Gets Little or No Coverage and NHS Media Failures Past and Present

Maybe in some ways the crisis is in the media coverage of the NHS and the Government’s public press relations policy to rubbish the public sector NHS services at every opportunity. However:

+ ‘The Guardian’ 20 July 2013 Letters page contains glowing personal experiences at NHS treatment centres including those in Freeman Hospital Newcastle, Barts, Homerton, a Drop In Centre in Sheffield and Kings College Hospital London.

+ As I queued for my appointment this month with the so called Independent Reconfiguration Panel I spoke with a local Paediatrician who was queuing to go in before me. He said Paediatric services at Ealing Hospital had never been better than they are now and it was clear that service needs are growing. The NHS/Government plans to close Paediatrics at Ealing Hospital will have disastrous consequences he said.

+ I’m reading the fascinating but shocking book ‘NHS SOS’. In it are chronicled failure after failure by the BBC and national broadsheet newspapers. These organs failed to report the various moves in the Bill and in Parliament to privatise the NHS and remove the statutory right for the Government to provide a universal health service. These news organisations bought all the garbage about ‘GP led’ Clinical Commissioning Groups and more or less completely missed the looming prospect (now a reality) that 49% of NHS ‘work’ could be private/paid for.

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I make no excuse for devoting much of this newsletter issue to the works of the excellent Keep Our NHS Public (KONP) campaign group. KONP was formed in 2005 by the NHS Consultants Association, NHS Support Federation, and Health Emergency.

Keep Our NHS Public (KONP) – www.keepournhspublic.com

I attended the KONP AGM in Central London on Saturday 13 July 2013. It was impressive in every way. 100 people attended from all over England. KONP now has 36 groups established throughout England. Its HQ has paid staff and in 2012 its operations showed a healthy surplus.

Guardian columnist and number one broadsheet newspaper NHS campaigner Polly Toynbee delivered the Keynote Speech. It was packed with useful facts and insightful views. You might hate the Labour Party for kicking off the current Coalition NHS privatisation – she boomed – but surely they could not do a worse job than the Coalition. UKIP won’t make any Parliamentary inroads in 2015 so your least worst option is to support the Labour Party! Single issue save the NHS Parliamentary candidates are unlikely to succeed she says.

Just what are the Department of Health and Jeremy Hunt actually for asked Wendy Savage. Hunt no longer has a statutory duty to provide a universal healthcare service. Is he just there to whinge about how bad the NHS is so that his private healthcare chums can come in and take it over? Polly was positively apoplectic about the failure of the BBC to accurately report what is happening to the NHS and the laziness of BBC journalists to supinely be spoon fed Government propaganda. If you don’t like BBC coverage on NHS matters phone the BBC and complain on 03700 100222.

It was clear from the meeting Q and A that more good work could be carried out by KONP in soliciting and receiving Union grant funding nationally, regionally and locally.

KONP felt it had failed somehow by not being able to kill off Section 75 of the Health and Social Care Act 2012. However successful concerted efforts by many had watered it down so that potential delays and ‘wiggle room’ have been introduced into this open sesame for private healthcare providers.

We have all failed to prevent the damaging and at times absurd introduction of European competition law into NHS processes. Possibly sensible  hospital/service mergers are now being halted/delayed while competition lawyers earn huge fees arguing the case for the glories of competition. Polly Toynbee quoted chapter and verse of the merger of Bournemouth and Poole hospitals now subject to an OFT competition review. Earnings by competition lawyers is £1.67 million so far on this case!

Many fears were expressed about the impending US/EU free trade agreement. If the Transatlantic Trade and Investment Partnership (TTIP) agreement, when signed, includes healthcare services, it will grant transnational corporations rights to access public procurement in England. KONP will lobby heavily to try and gain an exemption for the NHS in the TTIP. It will also lobby for exemption from ‘investor protection’ which allows corporations to sue governments for loss of future profits. TTIP is expected to be signed in November 2014. More information at:

www.opendemocracy.net/ournhs

However KONP did highlight some successes.

The 2013 book ‘NHS SOS’ edited by Jacky Davis and Raymond Tallis was rightly praised. I bought a copy. (ISBN: 978-1-78074-328-8. Publishers Oneworld – www.oneworld-publications.com). The book is both brilliant and disturbing.

The demo about BBC failures and inaccuracies in reporting on the destruction of our NHS outside the BBC in Portland Place caused quite a stir.

Many delegates wanted KONP to remain apolitical.

We all agreed that healthcare and social care must be integrated together.

One Manchester delegate suggested – quite correctly in my view – that KONP should reach out to synergistic campaigning groups like Shelter, Amnesty International, student unions and medical students’ networks.

The Lewisham Hospital campaign had shown us all the power of NHS Staff and residents working together. The 25,000 on the Lewisham march was awesome. However 6,000 nurses have lost their jobs in recent years and many of those remaining in the NHS are nervous or afraid of demonstrating.

Local democracy is under attack. All CCGs have just 5 elected local GPs and 25 paid officials. National democracy is under attack. CCGs report to the new NHS Commissioning Board now renamed NHS England which is directly accountable to no-one in Government.

There was universal agreement on the fact that the vast proportion of the population and huge numbers of NHS staff have little idea of what was actually happening to the NHS.

Jeremy Hunt Says NHS is Failing: If So Then He Must Take the Blame and Be Fired

Thousands have died needlessly apparently at 14 NHS hospitals in 2010 to 2012. Casualty and maternity units at the poorly performing hospitals may close.

All this data appears in a research report from NHS Medical Director Bruce Keogh and was broadcast in Parliament by Health Secretary Jeremy Hunt MP on 17 July. Clearly these NHS failings are happening on his watch and clearly he must be fired.

No doubt we are all assumed to deduce that the key to failing hospitals is to close them down, demolish them and sell the land for residential development (like Ealing Hospital). No doubt altruistic global healthcare companies will step in and offer new casualty services (such as at the BMI Clementine Churchill Private Hospital in Harrow) and new maternity services (such as at the HCA Portland Private Maternity Hospital in Great Portland Street, W1).

The ‘NHS SOS’ book tells us that 70 MPs and 142 Peers in the House of Lords ‘…have a vested interest in the promotion of private healthcare’. So the Right Wing press rubbishing the NHS may be the softening up process before we are all bludgeoned into ‘believing’ that the public sector can’t hack it and it’s time to bring in those wonderfully efficient private healthcare companies…..

Urgent Care Centres are Nothing of the Sort: 44 Medical Conditions Are Excluded

Care UK ( ‘Fulfilling Lives’ is their catchphrase ) advises us that its UCCs (like the one at Ealing Hospital) do not treat:

‘ACS/MI, acute anaphylaxis, actively suicidal/deliberate self harm (not suicidal ideation), acute confusion, alcohol or drug intoxication (likely to need obs), alleged rape (with major injury), children with complex fracture of upper or lower limb likely to require manipulation, complex fractures/pelvic fractures/hip or long bone fractures, colles fracture, collapse state, currently having seizure, CVA/TIA (separate pathway), dental injury (Northwick Park maxfax), Dvt or suspected Dvt, extensive burns, fever with oncology, hematuria post abdominal injury, inhalation of smoke or fumes, mandible dislocation, major head injury, meningitis or suspected meningitis, needle stick injury, overdose, penetrating eye injury, poisoning, pregnancy with persistent vomiting, psychosis, PV bleeding (heavy) ( pregnancy less than 20 weeks to ED and more than 20 weeks to obstetrics), pregnant with abdominal trauma, paediatric white card holders (will go directly to paediatrics), patients with GP referral letter go to speciality direct, renal colon (blood positive on urine dipstick), severe pain (requiring parental analgesia), severe breathing difficulties, shoulder dislocation, Sickle Cell crisis, significant epistaxis, significant haemoptysis/haematemisis, gunshot injury, significant stab wound, unconscious, uncontrollable haemorrhage and unresponsive floppy child’.

So – after Ealing Hospital A&E closes you’ll need to check through this list before rushing yourself or your loved ones for ‘urgent care’ to Ealing Hospital or Northwick Park Hospital or  West Middlesex Hospital or Hillingdon Hospital or where ever else.

Whittington Hospital Plans Ripped Up!

People power appears to have forced the cuts and sell off plans for Whittington Hospital in Camden to be withdrawn and the Board to apologise for coming up with cuts without a clinical plan in place. However local activists say the Board still wants to become a Foundation Trust and ‘transfer hospital services into the community’. Whittington Hospital is also the place that Ealing CCG supremo Rob Larkman disappeared from ‘overnight’ in 2011 when his NHS plans to close A&E and Maternity were rubbished – again by people power.

Camden Council Agree Public Inquiry into Harmoni

Camden Council Health Scrutiny Committee has agreed to set up an inquiry into Care UK’s Harmoni running of North Central London’s Out of Hours GP service. Keep Our NHS Public in Camden proposed the inquiry on the basis of Harmoni failing its CQC inspection and the contract being awarded on price not quality.

Privatising Our Blood

An American private equity firm – Bain Capital – has agreed to pay £200 million for 80% ownership of state-owned Plasma Resources UK, the main blood plasma supplier to the NHS. The deal was roundly condemned by cross-bench peer Lord David Owen who described the deal as ‘the worst possible outcome’. Professor Allyson Pollock, a prominent public health researcher, warned against Bain asset stripping and subjecting our blood supplies to open market economics.

Would You Recommend Your Local Hospital to a Friend?

This is the latest nonsense in ‘consumer tests’ on hospitals.  We don’t have such tests on Police Staions, state schools, Job Centres or Magistrates Courts.  Why is that? Well, it’s probably because it’s political dogma that is driving the Coalition Government to denigrate state healthcare so that it can be wheel in private providers.

Ambulance Chasers are Alive and Well

I visited West Middlesex University Hospital on 23 July 2013. Whilst waiting I glanced at an NHS leaflet on ‘Knee Injury’. Quite useful information. However filling the back page was an advertisement by a firm of solicitors – ‘Had an Injury?….let our super lawyers help you with your claim…’

Words fail me.

Tory Press Exposes NHS Scandal after Scandal – Why?

‘The Daily Mail’, ‘Daily Express’ and ‘The Telegraph’ vie with each other almost every day with horror stories about the NHS today or in the recent past. Nicholson, Stafford, A&E closures, NHS 111, Leeds heart surgery, Morecambe Bay, loss making, Bower, CQC, redacted reports, Furness, whistleblowers, cover-up, Burnham, Lansley….it just goes on and on.

Is the Tory press supporting the Coalition’s recipe for radical changes in the NHS by publicising these shambles?

Well….maybe this is true but as an approach it’s wearing a bit thin as the Tory led Coalition has now  been in power for over three years. NHS institutional and staff failings are of course meat and drink for those right wingers who want to flood the NHS with private healthcare providers.

And Please – Don’t Blame the Patients!

Allegations are also being thrown around every day that patients are visiting A&E when they should be phoning NHS 111, making an appointment with their GP or treating themselves!

I am one of millions of citizens who have paid National Insurance for decades for the £110 billion annual spend on the NHS to care for me for free at the point of service delivery. If I have an in-growing toe nail/heart attack which is giving me pain and I can’t sleep I’ll do whatever I can to gain relief. I may not know about NHS 111 or find can’t get through to them. My out of hours GP may not be available – so I would get myself down to my local A&E WHILE IT STILL EXISTS!

1,500 Whistleblowers Victimised in NHS

The charity Compassion in Care (CiC) reported in June that 1,500 people had lost their jobs or were victimised by trying to expose abuse, cover-up or wrongdoing. ‘Private Eye’ quotes Eileen Chubb of CiC rating both the 1999 Public Interest Disclosure Act and the new Enterprise and Regulatory Reform Act as unfit for purpose in offering any meaningful protection for whistleblowers. See www.compassionincare.com. The campaign group Whistleblowers UK wants a US style ombudsman with specialist lawyers to help those seeking to make public interest disclosures. See www.whistleblowers.uk.com.

Bureaucratic Response to Crises – Public Consultations

If it’s broke then go into public consultations mode seems to be the current response in accident and emergency, and care quality;

+ NHS A&E public consultation till 11 August 2013 – www.england.nhs.uk

+ Care Quality Commission public consultation till 12 August 2013 – www.cqc.org.uk

Private Healthcare Companies Cutting Corners

In 2011 the Organisation for Economic Co-operation and Development (OECD) rated the NHS as one of the best healthcare systems in the world. The NHS Support Federation has been tracking NHS service deterioration in recent years (www.nhscampaign.org). It notes many instances of private healthcare suppliers cutting corners. Currently causing concern are:

+ BMI/Netcare – children’s surgery halted

+ Care UK – failure to process 6,000 x-ray records

+ Carillion – 6 patients fear sight loss

+ Harmoni (Care UK) – out-of-hours service alleged to be ‘unsafe’

+ Netcare – Celia Collet case study of poor care

+ Serco – not enough staff and ‘fiddled’ figures

+ PIP – breast implant scandal

+ Virgin – understaffing at Kings Health Centre

First NHS Performance League Table Published – Branded as ‘Virtually Useless’

On 28 June 2013 the first performance league table for NHS medics was published. 472 Vascular surgeons were the lucky NHS professionals to be the first to rated and ranked. Several surgeons were listed as having the highest crude mortality rates in the country. ‘The Guardian’ quotes that a Simon Payne, a vascular surgeon based at Portsmouth Hospitals, had a ‘death rate of  31% – 10 times the national average and 30 times higher than some of his colleagues’. This rate related to two key vascular operations. Upon contacting Portsmouth Hospitals they told the newspaper that ‘Simon Payne has not carried out that procedure since 2011 after he had a shoulder injury’!

Professor Ben Bridgewater of the Healthcare Quality Improvement Partnership (www.hqip.org.uk) branded these crude estimates as ‘virtually useless’ as they failed to take into account the number of emergency cases, the age of the patients or the complexity of each operation.

A farcical development was that the tables had to be hurriedly re-issued. The new tables lowered the crude mortality figures substantially in many cases.

I await with bated breath the time when Members of  Parliament Performance League Tables are researched and published.

Medical Insurers Alert Competition Commission of Serious Lack of Private Healthcare Competition in Central London

Articles in ‘The Independent’ and ‘The Times’in June 2013 revealed details spilling out of the Competition Commission’s investigation into private healthcare in the UK.

We hear about the unhealthy domineering position of US private health care provider HCA in London. HCA UK apparently caters for about half of all private patients in London and 72% of all critical care in Greater London. It owns the Harley Street Clinic, the Portland Hospital, the Lister Hospital and the London Bridge Hospital. HCA UK also has joint NHS ventures all providing cancer care, renting space from public hospitals for exclusive private treatment at UCH and Queens Hospital Romford. HCA UK’s profits before tax in 2006 were £30 million.  By 2012 this had increased to £61.7 million.

Complaints Against Private Healthcare Providers On The Rise

20,316 grievances against health insurance companies were filed with the FSA last year. This is an increase of 38% over the last two years. BUPA was hit hardest by this increase in complaints. Grievance issues included:

+ Unexpected bills for excess payments after routine operations

+ A limited choice of consultants

+ Poor handling of claims

Private healthcare providers have been under investigation for more than a year since the Office of Fair Trading raised concerns about:

+ Poor transparency

+ Limited competition

+ Alleged cosy deals between insurers and hospital operators

Drug Companies Face Accusations of Overcharging NHS Hundreds of Millions of Pounds

An undercover investigation by ‘The Telegraph’ has resulted in allegations that the buy-in price to the NHS of more than 20,000 drugs could have been artificially inflated, with backhanders paid to chemists who agreed to sell the drugs.

The drugs involved are so called ‘Specials’ which are prescribed when a patient has a clinical need that cannot be met by a normal licensed medicine.

The newspaper investigation was launched after being approached by a whistleblower. The companies named in the allegations include Pharmarama, Temag and Quantum Pharmaceutical.

Jeremy Hunt MP, the Health Secretary, is quoted as having ordered an investigation into the allegations which he finds ‘deeply concerning’. And so he should.

49% of GPs Say They ‘Can No Longer Guarantee Safe Care’

A profoundly worrying survey of family doctors by the Royal College of General Practitioners (RCGP) reveals that 49% of them can’t guarantee safe care and 85% think General Practice is ‘in crisis’. Some GPs are having to deal with 60 patients a day.

General Practice currently receives only 9% of NHS funding, despite family doctors carrying out 90% of all NHS contacts.

Is Atos Fit For Purpose?

‘Private Eye’ in June exposed significant failures of delivery by Atos in the way it is assessing disabled people for the new Personal Independence Payments (PIPs). A year after a £184 million contract was signed just four NHS and four physiotheraphy providers in London /SE England have been signed up to provide assessment centres. What was promised in 2012 was a network of 740 assessment centres across London/SE England operated by 22 NHS and private healthcare providers.

The disabled in London/SE England are now incurring extended journey times travelling to assessment centres for PIP – in some cases totalling 90 minutes.

NHS NW London A&E Closures and the IRP

The so-called Independent Reconfiguration Panel (IRP) has been asked by Secretary of State Jeremy Hunt MP for its opinion on the NHS decision to close 4 of the 9 A&E units in NW London. The units to close are at Ealing, Central Middlesex, Charing Cross and Hammersmith Hospitals. Ealing Council’s Health and Adult Social Services Panel unanimously voted for the referral to the Secretary of State in March 2013.

I am indebted to Colin Standfield’s excellent research on the IRP’s rubber stamping of the NHS NE London’s decision to close the A&E unit at King George Hospital, Goodmayes (Redbridge)

According to ‘Ealing Today’ the IRP review is likely to present its report in September 2013.  The IRP members involved are likely to be past, present and/or future NHS staff or consultants. Some odd kind of independence that.  

IRP’s terms of reference are unlikely to include a phrase like ‘..the wishes of the general public..’. The major ‘test’ is likely to be whether the proposed changes ‘will enable the provision of safe, sustainable and accessible services.’ IRP Chair is Lord Ribeiro who worked as an NHS consultant for 29 years. He was ennobled in 2010 and has only voted once voted against the Government.

Colin recommends that activists persuade groups who did not lobby against the changes during the flawed 2012 consultation to make representations. He also feels that we should all make as much noise as possible about the distortion of the survey results –NHS claiming 17,022 responses when the true figure was about 4,550.  You can call the IRP on 020 7389 8046 and email at info@irpanel.org.uk. There’s also more information at www.ealing.gov.uk/soh

Child Heart Surgery Reform U-Turn

Controversial plans to reform children’s heart surgery have been suspended as the decision was apparently, based on a ‘flawed analysis’. The plan was to concentrate surgery in fewer bigger centres. This involved closing units at Leeds General Infirmary, Glenfield Hospital in Leicester and the Royal Brompton in London. Surgery now continues at these seemingly doomed surgical units. This is convenient for the Leeds unit as a High Court judge recently quashed the NHS decision to stop surgery there.

Informed observers had noted that the seven chosen centres (before the u-turn) were largely located in the western half of England leaving a large swathe of the east, from Newcastle to London, without a child heart surgery centre.

Ealing Clinical Commissioning Group (ECCG) Fails to Impress

I attended the ECCG Governing Body meeting on 22 May 2013. For budget year April 2013 to March 2014, no finalised budget exists. 60% of all NHS patient expenses in Ealing will be processed through the ECCG – a spend of £481million. 27 people sat around a very big table and 20 of them did not say a word.  On performance, red flags exist for cancer screening, meeting A&E targets, mental health referrals to therapies, mixed sex wards, serious incidents at the Imperial College Healthcare Trust, teenage conception rates and child immunisation

rates.

ECCG announced in April 2013 that it would be ‘commissioning or buying health and care services our residents need including elective/planned hospital care (operations), rehabilitation care, urgent and emergency care, community health services, mental health services and learning disability services’.

US/EU Trade Deal Threatens NHS

Ex-NHS doctor and crossbench peer Lord Owen and researcher Linda Kaucher have both recently warned that a US and EU trade deal could lead to unprecedented private sector competition in the NHS. The US/EU Free Trade Agreement will ‘dismantle hurdles to trade in goods, services and investment’ and ‘make regulations and standards compatible on both sides’. So any EU or US company can pitch to the NHS for doing your hip operation or removing that tumour. If foreign multi-nationals feel that they are being excluded from any invitation to tender they will have statutory rights to go to law and complain about it.

It’s no wonder, according to researcher Social Investigations, that over 60 MPs and 142 peers are connected to companies involved with national and international private healthcare companies.

Sir David Nicholson Should Keep His Mouth Shut

Disgraced ‘retiring’ NHS supremo Nicholson – the man recently implicated in the needless deaths of 1,200 patients in Staffordshire – is refusing to go quietly. He blames all the current NHS ills on politicians. He takes credit for putting doctors and nurses in charge of the new NHS. It’s a bit like putting tube drivers and tube maintenance engineers in charge of running London Underground.

More Nicholson screw-ups are coming to light. ‘The Economist’ has just reported that £74 million worth of Tamiflu – the anti-flu drug – has had to be thrown away because the NHS was unsure  whether it had been stored properly. He was also apparently behind spending £60 million in ‘bribes’ to encourage hospitals to adopt ‘hopeless’ IT systems. Mr Nicholson oversaw some £11 billion worth of failed NHS IT systems.

He has also publicly blamed the Treasury for the widespread use of gagging orders by hospitals. In the last seven years some £2 million has been secretly paid out to some 50 staff, some of whom presumably were whistle blowers.

It’s difficult to find any informed observer who believes that the approach taken in the ‘Nicholson Challenge’ (sounds like a reality show or a game show) to secure better value at lower cost is in any way viable or sustainable.  

Methinks Mr Nicholson should shut up, see out his time and then go home and spend more time with his money.

NHS Authorise Bounty Childcare Products Company Sales Staff  to Sell To New Mothers in Postnatal Hospital Wards

The National Childbirth Trust and Dr Margaret McCartney, a Glasgow GP, have both recently expressed anger that some NHS Hospitals allow Bounty sales staff access to new mothers on the ward. Bounty sales staff grill the mothers for their personal details which Bounty sells on to commercial interests. 168 NHS Trusts are being paid up to £5.50 per baby born for this access.  Bounty claims to be the UK’s leading parenting club (whatever that might mean). The company was founded in 1959 by an advertising executive. Bounty runs two web sites, neither of which states whether the company is a charity or for profit. Presumably the company exists purely in the ether as no terrestrial postal address is volunteered anywhere on its web sites.

Dr McCartney is also up in arms about the Royal College of General Practitioners (RCGP). RCGP has apparently endorsed GPs handing out a book of advertisements  called ‘Emma’s Diary’ to pregnant women. The diary contains 119 pages of advertisements and just 25 pages of editorial.

40% Fewer District Nurses Now than in 2003

A recent study by the Royal College of Nursing (RCN) points out that with so many fewer District Nurses patients are stranded in hospitals for days.  The study found a strong link between lengths of stay in hospital and quality of care closer to home. Britain lags behind France, Spain, Ireland, Italy, Norway and Sweden in long stay/community care quality.

Health Secretary Jeremy Hunt MP Attacks GPs and Says ‘It’s All Labour’s Fault’

Acting true to his public relations background Jeremy Hunt is going to extreme lengths to deflect criticism of the stalling NHS revolution away from the Tory-led Coalition Government.  As private healthcare companies sneak into the NHS under the radar, the NHS 111 telephone service failures, the over heated A&E units, the war against GPs and Labour’s changes to GP contracts in 2004 – are all anybody’s fault but the Coalition Tories.

And Now a League Table for Doctors

League tables are scheduled to be published beginning in July 2013 rating NHS doctors on how their patients fared after surgery or treatment. However not all clinicians want to play ball here and 92 surgeons have so far vetoed the publication of ‘their’ data. Jeremy Hunt is now threatening to name and shame these surgeons.

This occasional newsletter is written and edited by a group of concerned residents in Ealing, West London, who want to preserve our NHS. We view the wholesale engagement of private, for-profit healthcare service suppliers as unnecessary, profligate and dangerous. Process improvement is what is needed in our NHS – not revolution.

‘NHS – once the envy of the world’

Launched in 1948 our National Health Service (NHS) pioneered universal healthcare free at the point of delivery and funded by a National Insurance tax. Local doctors, called General Practitioners (GPs), became part of the NHS service, but were never on the NHS payroll as employees. They have always been private contractors. Consultants too would not go on the payroll  and not only were they retained as contractors, they got to use NHS facilities and equipment for treating their private patients.

In recent years over £100 billion has been spent annually to run and maintain the NHS in England. With 250,000 staff the NHS is the second largest workforce on earth (the Chinese Army is the largest).

The changing role of hospitals

The idea of hospitals is 2,500 years old. The first recognised hospital dates back to around 400BC in Sri Lanka. The traditional hospital idea is that it is a dedicated, secure site at which a range of research, testing, treatment, trauma, surgical and caring services are provided. Primary care (i.e. usual first point of patient contact) has traditionally been provided by GPs in England who until recently were not located in hospitals. Private hospitals have traditionally not provided Accident and Emergency (A&E) services.

Now all this is changing. In Ealing Hospital we have GPs with nurses running what is in effect a large General Practice. It’s called an Urgent Care Centre. A&E is closing down at Ealing Hospital and this will also happen at Central Middlesex Hospital. But luckily, and no doubt just by chance, a private Emergency Care Centre has recently opened in nearby Harrow at BMI’s Clementine Churchill Hospital. It’s a ‘self-pay walk in service’.

Sir David Nicholson, Head of the NHS gracelessly retires – but not until March 2014

This is the man who was recently implicated in the needless deaths of up to 1,200 patients at NHS Mid Staffordshire Hospital. Many feel he should have resigned months ago. We’ll still be paying his £211,000 annual salary until March 2014. His public pension pot is rumoured to be around £2 million.

Health and social care grants

Ealing Clinical Commissioning Group (the in-effect re-branded Primary Care Trust) admitted in April 2013 that because it had not finalised its budget, it could not commit to continuing paying health and social care grants beyond September 2013. Because of this a number of local care organisations who are dependent upon these grants are having to organise redundancies.

One does wonder what exactly is going on. The ECCG folks are largely the same people who were running the PCT. The ECCG has been meeting and working on the budget for many months. Just how credible is any organisation is which has not sorted out its budget after the beginning of its financial year?

Lack of Community Engagement Leads to Fury in Hanwell, Ealing as NHS Alcoholic and Drug Addict Recovery Centre Plans are Unveiled.

Some 100 residents and Councillors attended a public meeting on 7 May 2013. Since 1 November 2012 Recovery Intervention Services Ealing (RISE) has been providing drug and alcohol abuse treatment and recovery services .RISE is a consortium led by the charity Crime Reduction Initiatives (CRI). The EACH volunteer group and the NHS North West London Mental Health Trust (CNWL) are also involved.

RISE wants a base in the west of Ealing and has set its sights on The Studios in Cambridge Road, Hanwell. A Planning Application was submitted in January 2013 but it is still ‘Pending’. The application is incompetent in that it states that ‘the property is surrounded by other commercial properties’. This is so far from the truth as to be ludicrous. New flats are immediately to the north and established houses are immediately to the east and south. Some residents were clearly furious about this attempted deception. Other angry parents and residents pointed out that many children walked past The Studios to and from multiple schools. Others were annoyed that there had been no engagement with the local community during the formative stages of planning this drug addict/alcoholic centre. Many attendees made the point that they were aware of the problem and aware of the need for a treatment centre – but not on this site.

The obvious place to locate such a service would be a local, secure hospital site which had excellent public transport facilities. Both Ealing Hospital and St Bernard’s Hospital meet those criteria. However both hospitals are about to be largely demolished and much of the site ‘repurposed’ for housing. Also if this pantomime is an example of NHS NW London’s emerging ‘Out of Hospital’ strategy we are all justified in worrying about it.

Meltdown in A&E and the 111 telephone service?

A&E closed at Newark, Notts two years ago. Since then there has been a 37% rise in death rates (according to ‘The Mail on Sunday’). The FOI-obtained figures come from three NHS Trusts and cover six hospitals.

‘The Independent’ had a leaked letter from NHS leaders at 18 West Midlands Emergency  Departments. Rising numbers of patients have created a ‘state of crisis’ in these Emergency Departments which handle 1.5 million patient attendances each year across a population of 5.36 million.

Nationally an extra million A&E patient attendances were recorded during the period January 2012 to January 2013.

The NHS Direct health advice service referred an extra 120,000 patients to A&E departments in the past year. This happened during a period when NHS Direct staffing levels dropped by 1,200 people. (Facts courtesy of ‘The Observer’). It doesn’t take a genius to appreciate the link between these two facts. Also, of the 143 Trusts that have large A&E units, only 18 have hit the target of treating 95% of patients within four hours.

Three deaths in Derbyshire and the West Midlands are being investigated in connection with the NHS 111 telephone advice service (‘The Telegraph’). The NHS 111 advice service is being progressively rolled out across the country to replace the NHS Direct advice service. Why? NHS 111 employs call handlers who are not clinicians. NHS Direct employed clinicians on the end of the phone. NHS 111 is no doubt much cheaper to run than NHS Direct.  

50% Drop in Trainee Doctors and £500,000 spent annually by each trust

At a Select Committee on Health hearing on 22 May 2013 the College of emergency Medicine reported a 50% shortfall in trainee doctors and consultants.  On average trusts spend £500,000 annually on locums.

NHS NW London A&E Closures

In March 2013 the Secretary of State agreed to refer the decision to close 4 of the 9 A&E departments in NHS NW London.  The Seccretary of State decided to seek advice from the so-called Independent Reconfiguration Panel (IRP) on this.