Cumbria and Lancashire Strategic Health Authority

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The summary articles in the table below related to the strategic health authority area are copied from the following pages, indicated in the table by key numbers.

  1. Charges
  2. Construction projects
  3. Resource shortfall Sources
  4. Treatment approval or not
  5. Withdrawal of Local Facilities - Sources
    Other
1 2 3 4 5

Summary articles

          Health managers are blamed for a catalogue of serious failings in the quality of care at three NHS hospitals criticised in official reports published today. An investigation into problems at the Oxford Heart centre, one of Britain's leading coronary units, discovered poor standards of clinical care and under-supervision of inexperienced doctors. North Lakeland NHS trust in Cumbria is criticised by health service standards watchdog, the Commission for Health Improvement (CHI), for degrading and cruel practices, including the strapping of mentally-ill patients to their commodes. Officials at Carmarthenshire NHS trust in Wales came under fire for failing to tighten procedures quickly enough in the wake of a blunder in which the wrong kidney was removed from a seriously ill patient. Guardian 15 November 2000.
          The trio of reports documenting serious failings in the health service yesterday is not entirely bad news. It signals more openness in what has too long been a stealth service. Each report is alarming reading: a Carlisle hospital for elderly mentally-ill patients with "a shocking culture of cruelty"; a Welsh hospital where a man died after his one healthy kidney was removed; a heart unit in one of Britain's most famous hospitals, Oxford's John Radcliffe, "on its knees and riven by internal conflict". Even the BMA did not try to gloss over their seriousness. "Today's reports paint a picture of an NHS in trouble and under pressure," it said. "It could leave the public seriously concerned about the ability of the health service to deliver quality patient care, to learn from mistakes and to act swiftly when problems and concerns have been identified." Perverse though it may seem, yesterday's reports are an advance. Four years ago, five student nurses blew the whistle on Carlisle's unacceptable procedures including tying patients to commodes. There was an inquiry, but nothing happened. The students' complaints were "lost". Nothing emerged publicly. All that has changed. Even before yesterday's report, the trust chairman had been dismissed, the chief executive suspended pending disciplinary hearings, senior managers warned. Similarly, Oxford's warring heart surgeons only came to light because a senior clinical nurse complained. She suffered severe harassment and an unacceptable two-year wait, but she finally succeeded. What does emerge is that whistleblowers still need more protection; that hospital authorities need to move more quickly (10 months on in Wales the action plan is still not in place); and less obviously, that care needs to be taken in deploying the new health watchdog, the commission for health improvement. Using it in Wales made sense. It looked at wider issues than a single death. It might have made sense to use it in Oxford too, but that did not happen. But the CHI should not have been sent to Carlisle, where there had already been an external review. This was a diversion to deflect any political heat from ministers. The CHI is not a hit squad. It is a crucial monitoring unit, with a remit to visit every hospital and GP practice within the next four years. To raise standards, it needs their trust. Set up a separate hit squad if necessary, but the CHI's prime purpose must be protected. Guardian Leader 16 November 2000.
          The deaths of four women after botched operations by disgraced surgeon Steven Walker are to be investigated by both the police and a coroner, it was confirmed yesterday.  Guardian Society Monday November 5, 2001 [Blackpool Victoria Hospital]
          Where the treatment centres will be. The health secretary, John Reid, today announced details of the government's controversial programme of privately run fast-track diagnostic and treatment centres, and a number of new mobile ophthalmology units. This guide explains where they will be. Friday September 12, 2003 [South-west peninsula (Mercury Health Ltd), Lincolnshire (Mercury Health Ltd), Horton hospital, north Oxford (Mercury Health Ltd), North-east Yorks (Mercury Health Ltd), Southampton (Mercury Health Ltd), Northumberland (Mercury Health Ltd), East Berkshire (Slough, Bracknell, Maidenhead and Windsor/Ascot) (Mercury Health Ltd), Didcot, Oxfordshire (Mercury Health Ltd), Ashford, Surrey (Mercury Health Ltd), Maidstone (Care UK Afrox), Barlborough Links, Nottinghamshire (Care UK Afrox), Derriford, Plymouth (Care UK Afrox), Chase Farm, Barnet, London (Anglo Canadian), King George hospital, Redbridge (Anglo Canadian), Royal National throat nose and ear hospital, Kings Cross, London (Anglo Canadian), Bradford (Nations Healthcare), Burton (Nations Healthcare), Daventry (Birkdale Clinic), Trafford, Greater Manchester (Netcare UK), Royal National Orthopaedic Hospital, Stanmore (New York Presbyterian), Shepton Mallet, Somerset (New York Presbyterian).
Two mobile units will offer ophthalmology services in the following areas: Cheshire and Merseyside (Netcare UK), Cumbria and Lancashire (Netcare UK), Horton, Oxfordshire (Netcare UK), Wycombe, Bucks (Netcare UK), North Tyneside (Netcare UK), South-west Oxfordshire (Netcare UK), North-west peninsula (Netcare UK), Dorset/Somerset (Netcare UK), Kent/Medway (Netcare UK), Hants and Isle of Wight (Netcare UK), Surrey and Sussex (Netcare UK), Thames Valley (Netcare UK)]
          A surgeon told a patient's family an operation on her liver had gone well when she was barely alive and had lost 32 pints of blood during and after surgery, a court was told yesterday. Steven Walker, also turned his back on the patient during surgery to arrange for pictures to be taken of her liver, the jury at London's Old Bailey heard. He lied about Dorothy McPhee's condition and the 71-year-old died after the operation in December 1995, Rebecca Poulet QC said. James Meikle, health correspondent Thursday May 13, 2004 The Guardian [Blackpool Victoria]
          Fifteen hospitals have been hit by outbreaks of the new strain of the hospital superbug Clostridium difficile which has so far contributed to 25 deaths, ministers have admitted. So far there have been 75 cases confirmed by scientists at the specialist laboratory in Cardiff - the only one in the UK equipped to analysis the new strain - health minister Jane Kennedy said yesterday. The statistics reveal the outbreak of the new strain, which last week was confirmed at a second hospital in the UK, is much wider than originally believed. Hospitals where the strain has appeared are in: Preston, Birmingham, Winchester, Bristol, Romford, Southampton, Truro, Carshalton, High Wycombe, South Tyneside, Newcastle, South Tees, Sunderland, Stoke Mandeville and Exeter. Debbie Andalo Thursday June 30, 2005
        5 A petition of more than 1000 names against the closure of Brampton Hospital has been handed to the local PCT. The threat to the hospital came with North Cumbria PCTs' proposal to close 118 beds at hospitals in Alston, Brampton, Millom, Cockermouth, Keswick, Penrith and Maryport to save £2.4m. Summary by Keep our NHS Public of North West News and Star 21 December 2005
        5 Community beds cuts will hit rural elderly, say GPs. Cumbrian GPs have warned that North Cumbria PCT's proposed cut of 118 community hospital beds across six hospitals will leave elderly people in rural areas vulnerable and isolated and will be unlikely to save money due to the knock-on effects. The hospitals in question include Cockermouth, Maryport, Keswick, and Wigton.  Summary by Keep our NHS Public of  North West News and Star 6 January 2006
        5 "You will all have a say on future of hospitals." Cumbria and District PCT has committed to send the consultation document on the future of threatened cottage hospitals to every household in the county. Campaigners in defence of the hospitals will be meeting on Monday in Wigton. Summary by Keep our NHS Public of  North West News & Star 18 January 2006
        5 County Council Opposes Hospital Bed Closure Plan. Cumbria County Councillors have vowed to fight the threat to cut beds at Cumbria's cottage hospitals. There was cross party support for opposition to plans to cut 118 beds at community hospitals in Brampton, Alston, Keswick, Maryport, Cocker mouth and Millom. Plans for a new hospital to replace the Cumberland Infirmary already mean there will be a reduction in beds, but these were intended to be part of a move to community care rather than acute hospital care. Councillors said the plans were contradictory. Summary by Keep our NHS Public of  North West News & Star 19 January 2006
        5 Health chiefs defend ward closure. Morecambe Bay PCT proposes shutting two mental health wards at Kendal's Westmoreland General Hospital in Cumbria. One of the wards is for elderly patients, and the PCT claims it is seeking to move this care to the community, but financial pressures dictate the closure of the other. Morecambe Bay PCT chief executive Leigh Griffin said: "I've made it very clear throughout consultation, that we would wish to proceed with changes for service for older people regardless of our financial position. However, the specific changes that would affect Kentmere Ware are much more explicitly driven by our financial position." A march will take place in Kendal on Saturday in support of local health services. Summary by Keep our NHS Public of  BBC Online 20 January 2006
        5 Ward closure plan prompts protest. Hundreds of people marched in Cumbria on Saturday against proposals to close two mental health wards at the Westmorland General Hospital in Kendal. Summary by Keep our NHS Public of  BBC Online 23 January 2006
          Primary care opened up to commercial operators. The health white paper will announce six pilot schemes to open up the primary care market to companies such as United Health and Care UK. The projects will be centrally procured "to get economies of scale and to tempt new providers with significant capital backing". PCTs will then decide which services they want, including services in high streets and supermarkets, nurse-led practices and diagnostic centres that combine health and social care. The pilots will operate in London, Liverpool, Bradford, Plymouth and Ribble Valley, with ten more areas lined-up. Hewitt will also launch a "social enterprise unit" to aid professionals in setting up not-for-profit businesses. The FT says: "This is aimed, over time, at creating a purchaser/ provider split under which PCTs will chiefly purchase from a growing range of independent providers." Department of Health sources say the shift from hospitals to community care will move 5% of activity out of hospitals over a decade, about £2.5bn a year. This would force reconfiguration and in some cases closures. Meanwhile the increase in payment for treatments will only be 1.5% next year. This below inflation rise is intended to save £3bn in order to eliminate trusts' structural deficits and overspends and increase efficiency. It has been described by John Appleby, Kings Fund chief economist, as "very challenging if not impossible". Summary by Keep our NHS Public of Financial Times 28 January 2006
    3     Cumbria's health trusts face £10m deficit. Morecambe Bay PCT reported a deficit of £3.38m and has frozen recruitment and plans to cut two wards at Westmoreland General Hospital. Morecambe Bay Hospital NHS Trust is looking to cut beds and agency staff costs.   Summary by Keep our NHS Public of BBC Online 30 January 2006
        5 Hospitals fight still on as trust remains silent. North Cumbria PCTs have refused to offer any reassurances about the future of Cumbria's cottage hospitals, despite the government's white paper being taken as an endorsement of such facilities. Campaigners said the fight will go on, and said the government proposals failed to take account of the necessity for overnight beds.  Summary by Keep our NHS Public of North West News & Star 1 February 2006
        5 Let us run cottage hospitals, say GPs. A group of doctors from the Mayport Medical Centre are proposing to the Department of Health that they be allowed to take over the running of Maryport's community hospital, currently threatened with closure. The GPs' plan rests on them taking practice-based commissioning, giving them control of the commissioning budget for the town. If successful the method could be copied in Cockermouth and other Cumbrian towns with threatened community hospitals.  Summary by Keep our NHS Public of North West News & Star 3 February 2006
        5 Mass rally in Maryport. A rally against bed closures is taking place in Maryport today. It has been organised by the Maryport League of Friends and is part of a series of demonstrations against possible closures of community hospitals in Cumbria.  Summary by Keep our NHS Public of North West News & Star 3 February 2006
          Chemist slams firm in oxygen supply crisis. Patients in Cumbria with breathing difficulties have been left without oxygen for up to three days after the service supplying them was privatised. In the past doctors and pharmacists worked together to provide oxygen supplies to patients. But the Department of Health privatised the service nationally on February 1st, handing over the role to big regional companies. In Cumbria Air Products have been unable to keep up with the demand and supplies have not been delivered in time, with one Carlisle patient arriving at a pharmacy blue in the face after being unable to contact the company for three days. Another patient was told his supplies could take up to six days to arrive, rather than the previous maximum of four hours. Peter Walton of the North Cumbrian Pharmaceutical committee said patients were suffering significant distress and that Air Products was operating according to the terms of its contract rather than meeting patients' needs in any circumstance. He said pharmacists were irritated at having to step in and cover the company's failings.  Summary by Keep our NHS Public of North West News & Star 16 February 2006
          Dead: after eight hour wait for oxygen. The husband of Alice Broderick, the 63 year old woman from Carlisle who died while waiting for oxygen to be delivered by private company Air Products that has run the service since it was privatised at the beginning of February, has said he feels let down. He said: "It was too late for Alice. I can't say for definite whether she would have survived if she had got the oxygen sooner but I'll never know now. The new system wants changing - why couldn't they just have brought a bottle of oxygen over from the hospital ? It makes no sense." He also asked why the delivery man from Air Products only set off from Lancaster - 70 miles away from Carlisle - at 8.30pm, after the urgent need for oxygen was reported to the company at 1.45pm. Carlisle MP Eric Martlew blamed the new system for Alice Broderick's death.  Summary by Keep our NHS Public of North West News & Star 17 February 2006
          Thousands threatened by oxygen shortage. A woman has died and thousands of people with breathing difficulties are at risk after the breakdown of a newly privatised system to provide oxygen supplies to patients at home. Previously local pharmacists, working with GPs, arranged oxygen deliveries, but the service was privatised from the start of February and put in the hands of four multinational companies - Air Products, Allied Oxycare/ Medigas, Linde and BOC. Air Products and Allied Oxycare/ Medigas admit that they have been overwhelmed and have been unable to deliver all emergency orders within the target of four hours. Since the privatisation, which affects England and Wales, health trusts and boards have been flooded with complaints that people have been unable to contact the private suppliers. Patients have been told that the problem could continue for as long as two months while the new system beds in. In Carlisle Alice Broderick died while waiting for an emergency delivery of oxygen ordered by a doctor. The oxygen took almost nine hours to arrive. At 1.45pm the doctor requested an urgent oxygen delivery. The delivery was the responsibility of Air Products, an American multinational that has the contract for Wales and large areas of England. By 7.30pm, when Mrs Broderick stopped breathing, the oxygen had not yet arrived. She was rushed to hospital by ambulance but died at 9.30pm. Mr Broderick returned home at 10.30pm to find that a delivery of oxygen had just been left. Although Mrs Broderick lived only 200 yards from Cumberland Hospital in Carlisle, the oxygen had travelled from an Air Products depot 70 miles away.  Summary by Keep our NHS Public of Times 17 February 2006
          Oxygen contract: crisis talks at DoH over failures. Companies responsible for supplying oxygen to patients at home have been called into the Department of Health for crisis talks. The private providers have been 'overwhelmed' by demand since taking over the contract at the start of this month, a DoH spokesperson admitted. North Cumbria primary care trusts have launched an investigation into the death of Alice Broderick, 63, who died two weeks ago after waiting more than six hours for oxygen ordered from Air Products. Another of the companies, Allied Respiratory, said the poor handling of the transition had left its contract 'unserviceable'. It blamed the DoH for the way it handled the transition, in cutting off supplies from the pharmacies which previously provided oxygen. Meanwhile pharmacists, who supplied oxygen before the contract was privatised, have slammed the handling of the transfer. Pharmaceutical Services Negotiating Committee chief executive Sue Sharpe said that in many areas the transfer had been "utterly chaotic". Summary by Keep our NHS Public of Health Service Journal 23 February 2006
          Investigation into oxygen tragedy. The case of a 63-year-old Carlisle grandmother who died after waiting eight hours for an emergency oxygen supply is to be investigated by north Cumbria's coroner. In a highly unusual move, the coroner has opened an inquest into the tragedy after initially believing it was a straightforward natural death. Summary by Keep our NHS Public of North West News & Star 23 February 2006
        5 600 march to save our hospitals. Hundreds of people turned out for a march in defence of community hospitals in Wigton at the weekend. 45,000 people have now signed a petition to protect north and west Cumbria's nine cottage hospitals. Summary by Keep our NHS Public of  North West News & Star 6 March 2006
        5 Widdecombe backs battle over hospitals. Ann Widdecombe will speak at an elaborate demonstration on April 1 against the threatened closure of community hospitals in Cumbria. The event will stretch across nine towns and will involve a gyrocopter and a Lord of the Rings theme. Summary by Keep our NHS Public of  North West News & Star 16 March 2006
        5 Community Hospitals at risk in Cumbria and Lancashire SHA according to Public Finance 17 March 2006:
Alston Cottage Hospital
Cockermouth Hospital
Millom Hospital
Brampton War Memorial Community Hospital
Keswick Community Hospital
Maryport Hospital
Penrith Hospital
Workington Community Hospital
Pendle Community Hospital, Nelson
        5 Campaigners urging the retention of cottage hospitals in Cumbria are lobbying MPs in London over the issue. They were handing a petition in at Westminster urging ministers to ensure the future of community hospitals threatened with closure in the county. An NHS review cast doubt over community hospitals at Brampton, Keswick, Millom, Maryport, Cockermouth and Alston. Despite an £18m lifeline announced last week campaigners have said they are not convinced services will remain intact. The Nuclear Decommissioning Authority (NDA) revealed last week that it was to hand over the money over three years as a stop gap measure until a new acute hospital was built in west Cumbria. BBC Online 28 March 2006
        5 Hospital cuts protesters take to the roads and waterways. Protesters in Cumbria turned out at the weekend for an innovative demonstration across nine towns. The event was in defence of community hospitals at Wigton, Brampton, Alston, Penrith, Keswick, Cockermouth, Maryport, Workington and Millom. Summary by Keep our NHS Public of  North West News & Star 3 April 2006
        5 Sellafield clean-up cash for NHS. The Nuclear Decommissioning Authority is giving £18m to North Cumbria PCT to help it save up to nine community hospitals from closure. In an unprecedented move, the NDA, which owns the Sellafield reprocessing plant in Cumbria and is headquartered near Sellafield, has stepped into the breach created by the deficits crisis, giving £4m this year and £7m in 2007 and in 2008. The NDA claims this is part of its support for the community arising from a memorandum of understanding signed when supporting the West Cumbria Strategic Partnership. Summary by Keep our NHS Public of  Independent 2 April 2006
    3     Secret plan to ration patient care. Patients are being denied appointments with consultants in a systematic attempt to ration care and save the NHS money. The leaked document - 'Pan London Demand Management Arrangements 06-07' produced by the London Transition Team, led by John Bacon, a senior NHS manager - shows that while ministers promise patients choice, a series of barriers are being erected limiting GPs' rights to refer people to consultants. Health trusts across London have drawn up plans to establish panels that will monitor how many patients are referred to hospital by GPs. Trusts have been told that they must cut GP referral rates to those of the lowest 10%, saving £25m a year. Consultant-to-consultant referrals are also being limited, in many cases denying patients a second opinion. A& E departments are being told to "redirect" 40-70% of patients back to GPs or walk-in centres. Hospitals that treat people who ought to have been sent to their GPs will not be paid. The bureaucracy needed to screen all the referrals will itself cost £1.6m. The Times says: "The language of the document makes no pretence that this will improve care, and emphasises cost savings throughout. 'It is imperative that London balances its books overall,' the first paragraph says." The BMA says similar schemes are running in Kent, Oxfordshire, Dorset, Wiltshire, Surrey, Sussex, Cornwall, Shropshire, Suffolk, Lancashire and Yorkshire, as well as London. Jonathan Fielden, deputy chairman of the BMA consultants committee, said: "It's clear that clinicians don't know how these referral management systems aid improvements in clinical care. To them they are purely cost-saving. The way they work is not transparent or clear. If clinicians don't know, patients cannot know either. That certainly flies in the face of the Government's Patient Choice agenda." Myfanwy Davies and Glyn Elwyn, of the Centre for Health Services Research at Cardiff, said the centres had "appeared overnight in an evidence-free zone". Summary by Keep our NHS Public of  Times 7 April 2006
    3     Hospitals facing £6m cash crisis. The NHS trust responsible for North Lancashire and Cumbria is in a "very severe" financial position. The finance director of Morecambe Bay NHS Trust said the body ended the financial year nearly £6.4m in debt despite making £6.5m savings. No redundancies are planned. Summary by Keep our NHS Public of  BBC Online 24 April 2006
    3     NHS Direct, the nurse-led health helpline, will today axe more than 1,000 staff in a comprehensive restructuring of branches and business objectives, the Guardian has learned. Proposals will be presented for consultation with staff unions to close 12 call centres across England and shed more than a quarter of the workforce to avert a forecast £15m deficit for 2006-07. The move follows an announcement yesterday by Nottingham University Hospitals NHS trust that it plans to shed 1,200 jobs to avoid a deficit of £60m - caused partly by a new payment-by-results system introduced last month. The Nottingham cuts - like most of the 13,000 hospital job losses over the past few months - will be achieved largely through staff turnover, with few compulsory redundancies. But NHS Direct said up to 114 of its nurses may be sacked, along with managers and administrators. NHS Direct was founded in 1997 to provide a 24-hour telephone helpline advising patients on how to deal with symptoms and where to go in an emergency. It handles about 6.5m calls a year and its website attracts 1m visits a month. This side of its business is likely to grow, but a report to staff today admits the organisation has failed to meet targets for expanding into new areas. It expected to get the lion's share of contracts for call centres for patients wanting to see a GP outside working hours - but got only 20% of the business. It also runs an appointments line to support the choose and book system that enables patients to fix an outpatient appointment at a convenient time at the hospital of their choice. Delays in installing necessary IT equipment in hospitals and GP surgeries slowed this income stream. It says it can no longer afford to run many of the smaller call centres. The proposals call for the closure of centres in Doncaster, Scunthorpe, York, Chester, Bolton, Preston, Chorley, Southport, Cambridge, Croydon, Brighton and Kensington, London. They will shut over the next 18 months and staff will be made redundant unless they can be redeployed. Eighteen call centres will be expanded.John Carvel, social affairs editor Tuesday May 16, 2006 The Guardian
          DoH throws down gauntlet on APMS. The pace of private sector involvement in primary care has accelerated, with ministers trumpeting the first in a series of Government-backed private provider deals, allowing a private company to run a traditional GP practice in east London. Health Minister Lord Warner said private provider Care UK would run a new 7,000-patient practice and walk-in centre in Barking and Dagenham. The DoH said similar contracts that would "challenge the existing monopoly of independent GPs" were close to agreement in Hackney, Liverpool, Lancashire, Plymouth and Yorkshire. PCTs have also begun planning to put directly managed practices out to tender to avoid the cost of running them. Sunderland PCT has opted to put out to tender a practice run by two GPs for the past two years. Dr Ashley Liston and Dr Tracey Lucas, who transformed the struggling practice, had hoped to take it over. He said: "We are disappointed but not surprised by the outcome. We're keen to continue the work we've started here, so we will be putting in a bid. We recognise the challenges of competing with large multinational companies, but we will give it our best shot." GPC Medical Practitioners Union representative Dr Ron Singer said: "PCTs will get Brownie points from the Government by involving the private sector. They are beginning to realise that they don't want salaried practices." Dr Chaand Nagpaul, a member of the GPC sessional GPs subcommittee, called on the Government to make it a legal requirement that salaried GPs keep their NHS contracts when APMS providers take over a practice: "We need to ensure the private sector is not seen as a cheap option with doctors on lower rates. The worry is we will see a downward trend in employer and employee terms." Dr Richard Fieldhouse, chief executive of the National Association of Sessional GPs, told salaried doctors not to sign alternative contracts if their practice is taken over: "It's like a civil servant moving to become part of McDonald's." Summary by Keep our NHS Public of  Doctor Update 30 May 2006
          Mortuary-delay family 'in the dark'. Relatives of a man whose body was left on a hospital ward for eight hours have not been told because bosses said it would "distress" them. The admission came after the revelation that staff shortages at cash-strapped East Lancashire Hospitals NHS Trust had resulted in overnight porters being told to ask if bodies could be left until morning before they are taken to the mortuary. Summary by Keep our NHS Public of Lancashire Evening Telegraph 5 July 2006
    3     Job cuts ordered by email. The chief executive of North Cumbria Acute Hospitals NHS trust, Marie Burnham, has ordered fourteen departmental heads to cut one job each to tackle the trust's £4m funding shortfall. The trust, which runs the Cumberland Infirmary and West Cumberland Hospital, has already planned an overtime ban for September and warned of job cuts, particularly among nursing staff. The chief executive's language indicates the pressure the trust is under - in the email Ms Burnham demanded the nominations from department heads "before I really have to lose it" and added "I do not wish to discuss any of the above with you, I simply want action." Unison secretary at the West Cumberland Hospital, Christin Wharrier, expressed her worries over the overtime ban stating that the current understaffing of the NHS was its cause, not staff greed, and that the only way to ensure overtime isn't needed is to employ more full-time staff. She added that currently many staff contracted for only twenty-five hours end up working a full week. Dave Armstrong, Unison's Cumbria official said: "They are under pressure financially and it seems they'll do almost anything to get the deficit down." Summary by Keep our NHS Public of North West News & Star 10 July 2006
        5 Hospital injuries unit to close. Cockermouth Cottage Hospital's minor injuries unit will close because of a shortage of nurses. The West Cumbria Primary Care Trust says it has made 'successful efforts' to recruit qualified nurses, but is struggling because staff sickness levels are so high. This is the latest blow to Cockermouth Cottage Hospital which has been earmarked for closure be North Cumbria PCT along with eight others. The closure plans were proposed by the PCTs to offset mounting debts.  Summary by Keep our NHS Public of North West News & Star 3 August 2006
        5 Closure of injury unit is thin end of wedge. Campaigners fighting to save Cumbria's cottage hospitals say the closure of Cockermouth's minor injuries unit is 'shortsighted' and an excuse to get rid of services bit by bit. Penrith and the Border MP David Maclean, who has been campaigning to save the hospitals since it emerged they were under threat, claims this is just an excuse to gradually close hospital services. He said: 'I am very worried that closure in Cockermouth is the start of things to come in other community hospitals. They used the same excuse in Alston to close maternity units. 'Couldn't get enough staff' is the usual excuse.' 'I suspect the PCT is closing them off, a little bit here and there until there are no services left and we're left with something that's not worth fighting for Summary by Keep our NHS Public of North West News & Star 4 August 2006
    3     NHS life-blood 'consumed by clinics'. Health authorities are spending millions of pounds of taxpayers' money on private operations in the North West which could be provided more cheaply by the NHS and may eventually destroy the service, say critics. Hospital consultants, health unions and politicians in the region are protesting at the block contracts being awarded to Independent Sector Treatment Centres (ISTCs) to carry out thousands of operations, regardless of whether they reach targets set for them. Health trusts in the North West have paid £1.7m to Greater Manchester Surgical Centre, run by South African company Netcare, for operations that never took place. These were mainly minor surgical procedures, including hip operations, ear, nose and throat treatment and cataract removal. This week doctors, nurses and Unison members condemned the "breakneck" pace of privatisation within the NHS. Protest groups have been set up in Manchester and Liverpool under the "Keep Our NHS Public" banner. At least a further five new ISTCs are being planned, without public consultation, for the region. These include: Ormskirk and District General Hospital, where BUPA will provide up to 1,000 operations a year for Southport and Ormskirk Hospital NHS Trust, which recently announced that it is to axe 83 NHS jobs due to a £15m deficit; a centre in Cumbria or Lancashire; two further ISTCs in Greater Manchester; and a second ISTC in either Cheshire or Merseyside (there is already one at Runcorn). Deputy chairman of the BMA's consultants' committee and consultant gynaecologist at Fairfield Hospital, Bury, said: "Ultimately, this could lead to total disruption of NHS care and the closure of NHS orthopaedic wards. I'm worried about the quality of surgery and the risk of complications. A recent study by a surgeon at Bolton Hospital found there were six times more infections with eye cataract operations in ISTCs than in NHS treatment centres." Netcare is also likely to win a £30m contract to provide clinical assessment services in Manchester, which would allow it to refer patients to its own Greater Manchester Surgical Centre, based at Trafford General Hospital. In addition, Netcare subsidiary Amicus InHealth is bidding for the North West's diagnostics contract, which would involve carrying out blood tests, MRI scans, ultrasounds, X Rays and endoscopies. The Department of Health refused to comment on how much the five-year regional diagnostics contract will cost, but seven contracts nationally are worth £1 billion. The Greater Manchester Surgical Centre costs the NHS £10m a year. Summary by Keep our NHS Public of North West Enquirer 11 August 2006
          One in five ambulance trusts systematically misreported response times, making it look as if they reached serious life-threatening emergencies within government targets, the Department of Health disclosed yesterday. An audit of 31 ambulance services in England found six did not follow official guidance about how response times should be recorded. Some did not start the clock as soon as a 999 call was received. Others did not synchronise the clocks on the emergency switchboard with those used by paramedics. In some cases, ambulance trusts recategorised the urgency of the call after the job was done to make it fit the response time achieved rather than the priority given when the original call was made. This would have allowed staff to downgrade an emergency if the ambulance arrived late. The department said the six trusts were West Yorkshire, South Yorkshire, Cumbria, West Midlands, Staffordshire and the West Country ambulance service. John Carvel, social affairs editor Tuesday August 15, 2006 The Guardian
          Netcare lead bidder for ICATS. The Department of Health has named Netcare and Partnership Health Group - in partnership with Alliance Medical - as preferred bidders for its controversial integrated clinical assessment and treatment services in Manchester. The proposed contract has been dogged by criticism from local stakeholders in recent months as concerns were raised that awarding Netcare the contract would be anti-competitive. If Netcare wins the five-year deal to provide ICATS it would be in a position to assess patients for surgery and then refer them to its own Greater Manchester surgical centre for treatment. The deal will see Netcare providing 220,000 outpatient, diagnostic and surgical services in seven locations including Carlisle, Preston, Fylde Coast, Ulverston, Pendle, Ormskirk and Workington. In response to local concerns the DoH has decided to ensure that preferred bidder status for the two parts of the contract are awarded to different providers. The DoH has also named UK Specialist Hospitals - formerly part of the New York Presbyterian Hospitals group - as preferred bidder for a second-wave elective independent treatment centre in the South West. UKSH will operate an ITC based in North Bristol that will carry out 25,000 procedures a year over five years. Last month Bupa was named preferred bidder for two elective ITC schemes in the North East and Cheshire and Merseyside. Summary by Keep our NHS Public of Health Service Journal 17 August 2006
        5 Mental health a low priority. In a letter to the Times, Tim Loughton, shadow minister for health, writes: "Ticking the box by calling mental health a priority does not deliver. Judging its effectiveness on the basis of falling suicide rates ignores record numbers of people, especially schoolchildren, developing mental illness. Whereas mental health accounted for 14 per cent of NHS spending in 1997, that has dropped to 11 per cent - hardly suggesting a "priority". From Westmoreland to Sussex, acute mental health beds are being cut and day centres are closing. In Sussex every hospital is in the spotlight for downgrading or even closure as the strategic health authority wrestles with huge deficits. We are told that the prospect of losing our A& E department at Sussex's largest town, Worthing, and dicing with congested roads to reach Brighton is part of the clinical modernisation process." Summary by Keep our NHS Public of Times 17 August 2006
    3     At least 10 major hospitals are facing closure or cut-backs, with some facing the end of emergency care, the BBC said. The sites in London, Surrey, Sussex, Lancashire and Cornwall will either close or have their facilities downgraded to handle basic care in order to get back into financial health, after an unprecedented level of NHS debt was revealed earlier in the summer. Nearly a third of NHS trusts ended the year with a combined gross deficit of pounds £1.27bn. Hélène Mulholland and agencies Friday August 18, 2006 Guardian Unlimited
        5 Future of 10 hospitals 'in doubt'. At least 10 major hospitals in England face potential closure or a downgraded role, according to a BBC investigation. Talks are under way about removing emergency care from hospitals in London, Surrey, Sussex, Greater Manchester, Lancashire and Cornwall. The sites will either close or be left to handle basic care, with "super" regional centres seeing the most ill. There are concerns people will have to travel miles for life-saving treatment. Over 30 hospitals could be affected by the reviews - including those losing services and others left to bear the brunt of that work. NHS bosses involved in the reviews have said the measures are part of a push to provide more care in the community, either with hospital doctors setting up local clinics, GPs providing extra specialist services or medics treating patients in their own homes. However, they also acknowledge deficits and new European working time restrictions are forcing them to reconsider how services are provided. Dr Jonathan Fielden, deputy chairman of the BMA consultants' committee, said: "In some of these cases we have to ask whether this is being driven by financial reasons. If this is the case, it is likely not to be in the best interests of patients." The areas under review are: London - Talks under way over Harrow's Northwick Park and the nearby Central Middlesex hospitals. Project board set up to review services across the four north central trusts - Barnet and Chase Farm, Royal Free, Whittington and North Middlesex Surrey and Sussex - Widespread discussions have been followed by the creation of focus groups to discuss future of the 15 hospitals run by nine NHS trusts. Formal consultation to start in the autumn. Greater Manchester - Committee set up to decide the future of four hospitals run by the Pennine Acute Hospitals NHS Trust. Decision due end of September. Lancashire - Changes to the University Hospitals of Morecambe Bay Trust's three centres - spread across Cumbria and Lancashire, planned, with the Westmorland threatened with losing its acute facilities. Cornwall - Two proposals have been discussed by Royal Cornwall Hospitals NHS Trust, one of which involves withdrawing services from two of its three hospitals. Summary by Keep our NHS Public of BBC Online 18 August 2006
          NHS trust welcomes plan for independent centre. A second independent sector treatment centre in West Lancashire was welcomed as "great news" by health chiefs. The Ormskirk centre will be run by private health provider Netcare, which has yet to announce where the centre will be placed. The treatment centre will perform assessments and diagnostics after referral and handle minor surgery; elective surgery will be handled by NHS hospitals or other private centres. Summary by Keep our NHS Public of Liverpool Daily Post 22 August 2006
        5 Top consultants back cottage hospital fight. Cumbrian cottage hospital campaigners say they are now ready to fight any plans to close beds or cut services if health chiefs do not back down. The campaigners are now waiting for the PCTs to finish a review of facilities and set out their plans. They hope that initial proposals to close more than 118 beds across nine north Cumbrian hospitals will have been scrapped, following widespread local opposition. However, if that is not the case, members of the Joint League of Friends say they now have the ammunition they need to fight off such plans, in the form of a report compiled by two of the country's top medical consultants. Summary by Keep our NHS Public of North West News & Star 1September 2006
        5 Health chiefs jeered in services battle. Health chiefs have decided to move forward with plans which could put extra pressure on the Royal Lancaster Infirmary - despite opposition from thousands. Campaigners jeered as the board of the University Hospitals of Morecambe Bay agreed to move ahead with an option which could see the transfer of acute medical services from Kendal to Lancaster. Concerns have been raised by various public bodies, patients and members of staff about the additional travelling time it would take for Kendal patients to travel to the RLI. Morecambe councillor David Kerr, who is a member of the Cumbria and Lancashire joint health overview and scrutiny committee and who attended the meeting, said: "The trust has not listened to either the overview and scrutiny committee or the general public. People's feelings have not been taken into account and they are now looking at an option which nobody wanted." A petition containing 25,000 signatures along with thousands of public consultation response forms, had been sent to the trust opposing the changes. Summary by Keep our NHS Public of Lancaster Guardian 28 September 2006
          Health trust's set-up "has been shambolic". Outgoing health bosses overseeing the amalgamation of their trusts into the county-wide Cumbria Primary Care Trust have slammed the transition process. The new trust has only an executive director and none of the other posts have been announced leaving many of those involved in the transition completely unsure whether they will have jobs after the shake-up. A number of non-executive directors used their last public meeting to vent their anger at the way they feel management has been treated. Carole Ferguson, chair of Carlisle PCT, said: "We deplore the way this has happened but it is important to minute how our executive directors have managed this challenge in increasingly difficult circumstances…We have to hope lessons are learned at a higher level." The new PCT will have a range of challenges to contend with including the future of the county's community hospitals and a mounting £30m deficit. Summary by Keep our NHS Public of North West News & Star 2 October 2006
        5 First responders freeze 'will not affect patients. Ambulance bosses say their decision to freeze the county's first responders scheme for 4 months will not affect patients. They say the voluntary groups will continue to run as normal while they carry out an extensive review, but no new teams will be set up. South Lakes MP Tim Farron has hit out at the decision to put the scheme 'on ice', saying it will affect emergency services in the area. Summary by Keep our NHS Public of North West News & Star 23 November 2006
          Cumbria and Lancashire CATS contract goes to consultation. A contract to allow healthcare company Netcare to provide clinical assessment and treatment services (CATS) across Cumbria and Lancashire has been delayed after local primary care trusts decided to consult on some details. The decision comes following pressure from Unison, which had been calling for a judicial review of the way Netcare was chosen as preferred bidder for the £30m CATS contract by the Department of Health's commercial directorate in July. The union said it had not been subject to consultation by the region's five PCTs and NHS North West. Unison decided against the move after lawyers for the DoH said that any such action would fail on the grounds that public consultation was not obligatory as the contract was procured nationally on behalf of the health secretary. But this week Ian Cumming, North Lancashire PCT chief executive and lead for independent sector commissioning across Cumbria and Lancashire, said the PCTs had 'decided to take the opportunity to revisit [CATS procurement] and are planning an engagement and consultation phase'. 'We will look again at the actual activity level we require now from the CATS service 18 months on from the original modelling, and we will be asking if the original assumptions are still valid before we sign any contractual agreement with anybody,' he added. The contract has been dogged by criticism from local stakeholders after concerns were raised that awarding the contract to Netcare would be anti-competitive as the company could refer patients to its own Greater Manchester surgical centre. However, Mr Cumming said the decision to offer the services to Netcare would not be part of the consultation. In January, private providers were invited to bid for the work to provide CATS in general surgery; musculoskeletal; ear, nose and throat; gynaecology; and urology. If Netcare secures the contract it is set to provide 222,000 procedures in outpatient, diagnostic and surgical services in Carlisle, Preston, Fylde Coast, Ulverston, Pendle, Ormskirk and Workington. Unison North West regional representative Tim Ellis said that the union had 'grave concerns' about patients who would be 'left in the lurch' if they were not referred through a CATS centre. 'What will happen to the diagnostic scanners and the expertise of the NHS clinical teams who will disappear ?' he asked. 'Who will act as the gatekeeper on where patients go [for treatment] ? This will either fall to the NHS as the employers or to Netcare itself,' he warned. Netcare director of operations Julia Eadie said the company was not concerned about the delay. 'As far as we are concerned it is all still going ahead,' she said.  Summary by Keep our NHS Public of Health Service Journal 23 November 2006
          Legal challenge to private triage. Public service union Unison is mounting a legal challenge to a decision to set up a privately-run triage and treatment service for NHS patients in Cumbria and Lancashire. Unison wants a judicial review, as it claims that the scheme would remove patient choice and destabilise acute hospitals by removing their outpatient work. It says the DoH and the NHS North West Strategic Health Authority have failed to consult before putting in place plans for the 'capture, assess and treat service' (CATS), which it claims would substantially change the way NHS services are provided in the area. The DoH is now finalising the five-year contract with Netcare, its preferred bidder. The SHA's solicitors, Addle-shaw Goddard, argue that the scheme cannot be challenged because primary care trusts (PCTs) are not legally obliged to use it. In a letter to Unison, the lawyers said: 'There will be no binding legal obligation upon the PCTs to use [Netcare's] services. When the contract is in place, it will be open for the PCTs, operating under the auspices of the SHA, to make decisions how services should be provided.' PCTs would consult, as they are legally obliged to do, before deciding which services would be provided by Netcare, the lawyers added. Unison may argue that PCTs will not, in practice, be able to refuse to use the CATs. A local GP said the idea that a PCT could boycott the scheme was 'utterly disingenuous', adding: 'The SHA and PCTs are under pressure from the DoH to set up the scheme and use it.' DoH contract documents sent to potential bidders said that more than 131,000 referrals to CATS are expected each year. Hospital Doctor also understands that the DoH has agreed to guarantee Netcare a level of income for part of the contract. The SHA's argument that PCTs would consult before deciding whether to use the scheme also conflicts with claims made by Janet Butterworth, assistant director of the SHA, in an email to local medical committees on 23 October. She said: 'PCTs submitted an invitation to negotiate which included a large proportion of referrals going to CATS.' In an earlier email, she said that all ENT, urology and general surgery patients would be referred through the scheme except certain cancer patients.  Summary by Keep our NHS Public of Hospital Doctor 26 November 2006
        5 Unions join forces to fight health cutbacks. Trade Unions in Cumbria, including Unison and GMB, have joined forces to fight proposed cutbacks in the area's acute and cottage hospitals, ambulance control and mental health service. They are also concerned by the government's plans to bring in private companies to perform NHS work. The unions, already working together nationally under the banner NHS Together, have now decided to unite at the local level starting with a Save Our Services march in Whitehaven on the 9th December. The event is to protest against the potential loss of services at the West Cumberland Hospital in Whitehaven, including the possible downgrading of the maternity ward to a mid-wife led birthing unit. Further targeted marches are set to follow. Organising officer for the GMB union, Kevin Young, said that Cumbria could be one of the worst hit by the national NHS crisis and wants to make an impact through a combination of public campaigns and formal negotiations with politicians and health leaders. He said: "I would like to think they will listen to us and rethink their plans but we know that is not usually the case." He was also encouraged to see "that old fashioned solidarity coming back." Dave Armstrong, full-time officer for Unison, agrees that the united unions will pack more of a punch but added that something needs to be done because "morale is going though the floor". The march takes place on Saturday December 9th, leaving Whitehaven's Castle Park at 10am and ending with a public address at West Strand.  Summary by Keep our NHS Public of North West News and Star 28 November 2006
          MP attacks private health centre plan. A one-stop health centre planned for Preston may threaten the future of NHS hospitals in the area, a Lancashire MP has warned. The Capture, Assess, Treat and Support Centre would be at the Preston Health Court development on the former Sharoe Green Hospital site. The centre, funded by Central Lancashire Primary Care Trust, will be a middle tier between GPs and hospitals, providing services such as orthopaedics, general surgery and gynaecology. It will be run by private company Netcare UK and, according to NHS North West, will see around 26,000 patients a year. But critics have blasted the idea, saying it will take facilities and cash away from local hospitals and could lead to job cuts and slashed services. Chorley MP Lindsay Hoyle is urging the public to strongly object to the idea. He said: "We have very good hospitals at Preston and Chorley and I do not think we should put their quality and standard of service at risk by taking work away from them and giving it to the private sector. Private companies running these centres will not be doing it for the benefit of patients, they will be doing it for profit. I hope people object to these plans."  Summary by Keep our NHS Public of Lancashire Evening Post 30 November 2006
          Health scheme fear 'groundless'. Attempts to block a controversial private health scheme which hospital bosses warn could damage NHS services are "ground-less", Health Secretary Patricia Hewitt has said. She said a union would not be able to stop a plan she put in place to have a private healthcare firm treat East Lancashire patients using taxpayers' money. Hospital bosses in East Lancashire have warned the scheme could see their services collapse as patients, and the money for their procedure, would go elsewhere. But the Government has insisted the Capture, Assess, Treat and Support Services (CATs) deal for simple procedures and tests would drive down waiting lists and allow hospitals to focus on more complex work. Healthcare union Unison formally opposed the plans - worth £2.5 billion nationally - and said the Government had not consulted the public and local bosses. But Mrs Hewitt said she had the authority to give preferred bidder status to South African firm Netcare and had "no duty of consultation" to the public and local hospital chiefs. The solicitors' letter, on behalf of her and regional authority NHS North West, said: "Your clients' complaints that there has been a failure of statutory consultation in respect of the proposals to introduce CATs services. . . and in particular regarding the decision to award preferred bidder status to Netcare UK Limited are groundless and the forms of relief which your clients seek are unwarranted." But she said bosses at East Lancashire's Primary Care Trusts - which decide what health services should be available - would still have the choice not to use the services. It said: "There will be no binding legal obligation upon the PCTs to use such services. "When the contract is in place, it will be open for the PCTs. . . to make decisions how services should be provided in their areas". But it said the PCTs should "take into account the availability to them of services offered by Netcare". Unison spokesman Tim Ellis said it was highly unlikely the PCT would not use the firm once the deal was in place. He said: "The NHS has massively improved its waiting times in the last two years. The proposal to remove funding from NHS trusts endangers this achievement." This month The Lancashire Telegraph revealed bosses were worried the move could take work away from cash-strapped East Lancashire Hospitals NHS Trust. An internal trust report said: "We believe that the proposals as they stand may well present risks to the sustainability of some hospital services."  Summary by Keep our NHS Public of Lancashire Telegraph 30 November 2006
        5 Maternity fighters hand over petition. A 10,000-name petition against axing maternity services in west Cumbria has been handed in to the House of Commons. Downgrading the obstetric ward at West Cumberland Hospital in Whitehaven is one of the options being looked at in reviews of services across the county, however MP Jamie Reed hopes the number of signatures will make clear that it is not an option. "The Government's policy is to support birth choices for women and the women of west Cumbria have expressed their birth choice very clearly. They want a fully functioning obstetrician and gynaecologist-led maternity unit at the West Cumberland Hospital, and so do I," he said. There are also concerns in the area that a new building for west Cumbria health services will not maintain all the services of the current site. Marie Burnham, chief executive of the North Cumbria Acute Hospitals Trust which runs the West Cumberland said that any concern is premature because the plans are still being drawn up as part of a wider review of services in the area. However Rev John Bannister, who gave a public address at the 4,000 person march last Saturday, has said an eye has to be kept on the review and has started gathering political, faith and voluntary leaders to scrutinise it. Ms Burnham welcomed the move saying that "we share some of the concerns given the changing face of the NHS" but pointed out that a survey in 2004 had shown that 61% of the area's residents wanted a new hospital in the west. Rev Bannister has expressed his doubts about this survey and whether current suggestions are the only way forward. Summary by Keep our NHS Public of North West News & Star 15 December 2006
        5 Save Our NHS. People United Saving Hospitals, the campaign started by Nuneaton woman, Vanessa Casey, held a torchlit protest in the town last night. Chanting "no ifs no buts, no hospital cuts", the protesters marched from the Griff and Coton Social Club in Heath End Road to Nuneaton Town Hall to protest against proposed cuts to services at George Elliot Hospital. Under the plans, Nuneaton will lose its baby care unit and some children's services. Emergency out-of-hours operations will also be transferred to University Hospital in Walsgrave. Miss Casey, of Bucks Hill, said: "We need to keep our maternity, the special care baby unit and children's services at the hospital. I feel that years ago people fought for the things we've got and today if we don't fight for things at the hospital what are our children and grandchildren going to have ?" The rally was one of many held nationally in places such as Kendal, Chichester, Hinckley, Coventry and Redditch to form a united front. In London, marches sang carols at the gates of the Department of Health. Summary by Keep our NHS Public of Coventry Evening Telegraph 19 December 2006
          Business primed to expand GP role. BBC News has learnt that the government will soon extend proposals to get businesses to run GP surgeries in areas which have struggled to recruit doctors. An initial scheme has had only limited success - but ministers are planning a wave of advertisements next year in an effort to attract big companies and smaller organisations to fill gaps in 30 parts of England which are short of family doctors. The government says the scheme will help tackle health inequalities and strike a good deal for the NHS - but some campaigners disagree. Campaigners in the quiet Liverpool suburb of Maghull are fighting a low-budget but determined battle against plans for a new GP surgery in the area, which would be run by a company. Some local people are suspicious about the move - including Peter Crowder, a retired psychiatric nurse and chairman of the campaign group. "We want the opportunity to have a fair say. From our point of view, that means stopping the negotiations that are going on with a particular private company and going back to the public. Give us our voice and let us have our say." GPs have in effect always been independent operators - but Peter Crowder says that's very different to companies who may be answerable to shareholders. He said: "We accept our GPs as part and parcel of our local area so they're more than just a faceless entity. They have an investment in this area and they re-invest in this area." Leigh Griffin, who runs Sefton Primary Care Trust, said: "What's happened is that from an open tendering process, the Department of Health has identified a preferred provider and almost married us up with them, and we are talking to them." He would not confirm if that provider is Care UK. When challenged that not being able to confirm who the PCT was dealing with at this stage was bound to fuel a feeling of discontent among the local campaigners, Griffin said: "I've got a lot of sympathy with those concerns." The Merseyside scheme is part of a wider programme launched by the government last year, to boost coverage in areas short of doctors. It's led to two new surgeries in north and east London signing up fifteen hundred patients. But the programme has run into problems in other areas. In Plymouth and in Accrington, NHS managers decided none of the bids to run a new service was affordable. And in Bradford, an NHS board decided recently it was ending its participation in the scheme - again because the bidders' proposals cost too much. But the government says it is determined that the gaps in these and other areas will be filled, and so new advertisements will be placed for 30 areas next year. A Department of Health spokesman said: "The schemes will be advertised in tranches with advertisements placed in the local and national media. Taking forward the programme in a series of local procurements should help ensure a level playing field for big companies, smaller organisations and social enterprises. PCTs in under-doctored areas deciding not to take part in the national programme will be expected to take forward their own local procurements." And with ministers demanding that other GP surgeries, not just those in under-served areas, open up to different providers, we can expect to see more of these schemes in the future. Summary by Keep our NHS Public of BBC Online 20 December 2006
          Top docs slam private clinics plan. A group of top consultants has condemned government plans to bring in privately-run clinics to ease local waiting lists. The four ear, nose and throat surgeons say the proposals will disrupt existing services and have dire consequences for patients across the area. The Capture, Assess, Treat and Support (CATS) centres proposed for Workington and Carlisle would perform routine operations, diagnostic tests and aftercare. But they have been met with strong opposition from NHS staff, who fear it will affect quality of care and put their services and jobs at risk. A petition opposing the centres has been launched and now the four surgeons have added their combined weight to the campaign. The letter to Mike Farrar, chief executive of the North West Strategic Health Authority, is signed by Nick Murrant, Donald Clark, Richard Hogg and Andrew Robson, who together conduct ear, nose and throat (ENT) procedures at the West Cumberland Hospital and Cumberland Infirmary. One of their main worries is how far the contracting process has gone - with South African firm Netcare already named as the preferred operator - without any discussion with local clinicians. In the letter they state: "The matter was effectively raised with us surgeons, whose combined consultant experience totals over 40 years, only once a fait accompli. This is an outrageous omission from the perspective of our patients and the general public." They say the new clinics will give poor value for taxpayers' money and add an unnecessary tier, which will result in "wide-reaching, probably irreversible erosion of high quality, consultant-led care." They claim that similar centres elsewhere in the UK are already recruiting junior doctors to run these services. The consultants go on to list nine specific concerns about the impact of creating NHS-funded, privately-run clinics in north Cumbria and demand an urgent response. These concerns include the financial impact on the existing acute trust, potentially resulting in closure of units, the lack of public consultation and the impact it will have on staff training. However they are most worried that staff at the new clinics will not have the high standard of training expected, affecting the quality of care. They say: "It appears that care may be delivered by doctors with either no UK training or by a GP who has undergone a few hours training a week over 12 months. "Do you understand our frustration that the patient population, which is being sold a relentless 'choice' mantra, is in reality having the most fundamental choice - that of consulting with a fully accredited, audited, appraised and reputable NHS consultant surgeon - taken away ?" Ultimately the surgeons stress that there is no need for the private clinics in this area, as they are already on course to meet the new 18-week waiting target by December 2008. In fact, they say that in 2002 a fourth ENT consultant was appointed in north Cumbria to help do just that. The implementation of the CATS centres - at Workington Community Hospital and an unknown site in Carlisle - was due to get underway next month. However, this has now been postponed following threats from health unions of a judicial review. After receiving a copy of the consultants' letter, David Maclean, MP for Penrith and the Border, has publicly backed their campaign. He has also written to Mr Farrar calling for essential information about the proposed centres and demanding full consultation before they progress any further. Labour MPs Tony Cunningham, Eric Martlew and Jamie Reed have also expressed their concerns and have written to health secretary Patricia Hewitt. Summary by Keep our NHS Public of Cumbria Times & Star 8 January 2007
        5 The MP, the health secretary, and an unresolved conflict.  Campaign over A&E highlights discrepancy.  Hewitt said to see protests as legitimate response. Throughout last year, Kitty Ussher, an up and coming Labour MP, fought a high profile campaign to save the accident and emergency department at the NHS hospital in her Burnley constituency. It was slated for closure and there were fears among the townspeople that lives could be lost if they had to be taken in an emergency to the hospital in Blackburn. In June, Ms Ussher led local protesters on a delegation to London to plead their case with Patricia Hewitt, the health secretary. It may not have been too difficult for the 35-year-old MP to gain access to the minister. For three years, while Ms Hewitt was trade and industry secretary, Ms Ussher was her special adviser. Before the protesters' bus headed back to Burnley, Ms Hewitt said their presentation had been "amazing". But any decision to open or close a hospital unit is made by local trusts and health authorities. There was nothing Ms Hewitt could do to help her colleague, whose 5,778 parliamentary majority at the last election was not impregnable against the passions roused by loss of cherished NHS facilities. The health secretary could only intervene if local authorities backed a formal complaint. In this case, that required the support of a scrutiny committee of councillors from Lancashire county council and Blackburn with Darwen borough council. If Burnley won the case to keep its A&E, the chances were that Blackburn's rival department would have to close. Since there was no appeal, Ms Hewitt did not have a say in the matter. John Carvel, social affairs editor Saturday January 13, 2007 Guardian
          NHS privatisation plan slammed. Proposals to privatise outpatient services have been slammed by health staff and unions. Plans have been outlined for new independent treatment centres which are designed to provide community based assessment, diagnostic, treatment and support services for patients. A Clinical Assessment Treat and Support (CATS) centre, is planned for the Preston health court development at the former Sharoe Green Hospital site. CATS will be paid for by the NHS, but will be provided by the private sector and the centres will be run by Netcare UK. hospital unions have criticised the proposals and say it will mean that all initial assessments for general surgery, rheumatology, ENT, gynaecology and orthopaedics will be outsourced to Netcare who will profit from the NHS. Tim Ellis, regional officer for health union Unison, said: "If introduced, they will cause reductions, and in some cases, closure of outpatient services across Cumbria & Lancashire." Summary by Keep our NHS Public of Lancashire Evening Post 19 January 2007
          Private clinics threat to new hospital bid. Plans to build a new hospital in west Cumbria will be threatened by the proposed introduction of privately-run treatment centres, it is claimed. The controversial CATS centres, which aim to reduce waiting lists, are currently planned for Workington, Carlisle and Ulverston. But it is feared the centres will pose a major threat to existing services, jobs and future investment projects - such as the new hospital. Patient representatives in the county have used predicted case numbers to estimate the potential costs of the service - around £35m. They have now launched a joint campaign against the plans, which went out to public consultation on Monday. In a letter to Tony Blair and Health Secretary Patricia Hewitt, the chairs of the individual panels set out their fears. They include serious fears that the private clinics will take money away from NHS hospitals and put further strain on finances. The CATS (Clinical Support, Treatment and Support) centres stem from government plans to bring in private healthcare companies. They would perform diagnostic tests and routine treatment. But local patient groups, union officials and consultants argue that such centres are not needed in Cumbria. They say the area's existing NHS hospitals are already on target to meet the new 18-week waiting target by 2008. The patient representatives say that new government funding criteria - where hospitals are paid for actual patients treated, rather than predicted workloads - means any downturn will drastically impact on finances. As a result, they fear competition from the private sector will have a huge impact, closing existing outpatient clinics, leaving other services unsustainable and threatening future developments. Cumbrian union officials fear CATS will put NHS jobs at risk and have launched a petition opposing the plans. Meanwhile, several top consultants have expressed concerns about the quality of care that will be provided. Bosses say they need to find a way of introducing clinics that will compliment the county's existing health service, not jeapordise it. Summary by Keep our NHS Public of North West News & Star 19 January 2007
        5 Maternity transfers would cost lives, MP Jamie tells Commons. Downgrading maternity services could dramatically cut ambulance response times and ultimately put lives at risk, an MP has claimed. Copeland's Jamie Reed believes time spent transferring mothers from Whitehaven to Carlisle will leave gaps in ambulance coverage for other emergencies. His comments, in the House of Commons, add a new twist to the debate surrounding maternity care. Downgrading the obstetric ward at Whitehaven's West Cumberland Hospital is one of the options currently being looked at by health chiefs. If agreed, all specialists will be moved to Carlisle's Cumberland Infirmary and a dedicated midwife-led birthing unit, similar to the one in Penrith, would replace it. This option would result in west Cumbrian mums having to travel many miles to Carlisle, during labour, if they needed a consultant. The alternative is to maintain maternity and obstetric units at both of the hospitals, though each would require major modernisation. Jamie Reed, MP, believes about 1,000 births at Whitehaven need some kind of consultant intervention. He argues that, if this were the norm, 1,000 ambulance trips could have to travel the 42 mile distance between the two sites every year. Mr Reed believes any downgrading of services would go against the government's new choice policy, as he does not believe many mums would choose to give birth without consultant support. He added that although merging the maternity units would not be down to cost, extra cost would be incurred as additional ambulances would be needed. Mr Reed does not believe the difference in numbers of births at the two sites justifies the need for centralisation. Last month a 10,000-strong petition was handed to the government demanding it retain a consultant-led maternity service in Whitehaven. Summary by Keep our NHS Public of North West News & Star 22 January 2007
          Blair warned over CATS plan. Tony Blair has been told by patient groups that they fear for West Cumbria's NHS services if a controversial private treatment clinic is established at Workington's Community Hospital. A statement warning of the threat to local health care has been sent to Mr Blair and health secretary Patricia Hewitt by the county's Patient Panels which represent the public. They claim that proposed Capture, Assess, Treat and Support Centres (CATS) at Workington and Carlisle would jeopardise a new hospital for West Cumbria and will 'most certainly' affect its ability to deliver emergency care. Opposition from the patient watchdog group comes after fears about the impact of the proposed private clinic were voiced by nursing staff and senior consultants. Workington MP Tony Cunningham is demanding that the town's minor injuries unit must not close as a result. The Patient Panels' letter to Mr Blair, MPs, council leaders and health chiefs states: "We believe the consequences of introducing CATS Centres in Cumbria will have a devastating impact on the ability of our local NHS to provide effective acute secondary healthcare to our population, given that the baseline income for North Cumbria Acute Hospitals NHS Trust will be severely eroded." South African firm Netcare is the preferred bidder to run the centres. But a group of ear, nose and throat consultants have added their weight to a petition opposing the plan. The Patient Panels, comprised of 54 former and current patients of the West Cumberland Hospital and Cumberland Infirmary, attacks lack of public consultation and says that if the CATS centres treat their anticipated number of patients then £35 million could be removed over three years from local NHS acute secondary care services. They add: "Regardless of the numbers of patients they would treat, CATS centres would receive £25 million they have been guaranteed centrally from the NHS. "We believe this could be invested better in the NHS locally." By removing money from the NHS, hospital services such as accident and emergency could be put in jeopardy and the building of West Cumbria's proposed new hospital could be at risk. The Patient Panels say they are concerned about the quality of care that will be given to patients referred to the CATS centres. They claim the doctors who run them will not be trained to the standard of specialist registrars or consultants which could lead to over-testing of patients and to inappropriate surgery. The letter says: "Care would be delivered for reasons of expediency rather than with the aim of meeting overall clinical need and improvement to the quality of life. A 'quick fix' does not deliver patient-focused care as demanded by National Service Frameworks. It is our strongly-held opinion that CATS centres in Cumbria will destabilise our local NHS Trust health care provision and disrupt services to the whole community . . . they will introduce an unnecessary tier into an otherwise exemplary NHS service and will represent poor value for taxpayers' money in terms of patient care." Primary Care Trusts have meanwhile launched an eight-week consultation which ends on March 9 following a series of public meetings in Keswick, Workington and Whitehaven. Summary by Keep our NHS Public of Workington Times & Star 22 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
          Private centres 'a threat to NHS'. A new wave of privately run 'clinical assessment treat and support' centres (CATS) could worsen the NHS financial crisis and threaten jobs, the BMA is warning. It also believes the planned centres in Cumbria and Lancashire could lead to damaging conflicts of interest. The provider, Netcare, already runs a surgical treatment centre in Manchester and is a preferred bidder for an integrated assessment and treatment centre in the city. Under the plans for a network of 10 CATS in the north west, 60 per cent of GP referrals would be triaged by the centres rather than hospital consultants. Dr Hamish Meldrum, GPC chair, said the centres could have a huge impact on the on the availability of services and on patients' relationships with their doctors. He said: 'The Government's NHS reforms are supposed to be all about patient choice, but under these plans, it seems a private company would get to pick and choose between patients, rather than the other way round.' Dr Jonathan Fielden, chair of the BMA's consultants committee, said the long-term implications of allowing private firms to take work and staff away from the NHS had not been thought through. He added: 'It would fundamentally threaten the safe continuity of patient care provided by GP-to-consultant referral.' The centres are due to open in March and will handle GP referrals to ENT, orthopaedics, rheumatology and general surgery. Summary by Keep our NHS Public of Pulse 25 January 2007
          Top docs in revolt over privatisation. East Lancashire's four