- Muzzling the Watchdog.
The self-congratulatory fanfare announcing the launch of the national plan for the NHS has overshadowed real concerns about accountability, raised by the plan's proposed abolition of community health councils
(CHCs).
Established in 1974, CHCs have provided a national network of independent health watchdogs. The plan fragments part of their work across a number of new bodies and gives no indication as to who will perform which of their functions. There are also significant worries about how effective and independent the proposed replacement structures will be. Guardian 13 September 2000
- Getting rid of community health councils (CHCs) as outlined in the NHS plan has proved tougher than ministers might have thought. Guardian Society Wednesday March 21, 2001
- Health and
Social Care Act 2001
- National
Health Service Reform and Health Care Professions Bill and explanatory
notes
- A fresh attempt to strengthen patient power in the NHS in England got a
frosty reception yesterday from consumer groups and the Labour chairman of the
Commons health select committee.
John Carvel, social affairs
editor Guardian
Unlimited Tuesday September 4, 2001
Involving Patients and the Public in Healthcare. Department
of Health link to several documents at stages in consultation up to
November 2001 and our
response December 2001.
A
Healthy Outlook - Local Authority Overview and Scrutiny of Health: Audit
Commission Management Paper
The first signs of rebellion over the government's NHS reform bill emerged
today after a senior Labour backbencher called for new community councils to
be created to safeguard NHS patients' rights. Guardian
Society Friday January 11, 2002
Rebels urge rethink on patients' watchdog. Guardian
Society Wednesday January 16, 2002
Patient power deal for NHS. Low-key arrival for 'watershed'
reorganisation. James Meikle, health correspondent Guardian
Monday April 1, 2002
"Defeat this change to the health bill." Guardian
letter supporting Government proposals Thursday April 11, 2002
Peers rebel and back patients' councils. Patrick Wintour Guardian
Wednesday May 1, 2002
The job of ensuring that health care delivery in England is up to scratch
is to be transferred to local authorities. Are they ready for it?
Margaret Kubicek
Wednesday September 4, 2002 The Guardian
The government today appointed former health and social work manager Laura
McMurtrie as its new "patients' champion" for the NHS. Simon Parker
Friday November 15, 2002
The government wants people to shape their own local health services, but
getting the public interested is proving difficult. Margaret Kubicek
Wednesday January 15, 2003 The Guardian
Q&A: patient and public involvement in the NHS. Patrick Butler
explains what the government's new system of patient representation will mean
for service users.
Wednesday January 15, 2003
Harry Cayton carries his onerous responsibilities with admirable
cheerfulness. How would you like to be the key spokesman for the millions of
NHS patients? He must also endure the absurd title that Whitehall imposed:
director of patient experience and public involvement at the Department of
Health. Patients' tsar would have been preferable. Malcolm Dean
Wednesday January 22, 2003 The Guardian
Ministers have been accused of bungling the introduction of a new
patients' rights system for the NHS after they announced that community health
councils would be abolished six months before the new arrangements become
operational. Patrick Butler
Friday January 31, 2003
Q&A: patient and public involvement in the NHS. Patrick Butler
explains what the government's new system of patient representation will mean
for service users.
Friday January 31, 2003
Community health councils (CHCs) in England appear to be heading for
gradual disintegration, despite a government decision last week to postpone
their abolition by three months until December 1. John Carvel
Wednesday June 11, 2003 The Guardian
Preparation for patients' forums in crisis. Critics claim abolition of
Community Health Councils in favour of new system will lead to chaos. Hugh
Muir
Monday October 27, 2003 The Guardian
Forums are in good health. Letters
Wednesday October 29, 2003 The Guardian
Health minister Rosie Winterton today announced £2.25m to help improve
council scrutiny of local health services. Helene Mulholland
Thursday October 30, 2003
A new era of patient involvement in the NHS is heralded by the launch of
patient and public involvement forums (PPIFs) today, amid claims that the new
scheme is a pale imitation of its predecessor.
Monday December 1, 2003
Changes to the NHS complaints system mean Iain is out of a job. No need to
panic - Debbie Andalo has some tips for his next step in patient advocacy.
Wednesday December 17, 2003 The Guardian
Corrections and clarifications. Friday December 19, 2003 The Guardian . We
said that the National Association of Citizens Advice Bureaux manages "the new
NHS independent complaints advocacy services (Icas)" in a feature headed What
else can I do? (Society, page 40, December 17). This body is neither managed
by CAB nor is it part of the National Health Service but comes under the remit
of the Commission for Patient and Public Involvement in Health.
It has been heralded a "quiet revolution". But the volume will be notched
up a little today with the formal launch of a network of more than 570 patient
and public forums across England. David Brindle
Wednesday February 11, 2004
Patient forums were created so that communities could scrutinise local
health services. But Mark Gould finds a lack of resources, accessibility and
awareness .
Wednesday April 21, 2004 The Guardian
Seeking medical advice will soon be easy for patients in Southampton
thanks to a new online service. Michael Cross reports.
Wednesday June 30, 2004 The Guardian
The health secretary, John Reid, today named the health service quangos
which will be scrapped in a government drive to cut bureaucracy that will mean
the loss of more than 6,000 jobs. Ben Willis
Thursday July 22, 2004
About 6,000 jobs will be axed in a cull of NHS quangos in the next four years,
releasing an extra £500m for frontline patient care, the health secretary
promised yesterday. John Reid said a reorganisation of NHS agencies operating
at arm's length from the Department of Health would include the abolition of
the Mental Health Act Commission , the Health Development Agency and the NHS
Modernisation Agency. A government report said 38 "arm's-length bodies" spent
£4.8bn a year, including operating costs of £1.8bn. Half were created since
Labour came to power in 1997. By 2007/8 they will be reduced to 20
organisations. Many will be merged or subsumed into other agencies and there
were doubts in the service last night that the savings would be as large as
ministers claimed. John Carvel, social affairs editor
Friday July 23, 2004 The Guardian . Includes Commission for Patient
and Public Involvement in Health.
Patients and consumer groups today condemned plans to abolish the national
body responsible for involving the public in the health service. Scrapping the
Commission for Patient and Public Involvement in Health (CPPIH) will leave the
NHS unaccountable to the people it serves, according to campaign groups. David
Batty
Friday July 23, 2004
Labour wants to give people more control over services. But what, asks David
Walker, will this enthusiasm for public participation mean for local councils?
Wednesday January 12, 2005 The Guardian
Ministers' apparent U-turn over public involvement in health policy has
left one key player, Sharon Grant, baffled and bruised. She talks to David
Brindle.
Wednesday March 23, 2005 The Guardian
Why the NHS is a bad listener. The NHS has still not got the hang of
listening to patients, says Anna Coote.
Wednesday April 20, 2005 The Guardian
Calderdale primary care trust's patient and public involvement forum
should have held its annual general meeting this week. One of the topics for
discussion was hygiene levels and infection rates at the local hospital. Forum
members – volunteers in West Yorkshire who act as an independent patient
watchdog – had inspected the wards there, and their report was to be presented
to the meeting. Whatever its conclusions, the public will have to wait until
after the election to find out. The meeting has been postponed. Pre-election
purdah mania is spreading - and stifling public debate, says Alison Benjamin
Wednesday April 27, 2005 The Guardian
Patients' forums are failing to achieve their aim of scrutinising health
services and influencing policy and practice at a local level because they are
being hamstrung by weak structures and are mired in bureaucracy and
administration, say critics. The forums, composed of volunteers, were designed
to transform public involvement in the NHS in England. But from August, nearly
a quarter (126) of the 572 forums will lose back office support, leading to
fears that they will become even more ineffective. Mark Gould
Wednesday May 11, 2005 The Guardian
The organisation responsible for involving patients in NHS care has been
given a 12-month stay of execution, it emerged today. The Commission for
Patient and Public Involvement in Health (CPPIH) was due to be abolished next
August as part of a Department of Health (DoH) cull of arms-length bodies
announced last year by the previous health secretary, John Reid. Hélène
Mulholland
Tuesday
August 23, 2005
A welcome stay of execution. The government's latest rethink on patient
involvement in the NHS is good news for health trusts, says John Carvel.
Tuesday
August 23, 2005
Patricia Hewitt As the health secretary prepares to address the party
faithful on the government's stategy for the NHS, she tells John Carvel how
she is tapping into public perspectives of the service to help make it more
efficient.
Wednesday September 28, 2005 The Guardian
A key plank of the government's policy is putting the public and patients
at the centre of health and welfare. All the talk is of partnership and user
involvement; the "expert patient" and the "active citizen". Yet evidence shows
that the government's own benefits policy is pushing people in the opposite
direction, discouraging them from making a contribution and perpetuating their
social exclusion.
Wednesday October 19, 2005 The Guardian
Patients' forum excluded from the board of a foundation hospital. Members
of the patient and public involvement forum (PPI) for the University Hospitals
of Leicester NHS Trust said they were assured of a place on a council of
governors running a proposed foundation trust, but the hospitals trust has now
decided to exclude them. The trust, which runs Leicester Royal Infirmary and
Glenfield and General hospitals and has applied for foundation status, said
having the forum on the council would compromise the forum's independent role.
Leicester Mercury 21 December 2005
What's driving the health reforms.
Thursday
February 2, 2006 The Guardian
Patient power
enlisted to help hold GPs to account. The health white paper says that PCTs
will be forced to bring in new providers where patients want them. National
primary care director Dr David Colin-Thom said 'local triggers' could be
activated through patient surveys and petitions or local authority health
overview and scrutiny committees. First, six areas will have primary care
services procured by the DoH via a competitive tendering process.
West Yorkshire
SHA chief executive Mike Farrar is heading work on contestability in primary
care. Summary by Keep our NHS Public
of Health Service Journal 2
February 2006
Patient forums
could be on way out. Dr David Colin-Thom, the national primary care
director, has hinted that patient forums could be jettisoned in favour of a
more 'organic' approach to local involvement in health. Asked whether patient
forums had had their day, Dr Colin-Thom said: "That seems to be the view".
Instead PCTs will be held to account through a series of 'triggers' activated
through mechanisms such as patient surveys, local authority overview and
scrutiny committees and petitions via councillors. Patient forums were
conspicuous by their absence from the recent white paper. The chair of the
Commission for Patient and Public Involvement in Health, Sharon Grant, said it
is "inconceivable" that the government should press ahead with some of the
biggest changes in NHS history without an effective system for patients to be
heard. Summary by Keep our NHS Public
of Health Service Journal 9
February 2006
Fears over
changes to local health voice. The government is setting up a panel of
experts to assess how a strong local voice in health and social care
arrangements can be ensured. The move follows reports that patient forums
could soon be abolished and RCN concern about the government's intention to
review the process of statutory consultation on service consultation. The
recent primary care White Paper said that the review would ensure processes
were "swift and effective".
Summary by Keep our NHS Public
of Independent Nurse 21 February 2006
Patients: "Give
us a voice". The Patients and Public Involvement Forum for University
Hospitals of Leicester NHS Trust is calling for a reversal of the decision not
to allow it a place on the council to run the General and Glenfield hospitals
and Leicester Royal Infirmary, in the event of the trust winning foundation
status. The trust had said there would be no place for the forum, despite
earlier suggesting that there would be. The trusts foundation status has been
put on hold while the government scrutinises details of the £761 million
Pathway hospitals improvement project. The forum says that this gives the
trust the opportunity to reverse their decision. The forum was supported by
two Leicestershire MPs who said that the organisation needed a voice. The
forum has written to the Secretary of State, MPs and the joint overview and
scrutiny committee, urging them to put pressure on the trust to change its
mind. The trust remains unmoved. Summary by Keep our NHS Public
of Leicester Mercury 24 February 2006
Nine out of ten
want more say in running health services. Nearly nine out of 10 people in
the
South West think they should be given more say in how their local health
services are run, according to a survey. Summary by Keep our NHS Public
of Bristol Evening Post 3 April 2006
Death of the
forums. A Times leader says: "If ministers go ahead and end the experiment
of patients' forums in the coming months, as seems likely, mourning will be
misplaced… There is little to celebrate, though, in their demise. Their
problems were largely of design rather than performance, and ministers bear
responsibility for wasting time and effort given by well-meaning citizens and
money belonging to the wider taxpayer. Unlike their Community Health Council
predecessors, which were based on health regions, the forums covered
individual trusts and were too close to the bodies that they were supposed to
monitor… They were further hampered by bizarre arrangements whereby their
administration was outsourced to third parties, including charities, some of
which have increasingly decided such work to be unsuitable for them."
Summary by
Keep our NHS Public
of
Times 15 April 2006
NHS patient groups axed two years after creation. The country's network of
patient forums, introduced a little over two years ago to give patients a say
in the running of the NHS, is to be abolished in the latest reorganisation of
the service. It comes after the Commission for Patient and Public Involvement
in Health (CPPIH), a central body designed to promote patient views, was
abolished within two years of being created. Patient forums replaced community
health councils. Critics say the constant change is costly and wasteful.
Summary by
Keep our NHS Public
of Times
18 April 2006
Health forums
must stay open. In a letter to the Times, Joyce Robins, co-director of
Patient Concern, writes: "When [patient forums] were launched, Patient Concern
voiced its suspicions that the aim was to fragment and disempower the patient
voice. Community health councils, which had often exposed the defects of the
NHS, were abolished and patient forums became the new initiative. These
initiatives are fast becoming a scandal, launching one after another without
proper planning. When they don't work, we are thrust into another
reorganisation at a cost of millions. Unless the Government is willing to set
up a system that can hold local NHS services genuinely accountable to
patients, even if they do not always like its findings, those millions will
simply be thrown away."
Summary by
Keep our NHS Public
of Times
18 April 2006
NHS 'fails to
involve patients'. Patients in the UK play less
of a role in decisions about their own healthcare than those in
other
developed nations, according to a report by the Picker Institute.
Summary by
Keep our NHS Public
of BBC
Online 24 April 2006
Contract choice
'a travesty'. A patient involved in the decision to
award contracts to run
two practices in south London to Concordia Health has labelled the process a
"travesty". Martin Saunders, a member of
Southwark patient and public involvement forum and
a patient at one of the practices, said his views were ignored and his
involvement had been "tokenism". He said: "It was a travesty. It was so scary
the way it was done. They were very nice people but you could tell there was a
hidden agenda." Southwark PCT chose Concordia Health, whose directors include
former GPC negotiators Dr John Chisholm and Dr Simon Fradd, to run the Melbourne
Grove and Parkside practices. The decision not to award the contracts to
salaried GPs already running the practices has caused controversy.
Summary by
Keep our NHS Public
of Pulse 12 May 2006
An ambulance in
Tyneside was
misdirected twice by a satellite navigation system when on an emergency
call. The chair of the patient and public
involvement forum said, "... Satellite navigation can be very effective
when it is used correctly and with local knowledge. It should not
be relied on by itself though." Summary of Daily Mail 16 May 2006
[There is a danger of ambulance drivers' local knowledge becoming less
complete as a result of the Government's decision to merge ambulance trusts.]
Local
involvement networks set to replace PPI forums. The Department of Health
is to push ahead with a shake-up of public involvement in health and social
care despite delays to a local government white paper that could seek to
bolster the role of councils in voicing community concerns. A review
recommends that public and patient involvement forums be replaced by 'local
involvement networks' covering a geographic primary care trust area instead of
being linked to a particular organisation. The new networks would be voluntary
organisations with individual and organisational members, with directly
provided budgets of around £150,000 per annum to maintain an office and staff.
Regulators, including the merged Healthcare Commission and Commission for
Social Care Inspection, will be given explicit requirements to involve the
public fully in their work. However, ideas floated in the white paper Our
Health, Our Care, Our Say for more public involvement in health overview
and scrutiny committees, and for councillors to be given new powers to put
forward community petitions and force PCTs to tender-out poorly performing
services, are unlikely to feature. Guidance will be published next month
setting out how the duty to consult on reconfiguration, outlined in section 11
of the Health and Social Care Act 2001, will be extended to cover social care
and new providers. A new obligation to make a public response to consultation
is also expected.
Summary by
Keep our NHS Public
of Health Service Journal 18 May 2006
Can general
practitioners compete with big business? Dr Elizabeth Barrett writes: "The
Langwith case reached the High Court over whether there was an obligation to
activate section 11 of the 2001 Health and Social Care Act, in this particular
case.1 The act states, among other things, that patients
should be involved in the development and consideration of proposals for
changes in the "way" in which their services are provided. The national debate
on privatisation is a
separate issue, but the publicity given to this case has been an important part
of informing people how the culture and the drivers are changing in the NHS."
Summary by
Keep our NHS Public
of
British Medical Journal 2 June 2006
Government
reforms will 'destroy
the NHS'. Speaking to the annual BMA consultants' conference, Paul
Miller, chairman of the consultants' committee, said: "This has been the NHS's
best year ever ... for management consultants ... for losing staff ... for
wasting money." He estimated that
private management
consultants were costing around £3bn a year and used the work of private
managers in Department of Health-appointed "turnaround teams" sent into 18
trusts with financial
difficulties as examples of wasted money. This included £700,000 paid to
management consultants for three months' work at Surrey
and Sussex trust, despite the fact it still finished the last financial
year with "an operating deficit of £28m and an accumulated deficit of over
£57m".The multi-billion pound contracts awarded to independent sector
treatment centres were also a waste of money, Dr Miller said. Calling for a
moratorium on any other private treatment contracts, he said Oxfordshire
primary care trust had been made to pay £500,000 a year for the next four
years to a private
eye clinic despite there being no shortage of NHS capacity to do the work.
He said only 160 of the 400 operations planned in the contract annually were
carried out last year. This was unnecessarily inflating local NHS debt, which
stands at around £82m. Dr Miller also criticised the
PFI, highlighting
£130m wasted on three deals: the abandoned
Paddington PFI scheme, which cost £14.9m; the delayed Barts PFI scheme,
which cost an extra £35m; and the
Norfolk and Norwich PFI, under which the NHS missed out on £82m when the
private contractors refinanced the deal. "If you had made this up, you would
be laughed at," Dr Miller said. "If you were the one who did make this up, you
should be ashamed. If you continue to make it happen, you will destroy the
NHS. This is not the way to run our NHS… It is hard to avoid the conclusion
that we are working in a service which is being broken by policies which do
not work; devised by officials who have resigned; implemented by managers who
don't believe [in the NHS]; and patients without a say."
His speech, which got a standing ovation, was echoed by criticism of the
government made by delegates. A member of the BMA's consultants committee, Dr
Anna Athow, said the government had allowed the NHS to get into the current
financial crisis in order to ration services and push more resources and
patients into the private sector.
Summary by
Keep our NHS Public
of
Guardian 7 June 2006
Politicians in
line for a drubbing. Patient and public involvement is a 'sham' and
politicians are 'pretty useless' at explaining NHS reform, key NHS figures
have warned. Picker Institute chief executive Professor Angela Coulter
described patient and public involvement as a 'sham'. But Monitor chair Bill
Moyes questioned how much the public should be able to influence the
configuration of services given that they are not healthcare provision
experts.
Summary by
Keep our NHS Public
of
Health Service Journal 9 June 2006
Village fails
to block US GPs plan. NHS patients and villagers in Langwith on the
Derbyshire-Nottinghamshire border have failed in their challenge to
private US company United
Health's contract to run their local GP surgery. The villagers claimed
that the consultation process preceding the awarding of the contract was
flawed. However, in a ruling that has widespread implications for the NHS, the
judge Mr Justice Collins stated that while the
consultation was indeed flawed it "would not have been likely to have made
any difference." He went on to suggest that the patients should have sought an
"alternative remedy" to court action though his ruling includes guidelines on
the duty to consult which may have a widespread effect upon NHS institutions.
Anger at the proposals was previously aggravated by North Eastern Derbyshire
PCT's exclusion from its shortlist of a local, council backed proposal from Dr
Elizabeth Barrett. Summary
by Keep our NHS Public
of Liverpool Daily Post 15 June 2006
Herts
consultation labelled a 'sham'. A
Hertfordshire trust has announced plans to
withdraw services from one of its sites to help tackle a £28m deficit -
just 12 days after a public board meeting at which the issue was not
discussed. Under the new proposals, acute services would be centralised at
Watford from next year using 'modular buildings' to increase capacity: either
St Albans or Hemel Hempstead Hospital would lose all trust-run services, with
the other keeping elective surgery going until a new independent treatment
centre is due to open in Hemel Hempstead in 2008. Local councillors and MPs
were incredulous at the way the trust announced the proposals. Previously the
trust proposed consulting on three options, including one which would move
acute services away from Watford: this was dropped within days when it was met
by scepticism from the council's health scrutiny committee. Committee chair
Michael Downing said: "The build-up of services in the community that should
have happened in advance of the reconfiguration has not happened. People won't
get services or will have to travel further." Summary by
Keep our NHS Public
of
Health Service Journal 15 June 2006
Village to
fight on over US firm's surgery deal. Villagers have promised to fight on
after a judge refused them a judicial review over plans for an
American company to take
over the running of their GP surgery. Although Mr Justice Collins, in the
High Court, agreed with the residents of Langwith,
Derbyshire, that they were not properly consulted, he did not quash the
decision as he found the residents had not sought an alternative remedy before
going to court. The judge said the North Eastern Derbyshire Primary Care Trust
had not consulted the residents before they named UnitedHealth Europe as the
"preferred provider" for the contract to provide a GP service. He laid down
guidelines on the duty to consult which will affect NHS authorities around the
country. But he said the objectors should have gone first to the local
Patients' Forum. It was "unfortunate" that Pam Smith, the resident who led the
challenge, had apparently not known of its existence. Mrs Smith said she
believed that her community had been let down by the court's decision. "But we
can always appeal and if that fails, we'll be watching the company and how
that surgery is run and I'll be on to them as soon as it goes wrong." A Health
Department spokesman said: "We will shortly announce
steps to give people a stronger voice at all levels in the health service." Summary
by Keep our NHS Public
of
Telegraph 16 June 2006
Courts back
private takeover of practice. Health campaigners in
Derbyshire have lost their fight to block a contract awarded to
private company
United Healthcare Europe to run a practice in the area. High Court judge Mr
Justice Collins ruled against Pam Smith because he said she
should have taken the case to the Patients Forum
before bringing judicial review. However, in his judgment, he also said the
consultation process had been flawed and that PCTs should consult the public
in future, if there was any doubt. He awarded 75% of the costs against the
PCT. Lobby group Keep Our NHS Public, which backed the case, welcomed the
judgment as "a crushing defeat" for the Department of Health as it had
established the need for PCTs to consult the public, even though the case had
failed. Derbyshire LMC secretary Dr John Grenville said he still wanted to
know how UHE had been awarded top scores, having no track record of providing
primary medical services and knowledge of the locality: "It seems perverse
that they should have top-scored." The LMC will lodge a formal complaint with
the Information Commissioner under the Freedom of Information Act to access
the scores if necessary, which were denied to it for the duration of the court
case. Dr Grenville said: "The question remains how the PCT came to its
judgement that UHE was the best of a very large bunch of applicants. Until we
know how they arrived at their decision it is going to be difficult for future
applicants, be they multinational companies or single-handed GPs, to know what
the rules are."
Summary by
Keep our NHS Public
of Doctor
Update 21 June 2006
NHS must
consult over service changes, judge rules. The Department of Health cannot
legally change the way NHS services are provided without first consulting the
affected local population, a high court judge has ruled. The judgment
reinforces the statutory duty of NHS organisations to consult patients and the
public - outlined in Section 11 of the 2001 Health and Social Care Act - at a
time when the future of the existing Patient and Public Involvement forums are
in doubt. The case was brought to court by Pam Smith - a North East Derbyshire
resident - to overturn her local primary care trust's decision to outsource
local GP provision to the US-based United Health Group without public
consultation. Although the judge dismissed the case on the basis that Smith
should have taken her complaint to her local PPI forum first, he rejected the
PCT and DoH's defence that consultation in such cases was not necessary. In
his judgment, Justice Collins said: "Where there is doubt whether [section 11]
can apply, the PCT would be sensible to assume that it does, since it can in
most cases easily be met through the Patients' Forum." A spokeswoman for the
Department of Health said: "Although the court decided that the duty to
consult did apply, it also stressed that there is no evidence that the tender
process… was other than fair. We will shortly announce steps to give people a
stronger voice at all levels in the health service."
Summary by
Keep our NHS Public
of
Public Finance 23 June 2006
All work and no say. My role as a non-executive in the NHS seemed
to be to toe the line, maintain a happy consensus and 'supervise
deterioration' of trust services. Peter Barker
Wednesday July 5, 2006 The Guardian [Non-executive directors seem to be
no more influential than PPI forum members.
Contrast
elected councillors, who collectively are in control of their local
authorities]
NHS set to
boldly go where patients lead. Health minister Rosie Winterton is due to
announce plans to set up Local Involvement Networks (LINks) in every part of
England. They will replace the patient forums that were created in 2005 to
watch over the conduct of individual NHS trusts. But, unlike the forums, they
will look after all the concerns of patients and social service users
throughout each geographical area. The aim is to have joined-up complaining
for supposedly joined-up services. There will be a LINk in every local
authority area that has social services responsibilities. Winterton wants them
to dovetail with the councils' overview and scrutiny committees (OSCs). The
OSCs will be encouraged to focus on how health and social services are
commissioned, allowing councillors to exert an influence on priorities
determined by unelected primary care trusts and their private sector partners.
Winterton will promise legislation to place a duty on commissioners to respond
to what patients and the public have said. She will confirm the abolition of
the Commission for Patient and Public Involvement in Health - set up less than
three years ago after the government abolished community health councils.
There is no detail on what will replace it. Summary by
Keep our NHS Public
of Guardian
12 July 2006
Patient voice
'to be beefed up'. Firms are being invited to run PCT services in an
extension of private
involvement in the NHS. An advert was pulled from the Official Journal of
the European Union two weeks ago after it implied private firms could take
control of PCTs, which control 80% of the NHS budget to buy in services from
hospitals, GPs and community services. The government said the plan was to
allow PCTs to "pick and mix" the services they want to outsource to allow them
to take advantage of "specialist skills" of the private sector. It means
private firms are being given an opportunity to get their hands on local NHS
budgets, which much of the medical profession remains against because it means
firms will be involved in commissioning services and providing care, creating
a potential conflict of interest. Alex Nunns, of anti-private campaign group
Keep Our NHS Public, said the plans amounted to the same as what was proposed
in the pulled advert, but just added a "veneer of public accountability".
Ministers also announced that patients are to be
given the power to petition local health bosses to force changes in services.
A petition would need to be signed by 1% of the population to trigger a formal
response from PCTs which commission local services. If it was a specialist
service, a response would be triggered if a tenth of users signing up.
However, while the PCT would be duty bound to respond and put in place an
improvement plan, it would not have to do exactly as the public wished.
Ministers said patient power will be further boosted by the setting up of
patient bodies called Local Involvement Networks (LINKs) to take on the
responsibilities of patient forums. LINKs will be based on wider geographical
areas than those covered by individual trusts. Summary by
Keep our NHS Public
of BBC Online 13
July 2006
NHS may be
challenged by users. PCTs are to be required to respond to
public petitions that can garner significant
support, Patricia Hewitt has announced. A signup of 1% of the population, or
10% of the users of specialised service, will be enough to force PCTs to
consider a petition. While the PCT may disagree with any suggestions, it must
provide justification for its decision. The Times says the first test of the
scheme is likely to come from challenges to the involvement of the
private sector in the
management of PCTs. Summary by
Keep our NHS Public
of Times
14 July 2006
Petitioners
could get right to a response. Primary care trusts will be forced to react
to petitions from service users and the public if controversial proposals from
the Department of Health get the go ahead. The commissioning framework
released last week says such petitions could include demand for new services
or dissatisfaction with providers and provision. They could not be used to
prolong debate on a proposed service reconfiguration after the end of a formal
consultation exercise. The proposals have raised fears that well-resourced and
organised pressure groups could sway a primary care trust in their favour. Summary by
Keep our NHS Public
of Health
Service Journal 20 July 2006
Public asked
about health service.
Liverpool's health professionals are asking the
public how best to spend an extra £70m earmarked to improve the city's
local services. The government money is to be spent on services for people not
receiving hospital-based care. Members of the public are asked to join the Big
Health Debate by commenting on a specially set up website. The primary care
trust has posed a series of questions to test what people think about current
services. This includes such questions as how easily they can get
appointments, how far they travel and the journey they go through in the
treatment process if they are referred for tests. Other questions designed to
explore ideas for future improvements, include GP opening hours.
Summary by
Keep our NHS Public
of BBC
Online 26 July 2006
Public get say on health plans. The people of
Abingdon and Wantage will get their say on the future of healthcare in the
district following fears they could be left out of talks. Despite proposals to
possibly close Wantage Hospital and reduce services at Abingdon, the
Oxford Radcliffe NHS Trust did not originally include the two towns on a
list of places where residents would be consulted. Current thinking among the
health authorities is that Wantage and Henley hospitals should close, Abingdon
may be downgraded to a day care centre, Didcot would become a maternity unit
and that Wallingford should be expanded to a 60-bed unit. A jointly-organised
petition has already attracted 30,000 signatures, with residents wanting all
hospitals to remain open.
Summary by
Keep our NHS Public
of Abingdon
Herald 27 July 2006
Signs of the
times: will people power deliver accountability? In an appendix to the
annex of the Commissioning Framework for the English NHS is a proposal that
could become either a thorn in your primary care trust's side or a thoroughly
modern boost to local democracy and empowerment. 'Triggering community action'
envisages mechanisms that would make PCTs respond to petitions from the public
and/ or service users. This policy
seems to be attributable to Paul Corrigan, visiting professor of public policy
at London Metropolitan University and special adviser to Number 10. People
might, he has suggested, demand alternative services from independent
providers. Institute for Public Policy Research research fellow Joe
Farrington-Douglas said: "The health reform agenda is more driven by
marketisation than by strengthening civil society. There are elements of
devolving power [from the centre] to PCTs, but we have seen very little being
devolved to the public from PCTs." PCTs and national organisations contacted
by HSJ were by and large unwilling to comment but none saw the idea in
positive terms; a couple of PCTs felt that petitions would be a line of last
resort - an admission of failure to engage by other means.
Summary by
Keep our NHS Public
of Health
Service Journal
27 July 2006
NHS watchdog
'has no bite'. A leading health campaigner says the Government wants an
NHS watchdog with no teeth. Geoff Ryall-Harvey, who runs the administration of
Patient and Public Involvement (PPI) Forums
in this area, says a decision to abolish PPIs represents a further erosion
of public engagement in decision-making. The plan is to replace PPIs with
Local Involvement Networks from next summer. He said: 'Whatever they say about
wanting to involve the public, they don't want to involve the public who know
something about the health service. Under the new regime rights to access
information and make unannounced visits to inspect NHS premises would go.
Summary by
Keep our NHS Public
of Ellesmere
Port Pioneer 4 August 2006
Dismay as one
patient forum is cancelled to launch another. The chairman of a
Croydon patient forum, ensuring local people
have their say in decisions about borough health services, says he is angry at
Government plans to abolish the group. The Department of Health has announced
that Patient and Public Involvement (PPI) forums were to be replaced with
Local Involvement Networks (LINks), billed as a much wider patient and public
involvement system. However Peter Howard from Shirley is campaigning against
the plans and is encouraging the community to write to their local MPs in
protest. Mr Howard argues that LINKs will not be truly independent.
Summary by
Keep our NHS Public
of Croydon
Guardian 10 August 2006
Health plans
put debts above patients. A health watchdog has described a
consultation over local NHS cuts as
"'unsatisfactory". Members of
Cheshire County Council's Overview and Scrutiny Committee (OSC) said there
were concerns that proposals to redesign the local health service were not
based on the health needs and risks within the population. There was an
emphasis on "cuts in
service" compared with essential reinvestment in certain areas. OSC
chairman Cllr Brendan Doyle said it was ironic the turnaround team imposed by
the Government to sort out the funding problems costs £10,000 a day from a
hard-pressed budget. In his conclusions, he said: "There is little evidence
the proposals are based on need and risk or that they offer a vision for the
area."
Summary by
Keep our NHS Public
of Chester Chronicle 18 August 2006
A pensioner has scuppered plans by America's biggest healthcare
company to run a GP
surgery in Derbyshire by winning a case against them in the court of appeal.
Yesterday Pam Smith succeeded in forcing United Health Europe (UHE), the
British arm of the US firm, to reapply for the tender to provide family
doctors for the people of
Langwith, on the Derbyshire-Nottinghamshire border. The judges, Lord
Justices Keene and May, ordered North Eastern Derbyshire primary care trust to
start the tendering process from scratch after ruling NHS patients had not
been properly consulted. Sarah Hall, health
correspondent
Thursday August 24, 2006 The Guardian
Patient power
scuppers health plans. The Government's plans to encourage
private companies to
run GPs' surgeries received a huge blow yesterday when the Appeal Court ruled
that a primary care trust
[North Eastern Derbyshire] which awarded a contract to a multinational
health care corporation had failed to consider the
wishes of local residents. Pam Smith, 67, a resident who led the legal
challenge against the PCT's decision, said: "This is a victory for the common
people. This has set a precedent and we now know that if local people object
to a huge corporation coming in they will have to be listened to. At the
beginning of all this Patricia Hewitt stood up and said we would have choice
but we were given none. Everyone voted against UHE yet the PCT awarded them
the contract. We felt railroaded. Now the PCT will have to consult us and will
be left in no doubt our feelings on the matter." The Court of Appeal decision
has wide implications for Labour's health agenda which has opened the door to
private companies providing NHS services as well as implications for the
companies themselves.
Summary by
Keep our NHS Public
of Telegraph
24 August 2006
Pensioner
strikes blow against reforms of family doctor services. A pensioner has
struck a blow against government health reforms after she won a legal battle
to stop a US-owned company from taking over family doctor services in part of
Derbyshire. The Court of Appeal yesterday ruled that the North Eastern
Derbyshire Primary Care Trust had failed properly to
consult the residents of two former mining villages before provisionally
awarding UnitedHealth Europe a contract to run GP surgeries in the area. The
judgment could slow the government's drive to increase the involvement of the
private sector in the NHS. PCTs now face having to consult widely with the
public before tendering, providing a focal point for campaigners who say the
government is bent on privatising the NHS. The ruling is doubly embarrassing
for the government as the chairman of the European arm of UnitedHealth is
Simon Stevens, Tony Blair's former health adviser and a strong advocate of a
bigger role for the private sector in healthcare. The government is looking to
bring in private providers to deliver services of 800 GPs in 30 areas with a
shortage of doctors, mostly in northern England. Pam Smith, the pensioner who
brought the legal challenge, said it was "a real case of David and Goliath".
"I would love to be a fly on Patricia Hewitt's wall now. She keeps saying
patients have a choice; well we've made our choice. UnitedHealth would only
have taken profits. We will keep our NHS public, not private - that's what
makes Britain unique."
Summary by
Keep our NHS Public
of Financial
Times 24 August 2006
Health watchdog
attacks trust over £8m cuts. A patient watchdog has attacked plans by
health chiefs to
ration treatment in the struggle to save £8m.
Craven, Harrogate and Rural District PCT is examining cuts that could see
patients referred to hospital only for urgent treatment with more care being
provided in the community. Angry family doctors have already branded the
proposals unsafe, claiming the cuts will "undermine the principles of the
NHS". The plans would mean that for the first time in the history of the NHS,
doctors would not be able to refer people who in their opinion needed expert
help to hospital. The opposition from GPs has forced managers to think again
and now the area's patient and public involvement forum
has expressed its fears that plans to refer people to expert GPs rather than
to hospital specialists could put patients at risk. The forum has also
criticised proposals not to fill vacancies, leading to a reduction in nurses
dealing with young people with mental health problems and staff trained to
assist people with learning disabilities. Summary by
Keep our NHS Public
of Yorkshire
Post 25 August 2006
Budget cut to
fund other hospitals. Cash-strapped Royal Free Hospital is having more
than £2 million cut
from its budget to fund the building of
six new PFI hospitals
across
London. In what the Government is claiming to be the largest hospital
building programme in the history of the NHS, six new Private Finance
Initiative hospitals are set to be built using NHS money previously set aside
for education and training. Under the plans, the Royal Free will lose £2.1m
from its £33m training budget, which is used to teach nurses, midwives,
doctors, undergraduate medical students and other staff. Arthur Brill,
chairman of the Royal Free's Patient and Public
Involvement Forum said: "I think it's an absolute and utter disgrace that
they are taking away money from hospital training programmes to build
unnecessary hospitals. They never even consulted us. The Government needs to
cater for the needs of the local community which it's certainly not doing at
the moment." The trust's current deficit for 2006-07, which it aims to pay
back this year, is £16.2m. Summary by
Keep our NHS Public
of Edgware
& Mill Hill Times 25 August 2006
Your opinion
matters, as long as you agree. In an opinion piece, Alasdair Palmer
writes: "Consultation is supposed to be one of the
hallmarks of modern government. Decisions taken by public bodies are now meant
to be open, transparent, and accountable: they should respond to public
opinion, not ignore it. That, at any rate, is the theory behind "consulting
with the public", and who can oppose it ?
Well, probably everyone who has some experience of how "consultation" works in
practice. Last week, judges told the North Eastern
Derbyshire Primary Care Trust to re-tender the contract for providing GP
services in the village of Langwith on the grounds that it did not consult
sufficiently widely. The decision was hailed as a victory for a local campaign
against United Health Europe, an
American company that
the trust had chosen to run the GP services. Pam Smith, the Langwith resident
who organised the campaign, said that the judges' decision showed they agreed
with her that the US company "would only have taken profits. We will keep our
NHS public, not private." She is going to be disappointed… The primary care
trust now merely has to "consult" the local community, but it is not bound by
the results of that consultation, whatever they are, and they will probably
turn out to be whatever the Derbyshire trust wants them to be… Is it any
wonder that "consultation" now generates cynicism and disappointment with
government ? It promises "people
power" but it delivers the usual autocracy, with additional layers of
bureaucracy and mountains of paper. No wonder managers love it." Summary by
Keep our NHS Public
of Telegraph
27 August 2006
NHS cancels
2,000 ops.
Bristol's major hospitals cancelled nearly 2,000 operations at the last
minute over the last year, a figure that nonetheless improves on the year
before. Department of Health figures show that North Bristol NHS Trust, which
runs Southmead and Frenchay Hospitals, cancelled 1,406 operations in the year
up to March, 372 less than previously. United Bristol Health Care Trust which
runs the Bristol Royal Infirmary, among others, cancelled 535, down from 657
the year before. A spokesperson for North Bristol NHS Trust said: "A vast
majority of operations are cancelled because of a shortage of beds. The
problem is much worse in the autumn and winter months when our emergency
admissions are at their highest." Summary by
Keep our NHS Public
of Bristol Evening Post 28 August 2006
Learn from S11
ruling, advises PCT. The chief executive of the primary care trust which
had its contract with UnitedHealth Europe quashed by the Court of Appeal has
urged the rest of the NHS to learn from the case. North Eastern
Derbyshire PCT chief executive Martin McShane said last week's ruling -
that the PCT breached its duty to consult when it
awarded a primary care contract to UHE - provided the service with
clarification of how consultation should work. He said the message from the
judge was that under the Health and Social Care Act, organisations needed to
be able to formally demonstrate that they had taken the views of stakeholders
into account, which meant seeking input before setting the criteria for a
tender. Mr McShane said: 'If we had checked our criteria with the patient and
public involvement forum, that would have made the difference.' He pointed out
that the 'genuine belief' of the PCT - that section 11 of the act did not
apply in this case - had been backed by the strategic health authority and
health secretary. The process will now start again and be taken over by the
new Derbyshire County PCT in October. Pam Smith told HSJ that she was 'over
the moon' with the verdict - and would now urge the PCT to give residents a
vote to decide who provides medical services in the villages of Creswell and
Langwith. She said: 'UnitedHealth have never even run a surgery before and
they won the contract. I don't want our village to become a social experiment.
Patricia Hewitt says we have choice and now we intend to use the right of
choice.' While the verdict is seen as a blow to UHE, the company last week won
contracts to provide primary care services with neighbouring Central and
Greater Derby PCTs. In a statement, UHE chief executive Dr Richard Smith said:
'We support public consultation and are pleased that we will be providing
primary care services elsewhere for people in Derbyshire. We believe that we
can make a significant contribution in the region to reducing health
inequalities.' Alex Nunns of pressure group Keep Our NHS Public said Mr
Smith's statement was equivocal. 'It might be that UnitedHealth won't go for
the tender [for North Eastern Derbyshire] again, given the level of
opposition.' UHE said it would 'wait and see' details of the new tender before
making a decision. Dr Elizabeth Barrett, a GP in Creswell and one of the
unsuccessful bidders, said: 'The DoH rhetoric is that the alternative provider
medical services contract means we are all the same - how can a small village
GP and a massive multi-national company be the same
?'
Summary by
Keep our NHS Public
of Health
Service Journal 31 August 2006
Derbyshire
village wins court battle. Residents of a former mining village in
Derbyshire have won their battle for a greater say
in whether a private
company should be allowed to take over their local general practice.
Summary by
Keep our NHS Public
of British
Medical Journal 1 September 2006
You'll get no
say on hospital staffing cuts. There will be no
public consultation over plans to close 30 beds and
cut 27 jobs at
Kingston Hospital, health chiefs have said. The cuts are designed to help
clear the £9million deficit in Kingston Primary Care Trust's finances and
include the loss of 21 orthopaedic beds and five female health beds. Hospital
staff are being consulted about the changes, but no wider consultation would
take place because a modelling exercise has shown there would be no adverse
affect on patient care, a hospital spokesman said. Geoff Martin from pressure
group London Health Emergency said the situation was a "shambles" and that
cuts were bound to hit patients. The hospital's Unison representative Nora
Pearce said the cuts were coming in because a new referral centre system
introduced two months ago meant less referrals were reaching hospital. The
Kingston Clinical Assessment Service (KCAS) looks at all patient referrals
with a view to treating them in GPs' surgeries rather than wards. Mrs Pearce
said: "As a Kingston resident and potential patient, if I go to my GP and my
GP believes I should go to hospital and I was in pain, that is what I would
want." Other savings, including the Royal Eye Unit at the Galsworthy Road
hospital, are being put to the public.
Summary by
Keep our NHS Public
of Kingston
Guardian 1 September 2006
Oxford man to
fight closure of pain unit. An
Oxford man has received the backing of a High Court judge for a review of
the future of the Chronic Pain Relief Unit at the city's Churchill Hospital.
Kevin Comley and Vera Marriott are challenging the way the Oxford Radcliffe
Hospitals NHS Trust carried out consultation over
the clinic which treats more than 3,000 patients a year. The trust is
proposing closure of part of the in-patient part of the unit as part of
cutbacks because of an annual overspend of more than £30m. High Court judge Mr
Justice Collins has granted permission for a judicial review of the claim
against the trust. But the case is effectively adjourned for several months
for the trust to negotiate a settlement on the issue to avert a further
hearing. Mr Comley said: "The pain unit is vital to me. The PCT have not
thought about patients, not fully consulted them about what is going to
happen. Even now most people don't understand how it's going to affect them… I
feel they are trying to shove everything under the rug, ride roughshod over
everyone without them being given enough information about what is going on."
Summary by
Keep our NHS Public
of Oxford
Times 1 September 2006
Public will get
a say on future of inpatient care. Campaign leaders will meet hospital
chiefs for the first in a series of meetings aimed at securing hundreds of
thousands of pounds to save infirmary services. Action group Save Our
Northwich Inpatients Campaign (SONIC) has been fighting the closure of the
inpatients ward at Northwich's Victoria Infirmary (VIN) since health chiefs
announced plans to shut it down earlier this year. After amassing nearly
14,000 signatures, the Central Cheshire PCT bowed to public pressure and is
now working with SONIC to negotiate extra funding for VIN following the
Government's promised £750m cash injection for community hospitals. SONIC
leader June Chapman said residents already had cause for celebration following
the PCT's turnaround. She said: 'The result is a real tribute to
people power.'
Summary by
Keep our NHS Public
of Northwich Chronicle 7 September 2006
Victory for
patient power. Patients now have the power to
put the brakes on primary care
privatisation, claim
campaigners after winning an appeal court ruling. The Appeal Court said last
month that North Eastern Derbyshire PCT would have to retender its alternative
provider medical services contract for the Creswell and Langwith practice. The
PCT previously awarded the contract to United- Health Europe, but a local
patient group argued it was inadequately consulted. GP Dr Elizabeth Barrett,
who unsuccessfully bid for the contract, said the ruling meant PCTs would now
have to canvass patient opinion before drawing up the selection criteria for a
tender. She said: 'This is a significant valve in what seems to be an
uncontrolled process. Patients being involved will act as a stopper valve. I
think it will change things - how much I don't know.' Dr Barrett added that
she would resubmit a bid for the practice. Summary by
Keep our NHS Public
of Doctor
Update 7 September 2006
Hospital
crusader faces £80,000 bill. A pensioner is risking financial ruin to save
wards at her local hospital. Former nurse Pat Morris has been warned she could
have to pay up to £80,000 if a judge rules against her on Monday. She hoped to
get Legal Aid in her battle to challenge the closure of two rehabilitation
wards at
Altrincham General Hospital, but now she has been told her application has
been turned down. The Legal Services Commission, which administers Legal Aid,
rejected the request by Health in Trafford (HIT) - a protest group headed by
Morris. If she loses her case she will be handed a bill estimated between
£70,000 and £80,000 for the legal costs of the health trust and the court for
staging the judicial review. Morris's six-month battle is expected to end in
the Royal Court of Justice in London when her barrister, acting for free, will
argue Trafford Healthcare Trust (THT) "unlawfully" closed the last in-patient
wards at Altrincham because they failed to carry out
public consultation. Trafford hospital bosses closed the two wards in
March, claiming they had no choice because patient safety was at risk - but
admitted it would also save cash. At the last hearing, Mr Justice Collins
ordered THT bosses to consider re-opening the wards, but they decided not to.
Mrs Morris has so far funded the legal bid and a series of protest meetings
herself, collecting only a few hundred pounds in donations. The HIT protest
group is furious at the way the Legal Aid application was handled. HIT member
Judie Collins has written to Vera Baird MP, who oversees Legal Aid, to
investigate. She claims the aid was refused because of a mix-up over a phone
interview and because Legal Aid officials over-estimated the amount of funds
the protest group had. Ms Collins said: "This claim has been entirely
mismanaged. It was rejected on the most surprising of grounds of inability to
make contact at a pre-arranged conference call. Whatever the reason, I was
surprised that a single bungled call could dismiss a case of such importance
to an individual without a second opportunity. A second confusion is an
assertion that HIT is a fully constituted organisation with substantial
resources and membership. There has never been a formal group organisation,
canvassing for membership or mechanism for collecting or soliciting funds."
Summary by
Keep our NHS Public
of Manchester
Evening News 8 September 2006
Patient power
sees off US giant. Pulse writes: "It is a story worthy of being the next
Billy Elliot-style blockbuster. Set against the backdrop of a deprived former
mining community, a retired hosiery machinist thwarts the efforts of a
multibillion-dollar US company to muscle in on two small local healthcare
providers. The feisty pensioner is adamant that the public body that chose to
bring in the company ignored the wishes of a local community who were set
against its plans. Using state-funded legal aid, she instructs a renowned
human rights lawyer to fight her case. But the first legal challenge at the
High Court in June ends in ignominious failure. The judge rules that North
Eastern Derbyshire PCT had not needed to consult local people because it was
re-providing an existing service, not tendering for a new one. Even if there
had been consultation, the judge adds, the PCT would still have probably
picked the same US-based firm, UnitedHealth Europe. However, the woman, a
patient at one of the small GP surgeries to be taken over, is not to be
deterred. She contests the decision at the Court of Appeal. And, after a
nine-month fight that at times looked hopeless, she prevails. The court rules
that the PCT should start the tender process for the practices from scratch -
and this time let the public help set the criteria against which bids will be
judged. In stopping UnitedHealth Europe taking over the Creswell and Langwith
practices, Pam Smith has had a huge impact on the development of the NHS."
Richard Stein, Pam Smith's lawyer, said: The Court of Appeal sends out an
important message to all NHS bodies. It's not just a theoretical duty to
consult patients but one that if they don't comply, courts will force them
to." This duty should also increase the possibility that GPs will win such
contracts in future ahead of the larger private companies with no local ties.
If patients are more involved in setting criteria for selecting bids, they
will likely place more onus on local knowledge and community investment. At
the very least, selection processes should become more transparent. Dr
Elizabeth Barrett, local GP and a leading member of campaign group Keep our
NHS Public, said: "When we first bid we didn't know we would be up against
multinationals. Now the whole climate has changed dramatically. We've changed
the law and held the PCT and the Government to account. But ordinary,
mainstream NHS doctors find it difficult to succeed against the private
sector." Dr Chaand Nagpaul, chair of the GPC's commissioning and service
development subcommittee, is in no doubt that the verdict should help
safeguard traditional general practice: "We know the public values traditional
general practice much more than the Government seems to. Now the Government
cannot continue promoting ideological policies without the public behind it."
North Eastern Derbyshire PCT has already scheduled a meeting with the chairman
of the local Patient and Public Involvement Forum to work out how the group
can contribute to a new tendering process. As with the first process, a panel
made up of a representative of local clinicians, a PCT non-executive director,
a member of a practice patient participation group, the trust's chief
executive and its director of commissioning will interview shortlisted bids. A
restructured primary care trust - Derbyshire County PCT - will take over on 21
October and will be handling the final decision.
Summary by
Keep our NHS Public
of Pulse 8 September 2006
Consult
patients on change. A Court of Appeal ruling that North Derbyshire PCT
failed to properly consult patients over a tender to run two practices will
have a major impact on GPs, the chief executive of the trust has warned. Dr
Martin McShane said GPs who sought to merge practices or substantially change
the way their business worked would in future have to show they had taken
patients' views into account. Dr McShane, a former GP, said the requirement
could affect singlehanders wanting to retire and would also extend to
practice-based commissioning consortiums.
Summary by
Keep our NHS Public
of Pulse 8 September 2006
£1m
consultation had no impact on policy. GP complaints that the Government's
high-profile public consultation on the future of primary care was a sham have
been supported by an official evaluation of the project. Most people involved
in the Your Health Your Care Your Say consultation felt they had little or no
impact on the final policies, the evaluation commissioned by the Department of
Health found. Only one in seven people who attended the £1 million series of
'town hall'-style meetings felt they had had an influence on the eventual
White Paper. Almost half felt that issues raised in discussion at the events
were not considered in the questions they were asked as part of the
consultation. The evaluation highlighted a 'lack of transparency in the
iterative policy development and analysis process, during and after the
deliberative events'. Some participants felt that certain discussion topics
and polling questions were 'leading'.
Summary by
Keep our NHS Public
of Pulse 8 September 2006
MPs could probe
ward closure. The closure of a
Holderness cottage hospital ward may be scrutinised by the House of
Commons health select committee if it is found that services are being cut as
a result of overspending. Committee chairman and Rother Valley MP Kevin Barron
said: "We are continuing to look into the NHS deficits issue and what's
happening where there has been overspend and it might be that this is one of
those cases. If it came to our attention we would look at it. We need to know
whether this has come about as a result of deficits." Yorkshire Wolds and
Coast PCT announced last week it was shutting the 12-bed ward because it could
not afford to recruit agency staff to cover at the hospital. The trust said
current staffing levels were putting patients and staff at risk. It described
the closure as temporary and said it would review the situation in March. But
a national lobby group, which includes senior doctors and trades union leaders
among its ranks, has accused the trust's managers of using stealth tactics to
bring about the permanent closure of the ward. The group, Keep Our NHS Public,
fears the ward will close for good when it stops admitting patients on October
1. Spokesman Alex Nunns said: "We've seen this in other parts of the country
where trusts close a ward and say it's only for a limited period of time, and
when that time is up, surprise, surprise, it doesn't open again. It's a method
managers use to close things down." The axeing of the ward infuriated many in
the area, including those who successfully blocked plans to shut the
hospital's minor injury unit last year. Campaigners are considering a legal
challenge and Mr Nunns said he believed that was worth pursuing. He said:
"Closing a ward is a major service change and patients
have legal rights to be consulted. They need to use those rights to keep
this ward open. There was a case in
Oxford where they planned to close a pain relief unit, and just the threat
of legal action from patients forced a U-turn. Legal action is available to
patients and we would encourage them to use it." Staff from the ward, who are
being transferred to other services in the area, are also said to be unhappy
at the decision. Polly Worsdale, East Riding councillor for North Holderness,
and a member of Holderness Hospitals Action Group, said: "Just after it was
announced I saw one of the nurses and she was in tears. All they want to do is
look after people."
Summary by
Keep our NHS Public
of Yorkshire
Post 10 September 2006
Have a say on
health, ministers urged. Then they turned a deaf ear. A £1 million
public consultation into the future of NHS services
has been exposed as a "sham" by an official Government evaluation into the
landmark project. A large proportion of the people who took part in Your
Health, Your Care, Your Say, the consultation vaunted by ministers for
allowing people to influence a
White Paper on health published this year, felt they had little or no
impact on the final policies. Only 14 per cent of those who took part felt
that their views had been taken into account in the White Paper. Ministers
faced criticism that the whole event was geared towards getting the answers
they wanted to questions that did not reflect the issues people had raised.
Health campaigners point out that the pledges to bring care closer to home are
now being shattered by a wave of NHS "reconfigurations". The evaluation
report, commissioned by the Department of Health, said there were concerns
about "restricted polling questions" that were "slightly leading and framed to
get specific answers". Concerns about making sure money was ploughed into
hospitals and GP surgeries instead of walk-in centres at supermarkets were
lost.
Summary by
Keep our NHS Public
of Telegraph
18 September 2006
Children's
hospital proposals for closing kids psychiatric ward slammed by leading
Birmingham patients watchdog. Proposals by the
Birmingham Children's Hospital to pursue the closure of a key ward
treating children with serious psychiatric conditions have been slammed by the
Eastern Birmingham Patient and Public Forum. The forum, which was instrumental
in stopping the closure of the ward earlier in the year, following the
revelation that the hospital had not consulted
parents and children and was therefore in technical breach of the statutory
duty to consult, believes that the lessons of the previous exercise have not
been learned.
Summary by
Keep our NHS Public of Eastern Birmingham Patient and Public
Involvement Forum 11 October 2006
Welcome for report by maternity group.
Mums fighting to save a North-east maternity unit have welcomed a new report.
And they claim the findings by the
Scottish Health
Council are "open to interpretation". The council conducted an independent
inquiry into NHS Grampian's consultation process. They found the trust had
consulted adequately with the local population over its proposed
changes to rural health services, including the closure of four maternity
units. But members of the Save Aboyne Maternity group said that the review
also highlights many weaknesses in the consultation
process. And they are confident that these will be taken into account by
Health Minister Andy Kerr who will make a final decision on the proposals. In
the report NHS Grampian was accused of conducting an "arrogant" and "cloak and
dagger style" consultation. Under its plans, which were unanimously backed by
the health board in August, maternity units at Aboyne, Fraserburgh, Huntly and
Banff would close.
Summary by
Keep our NHS Public
of Aberdeen Press & Journal 24 November 2006
Health merger
consultation starts. A merger between a hospital trust facing an expected
£15m deficit by the end of the financial year and a foundation trust has moved
closer. Health Secretary Patricia Hewitt has approved a consultation on plans
to merge Good Hope Hospital NHS Trust and
Heart of England NHS Foundation Trust. Heart of England said it expects
the merger to take place on 1 April 2007. NHS West Midlands Strategic Health
Authority is now consulting whether Good Hope should be dissolved and become
part of the nearby foundation trust. If the foundation trusts' regulator
supports the plan, the Health Secretary will make the final decision. Heart of
England currently runs Birmingham Heartlands, Solihull and Birmingham Chest
Clinic. The new organisation would serve about a million people, from Solihull
through Birmingham and into south Staffordshire. Ms Hewitt said: "The proposal
to merge an NHS Trust with an NHS Foundation Trust indicates our seriousness
about NHS reform and our confidence in the rigours of the financial regime of
Foundation Trusts to take on this challenge." Summary by
Keep our NHS Public
of BBC
Online 13 December 2006
Hewitt
challenged over lack of ISTC consultation. A patient is challenging Health
Secretary Patricia Hewitt's decision to set up an
independent sector
treatment centre (ISTC) in north Bristol without
consultation. Rebecca Fudge, who is supported by the Save
Frenchay Hospital Group, is seeking a judicial review of the DoH's plans
for an ISTC to be run by UK Specialist Hospitals. According to documents filed
by Leigh Day & Co, solicitors for Ms
Fudge, the DoH is due to sign a contract with the company in March 2007. Ms
Fudge claims Mrs Hewitt wrongly advised NHS South West and South
Gloucestershire Primary Care Trust that they did not need to consult the
public, because the DoH was leading on the scheme. She will argue that as both
bodies provided information to potential bidders and evaluated bids they did
have a duty to consult. The DoH has also said consultation should occur only
once the contract is signed. But in their outline challenge Leigh Day said:
'[The consultation] will be taking place long after the decisions about the
planning and development of services have taken place.' The lawyers also said
it was 'immaterial' that patients would have a choice about whether to use the
ISTC, as it would still form part of the local health economy and
commissioners would be buying services from it. In her witness statement, Ms
Fudge said: 'I am shocked that such a large-scale development would be
proposed without any consultation with the public.' A judge will decide next
year whether Ms Fudge's case should be allowed to proceed. If successful, the
case will have significant implications for other schemes under the DoH's
'wave two' ISTC programme, such as the private Cumbria ICATS (integrated
clinical assessment and treatment service). NHS North West argued in response
to a challenge from Unison that consultation was only necessary once the DoH
had signed contracts with Netcare, the preferred bidder on the scheme. The
proposed contracts in both Bristol and Cumbria guarantee minimum levels of
income for the private providers if their services are not used.
Summary by
Keep our NHS Public of Hospital
Doctor 14 December 2006
Failure to talk to
public delays private GP plan.
Sefton Primary Care Trust has admitted that plans to commission a new
privately run clinic in Maghull would be delayed because it needs to
consult the public more. At the same time it was
admitted that the PCT is in negotiations with one company for the contract,
though strict Department of Health rules mean the name of the preferred
provider cannot be revealed. Merseyside campaigners claimed that, after
another private surgery plan in Derbyshire was ruled by the High Court to have
been inadequately consulted on, they had a similar case after the PCT refused
to release the names of ten short listed companies. Julie Goulding, the PCT's
acting director of Corporate Services, insisted that the PCT would closely
regulate the centre's standards. The clinic is one of six pilots under the
government's new Alternative Provider Medical Services (APMS) contracts.
Proponents of the contracts say it will increase efficiency but members of
Keep Our NHS Public say it will divert NHS resources towards profit driven
private companies. Peter Crowder, spokesman for the newly formed Maghull KONP,
formed to fight the GP surgery plan, accused the PCT of "back-pedalling".
"They have not fulfilled their legal obligation to consult the public, and now
they are trying to back-pedal and make it look as though they have consulted
us. It's a foregone conclusion now because they've chosen a provider. But for
the public it's a choice between this, or this. There isn't any choice for the
public, they've already decided - so what's the point of consulting us now
?" He added: "The only consultation they did was about where the clinic
should be, not who should operate it." Ms Goulding denied that there would be
any damage to quality and pointed out that the move was needed to attract GPs
to an area that had difficulty recruiting surgery staff. She added that GPs in
the area had now allowed the PCT to see if any extra patients could be taken
on by existing surgeries and that, while there was little chance the plan
would be dropped, if an existing surgery could take on an extra 200 patients,
it "would have to be looked into." Summary by
Keep our NHS Public
of Liverpool Daily Post 19 December 2006
Watchdog
refuses to back inquiry into future of wards. A patient's watchdog has
refused to back a consultation because they say that
health bosses have ignored a solution that received popular support in initial
meetings.
Trafford Healthcare Trust was forced to carry out consultation on the
future of two inpatient wards at Altringham General Hospital in March after
initially closing them because they were unsafe. Legal action by a former
nurse at the hospital, Pat Morris, forced the trust to perform public
consultation. Now local patients' groups say that the options being presented
to the public exclude the suggestion of turning the wards into a
rehabilitation and respite unit, an idea that had won support at two
pre-consultation "listening" events. However the only two options the trust is
offering the public are to close the wards and provide a centralised service,
or re-open and re-establish a consultant-led inpatient rehabilitation service.
Judie Collins, from Trafford Patient and Public Involvement Forum said: "We
feel the consultation document has been rushed - and we want to make sure the
public understand what they are being asked. Members of the public said they
wanted the beds back, to be used for rehabilitation and respite, and they will
be confused that this option is not included in the consultation." A hospital
spokesperson said the third option was not included because they wouldn't
receive any extra funding from Trafford Healthcare Trust to provide it. Summary by
Keep our NHS Public
of Manchester
Evening News 19 December 2006
Patient forum
changes "will fail". The British Medical Association has warned that the
establishment of Local Involvement Networks (Links) to replace existing forums
will fail because they lack funding and their structure is flawed and open to
unacceptable variations. The groups will differ from their predecessors in
covering a geographical area instead of being linked to specific NHS bodies,
as well as covering both health and social care. The BMA, in response to a
Health Select Committee inquiry on public involvement in the NHS, said the
proposals would mean fewer groups to represent patients and that the suggested
£100,000 and £150,000 funding would be insufficient. Juliet Dunmur, deputy
chairwoman of the BMA Patient Liaison Group, said: "Many people would like a
say in how their health services are run, but have never been given the
opportunity. If Links are to have any real influence they will need much more
support than their predecessors ever received." But a Department of Health
spokeswoman said: "The current arrangements to support a stronger patient
voice were designed to fit the health service five years ago. Since then, the
NHS and social care system has changed and it is now time to strengthen
peoples' voices further."
Summary by
Keep our NHS Public of BBC
Online 25 January 2007
Confed
criticises public consultation bill. The NHS Confederation has criticised
the government's new bill on public involvement in health services for placing
a duty of consultation on providers, as well as commissioners. The
confederation says only primary care trusts and strategic health authorities
should have to consult on the planning and provision of services and on
'significant proposals' to change the way services are provided and operated.
Foundation and other provider trusts should instead have a duty to involve
users, deputy director of policy Jo Webber said. The bill's proposals are
being interpreted as a response to the legal row over North Eastern Derbyshire
PCT's decision to commission GP services from independent provider
UnitedHealth Europe. The PCT was censured by the High Court for failing to
consult adequately on its proposals. Under the new bill, the health secretary
may also demand a PCT report on its consultation and the influence of results
on its commissioning decisions. Ms Webber said: 'Certainly, after Derbyshire,
clarification was needed about what was meant by consultation. I think [the
bill] will clarify this but we will need to look at the guidance associated
with it.' The proposal in the bill for LINKs hit controversy in the Commons.
Shadow health minister John Baron said they would lack the independence and
ringfenced funding of predecessor organisations. Where patients' forums had
the power to inspect services, LINks will have a right to enter and view.
Summary by
Keep our NHS Public of Health Service Journal
25 January 2007
Bill to abolish
patients' forums criticised as "disgraceful". A UK government bill to
reform the way patients and the public participate in decisions about local
health services had its second reading this week in parliament, where it faces
opposition from the Conservatives and Liberal Democrats. The Local Government
and Public Involvement in Health Bill will abolish patients' forums and
replace them with local involvement networks (LINks). It will also modify the
duty to consult the public about changes in health service provision. In the
place of patients' forums, local authorities will be put under a duty to make
contractual arrangements for the involvement of people in the commissioning,
provision, and scrutiny of health services and social services. LINks will
cover social care services as well as health, will be established for a
geographical area, and will decide locally how members will be appointed and
how others will contribute.
Summary by
Keep our NHS Public of British
Medical Journal 26 January 2007
NHS drive to
involve patients "is failing". A survey for the Department of Health has
revealed that patients are less involved in healthcare than they were three
years ago, signalling a blow to the Government's championing of choice based
on increased patient involvement. In the survey of 10,000 patients conducted
for the Department of Health, only 45 per cent said they were given as much
information as they wanted about their medicines and many were unhappy with
access to GPs with seven out of ten wanting surgeries open out-of-hours. The
report also showed that the government's target of 48 hours to see a GP was
being approached with nine out of ten being able to be seen within the
targeted time.
Summary by
Keep our NHS Public of Independent
30 January 2007
New patient
forums 'will not have enough money'. The organisations that will replace
patient forums will not have enough money to operate efficiently, doctors and
patients are claiming. The BMA's patient liaison group is warning that the
annual subsidy of up to £150,000 planned for each Local Involvement Network
(Link) branch may not cover staff wages, buildings expenses and other costs.
Summary by
Keep our NHS Public of Pulse
2 February 2007
LINks will fail
public, warns CPPIH chair. Government proposals to make the NHS more
accountable to patients will actually exclude the public from long-term
decisions worth billions, MPs have heard. Giving evidence to the Commons
health select committee, Sharon Grant, chair of the Commission for Patient and
Public Involvement in Health, said that by the time new organisations were set
up to replace patient forums, primary care trusts would already have made
crucial long-term decisions on commissioning. She said Department of Health
proposals to scrap her organisation and the 570-plus patient and public
involvement forums in England would result in less accountability. Ms Grant
said PCTs would take spending decisions before LINks had had time to mature
into effective scrutiny and involvement organisations. 'Commissioning
contracts would have been made lasting for five years or more from which the
public would have been largely excluded. I have serious concerns about what
these proposals will actually do for the public involvement agenda.' And she
added: '[Ministers] really need to think about the message all this chopping
and changing means for genuine local involvement.' Ms Grant and fellow
witnesses Elizabeth Manero, the chief executive of patient involvement charity
Health Link, and Barrie Taylor, the chair of Westminster Council's health
oversight and scrutiny committee, said that rather than starting afresh,
patients forums should be allowed to evolve and involve many other interest
groups. They pointed out that many were already doing this. Dr Richard Taylor
MP summed up the view of the committee: 'We all feel that the existing system
could be refined and built up and needs a further two years gestation to help
it grow its capacity'.
Summary by
Keep our NHS Public of Health
Service Journal 15 February 2007
'Raise bar' on
consulting. Trusts and strategic health authorities must 'raise the bar'
on the quality of local service consultations, says Sir Ian Carruthers in his
national review of current reconfiguration proposals. Although the review does
not name individual consultations or say how many succeeded or failed, Sir Ian
said the poorest performers were below the standard he would expect. The draft
letter presented to the DoH management board says that it has 'set out the
standards all SHAs and trusts should aspire to'. An appendix sets out a
framework which the letter says should be used by SHAs and trusts preparing
for service consultations. The letter also says primary care trusts should
take a central role in leading reconfiguration. 'PCTs should normally lead the
preparation and consultation on service improvement proposals,' it says. The
review found high variation in the manner and success of reconfiguration
consultations, even within the same area. Sir Ian said: 'The detail, style,
format [and] language of consultation documents varies too much. When you read
a lot of them, it is not clear what is being discussed.'
Summary by
Keep our NHS Public of Health
Service Journal 1 March 2007
CATS consultation "illegal". The Patient and Public Involvement (PPI)
forum for Central
Lancashire Primary Care Trust (PCT) has claimed that the trust's
consultation over CATS health centres is illegal. The forum's chairman,
Professor Peter McEwan, told a meeting in Preston that the consultation was
"inadequate" and being used as a "promotional vehicle" for Netcare, the
private company that is to run the centres. "This consultation process is
flawed. The time to carry it out has been far too short for such a complex
issue. It is a recipe for disaster to continue as we are. We are asking that
the matter is referred back to the Secretary of State for a proper
consultation," said Professor McEwan. The PPI's initial report on the
consultation says that its eight week length "flouts the minimum 12-week
consultation period" advised and that the consultation lacked clarity and key
information. Professor McEwan said in the report: "As a consequence, we
believe the consultation actually constitutes a breach of the requirements of
Section 242 of the NHS Act 200 and thus we formally request a formal referral
concerning the content and outcome of the consultation process to the
Secretary of State for Health." The primary care trust insisted that people
would be given a choice between Netcare and the NHS. Councillor Michael
Lavalette, who organised last night's meeting through the Preston branch of
the Keep Our NHS Public campaign group, warned that this was the start of "the
private sector taking more and more of our services". The meeting resulted in
a 150-strong unanimous vote to let the NHS run the centres instead of Netcare.
Summary by
Keep our NHS Public of Lancashire
Evening Post 1 March 2007
Power to the patients. The days of "Trust me, I'm a doctor" are
over, says Sophie Petit-Zeman. Patients got impatient last week. Or rather, at
one remove, 223 medical charities and related groups did, writing to the
government urging it to rethink a proposed ban on the creation of hybrid
animal-human embryos as sources of stem cells for research. That number, 223,
belies a far larger one: the people these groups help, and who support them,
in turn. The letter to the government represented patient power writ large; it
follows a growing trend for patients saying what they want, both from care and
research.
Tuesday April 10, 2007 EducationGuardian.co.uk
MPs say public
role in NHS being undermined. Proper public consultation on the National
Health Service will be undermined by "vague and woolly" legislation passing
through parliament, a committee of MPs has said. The Commons Health Committee
criticised government proposals to limit public consultation on healthcare
changes to "significant" proposals and decisions. The proposed changes are
contained in the Local Government and Public Involvement in Health Bill, which
is nearing the end of its passage through parliament. Consultation on NHS
changes, such as the closure of maternity wards, was already a sham in some
cases, the committee said. "The Department of Health needs to take a lead and
make it clear that such behaviour will not be condoned." MPs said the planned
replacement of England's 400 Patient Forums by 150 "Local Involvement
Networks" (LINks) only four years after the volunteer-run health watchdogs
were created was unnecessarily disruptive, and might push volunteers to leave.
"Once again the Department of Health has embarked on structural reform with
inadequate consideration of the disruption it causes," the committee said. The
MPs said the health secretary - currently Patricia Hewitt - intervened too
often in decisions after extensive local consultation, leading to illogical
conclusions and undermining public confidence in the consultation process. The
opposition Conservatives said the Labour government was wrong to abolish the
patient forums. "With Labour now seeking to close maternity and accident and
emergency units, it is the wrong time for the government to be weakening the
duty on NHS bodies to consult," said Conservative health spokesman John Baron.
Summary by
Keep our NHS Public of Mirror
20 April 2007
S11 changes
weaken consultation, says Commons health select committee. The commons
health select committee has warned that plans in the Local Government and
Health Involvement Bill to change section 11 consultation rules would further
weaken public and patient involvement which is already a "sham" in places. The
change would mean consultation would only have to take place on "significant"
decisions, not all, with significant being defined as having substantial
impact on the manner in which services are delivered to a wide range of users,
or the range of services available. The report states that at present the
theoretically excellent system suffers because "people feel they are consulted
after decisions have been made". "There has also been criticism of NHS
organisations' refusal to consult about major changes and of the Department of
Health's vigorous support of these decisions," the report says. "We fear the
bill will weaken section 11. The change of definition it proposes may lead to
confusion and could lead to more court cases when the act is tested." NHS
Confederation policy manager Maria Nyberg said the committee's conclusions on
the bill were worrying. "We do not believe that the legislation will weaken
consultation. Rather, we need to be clear about the difference between ongoing
patient and public involvement in decision-making, and formal consultations on
significant service redesign. Ongoing involvement and engagement with patients
and the public about health is of course essential if healthcare is truly
going to be patient focused. Engaging with the local population must be
properly embedded within NHS organisations. However, involvement is very
different from formal public consultation, which is not required unless
significant changes are being made to service quality, quantity or access."
She added: "Healthcare providers and commissioners need to be able to make
clinical and managerial decisions quickly and remain agile in a competitive
market."
Summary by
Keep our NHS Public of Health
Service Journal 26 April 2007
MPs fear
abolition of PPI forums will lead to lose of volunteers. Government plans
to scrap patient and public involvement forums and set up local involvement
networks (LINks) instead has come under fire from the Commons select
committee. The committee's findings state: "We do not see why PPIFs could not
have been allowed to ev |