Private Sector Involvement/Sources

Home ] Up ] The Campaign ] Petitions ] Events index ] Health Policy ] Democracy ] The NHS ] Talks Letters & Articles ] Contacts and Further Reading ]
 

For earlier material see

Private Sector Involvement Sources to 2006

  • Government accused of selling off NHS brand. The Government has been accused of "selling off" the NHS brand, after it emerged that a German parcel company has been given the right to use the blue and white logo. A private consortium, headed by DHL, the delivery company, now holds a licence "for use of the NHS marks". It was granted by the Department of Health, as part of the consortium's £1.6 billion, 10-year contract to supply healthcare products to hospitals and GP surgeries around Britain. According to a report issued by the Department of Health in 2005, the NHS logo "should be the equivalent of a quality 'kite-mark' - reassuring patients about the standards and safeguards". The department spent £330,000 last year to make sure that the NHS logo was used "correctly". The logo is now emblazoned across the consortium's delivery vehicles and letterheads, and the service has been named "NHS Supply Chain". Patients' groups and NHS workers' representatives have reacted with anger. Geoff Martin, the director of campaigns for the Health Emergency pressure group, said: "The Government is giving this company the opportunity to exploit public loyalty to the NHS brand, regardless of that company's track record and profit motives. It stinks." A spokesman for Unison, the public workers' union, described the sale as "symbolic". "It devalues the NHS as a whole. The NHS has a world-class reputation that has been earned over many years. Its logo is known and respected and should not be 'sold off' to a private company to use as its own." Summary by Keep our NHS Public of Telegraph 2 January 2007
  • Patients called to give evidence. Patients who suffered botched operations at a Cambridgeshire hospital have been called by the Healthcare Commission to give evidence in the investigation into the conduct of a French surgeon. Phyllis Brown, 68, Janet Norris, 64, and Michae Smith, 56, were all operated on by Roland Istria, and all received ill-fitting artificial knee joints. All three later had to undergo further surgery to correct the mistakes made. The investigation is focusing into the clinical standards of a Government initiative to use private hospitals in order to reduce waiting lists on the NHS. Nuffield Hospital has accepted liability in all three cases and are in the process of coming to a compensation agreement. Dr. Istra performed a total of 15 operations at the hospital during October and November 2004. He has since been suspended from operating in this country by the General Medical Council while the investigation continues. Summary by Keep our NHS Public of Medical & Legal 8 January 2007
  • Healthcare that's fit for the 21st century? A 107-bed, three-storey building on the outskirts of Lymington is to be officially opened on Tuesday 9 January and will soon be the first complete NHS hospital to be run by the private sector. Lymington New Forest Hospital has been dubbed a "one-stop-shop", incorporating appointment, consultant, diagnosis and treatment services - all under one roof. Built by Ryhurst under the private finance initiative, health bosses took official ownership of the building last week. That came as the Department of Health announced it wanted Partnership Health Group (PHG), a private company, to run all services at the hospital from July in a first scheme of its kind in the country. Hampshire Primary Care Trust will run it until then. PHG will invest £21m. The project is set to include a new 20,000 patient a year treatment centre at Royal South Hants Hospital in Southampton from 2008. The six-ward Lymington hospital will employ about 400 staff and see about 45,000 patients a year through its 8am to 10pm minor injures unit, outpatient clinics and diagnostic treatment centre, which will carry fast, prebooked day and short-stay surgery such as cataract removal, hip and knee replacements and hernia repair. The hospital has two theatres, two endoscopy suites, a larger radiology department with a CT scanner from next month, two ultrasound suites, medical and surgical day units, stroke rehabilitation and a surgical ward. There will be also be an urgent care centre plus support services such as a pharmacy, education and training centre. Half of the beds will be immediately filled by patients who are being transferred from the existing Lymington hospital, in Southampton Road, which will be closed. The site is being sold off to a developer to build 41 houses. PHG - jointly owned by Care UK Plc and Life Healthcare - currently operates NHS treatment centres in Plymouth, Barlborough, near Chesterfield, and Maidstone. Summary by Keep our NHS Public of Salisbury Journal 8 January 2007
  • Medical centre set for rugby club site. Birmingham and Solihull Rugby Club could soon become home to a new medical centre. Mercury Health, an independent healthcare provider, have applied to install a temporary mobile diagnostics unit at the home of Pertemps Bees RFC. The unit is one of 52 sites across the West Midlands. If all goes to plan, then the service should start in April when it will provide services including MRI scans and x-ray investigations via GP referral. Summary by Keep our NHS Public of Solihull Times 8 January 2007
  • Researchers see bias in private-funded studies.  Survey based on reports of health benefits of drinks.  Figures revive controversy over commercial influence. Research into the health benefits of drinks including fizzy pop, juices and milk may be severely biased in favour of food industry funders, American doctors say today. A survey of research on the nutritional value of drinks found that studies funded entirely by food and drink companies were approximately eight times more likely to produce results favourable to their funders, compared with studies which had no industry funding. The findings threaten to revive the row which started in the pharmaceutical industry about how independent scientists can be when they receive funding from a commercial source. The authors of the review of research conclude: "Industry funding of nutrition-related scientific articles may bias conclusions in favour of sponsors' products, with potentially significant implications for public health."  Polly Curtis, health correspondent Tuesday January 9, 2007 The Guardian
  • BUPA makes home healthcare move. BUPA has stepped into the expanding out-of-hospital care market with the acquisition of Clinovia, a UK home healthcare specialist. BUPA purchased the company for £87.7m from Lyceum Capital, which established Clinovia in 1975. The company provides comprehensive home healthcare such as delivering prescribed drugs and intravenous feeds to patients at home for more than 8,500 patients a month with a wide range of medical and chronic conditions like multiple sclerosis and haemophilia. It has around 450 staff at sites in Harlow, Manchester, Derby and Glasgow. Summary by Keep our NHS Public of Health Insurance & Protection 12 January 2007
  • Anger over contract at GP surgery. Patients have vented their anger over the awarding of the contract to run their GP practice. Stoke-on-Trent Primary Care Trust (PCT) chose to hand over the Moss Green surgery, which serves 5,000 patients in Bentilee, to a group that already runs the Moorcroft Medical Centre in Hanley. Patients' leaders, who want the surgery to be operated by a dedicated, single-site practice, believe the tendering process was flawed. They held a public meeting last night to send a message to the PCT that patients were not happy. Around 40 people attended the meeting at the Harold Clowes Community Centre, and everybody in the room wanted existing GP Dr Reis Cotta to run the surgery. The patients want to have the same doctors treating them every day, which they do not believe will happen with the Moorcroft practice. Patients' group leaders Ian Dyke and John Davis were both involved in the PCT's selection process. Four applicants were shortlisted and interviewed by a panel consisting of the two patients' leaders and four PCT members. Mr Dyke said he and his colleague were under the impression that a points system based on the applicants' answers was being used to determine the winner. This would have seen Dr Cotta being awarded the contract, but instead a simple show of hands was used, which the Moorcroft practice won 5-3. Mr Dyke said: "The Government has said we should have a patient-led NHS, but the PCT is not listening to what the patients want here." Stoke-on-Trent Central MP Mark Fisher promised to hand over a 600-name petition against the PCT's decision to health secretary Patricia Hewitt. Dr Cotta, who is appealing against the decision himself, has been advised against talking about the issue by the British Medical Association. Summary by Keep our NHS Public of Stoke Sentinel 12 January 2007
  • NHS 'being handed to private control'. The National Health Service is being "parcelled up into bite-sized pieces and handed over to private control", Keep Our NHS Public, a campaigning group of doctors and others opposed to the government's NHS policy and backed by the unions has said. Ministers were carrying out a "patchwork privatisation" of the NHS that would turn it "into a tax-funded insurer, paying for care provided by others" where only the NHS logo would survive, the group said. The service was being "dismantled by stealth" and was ceasing to be a comprehensive direct provider of care, with money instead flowing into private sector profits and shareholders' pockets, the campaign complained. Summary by Keep our NHS Public of Financial Times 20 January 2007
  • What's good for business is not always what's good for medicine. In a comment piece, GP Margaret McCartney writes: "I used the word 'patient'. I should, apparently, be more business-like. 'Patient', I am told, is old-fashioned and implies a status lower than the doctor. The word I should use is 'client'. 'Clients' have freedom to consult whoever they wish and can move between the brokers they prefer. Doctors are ordinary people trained to do a job but a professional relationship makes the patient-doctor relationship different from a business relationship. When medicine is practised in a business relationship, it is inherently different. The doctor has direct access to a financial gain. Cosmetic surgery and infertility treatments are two areas where medicine is practised as a business in the UK and demand leads supply. When disreputable clinics proceed to perform cosmetic surgery that is not warranted, professional standards slip. With infertility treatments, where the couples involved are often vulnerable, there is concern that women who are likely to become pregnant naturally are still offered fertility treatments when a perfectly reasonable option might be to simply wait, or use cheaper drugs instead of invasive procedures. There is nothing terribly new about either of these examples. But demand-led medicine does seem to have become more acceptable now… Good medical practice also means sometimes doing things that make bad business sense. For example, a small portion of patients makes up the largest portion of my work. If I wanted to make easier money, I would set up a lucrative "health check-up service" to see "worried well" clients. I might even employ a few cheap-rate doctors to do the actual work of seeing patients and then take a step back and manage them all very efficiently. This is already happening; there are doctors earning wildly disproportionate sums for this kind of work. Two problems: first, my professional ethical code tells me that neither is a good idea; second, could I discharge my highest-workload - and sickest - clients ? No. They are my patients." Summary by Keep our NHS Public of Financial Times 20 January 2007
  • Doctors angry at plan to assess patients at private clinics. GPs will lose the right to refer NHS patients for assessment at a hospital outpatient clinic under plans that were condemned by the British Medical Association yesterday as a step too far in the creeping privatisation of the health service. The BMA drew attention to proposals designed to cut hospital waiting lists by creating a network of private centres under contract to the government that would assess and test patients before they are allowed to get treatment as hospital outpatients. The private medical chain Netcare will set up 10 centres in Cumbria and Lancashire, where the company expects to be able to deal with 60% of patients without needing to send them for an assessment by an NHS consultant. John Carvel, social affairs editor Tuesday January 23, 2007 The Guardian
  • Pfizer blames job losses on NHS cost cuts. Pfizer is cutting around 250 jobs in the UK, blaming cost reduction measures by the NHS, as the drug maker embarks on a campaign to shed 10,000 staff worldwide. Announcing the UK cuts yesterday, Pfizer said: "Financial deficits in the National Health Service have resulted in a concerted effort to cut medicines' costs through increased use of older, cheaper generics. This shift away from prescription of new, more effective medicines - in particular, the pressure applied by the Department of Health to switch the majority of UK patients to generic statins - has caused Pfizer to reconsider the number of roles required to support the UK business." Statins are used to treat heart disease. Mark Milner Wednesday January 24, 2007 The Guardian
  • Keep Our NHS Public activists debate how to step up the pressure on New Labour. More than 250 health workers and campaigners attended the Keep Our NHS Public conference in London last Saturday. Sally Ruane from the Leicestershire Save Our NHS campaign opened the conference by highlighting the threats to the future of the health service. She spoke about the programme of "patchwork privatisation" which is allowing private companies to take control of parts of the NHS. Sally said, "The interests of the private sector are fundamentally opposed to those of patients and NHS staff. Private firms are accountable only to their shareholders." The government says that in areas where wards and services at local hospitals are being axed, it is because new specialist centres are being developed. It claims that by concentrating particular services in regional units, patient care will be improved. Sally disputed this, pointing out that the government bases its assumptions on a report called The Future Hospital, published by the Institute For Public Policy Research. Sally said, "The report made no mention of the two systematic reviews of the evidence. Both concluded that there is no clear evidence that the concentration of services works." The question of how campaigners should relate to the health service unions was raised repeatedly during the conference. There was frustration at the failure of the trade unions to call national or serious regional demonstrations in defence of the NHS. Many had hoped that such protests would have been the centrepiece of the unions' day of action over the health service on Saturday 3 March. Some activists argued that inaction by the union leadership meant that Keep Our NHS Public should call its own national demonstration - irrespective of what action the health unions decided to take. Responding to the argument, John Lister from London Health Emergency said: "If we want to force the government to back down, we cannot organise a small demonstration that doesn't match the widespread anger of the public. The 250 people here cannot substitute for the trade union movement. We must plan the best possible regional protests on 3 March in order to carry on putting pressure on the union leaders." Bobby Noyes, chair of Southampton health branch of Unison and president of Southampton TUC, argued that activists should use the day of action to mount lively regional protests that would prove that union members wanted national action. To loud applause, she told the conference how activists in Hampshire were planning a protest outside the new hospital in Lymington, which was built under the Private Finance Initiative. This is the first NHS hospital to be wholly run by a private contractor. "Instead of holding a small token protest outside every hospital in Hampshire, we have decided to hold one big one outside this symbol of a privatised NHS," she said. Other speakers discussed the ways in which campaigners could use the new Early Day Motion (EDM) for a moratorium on NHS cuts and closures proposed by Labour leaderhip contender John McDonnell MP. Activists were urged to pressure their MPs to support the EDM. Those MPs and ministers who campaign against hospital closures in their own constituencies but otherwise back the government's health cuts would be exposed as hypocrites. Tony Benn closed the conference. He said, "The people don't want war and they don't want privatisation. It's time that we brought all the opposition to New Labour together. Everyone active in defence of the NHS should come to the Stop the War demonstration on Saturday 24 February." Summary by Keep our NHS Public of Socialist Worker 24 January 2007
  • GP and patients vow to take legal action after PCT decides not to award practice contract to incumbent doctor. Patients at a practice that is about to be taken over are to launch a legal challenge against their PCT's decision not to award the contract to the incumbent salaried GP. The patients believe they were not properly consulted by Stoke-on-Trent PCT on its decision to give the contract for the Moss Green Surgery to another practice in the city. They have formed a 14-strong campaign group to try to get the decision overturned in favour of salaried GP Dr Reis Cotta, who had also bid. As well as legal action, the group has sent a 600-name petition to Health Secretary Patricia Hewitt and has the backing of local Labour MP Mark Fisher. Dr Cotta is also considering legal action himself and has the support of the BMA. The cases will draw on the landmark Court of Appeal judgment last year against Eastern Derbyshire PCT. It had chosen US firm UnitedHealth to run two GP practices but was forced to re-tender after the Court of Appeal ruled it had not properly consulted patients. The Stoke campaigners argued there were irregularities in the process of awarding the contract for the formerly PCT-managed practice to the Moorcroft Medical Centre. One concern they have raised is that a GP at the Moorcroft practice, Dr Steve Fawcett, is the PCT's professional executive committee chair. Ian Dyke, chair of the Moss Green Patient Participation Group, said this represented a conflict of interest. Mr Dyke said patients were concerned that Moorcroft would not provide the same GPs all the time, whereas giving Dr Cotta the contract would ensure continuity of care. He said: 'There are 5,000 patients here who want a dedicated surgery, not one where there will be different doctors all the time. What the PCT has done is wrong.' Mr Dyke was on the panel deciding on the award of the contract. He said the outcome was decided on a show of hands rather than a more sophisticated points scoring method which would have favoured Dr Cotta. Summary by Keep our NHS Public of Pulse 25 January 2007
  • GPs in Avon air their concerns over the 'cold steel of competition'. A market for primary care services will force surgeries to change drastically - and not necessarily for the better, GPs and practice managers warned at a meeting in Bristol last week. Dr Tom Frewin, a GP in Clifton, Bristol, said both providers and commissioners should be made legally, financially and personally accountable for their decisions to guarantee high quality services. He said: 'Private providers come and go. There's got to be a very heavy financial penalty if they can't do it. If [PCTs] commission a service that goes wrong, those commissioners should be legally liable. It's about quality and efficiency.' But Dr Frewin was not confident about GPs' prospects of competing. 'We don't stand a chance the way things are going because it's not a level playing field,' he said. Steve Mercer, chief executive of Avon LMC, said private sector providers had the ability to run a service as a loss leader whereas GPs did not. Summary by Keep our NHS Public of Pulse 25 January 2007
  • One year to save the NHS - what would you do? The chaos currently engulfing the NHS is due entirely to its "marketisation" by the government and the transfer of up to 50% of public money to the private sector-through contracts for the private finance initiative (PFI); independent sector treatment centres; GP services; IT and other services; billing, invoicing and marketing, and use of management consultants, says Professor Allyson Pollock of the Centre for International Public Health Policy at Edinburgh University. Increasingly, government has given away control of resource allocation and more and more of the NHS's scarce funds are flowing into the pockets of shareholders, bankers, management consultants, and for-profit providers - away from the service. Nothing but a complete reversal of government policy will save the NHS. "What is needed to save the NHS is a total abolition of the market and market mechanisms like payment by results, foundation trusts, and commissioning within healthcare, and the abolition of all contracts with private providers, including the compulsory repurchase of PFI hospitals," says Professor Pollock. Summary by Keep our NHS Public of British Medical Journal 26 January 2007
  • US clinical guidelines often influenced by industry, NEJM says. Many clinical guidelines for doctors in the United States are influenced by the pharmaceutical industry and special interest groups, said an article in the New England Journal of Medicine last week. "The quality of guidelines varies considerably," and some are controversial, says a commentary by the journal's national correspondent, Robert Steinbrook. Summary by Keep our NHS Public of British Medical Journal 26 January 2007
  • Blair defends private provision in public sector. There should be no limits in future to the role that private and voluntary sector organisations can play in delivering public services, the prime minister has declared. Tony Blair, speaking at the CBI public services summit in London on January 24, argued that the era of monopoly provision was over and ideology should not stop reforms. In a break with previous government policy, he also rejected constraints being placed on the proportion of public services that the private sector can provide. That tactic has been used by Health Secretary Patricia Hewitt to placate the unions over private sector involvement in the NHS. 'I don't see any reason why, if a GP service isn't working properly, an independent sector treatment centre shouldn't bid to provide it,' Blair told business leaders. 'It depends on who provides the best service. You shouldn't accept an arbitrary limit [on private sector involvement].' Mounting a staunch defence of his record, Blair said vested interests must not be allowed to derail the reform agenda, which had 'less to do with ideology and more to do with modernity'. He also said his impending departure from office would not herald a shift in the direction of public service reform. 'I believe the concept of breaking down barriers between the public, the private and the voluntary sectors is here to stay,' Blair told delegates. 'The values and principles may remain the same but it's high time we realised that public services, like everything else, have to move with the times.' Summary by Keep our NHS Public of Public Finance 26 January 2007
  • Prison firm expected to lose out on GP practice. A private prison company is understood to have lost its bid to run a GP practice in what would have been the first case of its kind in Scotland. Serco, which runs Kilmarnock jail, is believed to have been rejected by an independent panel of doctors and patients in favour of a traditional GP-run surgery. The company had bid to run the Harthill surgery in North Lanarkshire, which has 4081 patients on its books. It followed NHS Lanarkshire's decision to open up tendering to "alternative health providers" as well as GPs after a practice was dissolved. Three bids were received, two from GP practices. The winner is believed to be Dr Louise Eccles, one half of the previous Harthill practice. The panel's decision must now be signed off by the chief executive of NHS Lanarkshire. Serco's attempt to run the Harthill practice was revealed in November. The involvement of the global services firm prompted warnings of NHS privatisation. South of the border, where 3% of GP practices are run by private companies, critics claim services are cut to boost profits for shareholders, with more nurses and fewer doctors treating patients. In Scotland, there were concerns about ties between Serco and NHS Lanarkshire. Dr Colin Barrett, until last August clinical director of the health board's out-of-hours service, is now a medical director at Serco. NHS Lanarkshire's associate medical director, Dr Philip McMenemy, is also contracted by Serco to provide consultancy work and out-of-hours services. Carolyn Leckie, Scottish Socialist MSP for Central Scotland, who led the fight against the firm, said she was relieved at the result. "If it wasn't for the fight put up by the community and the patients, I fear NHS Lanarkshire would have got its way and let in an outside provider," she said. NHS Lanarkshire declined to comment on the winning bid. However, a spokesman said the board did not foresee any circumstances in which the chief executive would overturn the panel's recommendation. Summary by Keep our NHS Public of Herald 27 January 2007
  • NHS 'being parcelled up and privatised bit by bit'. Actress Emma Thompson and former Labour MP Tony Benn added their voices this week to a major campaign against "patchwork" privatisation of the NHS. Ms Thompson has signed a letter expressing her fears that market-based schemes are being pushed through with the minimum of debate. Other signatories include Helena Kennedy QC, agony aunt Claire Rayner and Keep Our NHS Public co-founder Professor Wendy Savage, who lives in Islington. Ms Thompson writes: "These untested rapid changes - the most extensive since the service was founded - threaten the values that bind the NHS together." At the same time, Mr Benn, a former Labour minister, told a packed conference at Friends Meeting House in Euston that soon only the very wealthy will be able to afford health care. He said: "The NHS came about because of the power people exercised at the ballot box. They brought health care with their votes instead of with their wallets, but now with NHS privatisation it's going the other way. Soon only people with money will be able to afford the best health care." He added that, instead of "spending all this money on Iraq", cash should be spent on the NHS. The 300-strong audience heard that the private company which took over Islington's care homes and then halved workers' salaries is about to run a hospital at Lymington in the New Forest. Professor Savage said that this was the first time an entire hospital has been privatised. She added: "Care UK will be taking over the running of the Lymington this summer. Their first action when taking over Islington care homes was to reduce the wages of staff. Profits should not be made out of health and social care." She added that, unlike the Thatcher privatisations of the 1980s, this time the whole NHS is not being put up for auction. Professor Savage said: "Instead, it is being parcelled up into bite-sized pieces, and handed over to private control bit by bit. This is happening on such a scale and at such a pace as to make it a unique phenomenon. The government's greatest achievement has been to push through the biggest change in the history of the NHS - under the radar and without a public mandate. It's time for an open debate about whether people want the patchwork privatisation of their health service." Kentish Town consultant Dr Jacky Davis told the conference that the government has squandered the goodwill of health workers. She said: "The frontline workers who have always put patients first will be struggling with the consequences of these reforms long after the architects retire to write their memoirs." According to calculations made by the Keep Our NHS Public campaign, the private sector will pocket at least £23bn of NHS money in profits and interest over 30 years through the private finance initiative hospital building scheme. Summary by Keep our NHS Public of Islington Tribune 29 January 2007
  • We want to choose our own doctor. Patients have launched legal action against health officials to stop them imposing unwanted GPs on their surgery. The move against Stoke-on-Trent Primary Care Trust is led by a London law firm which last year won a court judgement to force another PCT to back down over its choice of family doctors for patients. Solicitors from Leigh Day and Co have given the city PCT a fortnight to explain why the contract to run services at Moss Green, Bentilee, was not handed to the patients' own choice of the existing GPs. Despite opposition from patients, it was instead awarded to the Moorcroft partnership which already runs a practice in Hanley and is due to take over in April. Lawyers have asked for the PCT not to sign any contract with Moorcroft until the dispute is resolved. Moss Green's partnership group chairman Ian Dyke has been awarded legal aid to fund action and also sent a petition with 600 patients' signatures to Government health secretary Patricia Hewitt. He said: "All we want is to see the same doctor every time and we fear that won't happen if it is run by GPs from another practice. It'll become a branch surgery. We approached Leigh and Day because they had blocked attempts by a Derbyshire PCT to give a GP contract in Creswell to a private firm not wanted by the patients. After an appeal court judgement, that contract is now being re-tendered. The lawyers have now written to Stoke PCT which has a real fight on its hands. According to the Government, the NHS is supposed to be patient-led but that is clearly not happening." The letter to the PCT says: "Mr Dyke has raised a number of concerns about the selection procedure that we believe may have rendered the decision to award the contract to Moorcroft unlawful." The practice has been directly run by the PCT which employs Dr Reis Cotta on a salary to treat patients there. When it went out to tender last autumn he submitted a bid which was voted for by the two patient representatives on the selection panel. Following the decision to hand it to Moorcroft, Dr Reis lodged an appeal. But the row has now taken a new twist as the PCT has ruled there is no longer an appeals procedure as the process has been cleared by an independent review held by the West Midlands Strategic Health Authority. Patients' leaders have become even more incensed that one recommendation from the review is that patients from a practice up for tender should no longer be allowed to sit on the selection panel. The PCT has already denied Mr Dyke's allegation that there was a conflict of interest on the panel. Summary by Keep our NHS Public of Stoke Sentinel 29 January 2007
  • NHS board rejects private GP bid. NHS Lanarkshire has awarded the contract to run a GP surgery to an incumbent GP instead of a private company. If the private bid had been successful the surgery would have been the first privately run surgery in Scotland. NHS Lanarkshire is the second health board to put a surgery contract out to tender since a change to legislation. Summary by Keep our NHS Public of BBC Online 30 January 2007
  • Health trust may hand over most roles to companies. Hillingdon primary care trust in London may become the first to hand over almost all its core functions to the private sector, including the commissioning of millions of pounds of care for National Health Service patients. The move, which is likely to provoke bitter opposition from the health service unions, would see the private sector taking over not just the provision of community services but the assessment, planning, contracting, procurement and performance management of £258m a year's worth of health care for its local population. The primary care trust would retain a few core functions, including patient and public involvement, emergency planning and the handling of contracts. The move would be a big step towards the government's goal of turning the NHS primarily into a commissioning organisation. Provision in future will come from a mix of foundation hospitals, the private and voluntary sectors and social enterprise, but with the independent sector able to take part in the commissioning of care as well as its provision. The trust has insisted the proposal is only one of a number of options that would be put to the board in April. Anthony Sumara, Hillingdon PCT's interim chief executive who was brought in to troubleshoot one of the NHS's worst financial problems in London, was not available for comment yesterday. But he told the Health Service Journal that essentially, "I want to get rid of everything - outsource it". The trust would not be giving up responsibility because it would remain the statutory body, responsible for the outcome of the contracts. It would reduce staff numbers from about 300 to about 30, he said. Hillingdon has an accumulated deficit of £54m on its £258m turnover and has been projecting a further £11m deficit this year. According to papers put to the board last week, "outsourcing the majority of commissioning functions . . . gives the greatest probability of success" in turning that round. He acknowledges, however, that having to pay off £54m in debt will make it difficult to draw up a contract from which private companies could make a profit, and that Hillingdon on its own may be too small to attract private providers big enough to take financial risk on the deal. The NHS is negotiating a framework contract with big UK and US health providers that would allow primary care trusts to access anything from help with number crunching to the sort of "end-to-end" commissioning service that Hillingdon is examining. Nigel Edwards, director of policy for the NHS Confederation, said a number of PCTs were considering enlisting private sector help with commissioning. "But I am not aware of anywhere else considering anything remotely this radical." With NHS commissioning in its infancy, drawing up such a contract would be "quite a challenge", he warned. Summary by Keep our NHS Public of Financial Times 2 February 2007
  • PCT could slash 90 per cent of staff. A troubleshooter chief executive plans to strip an ailing primary care trust down to its core functions and reduce the number of staff from 300 to 30. Anthony Sumara, who has been interim chief executive of Hillingdon PCT since October, proposes to put three out of four commissioning support services out to tender, and to hand clinical services to a new provider. Under the proposals, the PCT would retain only its core functions like governance and emergency planning, as well as patient and public involvement. The move could see the PCT, which has £54m of historic debt, and is predicting an in-year deficit of £11m, reduced from a staff of '300 to 30', he said. But he said the chances of the board agreeing to the move were 50:50. The Proposal to Procure commissioning strategic outline case was published by the PCT on January 23. It states: 'Outsourcing the majority of the PCT commissioning functions gives the greatest benefit and the greatest probability of success,' when compared with three other options: doing nothing, building internal capability and developing synergies with other organisations. If the project gets approval in June the contracts will go out to tender. Mr Sumara told HSJ: 'I want to get rid of everything, outsource it - and we are distancing the PCT from its provider functions.' The government's commissioning framework allows PCTs to choose which areas they wish to outsource. The DoH is expected to publish its list of recommended commissioning experts within weeks. Hillingdon is looking at three of the four main categories identified in the framework: assessment and planning; contracting and procurement; and performance management to ensure better accountability. The organisation is currently working on defining what residual functions a PCT should hold. Mr Sumara said responsibility for monthly emergency planning, managing the outsourcing, governance of money, accountability and development of the market would remain with the PCT. 'You need a PCT because you need a statutory body to receive the money from government. We are also deciding what will happen to the provider side - should it come under the hospital or become a social enterprise ? We will keep public-patient engagement as we have a better idea on how to engage with the public locally and the voluntary sector than, say, [information analysts] Dr Foster,' he said. 'The PCT is not giving up responsibility. We are doing this as part of our recovery and to get some clarity around what a PCT should be doing. It's commercialising, not privatising and the public don't care - it's not about the provider services, it's about men in grey suits. It will still be free at the point of access.' The next step is to develop the outline business case for consideration by the board in April 2007 and appoint a dedicated project team. The strategic outline case states: 'Hillingdon PCT commissioning is currently weak and not fit for purpose. For example, acute providers will continue to over-perform by £9.8m in 2006-07, adding to the historic debt.' Mr Sumara said: 'At the moment it is 50:50 whether it will be approved but I do think it will save us money and I do think it will get the go-ahead. I don't think we are big enough for some companies but they will start with us with a view to providing a service across London.' Some of the risk factors considered in the proposals include: the supplier's set-up costs exceeding the potential gains of the contract; the delivery of financial balance for the PCT taking longer than currently planned; the requirement to repay the historic debt making the contract unattractive to outsourced suppliers; and an adverse reaction from the public. Summary by Keep our NHS Public of Health Service Journal 2 February 2007
  • Questions over Hewitt's role in privatised NHS plan. The Keep Our NHS Public campaign is calling on Health Secretary Patricia Hewitt to stand by her word and call a halt to plans to allow private companies to take over the functions of NHS primary care trusts (PCTs). In a letter to the Guardian on 1st July 2006, following a media storm over a 'stealth plan' to allow private companies to take over the commissioning role of PCTs, Patricia Hewitt wrote: "Primary care trusts are and will remain public statutory bodies responsible for using their growing budgets to commission the best possible services for local people. They can never outsource this responsibility, or ask others to make these decisions for them." It has now emerged that Hillingdon PCT in London has proposed to do exactly that - to hand over almost all of its core functions to the private sector, including the commissioning of care for patients worth millions of pounds, and the provision of community services. The trust's chief executive, Anthony Sumara, said: "I want to get rid of everything, outsource it". This clearly goes far further than Hewitt indicated in her Guardian letter, when she played down the issue by saying that the government merely wanted to make it easier for PCTs to "buy in some management and support services, including the detailed data analysis that helps to underpin sound commissioning". The story first came to light in June 2006, when Keep Our NHS Public alerted the press to an advertisement placed by the Department of Health in the Official Journal of the European Union, inviting companies to bid for the chance to spend substantial chunks of the NHS budget. Following front-page headlines of 'Stealth plan to privatise NHS care' (The Times) and '£64bn NHS privatisation plan revealed' (The Guardian), the government withdrew the advertisement, saying that drafting errors had given the "false impression" that clinical services provided by PCTs would be phased out in favour of the private sector. But the advertisement was resubmitted two weeks later and now Hillingdon PCT plans to use the scheme to outsource its clinical services. This is despite the fact that Patricia Hewitt wrote in her letter to the Guardian: "Most PCTs also employ district nurses, health visitors and many other frontline staff who provide vital clinical services. They are not affected in any way." Alex Nunns of Keep Our NHS Public said: "This blows the lid on the government's plan to privatise the NHS by stealth. When this scheme was first uncovered Patricia Hewitt rushed to deny that the story was true. Now our worst fears are coming to pass. This is the patchwork privatisation of the NHS." Keep Our NHS Public recently released a report, The patchwork privatisation of our health service: a users' guide, which identified the outsourcing of PCT commissioning and care as one of the key threats to the NHS. Summary by Keep our NHS Public of Medical News Today 2 February 2007
  • Asda plans late-night doctors' surgeries. Asda is planning to become the first supermarket to open after-hours GP surgeries in its stores across Britain. The supermarket, owned by US giant Wal-Mart, is in talks with several primary care trusts that could provide emergency surgeries for the company. These would be open throughout the night and at weekends. The Government's recent health White Paper recommended that retailers consider hosting GP surgeries on the high street to make them more accessible for patients. Boots has already announced plans to open daytime surgeries in its larger outlets after a successful trial with the Bournemouth and Poole NHS Trust. It is thought to be planning about a dozen surgeries. Sainsbury's has similar plans. Asda's plans are at an early stage, according to a spokeswoman for the retailer. The company was still in preliminary talks with primary care trusts. Only patients affiliated with local surgeries would be able to use the emergency practices. It might also be possible for a store's pharmacy section to open during the night to serve patients visiting the surgery. Summary by Keep our NHS Public of Independent 4 February 2007
  • PCT plans may move patients into care homes. Patients will be shifted from community hospitals into care homes under radical plans to privatise health services. East Riding of Yorkshire Primary Care Trust (PCT) has drawn up proposals for a major shake-up of healthcare across the county. All beds would be removed from Beverley, Driffield, Hornsea and Withernsea community hospitals. The PCT would then offer 60 overnight beds at three upgraded hospitals - Bridlington, Goole and possibly a new hospital to be built at Market Weighton. A further 50 beds would be moved into private care homes across the county. The PCT has not ruled out closing the community hospitals, which have serviced residents for decades. The move is seen as the latest - and possibly most significant - threat to rural hospitals in the East Riding. In the most recent victory, plans by the PCT to cut beds at Hornsea Cottage Hospital were blocked by the threat of a legal challenge over the way the decision was reached. Once again, people power is seen as the key to saving community hospital services. That was the message from Beverley and Holderness MP Graham Stuart during a recent debate on the issue in the House of Commons. Mr Stuart urged the Government to listen to patients who are angry about plans to axe beds in East Riding hospitals. He said the Government must live up to its promises of considering patients' views and respond to the united call to save services. Summary by Keep our NHS Public of East Riding Daily Mail 5 February 2007
  • All those who wish to see NHS remain a public service will oppose Hillingdon health trust's plan. Dr Peter Fisher, President of the NHS Consultants' Association, writes in a letter to the Financial Times: "If Hillingdon primary care trust hands over the bulk of its work, including commissioning, to the private sector there would be bitter opposition not just from the unions but from all those who wish to see the National Health Service remain a public service, not become a commercial market. It would also demonstrate the total incoherence of current health policy. After the expense of setting up and then reconfiguring PCTs they would become a mere shell, without significant function. What would happen to the much vaunted practice-based commissioning, or has it already been decided to scrap that ? Perhaps it indicates that despite all the inducements, referral management centres and the like, independent sector treatment centres are still under-used and can only be kept afloat by giving the private sector total control of the commissioning process." Summary by Keep our NHS Public of Financial Times 5 February 2007
  • Watchdog condemns deal behind health choice scheme. A groundbreaking deal with the private sector to provide millions of patients with information on the best hospitals and GPs in Britain is condemned today by a parliamentary watchdog as poor value for money and breaking almost every rule designed to protect the taxpayer. The National Audit Office has lambasted the Department for Health for signing an exclusive joint venture with the Dr Foster partnership - the organisation behind the Good Hospital Guide - without putting out the proposal to competitors and paying millions of pounds to the company to develop the ministry's own data. The scheme, personally endorsed by the health secretary, Patricia Hewitt, and former health minister Lord Warner, could, according to advice taken by the NAO, leave Britain facing a court case for giving illegal aid to a private company. The new system was seen as essential to Tony Blair's plan for every patient to be offered a choice of four hospitals for operations. The joint venture company, known as Dr Foster Intelligence, would sell the latest data to health trusts so they could help patients make an informed choice. According to the NAO some £12m of taxpayer's money was sunk into the project with a further £1.7m spent on consultants to evaluate it. This included a £50,000 payment to Dr Foster's partnership, headed by Tim Kelsey and Jake Arnold Foster, to advise them on setting up their own centre. The NAO says the £12m included a strategic premium of up to £4m - which was higher than the financial advisers told the ministry it was worth. Edward Leigh, chairman of the Commons public accounts committee, said: "Taxpayers should be grateful to the anonymous whistleblower who first alerted the NAO to the Department of Health's hole-and-corner deal with Dr Foster." "The department simply paid no heed whatsoever to the rules that are set to protect taxpayer's money ... there was an unseemly urgency to complete the deal ... the truth is that the department and its information centre cannot demonstrate how investment in one company, Dr Foster, rather than any other providing similar services, is to the benefit of the NHS." David Hencke, Westminster correspondent Tuesday February 6, 2007 The Guardian
  • Privatisation is at the root of the crisis. Up to 90 percent of workers at the Hillingdon Primary Care Trust in north west London could be slashed due to the privatisation of the NHS. "I want to get rid of everything, outsource it," trust boss Anthony Sumara told the Health Service Journal. The "outsourcing" will mean that NHS workers - including district nurses, health visitors and community health visitors - will find themselves working for private companies. "Our worst fears are coming true," said Alex Nunns of the Keep Our NHS Public campaign group and author of a new pamphlet on privatisation in the NHS. "What is happening at Hillingdon is a major escalation of privatisation. It's part of the government's plan to turn the NHS into a giant health insurance company. This new privatisation will mean that in Hillingdon private companies are buying health services for the NHS and selling them too - and now they are getting control of the budget. The ultimate goal for a private company is to make profits for its shareholders. It certainly isn't the wellbeing of the patients or the staff. The government is trying to disguise what is going on. It knows that most people don't want their health service privatised so it uses language and terms that most people, including many health professionals, don't understand. That is why Keep Our NHS Public has produced a pamphlet that explains what is happening. We wanted to alert people to the fact that there are dozens of schemes, which form a plan to get rid of the NHS. It will be turned into nothing but a logo. If your MP says that the local hospital is closing because of poor accounting or management, it is important to know how the market in healthcare has been the basis of the funding crisis and how the present government's policies have made matters worse." The "Patchwork Privatisation" Of Our Health Service: A Users' Guide is available from Keep Our NHS Public, c/ o NHS Support Federation, Community Base, 113 Queen's Road, Brighton BN1 3XG. Price £1 or ten for £5. Cheques payable to Keep Our NHS Public. Summary by Keep our NHS Public of Socialist Worker 7 February 2007
  • 3 March is a day to fight for NHS. The trade union day of action for the health service needs to be a focus for the anger of health workers and local campaigners fighting privatisation and cuts in the NHS. There is hardly an area of Britain that is not suffering the prospect of savage cuts to local health provision. In towns and cities there are protest rallies, marches and campaign meetings to save local hospitals and facilities. The need to provide a national focus for this anger and bring workers together with local campaigners could not be greater. The number of local and regional protests planned for 3 March is growing. Already the TUC's NHS Together campaign website (details below) lists 22 events outside the London area. Campaigners in London are also planning action in many parts of the city. A sign of the strength of feeling over health cuts could be seen in Waltham Forest, north east London, last Saturday where up to 2,000 people joined a demonstration against the downgrading of Whipps Cross hospital. Gillian Muir from the Waltham Forest Carers Association joined the march. She said: "They want to move many services provided at Whipps to the new Queen's hospital miles away in Romford. But they cannot tell us how older people, like the ones I represent, will be able to get there. I'm angry at the health authority making these proposals but I'm more angry at the government and I feel betrayed by it. Now they are telling us that maybe they won't move everything at Whipps but instead they will downgrade King George's hospital down the road in Redbridge. That is no answer, it will just put more pressure on the hospitals that remain." Summary by Keep our NHS Public of Socialist Worker 7 February 2007
  • SHA pays £2m for firm to size up PCT commissioning. South Central strategic health authority has called in turnaround specialists PricewaterhouseCoopers to assess whether its nine primary care trusts should contract out their commissioning functions to the private sector. The contract, worth approximately £2m, will run until July and will see PwC analysing the 'strengths and weaknesses' of each PCT's commissioning role. PwC will be charged with a number of tasks including: creating a strategic plan for each PCT to measure success and long-term goals; creating an operating plan which will develop the local delivery plan on a year-on-year basis; creating a capability and capacity plan which will identify areas for improvement so that strategic and operating plans can be successfully executed; understanding the detail of the commissioning function so that PCTs can individually and collectively assess their own particular strengths and weaknesses; specifically identifying areas for building, buying or sharing capacity and capability. South Central SHA's project director for reform Diane Hedges said that the work with PwC would put them in a position to judge which areas of work they outsource to the private sector under the DoH commissioning framework. The DoH list of approved commissioning support suppliers is due to be published soon. Summary by Keep our NHS Public of Health Service Journal 8 February 2007
  • National Audit Office slates DoH over £12m Dr Foster deal. The Department of Health has been savaged by the National Audit Office for the handling of its £12m deal with healthcare information analysts Dr Foster. The public health watchdog said the joint venture between the DoH Information Centre and Dr Foster, announced a year ago, could not demonstrate value for money because the DoH did not go out to competitive tender for the work, ignoring Treasury and Department of Trade and Industry guidance. The NAO said the DoH paid up to £4m more than the value of a 50 per cent share in the joint venture called Dr Foster Intelligence, and up to £1.7m in professional fees. The Information Centre did not obtain a controlling interest in Dr Foster Intelligence in return for this premium - as normally expected. Since the deal was signed, Dr Foster Intelligence has projected profits 50 per cent lower than presented in the business case. In addition, the NAO estimates the size of the health informatics industry at closer to £20m a year than the £325m projected by financial advisers KPMG during contract negotiations. The report expresses particular concern about a £50,000 payment to Dr Foster Ltd for advice about a possible relationship between the Information Centre and the private sector, agreed in March 2005, the same month that the DoH commissioned KPMG to carry out initial due diligence on Dr Foster Ltd and develop a business plan for the joint venture. Discussions began a month earlier, when analysis from the DoH commercial directorate suggested no tender exercise would be required. Group director of strategy and business development Hugh Taylor, now permanent secretary, gained approval from ministers to open up a commercially confidential and without prejudice dialogue with Dr Foster Ltd, the report said. The NAO described an 'urgency' to complete the deal, and confusion about the roles and accountabilities of the Information Centre and the DoH. There was a 'potential for conflict' in the roles of advisers, who were asked to help define the specification for working with the private sector, consider the options among the private sector and start dialogue with Dr Foster. Its conclusion was damning about the damage caused to the current market in healthcare information and the possibility of restoring a level playing field. The DoH said it had followed legal advice. The venture was not primarily about financial gain, but 'to harness private sector dynamism, efficiency and effectiveness'. Summary by Keep our NHS Public of Health Service Journal 8 February 2007
  • Private sector faces curbs on NHS role. Patricia Hewitt has spelt out strict limits on the role of the private sector in the commissioning of care for National Health Service patients. The statement was seen as a sign that some of the drive for growing private sector involvement in the NHS might be slowing in the run-up to Gordon Brown's anticipated arrival at Number 10. The Department of Health confirmed that plans would go ahead to allow primary care trusts to contract out some or all of their commissioning work - purchasing care for NHS patients from hospital, community and primary care services. But in a significant caveat, it said that only in "exceptional circumstances" would the private sector be allowed to undertake "end-to-end" commissioning of all patient services - as opposed simply to helping with number-crunching or contract management, for example. A programme board to oversee the private sector's involvement and to "manage" the take-up of private sector services is to be set up by the department. Part of its job will be to "ensure" that PCTs that want to outsource their entire commissioning function in the way that Hillingdon in west London is considering, for example, will have to satisfy very tough criteria. They will need permission not just from the local strategic health authority, but from the department. If and when they get the go-ahead, PCTs will only be able to transfer minimum amounts of risk - and therefore of potential profit and loss - to private sector providers, although that might be extended after a minimum of two years and following evaluation. One big potential bidder described the DoH document as "discouraging". The stipulation that only small amounts of risk could be transferred was "illogical", its chief executive said, when the biggest gains were likely to come from allowing the private sector to undertake the full commissioning role. "There may well be less enthusiasm for this than there was," he said. Chris Ham, professor of health services management at Birmingham University and a former head of strategy at the DoH, said that the NHS left to its own devices "is traditionally very slow to embrace the private sector". "The only reason independent treatment centres are up and running is because they were driven through by ministers and special advisers. What this document appears to indicate is a marked dilution in the political drive to bring the private sector into commissioning. That probably means a much smaller and weaker role for private sector companies than seemed likely when the policy was first announced." Summary by Keep our NHS Public of Financial Times 9 February 2007
  • Jobs to go at private hospital. The Manor Hospital in Headington has confirmed that it plans to close two out of four wards and two out of six operating theatres, however it is still unclear how many staff will go. The hospital, part of the Nuffield Hospital Group, has denied that the move is due to a slump in NHS work. This is the third round of redundancies at the hospital since it opened. Summary by Keep our NHS Public of Oxford Mail 13 February 2007
  • Drug firms urged to stop blocking blindness cure.  Hewitt wants NHS to get treatment used elsewhere.  Expensive alternative costs £1,000 a shot. The health secretary Patricia Hewitt has taken the unprecedented step of telling two drug companies that are blocking a cheap cure for blindness from use in the NHS that they should put it through clinical trials and seek a licence. Ophthalmologists in the US and the rest of Europe are successfully using a bowel cancer drug called Avastin, split into tiny doses, to save the sight of thousands of people with a common condition that quickly leads to a loss of vision. The injections can cost as little as £10 and often only a couple are needed to treat the illness, wet macular degeneration. But Genentech, the manufacturer, and Roche, which markets it in the UK, will not put the drug through the trials necessary for it to get a licence in the UK. Instead, Genentech has produced a far more expensive version called Lucentis, which costs more than £1,000 a shot and needs monthly injections. Lucentis recently got its European licence and is now being appraised by the National Institute for Clinical Excellence. But the bill to the NHS, if it is approved for general use, will be huge. According to consultant ophthalmic surgeon Michael Lavin from Manchester Royal Eye Hospital: "If all patients with wet AMD in the UK were treated with standard dose Lucentis costs to the NHS by year two would be approximately £1,008m a year; if Avastin were used the cost would be about £4m a year.  Sarah Boseley, health editor Thursday February 15, 2007 The Guardian
  • 'Exceptional circumstance' clause for PCT outsourcing. Primary care trusts will only be able to outsource all of their commissioning expertise in 'exceptional circumstances', with plans to be signed off by the Department of Health. A policy statement published last week introduced stringent conditions under which PCTs could fully outsource commissioning support. Last September, PCTs were told they could outsource micro, macro or 'end-to-end' packages of commissioning support, variously representing one service, more than one related services or 'a complete package of services' which would leave the PCT with only its statutory functions. The framework for procuring external support for commissioners, published last week, sets out significant limits to this. PCTs would only be able to outsource the 'end-to-end' package of all functions in 'exceptional circumstances'. Such proposals would require sign-off from DoH director general of commissioning Duncan Selbie, as well as the local strategic health authority. The document says a number of payment models should be used when procuring services, to provide an incentive to the supplier to deliver value. It adds: 'This requires the supplier, in some circumstances, to accept similar financial risk that the PCT faces as a commissioner.' But PCTs that do outsource the full 'end-to-end package' of all support functions, will not transfer high levels of risk to the private sector for two years. A list of approved commissioning support suppliers is expected to be published by the DoH shortly. Summary by Keep our NHS Public of Health Service Journal 15 February 2007
  • The World Health Organisation, the drugs company and the $10,000 funding offer.  Patients' group 'was asked to act as covert channel'.  UN body denies attempt to bend donation rules. The World Health Organisation is facing allegations that it attempted to secure a $10,000 (£5,100) donation from a drugs company by asking a patients' group to act as a covert channel for the funds, in the light of documents published today. The alleged arrangement would have broken the WHO's own rules on accepting money from the pharmaceutical industry. Emails between Benedetto Saraceno, the WHO's director of mental health and substance abuse, and the European Parkinson's Disease Association appear to suggest that the WHO was willing to take $10,000 from Britain's biggest drug company, GlaxoSmithKline, to help pay for the preparation of a report on neurological disorders, for which GSK makes drugs. However, Dr Saraceno made it clear that the money must pass through the coffers of the EPDA first because of the rules on WHO accepting drug industry funding. Michael Day and Sarah Boseley Friday February 16, 2007 The Guardian
  • UK firm chosen to run GP services. A UK-based company has been chosen to run a primary care centre in north Derbyshire, health officials announced. ChilversMcCrea Healthcare was chosen as the preferred bidder to take over GP services at Creswell and Langwith by Derbyshire County Primary Care Trust. The original decision to award the contact to US-based United Health Europe was made in early 2006. However, a judicial review ruled in August that the consultation process was "flawed". The Appeal Court ruled that Derbyshire County PCT should take a fresh look at its tender process. Scarcliffe Parish Councillor Pam Smith, who took the case to a judicial review, said she was not pleased with the decision. "It's not right for the people of Langwith. We went to court to stop it being taken over by a private company. We'll see what happens, I hope they will come and meet the people and explain what they want to do here but we'll be ready to take action if we're not happy," she said. The PCT will now enter into detailed contract discussions with ChilversMcCrea Healthcare. The company currently manages a range of NHS practices and health facilities across England. Summary by Keep our NHS Public of BBC Online 16 February 2007
  • Leeds private treatment ban. A primary care trust has removed the right of its patients to go to local private hospitals for NHS treatment, claiming they cost too much. The local Bupa and Nuffield hospitals in Leeds have treated hundreds of NHS patients over the past year, but general practitioners have been told to stop referring patients to them to help the trust "ensure we meet financial balance at the end of this financial year". The decision by Leeds primary care trust to remove the local private hospitals from its "choose and book" system has been greeted with disappointment by Bupa and Nuffield. NHS patients are being denied access to them just as more private hospitals are being added to the so-called "extended choice network" to which any patient can be referred. Leeds PCT claims it pays "a premium" to the private providers of 4% over the NHS price. But both Bupa and Nuffield argue that this is merely the so-called "market forces factor" that makes allowance for higher costs in Leeds compared with other parts of the country, and is in practice paid to the local NHS as well. Meanwhile, the trust is still referring patients to a local privately run independent treatment centre whose prices are higher than either the Bupa or Nuffield hospitals. This is because the centre is on a "take or pay" contract with the NHS, so that, according to a spokesman, the primary care trust "will still pay for any unused activity there". Summary by Keep our NHS Public of Financial Times 17 February 2007
  • Unison seeks end to market incentives. Britain's biggest health service union has called for a halt to the government's introduction of market-based incentives to the National Health Service and the ever-increasing use of private sector providers. Ministers were "allowing multinational companies to bleed the NHS dry," according to Dave Prentis, Unison's general secretary. He said the involvement of private sector firms was "destabilising the NHS and leading to widespread financial problems". The union's call comes in a report which acknowledges much of what the government is seeking to do - enabling patients to switch to better providers of care, making services more responsive, driving down costs and ensuring that those who fail to achieve higher standards are forced out of business - "sounds attractive in theory". But it says there is "real evidence for doubting that the new market will work this way in practice". The transaction costs of the new system, while largely unknown, were likely to be high, Unison said. There were no clear mechanisms to prevent organisations skimming off the most financially attractive patients. Regulation of the new market remains fragmented and unclear. And it is unlikely that providers can respond rapidly enough to changes in demand for services. High quality care increasingly depends on collaboration through networks. But the new market demands competition and threatens care continuity, Unison said. The better off are more likely to be able to exercise choice. Meanwhile, private providers have been paid above NHS prices to attract them into the market while the NHS last year ran a £500m-plus deficit. Mr Prentis said while independent sector treatment centres were being paid regardless of whether or not they treated all patients for whom they have contracted, "we have the obscene situation of NHS scanners and equipment lying idle, while trusts struggle to survive under payment by results without knowing what their income will be. We want a halt to privatisation, and an independent review into the impact of the market on the NHS." Summary by Keep our NHS Public of Financial Times 19 February 2007
  • Private sector 'bleeding the service dry'. Britain's largest trade union is calling for an investigation into what it claims are the "obscene" profits being made by private companies from the NHS. Unison said a "black hole" was opening up in the health service's finances because of the millions of pounds being made by such companies. A report published by the union described as a "damning expose" of damage being done by untested hospital reforms. Dave Prentis, General Secretary, said: "The Government is allowing multinationals to bleed the NHS dry. . . wards and whole hospitals are threatened with closure, the jobs of nurses and health workers are disappearing." Mr Prentis said that £5bn was going into private sector treatment centres that were at the root of the problems. Ivan Lewis, Parliamentary Under Secretary of State for Care Services, said the report was inaccurate. He said: "Independent provision brings extra capacity and efficiency. More than 250,000 NHS patients to date have either been treated by or received a diagnostic service faster then they would have otherwise done thanks to the independent sector. It is also nonsense to suggest that the jobs of nurses and health workers are disappearing. The latest returns show that of the 903 compulsory redundancies, only 136 were clinical staff, and overall the number of staff employed by the NHS has expanded by 306,000 between September 1997 and September 2005." Summary by Keep our NHS Public of Times 19 February 2007
  • Drug companies accused of overcharging the NHS. The Office of Fair Trading (OFT) has issued a long awaited study that reveals that the NHS is paying pharmaceutical companies up to ten times too much for some drugs. The study calls for an overhaul of the Pharmaceutical Price Regulation Scheme (PPRS) to ensure the NHS receives value for money. The NHS spends around £8billion a year on branded prescription medicines but the OFT has identified a number of cases where drug prices are "significantly out of line with patient benefits". The OFT recommends that the current scheme, where companies are able to set their own prices within broad profit constraints, should be replaced with a "patient-focused value-based pricing scheme", a step which it is claimed could save up to £500m. The move would also give companies stronger incentives to develop drugs for conditions where there is the greatest need. John Fingleton, chief executive of the OFT, said: "Focusing prices on the needs of patients rather than on the costs of drug companies would be good for both patients and business. It would allow more patients better access to more effective treatments and it would focus drug company innovation and investment on the areas where patients need it the most, creating more valuable drugs in the future." The Department of Trade and Industry now has 120 days to respond to the recommendations in the study. The OFT's study is a damning indictment of the PPRS scheme which results in slightly higher average prices than in countries such as Germany or France. Pharmaceutical companies have defended the scheme as providing stability for a vital British industry, with each five-year renegotiation allowing them to introduce products with confidence in continued demand for them whilst also providing the opportunity for price cuts. Defending the scheme from the study's criticisms, pharmaceutical companies claimed that the NHS medicine bill was growing due to increasing need and not price. Commenting on the OFT's report, a Department for Health spokesman said it would "study its recommendations carefully". He went on to say: "It is important that we have fair prices, which give value for money to the taxpayer. However, we recognise the importance of the pharmaceutical industry to healthcare and the development of medical advances and it is in all of our interests to encourage research and reward innovation." Summary by Keep our NHS Public of Times 20 February 2007
  • Watchdog questions drug prices. The NHS is wasting at least £640m a year by overpaying the major pharmaceutical companies for drugs, the Office of Fair Trading said yesterday. The finding came in a report which urged an overhaul in the way that drug companies charge the NHS for treatments. In some cases the OFT found branded drugs such as statins being prescribed that were 10 times more expensive than generic alternatives that delivered essentially the same benefits to patients. Switching to a generic instead of the Pfizer cholesterol treatment Lipitor could have saved the NHS £350m in 2005 alone, the report said. It could have saved £28m by switching to a generic instead of paying for the AstraZeneca drug Crestor and a further £11m if it had bought a generic instead of Pfizer's high blood pressure treatment Cardura XL. Between 2000 and 2005 the NHS drugs bill grew at an average annual rate of 7.3%. The report identified at least £575m in possible savings where generic alternatives existed to branded drugs in certain categories.  David Teather Wednesday February 21, 2007 The Guardian
  • Commissioning is going private. Signs that PCTs are taking the first steps towards outsourcing commissioning have led to renewed fears for GPs' role in the process. South Central Strategic Health Authority (SHA) announced it had commissioned the consultancy PriceWaterhouseCoopers (PWC) to work with its nine PCTs to identify the 'strengths and weaknesses' of their commissioning role. A spokesman for the SHA said PWC would be paid £2m over five months to develop a strategic plan for each PCT and 'specifically identify areas for building, buying or sharing capacity and capability'. The spokesman added: 'It's possible that, in the future, the commissioning function of PCTs could be outsourced. But that decision will be made by PCTs themselves further down the line.' Alex Nunns, of pressure group Keep Our NHS Public, described the move as 'pernicious'. He added: 'It looks pretty clear that South Central has decided that its PCTs should be outsourcing commissioning, but it's got the management consultants in to tell them what to do and how to do it. We see this as a big step on the road to privatisation. Pressure is coming from above - from the Department of Health and the SHA - to force the local NHS to hand over its responsibilities to the private sector.' In June 2006, the DoH was forced to withdraw an advertisement inviting companies to bid for commissioning services after claims of privatisation by stealth. However, two weeks later, a watered-down version of the advert reappeared in the Official Journal of the European Union. The DoH is due to publish a list of companies that would be eligible to bid for commissioning services. In London, Hillingdon PCT has said it wants to hand over most of its core functions to the private sector, including commissioning. Dr Michael Dixon, chairman of the NHS Alliance, said: 'Private commissioners could open up a competitive market that's harmful to local services, while people offering good continuity and personal care get thrown out.' Summary by Keep our NHS Public of Doctor Update 21 February 2007
  • Tie drugs fees to benefits, urges OFT. A wide-ranging overhaul of the drug pricing scheme that would tie the price of medicines more closely to their impact on patients' health has been urged by the Office of Fair Trading. In the conclusions to a study conducted over the past 18 months, the OFT called for a long-term shift towards "ex ante value-based pricing", which would set prices based on a review of the clinical and cost effectiveness of drugs and review them again periodically as new data became available. It recommended the scrapping after 2010 of the current pharmaceutical price regulation system, which has determined the rules over the past 50 years, allowing drug companies to set prices freely while capping their profits and introducing periodic price cuts. It also rejected the argument from the pharmaceutical industry that the PPRS provided incentives for research and development, and argued that its approach to pricing would more directly stimulate investment in innovation. The OFT cited price differences of more than 500 per cent between different drugs with similar effects, and estimated that switching to more cost-effective medicines could have saved the NHS more than £500m in 2005 alone, out of total drugs spending in that year of £11bn. It suggested branded drugs that had come off patent should be reimbursed at up to 25 per cent above the price of generic drugs to maintain a stimulus to increase generic prescribing. The OFT suggested an initial pricing mechanism based on available data or a risk-sharing arrangement with the price subject to change as new data became available. Rejecting an argument from the pharmaceutical industry that this process would delay launch and defer access to new drugs for patients in need, it said most countries already used such an approach with the exception of the UK and Germany. Summary by Keep our NHS Public of Financial Times 21 February 2007
  • Private UK firm wins practice. UK-based private company ChilversMcCrea has been awarded a controversial contract for a Derbyshire practice. The original decision to hand the practice to the European arm of US giant UnitedHealth Europe was overturned in court. Derbyshire County PCT was forced to repeat its tendering process after a judicial review ruled that managers had not properly consulted local patients before awarding the contract for services at Creswell and Langwith in Derbyshire. Some patients had been concerned that a private company might put profits before patients and not provide continuity of services. This time the PCT arranged public meetings and sent questionnaires to all patients seeking their views. Six bidders were interviewed, including three private providers and three local GMS/ PMS providers. Dr Elizabeth Barrett, a GP from Shirebrook, who bid for the practice with another GP, a pharmacist and nurse, said: 'I'm disappointed. Some patients worry the surgery may just have a series of doctors that act like locums, and that there will not be continuity.' Summary by Keep our NHS Public of Pulse 22 February 2007
  • NHS protests. Unions are to hold rallies in defence of the NHS. Unison is holding the protests on March 3rd at Castle Park in Bristol and also in Chippenham as part of a national Day of Action. Regional organiser, Liz French, said: "This event has been organised as one of many to demonstrate the strength of public feeling against cutbacks and privatisation." Candlelit vigils are also being held on March 2nd at Bristol Royal Infirmary and Gloucester Royal United Hospital. Summary by Keep our NHS Public of Western Daily Press 22 February 2007
  • NHS torchlight post. More than 100 people have taken part in a torchlight march and rally in support of the NHS. The event, organised by Merseyside TUC together with NHS Together, saw marchers, armed with torches, making their way from the Royal Liverpool Hospital to the William Brown Street fountain, to listen to speakers. Derek Jones, who works at Wirral Hospital Trust, said: "The idea about this and other events that will be going on for the rest of the year is to raise public awareness about the true extent of the changes the Government is forcing on the NHS. The Government is trying to create a free market in the NHS and free markets are based on instability. Who would want instability in a service like the NHS ? We want to encourage the public to lobby the Government and their local MPs to prevent the unbridled march of the privatisation of the NHS." Summary by Keep our NHS Public of Liverpool Daily Post 23 February 2007
  • 'Dishonest and disingenuous'. 88 per cent of NHS chief executives surveyed by the Health Service Journal thought the government is overly impressed by the private sector; 91 per cent thought the playing field on which the private and public sectors compete was unfair; 26 per cent believe the introduction of private providers into the NHS will end in privatisation. Inept, poor and dishonest was the verdict from trust chief executives asked for their views on ministers' handling of NHS finance. The survey of 97 chief executives from acute, primary care and mental health trusts shows frustration at the perceived failure of ministers to take responsibility for their part in creating the financial challenges now facing the NHS: 79 per cent said the government was trying to dodge the blame for its own financial problems by blaming trusts; 58 per cent believe the NHS would not be facing such severe financial problems if the government did not set such inflexible targets; 87 per cent said ministers use managers as scapegoats to hide their own inadequacies. Top-slicing and resource accounting and budgeting, in which trusts' deficits are deducted from the next year's budget, were particular causes of frustration aired in the survey. The survey shows that while the NHS plan published by Alan Milburn in 2000 was widely accepted as a good idea, the delay in introducing funding to accompany it diminished its impact. Overall, 72 per cent of those surveyed agreed that the plan achieved a consensus that is 'totally lacking' in the current reforms and 86 per cent said targets had transformed the experiences of NHS patients. Summary by Keep our NHS Public of Health Service Journal 1 March 2007
  • PCT is stuck with OOH firm. Cornwall and Isles of Scilly PCT looks likely to have little choice but to continue with its out-of-hours contract with private provider SERCO, despite undertaking a 20-day review. The PCT is reviewing the con-tract, which still has two years to run, because of continuing concerns about the service. Last week concerns reached Parliament with MPs holding a spe-cial debate on the service in Westminster Hall. However, the PCT was unable to detail what alternative services it could put in place if SERCO was found not to be fulfiling its contract. 'We have not ruled out any possibilities,' a spokesperson said. SERCO took over from GP co-operative KernowDoc, which had been providing the service for nine years, in April 2006 because it could provide it more cheaply. Dr Andy Stewart, a GP in Callington and Gunnislake, east Cornwall, who was one of the founders of KernowDoc, said he did not think GPs would now want to step in and take over. 'I don't think anyone would be prepared to,' he said. Ninety per cent of GPs believe the quality of the out-of-hours service has worsened since SERCO took over, a survey by MP for Falmouth Julia Goldsworthy found. The survey by the Liberal Democrat MP also found that nearly 80 per cent of the 70 GPs who replied were receiving more complaints about out-of-hours services since SERCO took over. Matthew Taylor, MP for Truro and St Austell, told the debate in Westminster Hall last week that formal complaints had risen from four a month to up to 27 a month. Summary by Keep our NHS Public of Pulse 1 March 2007
  • Hospital 'for sale' stunt. Health workers are to erect a giant "for sale" sign outside Leeds General Infirmary, as part of a national day of action organised by new alliance NHS Together, which brings together trades unions and medical organisations opposing the privatisation of the NHS. The organisation is organising events across the country including in London and Bristol. Leeds also has the Leeds Keep Our NHS Public (KONP) campaign which is seeking to highlight the sale of NHS property and land. In a statement the group said: "On Saturday we will also be handing out leaflets and petitioning against the escalating round of sell offs. In particular we will be highlighting how Hospital Trusts and other NHS agencies are using land and property sales to solve short term financial deficits." Summary by Keep our NHS Public of Yorkshire Evening Post 2 March 2007
  • Protesters march against NHS privatisation. Protestors took to the streets of Hampshire to get their campaign against the privatisation of the NHS noticed. Noisy marches took place in Winchester and Lymington, amid the busy shopping crowds. The events were organised by public services union Unison as part of the nationwide NHS Together Day of Action and were attended by healthcare workers and supporters. In Lymington, the protest was against the privatisation of the new Lymington New Forest Hospital. Bobby Noyes, chairman of the Southampton Unison health branch, added: "There was no consultation concerning the private company that's going to be taking over the running of Lymington hospital. The Department of Health just told the PCT that the hospital was going out to tender in the private sector. It means we will finish up with a dual system of healthcare." Summary by Keep our NHS Public of Hampshire News 5 March 2007
  • MPs quiz Dr Foster's 'cosy relations' with Whitehall. The Department of Health struck a £12m deal with healthcare analyst Dr Foster without talking to any of the firm's rivals, it has emerged. The disclosure came as MPs accused the government of having 'very cosy relationships' with Dr Foster. They examined the role of Matt Tee, who was seconded to the DoH as acting director of communications while in Dr Foster's employ, and the relationship between Jake Arnold-Forster, chief executive of the Dr Foster joint venture, and Josh Arnold-Forster, who was John Reid's special adviser from 2005-06, when former health secretary Mr Reid was defence secretary. HSJ has established that the two are brothers. The Commons public accounts committee last week held an inquiry on the joint venture between Dr Foster and the DoH information centre, following a damning report last month from the National Audit Office. At the hearing, permanent secretary Hugh Taylor told MPs that the £2m spent on market analysis before the deal to create Dr Foster Intelligence was agreed did not include any dialogue with any of Dr Foster's competitors, and that research on its main rival, benchmarking company CHKS, was 'essentially desktop-based'. Mr Taylor was DoH group director of strategy and business development when he gained agreement from ministers to enter discussions with Dr Foster over the deal. MPs also questioned Mr Taylor and information centre chief executive Professor Denise Lievesley about relationships between Dr Foster and the government, which Labour MP Ian Davidson described as 'very cosy'. In particular, Mr Davidson raised the question of whether anyone at the company 'could be considered to have had some sort of inside track to the NHS or to government by being a special adviser or anything similar'. Mr Taylor said: 'Could I say that it is certainly the case that members of Dr Foster, before we did this deal, saw it as part of their job to be well networked, to have dealings with ministers, special advisers and so on ?' Questioned about whether any of these were specifically special advisers, he said no, but asked whether there was 'anything similar that could cause concern and a feeling that they had an inside track which was not available to anyone else', he brought up a Private Eye story examining the move of a Dr Foster employee into the DoH. After stressing that there was 'no particular issue about that', he later confirmed that Matt Tee, now DoH communications director, was given the job on an acting basis while on secondment from being business development director of Dr Foster's. Summary by Keep our NHS Public of Health Service Journal 8 March 2007
  • United on the streets in day of protests. With placards, banners and, in some cases, daffodils, campaigners took to the streets on Saturday to protest over NHS job cuts, service closures, marketisation - all were targets of the day of action which saw rallies and marches take place across England and Northern Ireland. The events were co-ordinated by NHS Together, an alliance of organisations representing staff working in the health service, along with the TUC. According to TUC general secretary Brendan Barber, who addressed marchers in Sheffield, the government is in danger of squandering political credit earned through higher investment and improved services. He said ministers should take action to deal with financial problems, should stop imposing constant change and should move away from the current direction which was leading to fragmentation of the NHS. Health secretary Patricia Hewitt came under particular fire. She might have found Crawley in West Sussex - where she was strangled in effigy - particularly painful. Apart from inflicting symbolic violence, campaigners used many methods to get their message across. One intrepid group from Cumbria braved the mist and rain to unfurl the NHS banner atop England's third-highest peak, Skiddaw. Others employed street theatre, stilt walkers and steel bands. Summary by Keep our NHS Public of Health Service Journal 8 March 2007
  • Bid to stop 'piecemeal privatisation' of NHS. Green Party members have been protesting in Huddersfield about the privatisation of the NHS. Kirklees Green Party were at Cloth Hall Street on Saturday to collect signatures on a petition against the 'piecemeal privatisation' of the NHS. They are one of many groups that have come together under the umbrella organisation Keep Our NHS Public. Saturday was a national day of action for the Keep Our NHS Public supporters. The group is concerned about the increase in the commissioning of services such as cleaning from private providers in the NHS. They are also worried about plans to change the way primary care trusts commission services. Lesley Hedges, Green Party candidate for Golcar, cited the situation at Slaithwaite Health Centre as an example of the changes in the NHS. A 13-week consultation was launched in Slaithwaite last month about how the practice should be run in future. Kirklees Primary Care Trust, which currently manages the practice, has several options, including tendering out the practice to GPs or independent organisations and commissioning services from them. Ms Hedges claimed: "The NHS is being reorganised now so that it can be put out to tender in the private sector. It is the whole health service." Ms Hedges, who has worked in health since 1969, said protesters feel that private companies would be more concerned about profits for their shareholders than healthcare standards. Her fellow protester Paul Cooney, Green Party candidate for Greenhead, added: "Even when services are free to the patient, they will be paying more through taxation so that companies - many based in the USA and Europe - can pay a profit to shareholders." They said people in Huddersfield were keen to sign the Keep Our NHS Public petition. Ms Hedges said: "The response was amazing. People really wanted to sign. It is quite clear to those of us who talk to people in our communities that the public do not want these changes." Ms Hedges said the protesters fear that if the changes are put in place, it would be difficult to make the NHS totally public again in future. "It will be very difficult to change back to a genuinely public health service. It may even be impossible, because of the massive cost that would be involved in compensating private companies so that services can be taken back into public ownership." Summary by Keep our NHS Public of Huddersfield Daily Examiner 8 March 2007
  • Mini hospital raised in parliament. Plans to develop a privately-run mini hospital in Basildon are now being reviewed by the Government. Billericay Tory MP John Baron fears the centre would take cases away from Basildon Hospital, losing it £11m a year. But after raising the issue in Parliament, the shadow junior health minister has been assured the decision to develop a health centre for NHS patients at Festival Park industrial area is not "irrevocable". The pledge followed a Parliamentary debate about the NHS and private sector, in which Mr Baron accused the Government of forcing the centre on Basildon. The news comes just a week after plans for the centre were up in the air and might not even end up in Basildon. Mercury Health has been chosen by the Department of Health as the most likely firm to win a £36m contract to develop three centres in Essex, initially proposed for Basildon, Braintree and the Phoenix Hospital in Southend. The firm has just a week left to produce its final business case. Summary by Keep our NHS Public of South Essex News 9 March 2007
  • New man at NHS supplier CSC will keep health service job too - BMA warns he must 'declare conflict of interest'. CSC, a key supplier to the NHS's £12.4bn National Programme for IT (NPfIT), has appointed two NHS managers to beef up its UK healthcare business - one of whom will continue to work for the NHS as well. CSC is the lead contractor for three of NPfIT's five regions, following the pull-out of Accenture last year. The IT contractor named Pearse Butler, formerly chief executive of the Cumbria and Lancashire strategic health authority, as director of clinical engagement, while Rajan Madhok, medical director at Manchester primary care trust, has been appointed clinical director, in a move CSC said would support its approach to engaging with health professionals. But Madhok will retain his NHS post, and will "divide his time between his new position at CSC and his duties as medical director of the Manchester PCT", the company said. Dr Richard Vautrey, IT lead on the British Medical Association's GP negotiating committee, warned that Madhok should "declares his conflict of interest in any settings where it may be necessary for him to do so". Pearse Butler was a senior representative for NPfIT's North West and West Midlands region - one of three where CSC is lead contractor. The Cumbria and Lancashire SHA was abolished in an NHS reorganisation last year. Butler has also been chief executive at an acute hospital trust. Summary by Keep our NHS Public of Computer World UK 12 March 2007
  • Calls for clarity on NHS market strategy. The two big regulators of NHS and private care have warned that Ministers must be clearer about how far they want to use competition within the NHS. The extent to which market forces are to be applied to the NHS will be critical for what role the new regulator intended to cover the emerging market in the NHS will take. The outcome is also likely to be a strong indicator of how far Gordon Brown wants competition and the private sector to be involved in the NHS if he becomes prime minister. "It is clear that the new regulator will have a competition function," said Anna Walker, the Healthcare Commission's chief executive. "But it is not clear from the department's document whether the function will be to police anti-competitive behaviour, or to promote competition. These two roles are very different." The foundation trust regulator, Monitor, echoed her comments in its response to the healthcare regulation review saying: "Our view is that greater clarity is needed and that you need to decide on the policy before you can decide how to regulate it." Summary by Keep our NHS Public of Financial Times 15 March 2007
  • OOH contract ultimatum. A second out-of-hours provider has been told by the PCTs buying its services to implement wide-ranging improvements or risk losing its contract. The news came as the RCGP criticised out-of-hours services generally as 'confusing, fragmented, and of highly variable quality' and warned urgent action was needed to restore confidence in provision. Urgent Care 24, a not-for-profit organisation, has been told by Liverpool, Sefton and Knowsley PCTs that it must improve its staff training, operating and reporting procedures, and demonstrate its triage procedures by April. The PCTs told Pulse they would take up their option of putting Urgent Care 24's contract out for re-tender in October if adequate improvement is not shown within a month. The move follows a similar review of out-of-hours contractor SERCO by Cornwall and the Isles of Scilly PCT. Dr Rob Barnett, Liverpool LMC secretary, said: 'The LMC is aware of the fact that a number of GPs and practices have expressed concern at the way the organisation is run as well as the way the service has responded to requests from patients out of hours.' The GMC is leading the investigation into the death from cardiomyopathy of a patient under UC24's care. Summary by Keep our NHS Public of Pulse 16 March 2007
  • Fruit, veg and a trip to the GP as stores are asked to open surgeries. Leading retailers such as Boots and Tesco will be invited to bid to open GPs' surgeries in their stores in areas with too few doctors under an initiative to be announced by the health secretary, Patricia Hewitt, today. Advertisements calling for "experienced healthcare providers" to apply for four contracts initially worth £30m over five years will be placed in the national and local press this month. Entrepreneurial GPs, social enterprises and companies in the FTSE 100 will be asked to apply. But supermarkets will have to team up with existing GP groups before they can be considered. The expectation is that supermarkets would provide the space for GPs to open surgeries within their stores, an idea in which several have expressed interest. The initiative, first mooted in the 2006 health white paper, is designed to increase the number of GPs in deprived areas that have the fewest doctors. Sarah Hall, health correspondent Monday March 19, 2007 The Guardian
  • 'Personal' public services launched. Prime Minister Tony Blair heralded the introduction of "truly personalised" public services as he launched the Government's long-awaited policy review. He said there should be a "much greater diversity" of providers, moving away from the monolithic state just as industry had moved away from mass production to customised choice for consumers. Mr Blair, flanked by his likely successor Gordon Brown, Health Secretary Patricia Hewitt and Education Secretary Alan Johnson, unveiled the document which a No 10 aide said was designed to help complete the New Labour "project". Proposals include the new walk-in GP centres, possibly in supermarkets, to combat shortages. Summary by Keep our NHS Public of Express 19 March 2007
  • When gold won't buy quiet. A leading article in the Guardian reads: "The chaos facing junior doctors applying for training posts, which is the immediate cause of the weekend protests, is just the latest in a line of difficulties. Deficits requiring cutbacks in parts of the country have been aggravated by an inflexible accounting system. The new GP contract was negotiated with insufficient regard to value for money - as doctors' pay rose, their responsibility for out-of-hours care was actually reduced - and the public accounts committee is expected to conclude tomorrow that the deal has now overshot its planned costs by £300m. The concern in the NHS, however, is that the policies of a government determined to flex muscle and show that it is grappling with reform are aggravating the risks. David Cameron has been quick to pick up on this, highlighting the repeated redrawing of health authority boundaries and responsibilities, which has indeed been an unhelpful distraction. Yet looking ahead, the main driver of instability is set to be the ongoing move to market-based healthcare, to which the Conservatives are every bit as committed as Labour. Hospitals have already started the shift from fixed funding to a system where they are paid for each procedure they perform, and the prime minister is expected to set out plans to involve the likes of Boots and Tesco in running GP surgeries. As the purse strings tighten after 2008, the private sector will increasingly be substituting for, rather than adding to, established NHS provision. At that point - even if, which is not certain, the reforms successfully grind out greater efficiency - they might become unpopular. The change is more rapid than that in any other country. When he takes the reins, Gordon Brown may slow the pace. Medics would welcome that, but it might serve his own interests too." Summary by Keep our NHS Public of Guardian 19 March 2007
  • Blair warns Labour to continue his reforms. Tony Blair will warn Labour not to "turn back" from his public service reforms after he stands down but to extend them for more "personalised" services. Unveiling the findings of the Cabinet's policy review on public services, Mr Blair will promise to speed plans to extend choice in the NHS, so patients will be able to be treated at any hospital they choose, including private ones. This was to take effect in December next year but will be phased in earlier. Other plans include "real engagement" with parents and allowing people to choose their GPs. Mr Blair argues that the Government should not "turn back and eschew further reform" but must "draw on the lessons learnt from what has been done so far and continue with the underlying mission to personalise and empower". Summary by Keep our NHS Public of Independent 19 March 2007
  • Press statement 20 March 2007:
    "
    One week today, on the 27th March 2007, the Save Frenchay Hospital Group, who are in support of a legal challenge on the failure of South Gloucestershire PCT and the SHA to consult on the proposal to implement an independent sector surgical hospital in South Gloucestershire will be attending the High Court at midday to witness the proceedings and we should arrive there by midday. It is possible that the proceedings will extend over two days but due to work commitments, the SFHG members can only attend on the first day. We would like to point out to the media that, if the challenge is successful then it will benefit patients and public throughout the country as it will ensure that no substantial variation to healthcare provision can take place without prior consultation with the public. This challenge is an attempt to restore our right, as enshrined in the Health and Social Care Act 2001, to influence the way our healthcare is provided by the NHS. In addition, we have a number of allegations of maladministration currently being dealt with by the Deputy Parliamentary and Health Service Ombudsman, Trish Longden. This challenge is of paramount importance at this time, as we hope to bring an end to the way in which the public is being ridden over roughshod by the NHS. We hope that you will give due prominence to this challenge by all means at your disposal."
  • Retailers fail to embrace Blair's GP plan. Retailers including T