- DEPARTMENT
OF HEALTH 97/351 Tuesday 18th November 1997 FRANK DOBSON ANNOUNCES ACTION
ON WAITING LISTS AND TIMES
- Waiting List Pledges Will Be Delivered - Says Frank Dobson. Department
of Health Press Release 98/064 Thursday 19th February 1998
- Spread Innovation, Says Dobson. Department
of Health Press Release 98/111 Wednesday 25th March 1998
- Rewards For Hitting Waiting List Targets - Frank Dobson - Patients To Gain
From Extra Cash For Operations. Department
of Health Press release 98/139 Thursday 09th April 1998
- Government Gets Tough On Waiting List Targets - List Buster Appointed To
Head New Team. Department
of Health Press Release 98/166 Thursday 30th April 1998
- Ministers were warned yesterday by the outgoing chief executive of the NHS that the drift towards excessive centralisation of the health service was in danger of squeezing out the local initiative essential for meeting patients' needs. Guardian 29 June 2000
- Hit squads were yesterday ordered in to seven English hospital trusts "named and shamed" after a sharp rise in outpatient waiting lists left the government embarrassed.Guardian 8 August 2000.
- Labour's approach to the NHS is increasingly "Bevanite". Tony Blair sounds as if he wants to be held responsible for every dropped bedpan in every ward. In education, too, this centralising approach has got stronger. The logic of league tables for schools and surgery is yet more central intervention to secure uniform standards. The danger is that teachers and nurses spend their time ticking boxes, afraid to use their professional initiative. Guardian, 15 January 2001.
- Britain's health service is stuck in the Forties with too many patients queueing for treatment, overstretched staff and a paternalistic attitude that does not put the public first, the Government has admitted.
Observer 18 February 2001.
- NHS reform falters - ministers must let go of the reins
Leader
Guardian Unlimited
Tuesday April 24, 2001
- The government's drive to cut NHS waiting lists distorted the clinical
judgment of doctors and caused suffering for some of their most seriously ill
patients, says a report today by the national audit office, parliament's
spending watchdog. John
Carvel, social affairs editor Guardian Thursday July 26, 2001
- MS drugs likely to stay off health service list. Sarah
Boseley, health editor Guardian Tuesday August 7, 2001. But see Guardian
Society Monday February 4, 2002
- Watchdog says hospital waiting lists were fiddled. Audit office
says patients were betrayed by massaging of figures. Guardian
Society Wednesday December 19, 2001
- Opposition flays Blair over waiting list 'fiddles'. Guardian
Society Thursday December 20, 2001
- End the numbers games The NHS needs targets, but the right ones. Leader
Guardian Thursday December 20, 2001
- Doctor who blew the whistle and suffered a reign of terror Stoke Mandeville
is one of Britain's most famous hospitals, but when a doctor in A&E warned
about a consultant she was ignored - then the anonymous threats began.
David Rose. Observer
Sunday January 27, 2002
- Comment Oh, just get on with it. Hand control of the NHS to faceless
administrators? Actually, we could do a lot worse. Mary Riddell Observer
Sunday January 27, 2002
- Stop meddling and let us get on. Richard Lilford argues that it may be
time to set doctors and nurses free from political interference. Observer
Sunday January 27, 2002
- Fight for MS drug fails. Guardian
Saturday January 26, 2002 But see next item.
- Patients' groups have welcomed a £50m scheme which will ensure that
thousands of multiple sclerosis sufferers receive the "banned" drug
beta interferon on the NHS. Guardian
Society Monday February 4, 2002
- The issue explained: beta interferon Why has the drug beta interferon, used
in the treatment of multiple sclerosis, proved so controversial? Guardian
Society Monday February 4, 2002
- The National Institute of Clinical Excellence, the body set up by the
Government to decide what drugs the NHS should prescribe, said it would
severely restrict the use of the drug irinotecan for treating bowel cancer,
which kills 16,000 people a year. The new drug is now standard treatment
across the Continent and the United States, and the effective ban means that
thousands of NHS patients will have to make do with drugs 40 years old. Observer
Sunday March 10, 2002
- The government's hospital construction programme is one of its few outright
errors of policy, the independent King's Fund said yesterday in an otherwise
upbeat post-budget audit of Labour's health initiatives. David Walker Guardian
Thursday May 9, 2002
- Freedom to create more NHS bureaucracy. Plans for foundation hospitals
are an extension of the government's carrot-and-stick approach to public
services and the real winners could be the bureaucrats, says Simon
Parker. Society
Wednesday May 22, 2002
- NHS trusts 'strangled by bureaucracy'. John Carvel, social affairs
editor Guardian
Thursday May 23, 2002
- Milburn urged to portion out health powers. David Batty Society
Thursday May 23, 2002
- Health service 'slow' to devolve power. David Batty Society
Thursday May 23, 2002
- Cancer specialists attack drug curbs. Colorectal patients 'condemned
to poor treatment'. Sarah Boseley, health editor Guardian
Saturday June 8, 2002
- Organisations representing the blind and partially sighted last night said
they were outraged by the recommendation of a government advisory body that
patients suffering the leading cause of age-related blindness should have
treatment only for their better eye. Thursday
June 13, 2002 The Guardian
- Thanks for the money, now set us free. Luton, a testbed for Labour's
spending plans - and its survival as the governing party - sends out a clear
message. Jonathan Freedland Guardian
Tuesday July 16, 2002
- NHS mergers fail to boost service, say researchers. James Meikle,
health correspondent Guardian
Friday August 2, 2002
- Thousands of people could be denied eyesight-saving surgery because of plans
to withhold a new blindness treatment from NHS patients, it was claimed today.
Monday October 14, 2002
- A fresh row has broken out over centralisation of the NHS, with calls for
the resignation of a senior civil servant over the departures of two experienced
hospital managers. Mark Gould
Wednesday January 8, 2003 The Guardian
- Incentives to encourage every hospital to appoint a "modern matron" in its
accident and emergency department were offered yesterday by Alan Milburn, the
health secretary, following the matrons' success in raising standards elsewhere.
John Carvel, social affairs editor
Tuesday
April 8, 2003 The Guardian
- How Britain is losing the drugs war. Today, the Guardian launches the
biggest investigation of the criminal justice system ever conducted by a British
newspaper. Beginning a series which will run throughout the year, Nick Davies
looks at the government's attempt to deal with the most prolific of offenders -
the drug users who commit an estimated 7.5 million crimes a year.
Thursday
May 22, 2003 The Guardian
- Britain's new drug policy in the dock. Leader
Friday
May 23, 2003 The Guardian
- The government's obsession with performance targets means the NHS is driven
by "tick boxes" rather than the needs of individual patients, the leader of
Britain's doctors warned today.
Monday June 30, 2003
- BMA blinkers. Doctors need a dose of realism. Leader
Monday
June 30, 2003 The Guardian
- The leader of Britain's 124,000 doctors warned Tony Blair yesterday that the
government would not be able to keep a manifesto promise to cut the maximum wait
for an NHS operation to six months by 2005 without causing unnecessary suffering
for the sickest patients. John Carvel Social affairs editor
Tuesday July 1, 2003 The Guardian
- MPs opposed to plans to put fluoride in public water are preparing to take
the government on in court if they lose a crucial vote in the Commons next
week. Sarah Hall, political correspondent
Wednesday October 29, 2003 The Guardian
- The Department of Health (DoH) is set to slash 1,400 Whitehall jobs and
review the future of 19,000 other staff in health and social care quangos in the
"first and largest" downsizing in Whitehall, the health secretary, John Reid,
has told MPs. Tash Shifrin
Friday October 31, 2003 . This seems to be a move away from
excessive centralisation.
- Sweeping new measures to allow fluoride to be added to large parts of
Britain's water supply are set to provoke a huge political row amid fears that
'mass medication' may harm children and lead to more tooth disease. Kamal Ahmed
and Mark Townsend
Sunday November 2, 2003 The Observer
- Fluoride in the water - saving children from the dentist, or an abuse of our
civil rights? Edward Baldwin and Ian Wylie disagree.
Saturday November 8, 2003
- The Department of Health used bully-boy tactics to force local NHS trusts
to sign contracts with foreign healthcare corporations for treatment centres
they did not need, according to the chairman of a primary care trust (PCT) who
lost his job for resisting the scheme. John Carvel, social affairs editor
Tuesday June 1, 2004 The Guardian
- There were allegations of 'bullyboy tactics' when Whitehall and the leaders
of local health organisations clashed over plans for a new privately-run
treatment centre. John Carvel reports.
Wednesday June 2, 2004 The Guardian
- We should value NHS chairs who are prepared to rock the boat, says John
Carvel.
Wednesday June 23, 2004 The Guardian
- Rural healthcare 'neglected'. Government NHS reforms are designed for
cities and neglect the health needs of people living in the countryside, the
British Medical Association (BMA) warned in a report published today. Lack of
public transport in rural areas means that patients without access to a car -
particularly the elderly or the young - have problems travelling to health
services outside their immediate community, according to the report, entitled
Healthcare in a rural setting. People living in rural areas are also at risk
from worse health outcomes compared to people who live in towns because they
have difficulty reaching services which have been centralised. Debbie Andalo
Friday
January 21, 2005
- RADICAL proposals to transform key public services in Rugby could put
lives at risk, a leading councillor has warned. The changes, which are part of
Government attempts to reorganise the delivery of major public services across
the country, would affect police, health, fire and ambulance provisions in the
town.
Rugby Advertiser 10 November 2005
-
Superbug hospital chairman resigns. The chairman of the NHS hospital
trust where 90 patients died from Clostridium difficile infection accused the
government last night of singling it out for vilification when ministers knew
scores of other trusts had worse infection rates. James Lee resigned as chairman
of Maidstone and Tunbridge Wells NHS trust, after Alan Johnson, the health
secretary, launched fresh inquiries into his role in organising a £250,000
pay-off for the chief executive, Rose Gibb. Mr Lee, a film executive and former
director of the Financial Times, was already under investigation by the
South-east Coast strategic health authority for the part he played during two
outbreaks of C difficile between April 2004 and September 2006. The Healthcare
Commission said last week that 1,176 patients were infected with C difficile
during two outbreaks when 345 patients died. It said 90 of the deaths were
definitely or probably caused by the infection and blamed slack management for
failing to contain it. Last night Mr Lee released the text of a four-page letter
to Mr Johnson admitting there was no excuse for what happened at the trust's
three hospitals. He said: "I am deeply saddened by these terrible events and
take full responsibility for my part as chairman of the board for the past five
years. I apologise unreservedly." But he hit back at the unreasonable pressures
imposed on the trust by the government. "We have been struggling with a state
pretty close to bankruptcy," he said. The trust's clinical income last year
increased by 1.5% in cash terms when staff pay rates were rising by over 5%. "We
knew the Treasury was pumping money into the NHS, but quite frankly none of this
seemed to be getting to the coalface." As income fell, hospital activity rose by
11%. The trust cut costs by more than £40m in an attempt to break even. It
struggled to cut maximum waiting times to 18 weeks. But this was "never really
achievable". Mr Lee said attempts to get rid of a small minority of poor nurses
were ineffective because "NHS employment practices make it difficult to take
action, even against transparent incompetence". He sent the letter, labelled
strictly private and confidential, before he knew whether Mr Johnson would back
him or accept his resignation. He denied any impropriety in the severance
payment to Ms Gibb. The government was persisting in treating Maidstone as a
"rogue trust", when it knew there were 83 acute trusts in Britain with higher C
difficile rates in the first three months of this year. "We are now so
discredited that we are no longer believed," he said, appealing to Mr Johnson to
explain the facts to the public. He added: "The NHS is run on the basis of
command and control. I personally have never experienced such centralised or
detailed control ... This way of managing things is fundamentally incompatible
with the whole concept of independent trusts ... I have done my best." Mr Lee
broke his silence after Mr Johnson told MPs he had ordered a departmental review
of the chairman's role in agreeing severance terms for Ms Gibb. John Carvel,
social affairs editor
Tuesday
October 16, 2007 The Guardian
-
The fruits of Kiwi health reform. Slowly but surely, the health reform
tide in England is turning. Gordon Brown and health ministers have signalled
their intention to place much greater emphasis on public health than their
predecessors, alongside a continuing commitment to improve the performance of
the NHS. Lord Darzi's interim report on the NHS specifically highlighted the
need to make more progress in tackling health inequalities. With a boy born in
Manchester likely to die almost 10 years earlier than a boy born in Kensington
and Chelsea, a concerted drive to improve health by focusing on people most in
need seems certain to loom large in the next stage of health reform. Last week's
announcement that the government is planning 10 eco cities, designed to make it
easier for people to exercise, is an indication of the way in which ministers
are thinking. The risk with this approach is that it will become just another
initiative unless it is part of a well-designed public health strategy.
Ministers should look to New Zealand for lessons on how to avoid risk. Recent
analysis showed that the widening of health inequalities there has been stemmed
and, to some degree, reversed. Although the precise reasons are not fully known,
inequalities in New Zealand appear to have been tackled successfully as a result
of a long-term commitment to public health and primary care. Under prime
minister Helen Clark, New Zealand turned its back on the failed internal market
experiment of the 1990s, and set up health boards - integrated organisations
whose members are made up of some people elected by the public and others
appointed by the health minister - with responsibility for planning and
providing health and disability support services. Health inequalities in New
Zealand are most evident in the poorer health experienced by Maori and people
from the Pacific Islands. To address these inequalities, Clark's government
developed a health strategy in 2000 in which public health received as much
attention as healthcare services. The strategy included health boards working
with public agencies and third sector organisations to implement population-wide
programmes to address risk factors such as unhealthy diet and lack of exercise.
A major focus of these programmes has been to target support at hard-to-reach
groups by working with Maori and Pacific Island organisations. In the case of
people from the Pacific Islands, health boards have capitalised on the role that
religious life plays in these communities, by delivering health advice and
medical care with and through churches. Similarly, tribal structures have been
engaged to reach the groups most in need among Maori. Equally important has been
the emphasis on primary healthcare. Concerned at the adverse effects of charging
patients to see a GP, Clark's government developed a primary care strategy that
has resulted in an investment of NZ$2.2bn (£0.81bn) over seven years. The fees
paid by patients and the costs of prescriptions have fallen considerably, making
it easier for families on low incomes to get care. This has contributed to a
stronger emphasis on prevention in primary care, with a particular focus on the
management of people with diabetes. Patients in New Zealand find it much easier
to make an appointment than their counterparts in the UK because GPs lose income
if patients seek primary care from a practice other than the one where they are
registered. The Brown government would do well to consider how to adapt this
arrangement. An option would be to claw back funds GPs receive from the
government where practices have higher than expected use of services by patients
out of hours. This could be done while maintaining care free to patients at the
point of access - an aspect of the NHS superior to that found in New Zealand.
Another lesson from New Zealand is the value of local people involved in health
boards. The two-thirds of members elected by the public are chosen every three
years, with elections held at the same time as those for local authorities.
Turnout is around 40%, and most candidates stand as independents. New Zealand's
system has the twin virtues of engaging the community directly and avoiding the
risks of overcentralisation to which the NHS is so prone. There is a greater
willingness to deal with the challenges of the health system at a local level,
instead of pulling these challenges in to the government in Wellington. At a
time when the NHS is entering a much more difficult financial climate, Brown and
health ministers may well be attracted to an arrangement where the blame for the
NHS no longer gravitates towards Whitehall, but is dealt with by
locally-accountable bodies. Chris Ham
The Guardian Wednesday November 7 2007
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