Essex Strategic Health Authority

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

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

          Boy's operation death linked to safety failures. Inquest told staff unaware of advice to check equipment. James Meikle, health correspondent Tuesday May 20, 2003 The Guardian [Chelmsford]
          An ambulance trust and private healthcare company today unveiled a landmark joint venture to provide out-of-hours care. Care UK, the main private sector provider of health and social care services, will take on non-emergency calls from the Essex ambulance service NHS trust. It is estimated that the service, which covers around a fifth of Essex, could eventually cut the number of unnecessary ambulance call-outs by more than half. If the two-year scheme is successful it could be expanded to other parts of the country. Monday November 22, 2004
          More than 6,000 women who underwent breast cancer screening or follow-up assessments over a two-year period are having their records checked after the discovery of "inconsistencies" at a hospital in Essex. So far only seven women have been recalled for further checks, three of whom have been found to have breast cancer after they thought they were clear of the disease. They were among 121 women who underwent biopsies for tissue examination after their scans indicated the need for further assessment. James Meikle, health correspondent Thursday May 5, 2005 The Guardian
    3     GP's fury at minor injuries service cut. Essex GP Dr Philip Woodcock has hit out at the decision of Colchester PCT to restrict GPs from performing minor operations on cysts and lumps and from administering pain-relief injections. The PCT has imposed the restrictions, which mean patients will have to see a salaried doctor at Colchester General Hospital for the treatments, in a bid to cut it's deficit, with the implication that GPs were carrying out unnecessary procedures. Summary by Keep our NHS Public of East Anglian Daily Times 13 February 2006
    3     PCT fury over lost millions as PbR compensation withdrawn. Primary care trusts are furious after learning that compensation for those that will see costs rise under payment by results is to be halved next year, before abolition in 2008. The change in policy, announced just two months before the new financial year, will leave black holes in their finances. Coventry PCT will be hit hardest with a £16.2m funding gap, and Huntingdonshire will be left with a £14.9m shortfall. PCTs in West Midlands South strategic health authority area will face a £53.1m gap, PCTs across Essex SHA will have to deal with a cut of £48m, and the four Birmingham PCTs are set to lose £20m. Norfolk, Suffok and Cambridgeshire SHA said its PCTs face a loss of £39m. Summary by Keep our NHS Public of Health Service Journal 16 February 2006 
          PCT's minor surgery pull-out sparks fury. GPs are furious after Colchester PCT announced it would move some minor surgery work to a local acute hospital rather than pay local practices to do it, warning that more PCTs would follow suit as they ran out of money towards the end of the financial year, regardless of the Government's drive to move such services into the community. Essex LMC is investigating whether Colchester PCT is in breach of contract, as practices were doing the work under directed enhanced service (DES) nationally agreed terms. Summary by Keep our NHS Public of  Doctor Update 23 February 2006
1         Hospital car parks make millions. Hospitals in England are each charging their patients up to £1.5m a year for car parking. Twelve hospital trusts each raised over £1m in charges, figures obtained by the BBC from the Department of Health under the Freedom of Information Act show. University Hospital Birmingham, raised £1.5 million from car parking charges in 2004-5; Cambridge University NHS Foundation Trust raised more than £1m; Basildon and Thurrock University Hospitals NHS Foundation Trust raised just over £1m; Oxford Radcliffe Hospitals NHS Trust raised more than £1.2m. Summary by Keep our NHS Public of  BBC Online 28 March 2006
    3     Hospital announces 200 job cuts. Staff at St Richard's Hospital in Chichester were told on Wednesday that 10% of the workforce - or 200 jobs - would go over the next three years. The Royal West Sussex NHS Trust said it would try to keep redundancies to a minimum but some may be necessary. The trust has overspent by a total of £40m and had a £14m deficit last year. The St Richard's cuts are the latest to affect hospitals in the South East, where more than 1,000 job losses have been announced in the last two months. Surrey and Sussex Healthcare NHS Trust, which manages Crawley Hospital and East Surrey Hospital, has said 400 jobs will go; East Sussex NHS Hospitals Trust, which runs the Conquest Hospital in Hastings and Eastbourne District General, has axed up to 250 jobs; Up to 160 jobs are to go at the Medway Maritime Hospital in Gillingham, Kent; Brighton and Sussex University Hospitals NHS Trust plans to lose 325 jobs; East Kent Hospitals Trust warned of possible cuts to claw back a £35m deficit. Summary by Keep our NHS Public of  BBC Online 4 May 2006
          Mental health trusts get new status. The first three mental health foundation trusts have been launched following authorisation from regulator Monitor. From May 1, Oxleas Foundation Trust, South Essex Partnership Foundation Trust and South Staffordshire Healthcare Foundation Trust joined 32 acute foundations. The authorisation came a month late because of the complications surrounding the payments by results tariff. Summary by Keep our NHS Public of  Public Finance 5 May 2006
  2       'Start small' says primary care boss. PCTs should "start small" and begin sharing information quickly in order to introduce practice-based commissioning by the government's December deadline, according to Gary Belfield, the DoH's top primary care official has said. Meanwhile Patricia Hewitt urged practices and new providers to examine a partly privately funded primary and community service provider in Harlow as a possible best-practice model for how to attract extra funding in primary care. Harlow Health Centres Trust has some capital investment from insurance companies. Hewitt said the model appeared "less bureaucratic than LIFT" and showed that not everything had to be paid for using "public money". HHCT owns and manages seven health centres in Harlow, originally opened in the 1950s. The organisation became a limited company in 1997, and a charity in 1998. Summary by Keep our NHS Public of  Health Service Journal 18 May 2006

 

          ISTC chaos ignored. The Government is ignoring local concerns over the national ISTC programme as evidence emerges of more schemes being scrapped or put on hold. At least eight of 24 schemes in the £2.5bn wave two ISTC procurement have now been dropped and another put on hold after commissioners said they were not needed. But the DoH is not only insisting that Norfolk, Suffolk and Cambridge SHA spends £38m on a elective surgical ISTC, it has also rejected its proposals for case-mix of patients treated there. A recent report by Cambridge City and South Cambridgeshire PCTs said the DoH had "modelled that we need this capacity" without factoring new NHS capacity into the model. It said "there will be high risk to local providers because the aim is for the [ISTC] to fill up first". The PCTs are also under pressure to buy more scans under the national diagnostics procurement. Most of the commissioned scans would substitute for work done in the NHS rather than supplement it, the report says. Essex SHA has been ordered to spend £45m on independent sector schemes, despite the collapse of two ISTC projects in 2005. A paper presented to Colchester PCT's board in January said the SHA had "identified a number of concerns" with this but the scheme was going ahead anyway. A surgical scheme for Leicestershire, Northamptonshire and Rutland SHA has been halted. The SHA said that a PFI project to upgrade three hospitals and an ISTC could lead to over-capacity. The SHA is negotiating to leave the national private diagnostics procurement. The DoH has allowed the scrapping of a surgical ISTC in York, which already has a surgical treatment centre, at Clifton Park. Birmingham City Hospital's ISTC had been dropped and it has been reported elsewhere that a further six schemes have been abandoned. These are: County Durham & Tees Valley, South Yorkshire (both cardiology and general surgery), South West Peninsula, and West Yorkshire (both plastics and multi-specialty centres). Dr Paul Miller, chairman of the BMA's seniors' committee, said: "There's clear evidence that wave one schemes are surplus to requirements - spare capacity is being hawked around like soft fruit at the end of market day. Rather than imposing wave two schemes where they are not wanted the DoH should stop now. It should not sign another contract before it has reviewed the whole policy." Summary by Keep our NHS Public of  Hospital Doctor 8 June 2006
  2       NHS Trust scraps 'one roof' plan. A £167m project designed to transform the provision of healthcare in North Essex has been scrapped. Essex Rivers Health Care Trust had already spent £3m on a private finance initiative to centralise its services at Colchester by 2009. Services would have been moved to Colchester General Hospital, and Essex County Hospital would have closed. Health bosses now say the plan is at odds with government white papers which call for healthcare in the community. A spokesman for Essex Rivers Health Care Trust told BBC news that of the £3m already spent £2.4m had come from the Department of Health. Another £600,000 had come from the trust itself. Summary by Keep our NHS Public of  BBC Online 14 June 2006
  2       £7m claim after PFI deal scrapped. Developers involved in a failed £167m PFI deal to centralise health services in Colchester are trying to claw back millions of pounds. Essex Rivers Health Care Trust said last week that its private finance initiative to move services to Colchester General Hospital and close Essex County Hospital had been scrapped. The private sector developer AMEC is calling for £7m in compensation for the costs of preparing the project. The Department of Health that at least part of that bill should be paid. When the PFI deal was scrapped, the trust said it had already spent £3m on the scheme to centralise its services at Colchester by 2009. Summary by Keep our NHS Public of BBC Online 21 June 2006
  2       New hospital plans "needed quickly". Health chiefs must come up with plans to replace a failed £167m project in Essex, a Public and Patient Involvement forum has warned. The PFI project in Colchester in Essex has been scrapped and Essex Rivers Health Care Trust has begun looking at more affordable options. However the local Patient and Public Involvement forum has expressed its "dismay" at the plans and stressed the need to move quickly to ensure that some of the key proposals, such as an emergency care unit and dedicated cancer centre, are still implemented in another form. The group blamed a government shift away from district hospitals for the collapse. Summary by Keep our NHS Public of East Anglian Daily Times 27 June 2006
  2       Trust faces bill for dropped PFI deal. A £167m scheme to centralise a hospital trust's services on one site has been dropped at a likely cost of £10m. Essex Rivers Healthcare trust made because the decision because the opening of a new independent treatment centre would have made it unaffordable and because the plans did not align with the government's desire to move more services into the community. Now the private finance initiative partners want as much as £10m in recompense for the costs they have incurred on the project. It is thought likely that the DoH will agree to meet at least some of the company's costs, to calm the commercial sector's nerves over the future of PFI. Chief executive of Essex Rivers Healthcare, Peter Murphy, said four factors had influenced the decision: the white paper on care outside hospitals; payment by results; plans for an independent treatment centre in Essex which is expected to take 20% of the trust's elective income - £7.8m in 2008-09; a strategy for patients with chronic conditions to visit hospital less. Summary by Keep our NHS Public of Health Service Journal 6 July 2006
    3     Loan sparks fear of NHS queues. Patients in south Essex may face longer waiting times and fewer services as the NHS is forced to hand over millions of pounds to bail out debt-ridden health departments in other counties. The East of England Strategic Health Authority is demanding an unspecified amount as a loan from the South West Essex Primary Care Trust. The money, which could run into millions, will be used to balance the books of ailing PCTs in Hertfordshire, Suffolk, Norfolk, Cambridgeshire and Bedfordshire. Basildon PCT has already forked out £6.1million to help the areas which are in the red. Now there are fears the extra loan could impact on patient services, increase waiting times and affect staff morale. Summary by Keep our NHS Public of Essex Echo 3 August 2006
  2       Southeast Essex LIFT partner announced. The private partner in a multi-million-pound scheme to fund and build a range of primary care centres across south east Essex has been announced. The preferred provider is gbPrimaryCare, which will be working with Southend Primary Care Trust and Castle Point and Rochford PCT, plus other local health and social care providers to fund and develop up to 11 health and social care buildings across the region. Summary by Keep our NHS Public of thePFI.net 15 August 2006
  2       Hospital projects to receive Autumn announcement. 11 NHS hospital projects, which are currently under review, will receive a decision in the autumn. They are: Hillingdon Hospital redevelopment - £271m; Leeds Maternity and Childrens Hospital scheme - £204m; North Bristol and South Gloucestershire scheme - £310m; North Mersey Future Healthcare Project - £1bn; Northwick Park and St Marks redevelopment - £305m; Papworth Hospital NHS Trust redevelopment - £148m; Royal National Orthopaedic Hospital Stanmore scheme - £121m; Sandwell and West Birmingham Acute Trust - £591m; Southend Hospital redevelopment - £100m; Taunton Surgical Centre - £75m; Watford and Hatfield Hospitals redevelopment - £880m. Summary by Keep our NHS Public of PFI.net 31 August 2006
    3     100 more hospital posts at risk. More than 100 jobs could be cut at two hospitals in Essex to help meet a £14m budget deficit. Mid Essex Hospital Services NHS Trust, which runs Broomfield Hospital and St John's Hospital in Chelmsford, has already cut 150 posts to make savings. On Wednesday the trust said it had now saved £7m but still needed to make a further £7m in cuts this year. This is about £2.5m more than was predicted at the beginning of the year. Summary by Keep our NHS Public of BBC Online 31 August 2006
        5 MP's anger at hospital ward closure. An MP has branded the decision to close a ward in an Essex hospital "absolutely appalling." Clacton Hospital said it will be closing the 19-bed ward next month. But Douglas Carswell MP, who represents Harwich and Clacton, insisted yesterday that the closure is part of cost cutting and a sign of a lack of money. He said: "It's absolutely appalling. What they're avoiding saying is that they don't have enough money. They should be open about it. It is a cause of great concern to a lot of local people. They ought to be taking on more staff, not getting rid of more patients." The closure of the Percy Coleman Ward on October 2 will reduce the amount of beds available at the hospital from 97 to 78. Summary by Keep our NHS Public of East Anglian Daily Times 8 September 2006
1         Hospital's multi-storey car park plan. A multi-storey car park could be built to ease notorious parking problems at Southend Hospital. Plans are being drawn up for a three-storey building with 400 staff spaces and 300 for patients and visitors. Hospital officials say profits from charging visitors - and possibly staff - would fund measures to persuade people to abandon their cars for greener modes of transport. It would be built in partnership with a private firm. The hospital has provisionally put aside more than £1million over the next two years, with the expectation of recouping £1.5million in the two years following that. Summary by Keep our NHS Public of South Essex News 8 September 2006
    3     Hospital to slash 250 jobs. Tony Blair has been accused of talking "a load of rubbish" by an MP after it was announced 250 jobs would be lost at a mid-Essex hospital. On the day that Blair predicted only a few hundred compulsory redundancies country-wide in the health service this year, staff at Broomfield Hospital in Chelmsford were called into briefings where job cuts were finally confirmed. The cash-strapped hospital has been trying to save £14m this financial year and its 3,000 staff have already been encouraged to cut down on photo-copying and remember to switch off lights. The hospital has managed to save £10m but is now seeking to make up the remaining £4m with the loss of 250 jobs. Staff have been now invited to volunteer for redundancy. The hospital is reviewing its administration, clerical, human resources, estates and facilities and IT departments with the possibility of reducing staffing. West Chelmsford MP Simon Burns said: "Tony Blair is talking a load of rubbish. You only have to look over the last eight weeks at the job losses in West Suffolk and Ipswich that those losses together with Chelmsford amount to more than the job losses Blair spoke of. It is an insult that on the day that Mid Essex Hospital Trust announce 250 job losses for the Prime Minister to claim that the total job losses in the NHS throughout the country will be a few hundred. That is quite clearly spin and it is not based on a scintilla of factual evidence." Summary by Keep our NHS Public of East Anglian Daily Times 19 October 2006
          Anger over GP decision. A decision to stop local doctors from providing patient care at a newly built hospital in an Essex town has been branded "horrendous". GPs from three surgeries in Harwich have provided "in hours" care for their patients at the town's hospitals for 50 years. But the recently formed North East Essex Primary Care Trust (PCT) has told them their services would no longer be required. To save money the service will now be provided by Primecare, a company the NHS uses to provide care for patients at weekends and during the night in Tendring. The company will take full control of patient care at the new £12m Fryatt Hospital and Mayflower Medical Centre. Dr Richard Alldrick, a GP who has worked in a practice in the town for 23 years, is among those to be hit by the changes. He said: "The new PCT has just taken a unilateral decision that is going to severely affect the people of Harwich and Dovercourt. The trouble is that this is a Government driven issue that we can't do anything about. What will be lost is the personal service that the people of Harwich and Dovercourt have had for 50 years. Our input into the hospital will actually now be nil." The new hospital has been beset by problems, even before opening its doors. Earlier this month the site was still not fully operational and services, including the minor injuries unit, were left unused as workers were sent to Colchester to cover staff shortages. Questions still remain about the unopened operating theatre and X-ray department while there are fears about the future of the maternity unit. Matt Bushell, director of strategic development and commissioning for North East Essex PCT, said all areas of current expenditure were under review. He said the PCT was responsible for delivering "appropriate, continuing and effective" care to the local population but also for getting best value from its funding allocations. The new service arrangements in Harwich will be fully reviewed during the pilot period and a tender will then be issued setting out "specification of need" for future requirements, which local GPs will be able to bid for.  Summary by Keep our NHS Public of East Anglian Daily Times 24 November 2006
  2       Health centre project in jeopardy. Campaigners voiced their concern last night after it emerged a long-awaited healthcare centre may never be built. Thousands of patients in Great Clacton and Holland on Sea had been told their doctors' surgeries were like something "out of the dark ages" and would be replaced by a multi-million pound facility. But the recent merger of Tendring into the new North East Essex PCT cast doubts about whether the funding would still be available. And residents' fears were confirmed last night when bosses confirmed the proposed health centre was now under scrutiny. The news came as a blow to campaigners, who had initially fought against the closure of their out-dated surgeries. Hugh Morrison, chairman of Residents Action Group (RAG), said people felt let-down because the old Tendring PCT had balanced books when it was merged. He said: "Where do we go from here ? We were told we would be having a new health centre and, because of that, the surgeries have been put on hold. If it does not go ahead, would the PCT then be prepared to update the surgeries ? It is all up in the air.'' Four GP practices in Holland on Sea and Great Clacton were due to make way for the new facility.  Summary by Keep our NHS Public of East Anglian Daily Times 1 December 2006
1         Nurse anger over parking fee hike. Nurses at an Essex hospital have reacted angrily after health bosses announced plans to hike up staff parking fees by more than 400 % to help pay off NHS debts. Charges for employees wanting to park their cars at Broomfield Hospital in Chelmsford are set to rise from the current £3.33 per month to £16.67 a month from February next year. Colin Rolfe, who represents trade unions and professional organisations at the trust, said he felt hard-working and already pressurised hospital staff were being punished for the inability of the trust to manage its own finances properly. Mid Essex Hospital Services NHS Trust, which runs the hospital, recently announced it was to shed as many as 250 jobs in an effort to pay back a £14m deficit. In an email sent to staff this week it announced that in order to generate additional money to help pay its debts it was going to increase staff car parking fees by five times. Patient and visitor parking fees would also be increased, it added. "The extra income generated from the increases, after paying for the upkeep of the car parks, will go straight back into the trust's overall budget. If you work more than 20 hours per week the change will increase to £16.67 a month. If you work 20 hours or less, the charge will be £8.33 per month." The email also said that the hospital staff's parking fee had not been increased in eight years, and that similar trusts in Essex, including Basildon and Thurrock university hospitals, were also increasing their charges. Mr Rolfe said: "It is indicative of what is going on in the wider NHS at the moment, with the poor financial controls of the trusts and a staff who are under great pressure to increase patient care and workloads. What with the redundancies as well, this feels like yet another nail in the coffin." Summary by Keep our NHS Public of East Anglian Daily Times 8 December 2006
          NHS to restore health at Tribal. Mercury Health, the healthcare delivery arm of struggling public sector outsourcing specialist Tribal, has won preferred bidder status for a "substantial five-year contract" to provide a range of surgical, orthodontic, rehabilitation, sexual health and family planning services to NHS patients in Essex. It is already contracted to design, build and manage five other NHS centres for diagnostic procedures and surgery. Tribal said the Mercury deal was for 29,000 procedures and appointments annually in Essex. Mercury Health chief executive Peter Martin said: "This announcement extends our partnership with the NHS and builds on recent success in being chosen as preferred bidder for a major diagnostics contract treating NHS patients in the West Midlands." Summary by Keep our NHS Public of Western Daily Press 14 December 2006
          Plan to farm out post-op checks to GPs unsafe, says top surgeon. The president of the Royal College of Surgeons has warned that government plans to farm out the aftercare of surgical patients to GPs are potentially unsafe. Bernard Ribeiro, who still practises as a general surgeon, said in a letter to the Guardian that the proposal is a cost-cutting measure that puts patients at risk. The government wants to free up surgeons by requiring GPs to see patients for the follow-up checks now carried out by the surgeon responsible for the operation. Mr Ribeiro says GPs are too busy and would have neither the skills nor adequate knowledge of the case. "There is neither the expertise nor the capacity to deal with this. It appears to be attempting to move this work from surgeons trained in managing these cases to GPs." Basildon and Thurrock University hospital, Essex, where Mr Ribeiro practises, has for the last three months invited GPs to take back the patient after surgery. Only 24 patients out of thousands went back to their GP rather than the surgeon's outpatient clinic. Most GPs did not appear inclined to take on the extra cases. Mr Ribeiro is sceptical about government claims that the measure would free up surgeons to carry out more operations. Surgeons would still have to hold outpatient clinics, and since consultations with new patients take longer than follow-ups, the increase in surgery would not be great. He also questions whether there will be enough theatre capacity and staff for more operations. Safety is the biggest issue, he says. There is no obvious way in which the care of the patient will be improved if he or she is seen by a GP. "If I'm treating a patient, I want to be in a position to say to the patient your treatment is complete," he said. He felt the measure had little to do with quality of care and was perhaps prompted by government commitment to meeting its waiting time targets for patients by increasing the number of operations. The proposal has been recommended by David Colin-Thome, the national clinical director for primary care. Summary by Keep our NHS Public of Guardian 30 December 2006
    3     Health chiefs face "rationing" claim. Health chiefs at North East Essex Primary Care Trust have been accused of rationing treatment to cataract patients. A leaked memo has revealed a policy supposedly designed to ensure that those with the most serious conditions get treated quickly. The new system of "affordable eye care" means people in the Colchester, Clacton and Harwich areas who suffer from cataracts will be graded on a points system depending how serious their condition is. Health bosses have claimed it is designed to avoid those with more advanced conditions being blocked by those with less serious ones. However North Essex MP Bernard Jenkins has accused the PCT of massaging figures and covering up the true numbers waiting by not adding many to the list. The PCT's director of strategic development and commissioning, Matt Bushell, defended the new system saying: "Patients who need cataract surgery will receive an operation within three months, which is in accordance with national guidelines. Patients are assessed as to those who need prompt access to surgery, those who can wait three months and those that do not need surgery. People with more advanced cataracts need an operation as soon as possible and this system means they will not be delayed." He added that the new system would "ensure that the PCT operates within its means, as there are limited resources available for elective surgery - across the East of England PCTs are in overall financial deficit situation." Summary by Keep our NHS Public of East Anglian Daily Times 8 January 2007
    3     Hospital told to treat fewer patients. One of Essex's biggest hospitals has been ordered to see fewer patients because of the cash crisis in the NHS. Colchester General Hospital has been told that the North East Essex Primary Care Trust (PCT) cannot afford to pay for it to continue treating people at the current rate. More than 1,500 people will now be seen later than they could have been because the PCT has ruled that non-emergency patients must wait at least 16 weeks before going to the hospital. This means people waiting to see a hospital consultant will face the minimum wait even if the consultant is available for an NHS appointment the following week. Summary by Keep our NHS Public of East Anglian Daily Times 12 January 2007
    3     We'll get NHS cash back - eventually. The county's top NHS boss has defended £27.3m worth of loans from south Essex health services to bail out debt-ridden health departments in other counties. Neil McKay, newly-appointed chief executive of the east of England Strategic Health Authority, said he has a responsibility to balance the books for the entire region. But patients fear longer waiting times and fewer services as £18.4m is taken from the £460m budget of the South West Essex Primary Care Trust. A further £8.9m has been demanded from the South East Essex Primary Care Trust. There is no guaranteed date for when the cash will be returned. Summary by Keep our NHS Public of Essex Echo 12 January 2007
          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
          Health hijack. In a comment piece, John Lister writs: "A brand new hospital in the New Forest, to be paid for by the NHS, is handed over to the management of a private company before it even opens: in Oxfordshire a long-standing NHS orthopaedic hospital, which has just spent millions on rebuilding work, faces the threat of closure or merger as private sector treatment centres hijack the simplest routine cases. Two Essex NHS trusts scrap plans for new hospitals because they face massive losses under the new system of payment by results: west Hertfordshire residents fight the "centralisation" of A& E services on the condemned crumbling site of Watford General, now plans for a £550m super-hospital have been binned. In Bolton 132 medical and nursing staff face the axe as a strategic health suthority opts to divert work to a private treatment centre. Like the sorcerer's apprentice, Tony Blair's "modernising" reforms of the NHS now threaten to lurch out of control: they have conjured up a booming new, costly, private sector in health care provision, while the core public sector hospitals and health services are sent reeling from one cash squeeze and reorganisation to the next. A new pamphlet outlining the dynamics and the implications of what it terms the "patchwork privatisation" of the NHS has just been published after months of research by the Keep Our NHS Public campaign. It shows that while Thatcher's privatisation of state-owned utilities were high profile campaigns with mass sales of shares, the piecemeal process of hiving off key NHS services to private providers has been an obscure process, largely conducted behind a cloak of "confidentiality" with minimal public involvement or debate. Especially tight security has shrouded the contracts for Independent Sector Treatment Centres (ISTCs) with all future decision-making now in the hands of Strategic Health Authorities with no local accountability to patients or public. The Healthcare Commission this week underlined the lack of data on the clinical quality of ISTC services: but the general public is equally in the dark on the real cost of these controversial new units. Ministers admit that the ISTCs get paid an average 11.2% more than the NHS for each operation they do: but no details are published on the profits pocketed by ISTC companies at the expense of the NHS. Similarly, the details of the £8bn worth of new hospitals to be built through the controversial Private Finance Initiative (PFI) remain under wraps, with deals signed behind closed doors and not a single unexpurgated full business case having been published. Government figures now show the long-term cost of borrowing the £8bn capital in this way will be a staggering £53bn - £37bn in "rent" for use of the new buildings over 30-35 years, almost five times the initial cost. Had trusts been allowed to borrow as a conventional repayment mortgage at 6% they would pay back twice the cost of the initial investment - over just 25 years. The extra cost above this (equivalent to paying a massive 18% interest) is the premium that the NHS is set to pay for this one-sided, extravagant "partnership" with the private sector - without taking any account of further windfall profits from refinancing their loans on the money markets once the construction phase is complete. It seems the secrecy surrounding these deals is because there is plenty that ministers are understandably eager to hide. But while every million extracted from the NHS in profit is a million less in resources for patient care, the real cost of private sector involvement is far higher than its profits and bureaucracy… All of the constraints have fallen on the public sector: all the growth is in the private sector. That's why NHS trusts like Ipswich, which once sweated to reduce waiting lists and waiting times, are now being forced to drive them back up again, or face fines and penalties from indebted primary care trusts. It's all gone horribly wrong, leaving a dozen ministers - and dozens more local communities - supporting local campaigns against "reforms" endorsed by Tony Blair. In 2005 New Labour were reinventing failure in health policy: now with their own Starship Enterprise they are exploring new dimensions in failure, with patchwork privatisation at the centre of policies that have managed to be both more expensive and more unpopular than ever before." Summary by Keep our NHS Public of Guardian 20 January 2007
          Hospitals A&E merger threat. South Essex could be left with a single Accident and Emergency department if too many people choose to go to NHS-funded private clinics, it has been warned. Marlene Moura, chairman of the patient and public involvement forum for Basildon Hospital, said a secret hospital report suggested it may have to merge services with Southend if funding dropped below a certain level. Mrs Moura said: "If 15% of finances and patients are removed from the hospitals, we could end up with one hospital. A& E would be the first to feel it." Mrs Moura said patients choosing to seek private treatment outside the hospital, at centres such as a proposed mini-hospital (ISTC), would take money from the main hospitals and cause services to be scaled down as a result. She said: "I'm really worried. They're allowing this new mini-hospital to go ahead, which will take out huge amounts of services for our hospitals." A separate report, released by the NHS in December, suggests hospitals of the size of Basildon and Southend are being encouraged to combine their emergency services. The report, called Looking to the Future: Development of hospital services in the East of England, states: "It must be questionable whether units serving a catchment population below 300,000 can or should continue to plan to provide these services on their own." Both hospitals just scrape over the 300,000 mark in terms of patients they provide services for. A spokesman for Basildon Hospital confirmed they were also worried about the "knock-on effects" for emergency services and said some services may be lost if the majority of patients chose to go private. Basildon Hospital chairman David Hooper estimated about £11m funding would be at risk if patients were treated at the planned mini hospital instead. He said: "Although this is the worst-case scenario, even smaller numbers of patient treatments transferring from this trust will create significant financial and service risks for the trust." Summary by Keep our NHS Public of Essex Echo 9 February 2007
  2       Hewitt approves seven PFI hospitals at cost of £1.5bn.  Patricia Hewitt, the health secretary, gave the green light yesterday to plans for seven new hospitals to be built under the private finance initiative at a cost of £1.5bn. Her decision to back the NHS's biggest ever tranche of investment will provide modern facilities for patients in Bristol, Peterborough, Middlesbrough, Wakefield, Tunbridge Wells, Chelmsford and Edmonton, north London. But it added to anxieties among health service managers and union leaders that the NHS is locking itself into repaying huge sums in 30-year deals with the private sector for buildings and equipment that may not meet changing medical needs. John Carvel, social affairs editor Tuesday February 27, 2007 The Guardian
  2       Seven more PFI hospitals to go ahead. Seven more private finance initiative hospitals, with a capital value of almost £1.5bn, were finally given the go-ahead but amid growing frustration among PFI providers at the time it is taking for the Department of Health to adjust hospital building plans to the new, more competitive, NHS market. The hospital PFI programme is being cut back from an original £12bn of additional schemes to something closer to £7bn-£9bn, according to the health department, as hospitals adjust to the uncertainty of a system that pays them for each patient they treat, in contrast to block contracts. The announcements in part reflect that. The value of the seven schemes given the go-ahead is being reduced by about 15 per cent, or by £248m on their original £1.63bn value. But although the go-aheads - for schemes at various stages of procurement - has now been given the first stage of the review was meant to be completed by late last year. And a reappraisal of 23 other schemes with a capital value of about £5.5bn, including some individual projects worth £500m and more, is unlikely to be completed before the autumn, the health department said - the better part of two years since the review of PFI projects was launched. To date, only a few PFI projects - the £1bn Paddington campus scheme, Whipps Cross and Essex Rivers - have been withdrawn. Three of yesterday's approvals - Peterborough, a rebuild in North Bristol, and a smaller project in the north-east, went through unchanged. Two more have undergone relatively minor revision. But the Maidstone deal has been cut back from a £269m scheme to £218m, while one in Mid-Essex is down from £199m to £143m. Unison, the health service union, protested that taxpayers will be "paying over the odds" for the new facilities for years to come because they have been built through the PFI. Summary by Keep our NHS Public of Financial Times 27 February 2007
        5 Surgery of banned GP facing closure threat. A GP surgery is facing closure just a month after its doctor was banned from practising in the NHS for inappropriate behaviour. South East Essex Primary Care Trust confirmed it was considering the closure of the Fairway medical centre, in The Fairway, Patients have been fighting the possible closure of the surgery for months, with more than 600 signing a petition against it. But to their dismay, South East Essex Primary Care Trust is now considering its closure. A decision will be made on March 29. David Woods, chairman of Friends of the Fairway, said: "The trust is putting 2,500 patients out on the street. It is going to affect a hell of a lot of people." Summary by Keep our NHS Public of South Essex News 5 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
    3     Longer wait for NHS patients. Patients will have to wait up to five months for surgery to save NHS cash, a leaked letter has revealed. The current average waiting time is eight weeks but hospitals are being told to treat fewer patients to avoid overspending their budgets. A document from the East of England Strategic Health Authority, leaked to MP John Baron, tells how primary care trusts are told to ensure surgery is "limited" to urgent patients or those who have waited 20 weeks. The Billericay and district MP said it meant efficient hospitals, currently hitting targets, would be penalised and forced to limit the numbers of operations they carry out. He said: "South West Essex PCT has been ordered to transfer £3.5m to the health authority so it can be given to other trusts in the region with deficits. However, it is struggling to find all the cash. Why should our PCT be made to make cutbacks because other PCTs are in deficit ?" Summary by Keep our NHS Public of South Essex News 16 March 2007
        5 Save our surgeries! More than 1,000 people have backed a campaign to save two threatened doctors surgeries. Patients have been campaigning against South East Essex PCT's plan to close the Leecon Way surgery, in Rochford, and the Hawkwell Park Drive practice, in Hawkwell. Supporters have organised a petition demanding the surgeries stay open and more than 1,000 people have signed it. Summary by Keep our NHS Public of South Essex News 16 March 2007
    3     NHS cash is being wasted, claims MP. Vital NHS funding is being "wasted" and is not getting through to frontline services, it has been claimed. Simon Burns, the MP for West Chelmsford, said although extra money had been poured into the NHS, much of it was being spent on bureaucracy. Figures from the Department of Health have revealed there are fewer beds available now in mid Essex than there were a decade ago when the Conservatives left office. Figures given to Mr Burns following a Parliamentary question showed that in 1997, mid Essex had 888 beds, a figure that has fallen to 809 now. The number of beds has dropped in recent years because of the closure of the intermediate care wards at St John's Hospital. Summary by Keep our NHS Public of East Anglian Daily Times 23 March 2007
          NHS dentist reforms have failed, says survey. The government's reforms of NHS dentistry have failed to improve the scope and quality of the service, according to two surveys today. A year after the introduction of a new dental contract there is still "huge inequality in access to NHS dentistry", with no change in the number of people receiving treatment, according to the Citizens Advice, the umbrella group for Citizens Advice Bureaux. It estimated that nearly 2 million people were unable to get treatment. Two thirds of the 4,000 people polled in England and Wales said they ended up going without treatment due to "huge problems accessing NHS dentistry and not being able to pay for private treatment". More than three quarters of the respondents to the survey, called Gaps to Fill, said they were unable to get treatment because none of their local dentists were accepting NHS patients. Some patients said they were forced to do round trips as long as 120 miles to reach an NHS dentist. The British Dental Association (BDA) also criticised the government's reforms, backing the CAB's findings that the new dental contract has failed to improve access to NHS treatment. Its research found that 85% of 394 dentists surveyed believe the new contract has not improved patient access to NHS dentistry. Furthermore, 95% of dentists questioned felt less confident about the future of NHS dentistry than they did two years ago. Citizens Advice called on ministers to take urgent action to deal with "dentistry deserts" in some parts of England and Wales. The charity said there was a postcode lottery of NHS dental care with some areas, such as Hartlepool and Hornchurch, "spoilt for choice" and others, including Blackburn and Petersfield, having "very poor access". David Batty and agencies Wednesday March 28, 2007 Guardian Unlimited
          £60,000 for hospital marketing director. Southend Hospital has been accused of insulting nurses by seeking to recruit a director of marketing with a £60,000 salary. The Patients' Association said the hospital would be better spending the money on medical staff. Insiders said the salary offered to the director of marketing was more than a director of midwifery would earn at a major hospital. Blair Gibbs, campaign director of the TaxPayers' Alliance, said: "At a time when the NHS is struggling to afford the latest drugs, creating a new corporate role like this that pays more than twice a junior doctor's starting salary is an insult to hardworking frontline staff." The advert for the post comes at a time when the hospital, which is £1.5m in the black, is advertising for a staff nurse on a salary of up to £25,000 a year. Summary by Keep our NHS Public of Essex Echo 22 May 2007
        5 MP quizzes minister over service fears. An Essex MP tabled three parliamentary questions as concerns grow about health services in his constituency. Harwich MP Douglas Carswell spoke out after it was revealed that the Harwich maternity unit at the newly-built Fryatt Hospital was to close overnight because of staff shortages. The £12m hospital has already hit the headlines after a series of delays in getting services up and running at the new facility. The future of Peter Bruff ward at Clacton Hospital, which is for people with mental health issues, is also currently under review. Mr Carswell said: "Our local NHS is being salami-sliced. Tendring's own primary care trust was merged with Colchester's. Last summer we lost one of the wards at Clacton hospital. Now we hear that another one might disappear, and that the brand new Harwich hospital stands under-used. At the same time, local people are having to wait ever longer for even basic procedures. I am angry that local services are being cut. And like local people, I am furious at the underhand way it is being done. Ministers blame local officials. Local officials remain unaccountable. Amid all the confusion, services get cut. Local people have every right to be angry. As their member of parliament, I will ensure that their voice is heard." Summary by Keep our NHS Public of East Anglian Daily Times 5 June 2007
  2       Empty GP surgery row heads to Commons. An MP has accused the Health Minister of "passing the buck" in the row about a new doctor's surgery which has stood empty for six months. Villagers in Dedham raised funds for the surgery to be built after the current one was deemed unsuitable under health and safety and disability access laws. The building, part of a larger construction project, was unveiled in December - but has never been used because of a funding row. Villagers currently have to travel up to five miles to a doctor's surgery in East Bergholt, for which there is no regular bus route, costing as much as £25 in taxi fares. Now North Essex MP Bernard Jenkin has applied for an adjournment debate in the House of Commons so he can question health ministers about the situation. He is angry after receiving a letter from Andy Burnham MP, health minister for delivery and reform, saying the issue should be resolved by the two primary care trusts (PCT) which cover the area. Essex PCT boss Dr Paul Zollinger-Read has said the funding to run the surgery would be too costly and that Suffolk PCT will not hand over money for the patients Essex PCT would take on if they transferred from East Bergholt. Mr Jenkin said yesterday: "They (the Government) are hoping the problem is just going to go away but it is just monstrous that the people of Dedham dug into their own pockets to build a surgery and it is standing empty." Summary by Keep our NHS Public of East Anglian Daily Times 11 June 2007
          MP Baron is worried by 'secrecy' over hospital. MP John Baron has been assured NHS patients will be given a choice over where they are treated if a privately-run mini hospital is built. The Tory MP for Billericay met health chiefs amid mounting concern the Government will force through the health centre without consultation. Mr Baron said: "After hearing the so-called Government consultation on this independent centre is going to be a sham, the Primary Care Trust has assured me patients will have genuine choice as to where they receive their care. I remain concerned a centre is being forced on Basildon by decisions being made in Whitehall, between the Government and private firm Care UK. I feel this whole project has been wrapped in secrecy." Summary by Keep our NHS Public of Essex Echo 13 July 2007
  2       Hospitals facing massive lawsuit. Triskelion Healthcare, the private company contracted to carry out the Leicester Pathway PFI project has announced it is considering suing for compensation after the £711m project was scrapped. The project, which has already swallowed £23.4m of taxpayer's money, was halted after Triskelion said the cost of the revamp had reached £921m. The company says it has spent millions preparing the project, although bosses will not reveal the exact figures. The scheme is the third recent PFI failure in the NHS. A £150 million scheme for a new hospital in Colchester and a £200 million project in Torbay have also been scrapped. The Department of Health said compensation talks were taking place in both cases. Summary by Keep our NHS Public of Leicester Mercury 24 July 2007
          Health trust's management cost shock. Essex Rivers Healthcare NHS Trust spent £7.376m on management in 2006/ 07, compared to £6.263m the previous year, a rise of over £1m. The trust attributed the "small" increase to a "reclassification of revenue" and said the amount was only a tiny part of the total budget. But Douglas Carswell, Conservative MP for Harwich, condemned the figures. He said: "Only today I met an old age pensioner who has been waiting weeks for a hearing aid and there are people campaigning in Clacton to save Peter Bruff ward which treats vulnerable people with mental health problems in Clacton Hospital. Yet now we hear management costs have been significantly increased. This is not what our tax pounds should be being spent on."  He added: "Think what £1million could do - just a fraction of that sum of money could make sure everybody waiting for a hearing aid could have one. Just a fraction of that money could dramatically cut any waiting list and just a fraction of that money could guarantee the future and long-term security of Peter Bruff ward in Clacton." A spokesman for Essex Rivers Healthcare Trust said: "There has been a small increase in our management costs most of which are due to a reclassification of revenue. More than 50% of the management cost increases were previously classified in other costs areas. There has been extra money spent on recruiting clinical support to advise managers on the running of the hospital. Funds have also been spent on improving IT services in management and the usual annual pay rises." Summary by Keep our NHS Public of East Anglian Daily Times 29 August 2007
          Patients pull own teeth as dental contract falters. Large numbers of people are going without dental treatment and some even report extracting their own teeth because they cannot find an NHS dentist in their area, a survey reveals today. The Dentistry Watch survey of more than 5,000 people, from the Commission for Patient and Public Involvement in Health, found widespread unhappiness among both patients and dentists despite government reforms to increase the availability of NHS dentistry. More than three-quarters of those who have a private dentist consider they were forced into it because their own dentist went private or they could not find an NHS dentist. Just over 10% were not registered with a dentist at all. A third of those (35%) said there were no NHS dentists nearby, 22% said they did not know how to find one, 13% said they were on a waiting list and 30% said there were other reasons. But 6% of the respondents said they were self-treating, which often included pulling out their own troublesome teeth. "Fourteen teeth have had to be removed by myself using pliers," said one Lancashire respondent. "Have pulled teeth out before, easier than finding a dentist," said one in Hull. "Because I could not afford the treatment cost, I had to extract my own tooth on one occasion," said one in Harrow. "I took most of my teeth out in the shed with pliers. I have one to go," said another in Wiltshire. Some of the respondents show considerable ingenuity. "Filled own teeth - clove oil and Polyfilla," said one in Essex. Another fixed a crown with Superglue and a third used a screwdriver to scrape off plaque. The survey was carried out by Patient and Public Involvement (PPI) Forums around England. It was triggered by complaints received by PPIs following a new contract for dentists in April 2006, which was supposed to increase access and simplify the charges levied on NHS patients. Almost half the 5,212 respondents said they did not understand the charging system and 20% of those with NHS dentists went without treatment because of the cost. There are three treatment bands - £15.90 for a basic examination and x-rays, £43.60 if treatment such as root canals is also carried out and £194 if construction work such as crowns is included. In August the Department of Health announced a drop of 50,000 in the numbers attending an NHS dentist, to 28 million. It also said there had been a shortfall in the expected revenue of £159m as a result. Most (84%) of the 750 dentists surveyed said the contract had not made it easier for patients to get NHS treatment and 45% said their practice was not taking new NHS patients. A majority (68%) had either reduced or kept the same number of NHS patients as the year before. Fixed charging bands meant dentists were better off if they treated people who needed less work, they said. "If one orange costs 10p, then 10 oranges cost £1. BUT if one filling costs £43.60, ten fillings cost £43.69. RUBBISH," wrote one dentist in Sheffield. "There is no incentive in the contract to take on new patients who often have high needs. I feel the contract discriminates against people who probably need me most," wrote another. Norman Lamb, Liberal Democrat health spokesman, said: "Eight years after Labour promised that everyone would have access to an NHS dentist, this survey shows the system is at breaking point." Sarah Boseley, health editor Monday October 15, 2007 Guardian
  2       Trusts 'shell' bed space to keep grip on PFI approval. Hospital trusts are being forced to mothball significant numbers of beds to get government approval for private finance initiative deals. The process - known as shelling - cuts the annual charges the trusts pay the PFI developer as some areas are not fully fitted out, reducing both initial cost and ongoing facilities management charges. Trusts say they are using shelling to build in flexibility in using the space. The Department of Health confirmed that it was concerned over the affordability of the schemes and said that shelling was 'an appropriate solution to this concern'. Involved are Barts and the London trust, where 181 beds out of 1,248 will be shelled; University Hospital Birmingham foundation trust (108 out of 1,213); and St Helens and Knowsley trust (100 beds). Mid Essex Hospital Services trust, whose PFI plan is awaiting approval, is also expected to have some shelled space but says this was planned from the outset. Barts and the London has reduced its unitary charge by £9.4m by shelling. It will still have to pay £98m a year. Trusts need to make a business case for bringing the extra capacity into use, which normally requires government approval. Although trusts escape some of the costs of running the beds until they open, they still incur the cost of building the extra space. Unless this can be put to good use, it will not contribute income towards the annual charge. Summary by Keep our NHS Public of Health Service Journal 1 November 2007
          Fears over impact of health centre. An Essex MP has said he is concerned about the impact a multi-million-pound privately run health centre will have on NHS services. The Government has given the go ahead for an Independent Treatment Centre (ITC) to be built in Braintree. The development is designed to give patients a wider choice while cutting hospital waiting times for patients with knee, hip and cataract problems. Earlier this year Richard Bourne, the head of Essex Rivers Healthcare NHS Trust, which runs Colchester General Hospital and Essex County Hospital cast doubt on the proposal, saying not enough had been done to ensure it would work effectively. And Simon Burns, MP for West Chelmsford, has been calling on the Government to abandon the scheme claiming it could have "devastating" impact on Broomfield Hospital in Chelmsford. The Conservative MP has said he fears the ITC would harm Broomfield's ability to meet its targets because it would "cherry pick" certain services which would adversely affect the hospital. He warned there could then be a downward spiral where the financial wellbeing of the hospital would be affected. But the chief executive of Mid Essex Primary Care Trust, Sheila Bremner has welcomed the announcement. Summary by Keep our NHS Public of East Anglian Daily Times 22 November 2007
  2       Southend Hospital PFI spiked. An Essex NHS Trust has scrapped its plans to redevelop its acute facilities using the private finance initiative. Southend University Hospital NHS Trust had planned a new building to house services such as accident and emergency, and stroke rehabilitation. But a spokesman says they have now binned plans to use PFI. "The project will proceed at a much smaller scale and will rely on public and foundation trust funds," said Southend NHS Trust's director of facilities, Dave Walsh, "This gives us much greater financial freedom." The hospital was awarded £105m in PFI credits in 2004. Summary by Keep our NHS Public of Public Private Finance 29 November 2007
          Opposition calls for rethink on data storage. The debate over healthcare data security took a political turn as the opposition called on the government to change its plans for central data storage in favour of local, interoperable services. Shadow health secretary, Andrew Lansley, told said that plans for the national database in England holding around 50m records should be replaced by storage on 'local servers with interoperability between them.' Encryption was fine, he said, but there was a risk if many people had the passwords to get into the system. The Department of Health defended the centralised approach currently being rolled out and responded to Lansley's comments saying that the planned central system had particularly strong data protection rules and the highest standards of security control. Lansley's comments came as review of NHS trusts security showed nine reporting data losses. The trusts are: City and Hackney Primary Care Trust ; Maidstone and Tunbridge Wells; Bolton Royal Hospital; Sutton and Merton PCT; Sefton PCT; Mid-Essex Care Trust; East and North Hertfordshire; Norfolk and Norwich and Gloucester Partnership Foundation Trust. Ross Anderson, professor of security engineering at Cambridge University, commented on one of the incidents at City and Hackney PCT where 160,000 children's records were lost. Professor Anderson asked: "How is it that somebody had access to 160,000 children's records? Surely that's not right." Summary by Keep our NHS Public of E-Health Insider 9 January 2008
           
           
           
           
           

Heat Map East of England

  PETITIONS

Home ] Resources/Sources ] Policy led budgeting ] Treatment approval or not ] Construction projects ] Charges ] Payment by Results ] Practice Based Commissioning ] Resource Shortfall/Sources ]

 Resource Shortfall Sources to 2006 ] Trusts in financial problems ] Avon, Gloucestershire and Wiltshire Strategic Health Authority ] Bedfordshire and Hertfordshire Strategic Health Authority ] Birmingham and The Black Country Strategic Health Authority ] Cheshire and Merseyside Strategic Health Authority ] County Durham and Tees Valley Strategic Health Authority ] Cumbria and Lancashire Strategic Health Authority ] Dorset and Somerset Strategic Health Authority ] [ Essex Strategic Health Authority ] Greater Manchester Strategic Health Authority ] Hampshire and Isle Of Wight Strategic Health Authority ] Kent and Medway Strategic Health Authority ] Leicestershire, Northamptonshire and Rutland Strategic Health Authority ] London Strategic Health Authority ] Norfolk, Suffolk and Cambridgeshire Strategic Health Authority ] North and East Yorkshire and Northern Lincolnshire Strategic Health Authority ] Northumberland, Tyne and Wear Strategic Health Authority ] Shropshire and Staffordshire Strategic Health Authority ] South West Peninsula Strategic Health Authority ] South Yorkshire Strategic Health Authority ] Surrey and Sussex Strategic Health Authority ] Thames Valley Strategic Health Authority ] Trent Strategic Health Authority ] West Midlands South Strategic Health Authority ] West Yorkshire Strategic Health Authority ] New Strategic Health Authorities ] Northern Ireland ] Scotland ] Wales ]

Sheila Porter-Williams
Campaign for Health Service Democracy
Green Haven, Halfway Lane
Dunchurch
Rugby, Warwickshire CV22 6RD
sheilaCHSD@porter-williams.freeserve.co.uk