Greater Manchester 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
          'Lessons to be learned from Shipman crimes'.   Society Friday July 19, 2002 [Greater Manchester]
    3     Patients are being told that they will be put on waiting lists for chemotherapy, because of a funding crisis at one of Europe's leading cancer treatment hospitals. Helen Carter Thursday May 15, 2003 The Guardian [Christie Hospital, Manchester]
    3     Cancer patients at Manchester's Christie hospital have been saved from the prospect of waiting lists for chemotherapy, after a last-minute meeting produced a cash lifeline. Faisal al Yafai Friday May 23, 2003 The Guardian
          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)]
          Commuters will be able to get free medical attention on their way to and from work at a chain of NHS walk-in centres to be built near city-centre stations, the government announced yesterday. John Hutton, the health minister, said the first seven centres would open in the spring in London, Newcastle, Manchester and Leeds at a cost of £25m over the first three years. John Carvel, social affairs editor Thursday November 4, 2004
      4   A man who had to pay £8,000 for surgery to rid him of prostate cancer is demanding a refund and apology from his health trust, saying he was the victim of a "postcode lottery". Bob Norburn, 56, an engineer from Westhoughton, near Bolton, was diagnosed with terminal prostate cancer, but the NHS refused to pay for cryotherapy - a procedure offered at Sunderland hospital specifically for this illness. Though not approved by the National Institute of Clinical Excellence (Nice), the treatment has a 98% success rate. He opted to pay privately. The operation was a success and, two months on, he has been given the all-clear. Helen Carter Saturday December 11, 2004 The Guardian
          More than 2,000 women who were screened for breast cancer are having their records reviewed "as a matter of urgency" following concerns about accuracy. The first of the women were recalled for further investigations yesterday afternoon after having mammograms at two hospitals in Greater Manchester between April 2003 and April 2005. The review involves 1,267 patients screened at Trafford General hospital and 1,195 patients seen at North Manchester General hospital. It does not involve any women who were routinely checked under the NHS Breast Screening Programme. Paul Marinko Saturday May 28, 2005 The Guardian
    3     Health services in Greater Manchester will face a funding shortfall of more than £700m unless urgent action is taken, it was claimed yesterday. Helen Carter Friday September 5, 2003 The Guardian
          An IS-TC in Greater Manchester run by South African company Netcare has lost the health economy nearly £2m in its first six months, according to a confidential report by Greater Manchester surgical centre's contract management board. 14 PCTs have paid £1.9m to Netcare for operations that were not carried out, as patients opted for traditional NHS care. The IS-TC performed fewer than 4,000 of 6,000 contracted operations, yet under the contract Netcare have been paid for the full amount. The biggest loser has been Ashton, Leigh and Wigan PCT, which paid nearly £500,000 for an anticipated 688 procedures, of which only 67 were performed. Ashton finance director David Wharfe admitted the situation "does not represent value for money."  Health Service Journal 15 December 2005
    3     A crisis-hit mental health trust has withdrawn up to £2m of cuts and dropped plans to close a care ward for elderly people, after staff threatened to strike, but unions have declared a formal dispute over high risk levels.  Tash Shifrin Friday December 19, 2003
  2       Banks and property developers made windfall profits of £73m by refinancing one of the Labour government's first privately financed hospitals, the 989-bed Norfolk and Norwich hospital, the National Audit Office reveals in a report published today. The windfall is the third to be disclosed by parliament's financial watchdog after complaints from MPs and the public. The other two are Fazakerley prison in Liverpool and the Dartford and Gravesham hospital. The report says that funding for five other privately financed hospitals - South Buckinghamshire, Calderdale, North Durham, Bromley and South Manchester - could also yield windfall profits for developers.  David Hencke, Westminster correspondent Friday June 10, 2005 The Guardian
        5 Possible judicial review over baby units shake-up. Salford City Council is considering launching a judicial review over fears that maternity services in the city could be scrapped. Salford council is threatening legal action because it believes the process used to choose favoured options in the streamlining of services by Greater Manchester SHA could be flawed. If health bosses go ahead with their preferred model it would mean the maternity unit at Hope Hospital in Salford would close. Summary by Keep our NHS Public of  Manchester Evening News 12 January 2006
          Seventeen women are at an increased risk of dying of breast cancer because a consultant radiologist wrongly gave them the all-clear. Doctors investigating the work of the unnamed radiologist's work said the delay in getting a correct diagnosis could "significantly alter" the women's chances of survival; one had been diagnosed two years after being told she was in the clear. The findings are the result of a massive review of breast cancer cases in greater Manchester ordered when concerns were raised about the radiologist's work at Trafford General hospital and the North Manchester General hospital. Doubts were first voiced in April last year, and he was suspended when a small sample of his tests was found to be wrong. Sam Jones Tuesday January 24, 2006 The Guardian
        5 Petitions "not worth the paper they are written on". Healthy Futures, the team carrying out a review and consultation on the future of Greater Manchester's hospitals, has angered residents by saying that petitions "carry absolutely no weight and will not be considered as we can't analyse a signature". Campaigners against the closure of the children's, maternity and emergency wards at Rochdale Infirmary have so far collected 30,000 signatures. Summary by Keep our NHS Public of  Manchester Evening News 27 January 2006
          The two-star Royal Bolton hospital has commissioned an independent inquiry after three women died in childbirth in its maternity unit between October 2005 and the middle of this month. The baby of one of the mothers also died. Internal investigators have found no link, but because deaths in childbirth are so rare it requested the second inquiry, which will report at the end of February. Sarah Hall, health correspondent Tuesday January 31, 2006 The Guardian
        5 New hope for threatened hospital. A report commissioned by the Greater Manchester SHA has recommended that threatened Altrincham General Hospital be kept open as it has a long-term future, as do Trafford General and Stretford Memorial hospitals. A budget deficit at Trafford Healthcare Trust had led to proposals to relocate the services provided by Altrincham. Summary by Keep our NHS Public of BBC Online 2 February 2006
          Up to 1,000 patients may have been wrongly diagnosed with heart problems due to mistakes made by a temporary technician at an NHS hospital, it was revealed last night. Managers at Fairfield general hospital in Bury, Greater Manchester, launched an inquiry into all echocardiogram examinations carried out by an individual technician between May and December last year.  John Carvel and Polly Curtis Friday February 3, 2006 The Guardian
        5 SHA warns ministers to back off. Greater Manchester SHA has proposed radical restructuring of services, and is warning politicians not to buckle under democratic pressure to retain hospitals and A& E departments. The acute services review in north-east Manchester could see fewer A& E departments, with some hospitals no longer carrying out emergency surgery. In Rochdale, a 20,000-signature petition has opposed the changes, which could see Rochdale Infirmary become a 'locality' hospital. More radical options under consultation would see the acute sites across the SHA reduced to two or even one. A LIFT project would provide 35 new health centres. Changes to other services would include a reduction in the number of centres carrying out breast surgery. Under four of the five options, sites with inpatient obstetrics and paediatrics would be reduced to seven or eight. Each would have high dependency and special costs, and there would be three neonatal intensive care unit sites. The favoured option for children's and maternity services is already being opposed by Salford city council, whose leader has talked of applying for a judicial review. Summary by Keep our NHS Public of Health Service Journal 16 February 2006
        5 'No admissions' at NHS hospital. 24-hour care is no longer available at Altringham General Hospital due to a cash crisis. Trafford NHS Trust in Greater Manchester is closing two in-patient wards, used mainly for rehabilitation of the elderly,.to save money. Only day clinics will remain. Summary by Keep our NHS Public of  BBC Online 8 March 2006
          Wards closing "as cash goes private". Bernard Ribeiro, president of the Royal College of Surgeons of England, has said hospital wards across Greater Manchester are closing because a private clinic is attracting funds from the NHS. At the same time as Trafford Acute Trust last week announced that two 26-bed wards will shut at Altrincham General, millions of pounds of public money is being channelled into the private Greater Manchester Surgical Centre in Trafford, a 48-bed unit run by Netcare and staffed with South African surgeons. Ribeiro said that in the first six months of this year, £2 million had been diverted away from Trafford to fund treatments at the private clinic. Summary by Keep our NHS Public of  Manchester Evening News 13 March 2006
        5 Hundreds of people have protested in the North West against the proposed closure of hospital wards and units. Staff and parents gathered near Hope Hospital, Salford, Greater Manchester, on Saturday to voice their anger at plans to shut down its neo-natal unit. People trying to save Macclesfield General Hospital's maternity ward were involved in a "pram push" in Cheshire. Public consultations involving Greater Manchester Health Strategic Health Authority finish on 12 May. It follows plans to review community and hospital health services in Greater Manchester and Rossendale in Lancashire. A public consultation is also taking place on the options for change for healthcare services for children, young people, parents and babies across Greater Manchester, east Cheshire and High Peak. BBC Online 25 March 2006
    3     The mood of crisis in the NHS deepened yesterday with the announcement of 720 further job losses at a hospital trust in the Midlands and the resignation of a trust chief executive in the north-west, with a £475,000 payoff. Worcestershire Acute Hospitals NHS trust said it would have to shed 720 jobs over the next 12 months to balance the books after accumulating deficits worth £31.5m over several years. The staff affected will include nurses, doctors and administrative workers at hospitals in Worcester, Redditch and Kidderminster, where Labour lost a safe parliamentary seat in 2001 due to local protest at the downgrading of NHS facilities. The job losses bring the total announced by trusts in England over the past five weeks to more than 6,000. The toll this week included 160 jobs at Medway trust in Kent, 400 at Surrey and Sussex Healthcare trust and up to 300 at Royal United hospitals in Bath. Meanwhile Pennine Acute, the largest NHS trust in the north-west of England, with hospitals in Bury, north Manchester, Oldham and Rochdale, announced the early retirement of its chief executive, Chris Appleby, who was under pressure to go after a vote of no confidence from the trust's doctors last summer. An independent inquiry into the trust by Sir George Alberti, former president of the Royal College of Physicians, found a "lethal mixture" of suspect leadership styles and poor relations between doctors and managers. Other NHS developments included a report from the Audit Commission warning of serious concerns about the financial position of George Eliot hospital trust in Nuneaton. It had "deteriorated to such an extent that it cannot be managed simply through local measures", said the auditors, PricewaterhouseCoopers. And in Weston-super-Mare, Somerset, NHS managers said a new multimillion-pound mental health ward may never be opened because there was not the money to run it. John Carvel and Les Reid Friday April 7, 2006 The Guardian
          Health chief gets £475,000 pay-off. Chris Appleby, the chief executive of Pennine Acute Hospitals Trust who has agreed to retire early after conflicts with doctors, is to receive a payout of almost half a million pounds. He had been under pressure to go since the trust's medics held a vote of no confidence into his management last summer. Senior medical staff felt patient care was suffering in the drive to meet targets. Politicians who campaigned for Mr Appleby to go say they are "disgusted" by his payout. David Heyes, MP for Ashton under Lyne, said: "The large sums involved are a terrible contrast to the way other NHS employees are treated." Summary by Keep our NHS Public of  Manchester Evening News 11 April 2006
        5 Hospital plea goes to Blair. A 30,000-signature petition from the people of Rochdale against plans to shut or scale down emergency, children's and maternity services at Rochdale Infirmary has been hand delivered to Downing Street. It comes after Celia Gaze, director of the Healthy Futures review of services in north east Manchester, was quoted as saying the petitions "carry absolutely no weight and will not be considered as we can't analyse a signature". Summary by Keep our NHS Public of  Manchester Evening News 14 April 2006
          Up to a third of dentists won't sign NHS contract. Nearly a third of dentists in some parts of England have refused to sign new NHS contracts - contradicting a recent statement by Tony Blair that "about 90 to 95%" of dentists had signed up. A leaked government document, showing exactly how many dentists in each area have taken up the contracts, reveals that in the south west, 29% of dentists have refused to sign up; in the Thames Valley, 15%; in Hampshire, 18%; in Yorkshire, 23%; and in the West Midlands, 24%. In south-west London, the figure is 12%; in Manchester, 11%; in Kent, 14%; and in Dorset, 15%. In Avon, Gloucestershire and Wiltshire, 23% have not signed up. Of the 9,419 contracts offered in England, 1,096 have been rejected, including some covering more than one dentist - a national average of 12% more than Mr Blair's claim.  Summary by Keep our NHS Public of  Telegraph 16 April 2006
          Heywood and Middleton primary care trust in Greater Manchester has agreed to pay about £2,500 for laser treatment to remove a transsexual woman's tattoos.  Riazat Butt Thursday April 20, 2006 The Guardian
        5 Hospital is a financial risk to the NHS. South Manchester PCT has raised concerns about the viability of Withington Community Hospital less than a year after it opened. The PCT said the under-use of the hospital's theatre for operations posed one of the most significant financial risks to the PCT. But to increase the number of operations done in the theatre, near-by Wythenshawe Hospital must send patients there for treatment. Wythenshawe said it would like to use this extra capacity to cut waits, but it can not do this without more money from South Manchester PCT. A spokesman for South Manchester University Hospitals Trust, which runs Wythenshawe Hospital, said they were in a catch 22 situation. The PCT said it is exploring ways to get more patients through the door now they can choose where they want to go for treatment, include making a marketing video to send to GPs explaining what services are available at the hospital and how they can be accessed. Summary by Keep our NHS Public of  South Manchester Reporter 24 April 2006
        5 England hero slams maternity closure plan. A world-famous footballer has described plans to shut Rochdale Infirmary's maternity unit as 'disastrous'. Manchester United's midfield star Paul Scholes, whose children were born at the Infirmary, is backing the Hands Off Our Hospital campaign. He is urging local residents and football fans to get behind the campaign, which last week went to 10 Downing Street with thousands of signed petitions against plans to scrap maternity, neo-natal and children's services. Plans are also in place to cut urgent accident and emergency care, turn the Infirmary into a locality hospital and create an Urgent Care Centre. Scholes said: "My children were born at Rochdale Infirmary and the staff were absolutely fantastic. I have been keeping a close eye on what is happening at Rochdale and the thought of the maternity unit closing down would be disastrous for everybody in the area. I urge everyone to back this campaign and fight for what should be every mother's right, to give birth at their local hospital." Summary by Keep our NHS Public of  Rochdale Observer 27 April 2006
1 2 3   5 The politics column - Allyson Pollock. In the New Statesman's main political column, Allyson Pollock writes: "According to Patricia Hewitt the NHS has had its best year ever. So why is the Royal College of Nursing threatening industrial action over cuts and closures, and why did the annual conference of Unison, traditional Labour supporters, greet the secretary of state with heckling? In her words, "the NHS must modernise or die". So why, from Surrey to Manchester and from Gateshead to Shropshire, are local people banding into hospital action groups and "Keep our NHS public" campaigns in an effort to defend the health service ? The chief targets for cuts are mental health services, palliative care, older people's care and emergency hospital care, yet Hewitt maintains, to general derision, that quality will not be affected… Pay accounts for 60-70 per cent of NHS hospital budgets, but pay awards accounted for less than 30 per cent of the new money and should have been absorbed easily. Nor was greed involved; the increases returned NHS pay to previous levels after years of pay freezes. The hourly rate of the lowest-paid rose initially from £5.16 to £5.67 an hour; medical consultants got increases of 4-5 per cent a year, taking them to averages of between £75,000 and £95,000, while managers - their numbers swollen by the complications of marketisation - got 7.5 per cent more last year. The real reason for the decision to axe in excess of 13,000 clinical staff and 1,000 NHS beds, plus associated services, is market-oriented reforms such as "choose and book", "payment by results" and foundation hospitals. Hospitals and services are required to behave like stand-alone companies, competing with each other and private corporations for income and patients… The government plans to hand over most of the NHS budget to the private sector through "practice-based commissioning". Under this policy, local PCTs will eventually contract with for-profit companies such as the US-owned UnitedHealth Europe to provide GP services… The Prime Minister asserts that the reforms are bearing fruit, and so they are - for "investors" such as the lucky shareholders of Norfolk and Norwich and Bromley PFI hospitals, who received a windfall of more than £500m within months of the new hospitals opening. But the PFI has been less "fruitful" for local people, who have seen a quarter of beds closed and clinical staff and community provision cut. A large part of hospital trust deficits is due to PFI debts, running at £1.5bn a year… And then there are the costs associated with establishing and operating a market - costs the NHS was explicitly designed to avoid: these are for invoicing, marketing, advertising, drawing up hundreds of thousands of contracts, legal disputes with contractors and rival hospitals, and using management consultants… And though NHS hospitals remain responsible for balancing their books, the government has ensured that the only way they can do so is by cuts, closures, the sale of land and buildings - and more privatisation. Some foundation trusts are entering joint ventures with companies such as the Hospital Corporation of America, providing care to private patients in what were previously NHS beds. Others are charging NHS patients for "extra" care: Queen Charlotte's and Chelsea NHS hospital has introduced a fee of £4,000 for one-to-one midwife care - once the NHS standard - and the government is allowing it. The less fortunate hospitals - if that is the right word - are closing services and sacking staff. Is this what the English patient needs or wants ?" Summary by Keep our NHS Public of  New Statesman 2 May 2006
        5 Health bosses reject unit closure. Bury PCT has rejected plans to close the maternity unit at the town's Fairfield Hospital. Greater Manchester SHA wants to locate in-patient, maternity and neo-natal wards at eight larger sites across the region. But Bury PCT said this would "significantly disadvantage" people living in Bury and Rochdale. The PCT is now calling on a re-think of the strategy, which could also see the closure of the neo-natal unit at Hope Hospital and maternity units at Rochdale Infirmary and Trafford General. Dr Derek Fletcher, chair of the Professional Executive Committee, said the PCT shared the concerns of the people of Bury. A public consultation on the strategy ends on 12 May. Summary by Keep our NHS Public of  BBC Online 4 May 2006
        5 Why the NHS is on the ballot paper. Overview and scrutiny committee's (OSCs) of local authorities can demand NHS chief executives appear before them and set their own agendas of what they want to examine, as well as being consulted on major NHS changes. As such they can have a big impact on reconfigurations, and parties could campaign in local elections on the claim that their party was the one standing up most strongly for their local hospital. All this explains why many councillors are making the NHS a bigger issue at elections than ever before. For example in Kirklees three Save Huddersfield NHS candidates could hold the balance of power on the council if elected. The trio have been leading the campaign against plans to move services from their local hospital to Halifax. Tens of thousands of people have signed petitions and attended demonstrations. Service changes at the hospital have recently been accepted by the trust but the group is seeking a judicial review, and Kirklees council OSC has also expressed reservations, referring changes to maternity services to the health secretary. In West Sussex, Conservative county council leader Henry Smith says the loss of services at Crawley Hospital has had a big impact on local politics, and recent job losses announced by Surrey and Sussex Healthcare trust are uppermost in residents' minds. The East Sussex committee, which covers an area where the health service has struggled in recent years, has a high profile and a reputation for tough questioning. In Rochdale the OSC supported a proposed restructuring of services, which has been attacked as a downgrading of local services. Local Liberal Democrat MP Paul Rowen has steadfastly opposed changes and his party sees it as a major issue in the local elections. OSCs look set to become the forums on which public concern about local service redesigns are vocalised. Summary by Keep our NHS Public of  Health Service Journal 4 May 2006
    3     The largest NHS trust in the north-west of England announced plans to axe nearly 10% of its staff yesterday in an attempt to eliminate a £21m deficit. Pennine Acute trust said it would remove 800 posts at its hospitals in Bury, north Manchester, Oldham and Rochdale - one of the largest job losses to emerge since the NHS went into a period of retrenchment two months ago. John Carvel , social affairs editor Saturday May 6, 2006 The Guardian
    3     800 NHS jobs face the axe. Up to 800 jobs could go at four hospitals in Greater Manchester. Doctors and nurses could face the axe in massive cuts at the Pennine Acute Trust, which runs North Manchester General, Rochdale Infirmary, the Royal Oldham Hospital, and Fairfield Hospital at Bury. Staff have had no warning and no consultation from the trust, which is £21m in debt. The figure of 800 job losses equates to one in 11 among the 9,000 workforce. Summary by Keep our NHS Public of  Manchester Evening News 5 May 2006
          NHS managers are offering "bribes" to GPs to persuade them to send patients to a private treatment centre instead of local NHS hospitals, it emerged last night. The unorthodox payments came to light in the primary care trust covering the Leigh constituency of the health minister, Andy Burnham. An investigation by Hospital Doctor magazine found GPs in the area were being paid £30 for every patient sent to Greater Manchester surgical centre, a private unit run by the South African operator Netcare.  John Carvel, social affairs editor Thursday May 11, 2006 The Guardian
          GPs are offered £30 'bribe' for private centre referral. GPs are being offered a £30-per-patient 'bung' to refer patients to an underused independent sector treatment centre run by Netcare. Figures from Ashton, Leigh and Wigan PCT showed only 243 patients had been treated at the centre up to February this year, compared with an expected level of 711. Earlier figures from September last year show the PCT had paid out almost £500,000 to that point for operations not carried out. A spokeswoman for the General Medical Council said it was "concerned the standards may have been breached". Summary by Keep our NHS Public of  Pulse 12 May 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
          The Department of Health does not support any payment being made to GPs as an "inducement" to refer patients to any particular provider (GPs offered payments to send patients private, May 11), nor has it seen any evidence that this has occurred. GPs do receive payment for pre-operative work, but this is payment for additional work done. If the patient chooses to go to the Greater Manchester Surgical Centre, they may need some preparatory tests, such as blood tests etc. Traditionally, this would involve one or more hospital outpatient appointments. But for some procedures it is now possible for these to be carried out by a GP who has had extra training. This benefits patients as it can be undertaken more quickly and conveniently, and frees up hospital consultants' time. We understand that the PCT approved a payment of £30 a patient in recognition of the extra work needed. We have reiterated that any payments to GPs must be for services not for any other reason. Norman Warner Minister of state for NHS Reform. Letter Guardian 19 May 2006 
          GPs advised to reject 'bungs'. Medical defence bodies, LMCs and GP leaders have strongly advised GPs to reject 'enhanced payments' on offer to refer patients to independent sector treatment centres. The advice came in the wake of Ashton, Leigh and Wigan PCT's offer of £30 per patient for GPs to refer patients to Greater Manchester Surgical Centre, which is run by the South African firm Netcare. Despite the GMC saying it was 'concerned' GPs would be breaking Good Medical Practice guidelines if they accepted the offer, the PCT has refused to scrap it. Summary by Keep our NHS Public of  Pulse 19 May 2006
          'Fee was not inducement'. Health minister Lord Warner has approved a PCT's £30 per patient payment to GPs for referring to an independent sector treatment centre. In a letter to the Guardian, Lord Warner said Ashton Leigh and Wigan PCT's payment to GPs for referring to Greater Manchester Surgical Centre, was not an "inducement" but for additional screening of patients. Summary by Keep our NHS Public of  Pulse 2 June 2006
          The chairwoman of an NHS trust is set to attack Government health reforms which, she claims, threaten the future of the service. Debbie Abrahams, chair of Rochdale Primary Care trust, will tell a protest rally in Manchester she is speaking out before the health service reaches "the point of no return". She will say: "I believe passionately in the NHS. For me it is not just about how we organise and provide health care, it reflects and represents the values of our society." And she will continue: "During my period as chair of Rochdale PCT, I have seen a steady stream of national policies introduced - Foundation Trusts, Choice, Independent Treatment Centres and now Commissioning a Patient led NHS - which threaten these values and the future of a NHS that is equitable and free at the point of need." Press Association Saturday June 24, 2006 10:03 AM
          GPs turn the tables to win. Dr Martin Whiting has won the contract to run a neighbouring practice after tendering with a corporate-style business plan. He and his seven partners in north Manchester beat off competition from several private companies to win the contract to run the Newton Heath practice in Cheetham. Summary by Keep our NHS Public of  Pulse 9 June 2006
          NHS trusts pledge to copy Tesco business methods. NHS chief executives have promised to follow "lean" management techniques that have been adopted by successful companies like Tesco and Toyota. By redesigning procedures around patients and focusing on reducing the transfer time from area to area, such as A& E to operating theatre, the trusts hope to save lives and reduce costs. A test of the approach in Bolton cut mortality rates by at least a third. Summary by Keep our NHS Public of  Guardian 15 June 2006
    3     Hospital staff in protest over cuts. More than 1,000 NHS staff angry at plans to slash hundreds of jobs within the trust which runs Fairfield and North Manchester general hospitals will be protesting at the weekend. The Pennine Acute NHS Hospital Trust is being forced to axe up to 800 jobs within its four hospitals at Fairfield, North Manchester, The Royal Oldham and Rochdale Infirmary although union representatives claim that figure is more likely to be around 1,200. Staff from the trust have joined together to form "Keep Our NHS Public" and will be demonstrating on Saturday June 24 at Victoria Station in Manchester at 11.30am. Karen Reissmann, UNISON health service executive member, said: "The NHS faces massive cuts in jobs. Accident and emergency services may have to close, mental health is in crisis and maternity and baby care is under threat in Bury. These cuts and job losses will devastate health services. The Government could easily afford to pay the current NHS debt, which is less than one per cent of its total budget. This is a direct result of their privatisation policies. We demand that the government gives the NHS the money and keeps our NHS public." Summary by Keep our NHS Public of This is Lancashire 19 June 2006
    3     Staff to join jobs demo. Health workers and patients are being urged to join a demonstration in Manchester to persuade the government to give Pennines Acute NHS Trust more time to pay back its £28m debt. Unison bosses have called upon people in the trust's area of Oldham, North Manchester, Bury and Rochdale to turn up to the march at 11:30am on Saturday June 24th from Victoria Station to Piccadilly Gardens. The trust has already announced 800 job losses but Unison officials believe it will be closer to 1,200 after including part-time staff and low-paid workers. Karen Reissmann, Unison executive member attacked the government saying it "could easily afford to pay the current NHS debt, which is less than one percent of its total budget. This (the cuts) is a direct result of their privatisation policies." She went on to "demand that the Government gives the NHS the money and keeps our NHS public." Trust officials have not ruled out compulsory redundancies and the projected 800 job losses would amount to one in eleven in the trust, the second largest in the country. Local politicians have been invited to speak at a rally after the march, under the banner of Keep Our NHS Public. Summary by Keep our NHS Public of Oldham Advertiser 23 June 2006
          Chair quits over private power. A primary care trust chair has resigned in protest at the increasing role of the private sector in the NHS. Rochdale PCT chair Debbie Abrahams said: "The NHS will be a very different animal if we continue to increase the amount of private sector provision. Ultimately, the private sector is in it to make money." She added that when an independent treatment centre opened in Manchester, "we were told what the levels of activity were and what investment we should make whether we needed it or not". The strategic health authority negotiated the contract for the Greater Manchester Surgical Centre without involving the PCT, she said, and instructed the board to agree to the use of the centre "without having seen the contract documents". As a result, the PCT got a £2m bill for capacity it did not use in the first six months of operations. Ms Abrahams appealed to health secretary Patricia Hewitt for an independent evaluation of the impact of the private sector on local NHS services, but this was rejected. The "final straw" was when her attempts to assess the impact of the surgical centre were blocked. Summary by Keep our NHS Public of Health Service Journal 29 June 2006
          The five specialist orthopaedic hospitals in England may have to abandon complex surgery on hips and bones because of a bizarre twist in the government's rules to turn the NHS into a competitive market, chief executives warned last night. In a private briefing paper for MPs, they said patients are set to become the victims of the health secretary Patricia Hewitt's new system of payment by results. They observed that much routine orthopaedic surgery is being diverted into private sector treatment centres, leaving the five NHS centres of excellence to concentrate on more highly skilled work. However, they said the national price list for every type of operation did not recognise the extra costs of more difficult work. The five hospitals are: the Royal National Orthopaedic hospital at Stanmore, Middlesex; the Nuffield Orthopaedic centre in Oxford; Robert Jones and Agnes Hunt hospital in Oswestry, Shropshire; Royal Orthopaedic hospital in Birmingham; and Wrightington hospital in Wigan. John Carvel, social affairs editor Thursday July 6, 2006 The Guardian
          GPs in 'bung' victory. GPs are claiming a 'pyrrhic victory' after a PCT scrapped a controversial scheme to pay them for referring to an independent sector treatment centre. Ashton, Leigh and Wigan PCT has ditched the £30 per patient 'enhanced payment' to send more patients to the underused Greater Manchester Surgical Centre. It was widely condemned by GPs as a 'bung'. Summary by Keep our NHS Public of Pulse 30 June 2006
        5 Save our baby unit! The fight against proposed cuts at Wythenshawe hospital's premature baby unit was given a boost with the launch of the "Save Our Baby Unit" campaign. Health workers, activists and local residents at the launch were furious at the cuts, which managers call "Making It Better". Management want only a "stabilisation cot" to remain at Wythenshawe, with neonatal services "concentrated" in central Manchester, Oldham, etc. Save Our Baby Unit agreed to affiliate to Keep Our NHS Public, and to support all moves towards a national anti-cuts demonstration, linking campaigns across the country. Summary by Keep our NHS Public of Socialist 4 July 2006
          Axed wards win a reprieve. Two Altrincham hospital wards at the centre of an NHS cash row could reopen after a landmark High Court decision. Health bosses closed the last two wards at Altrincham General Hospital in March, claiming they had no choice because patient safety was at risk, but admitted it would also save vital cash towards their £9m debt. But campaigners refused to accept the closure of the two rehabilitation wards, and won the right for a full judicial review. At a preliminary hearing, Mr Justice Collins ruled that Health In Trafford, led by former Altrincham General nurse Pat Morris, had an "arguable case" that Trafford Healthcare Trust's decision was "unlawful" because of a lack of consultation. In the meantime, the judge has asked that the Trust consider reopening the wards, to the delight of Mrs Morris. Summary by Keep our NHS Public of Manchester Metro 5 July 2006
          Save our baby unit! A campaign has been formed to defend maternity services at Wythenshawe Hospital. The Save Our Baby Unit campaign opposes the potential loss of four beds in Wythenshawe Hospital's intensive care neonatal unit, leaving seriously ill premature babies facing helicopter transfers to other hospitals. Campaign organiser Lynn Worthington said: "NHS managers plan to run down the neonatal intensive care unit at Wythenshawe Hospital. There will be less beds and less specialised staff, which means prematurely born babies may have to be flown by helicopter across Greater Manchester, possibly as far as Oldham. We talked to many people whose children had been in the unit. They are all opposed to the closure. And staff are also against the cuts. The facilities are there because they are necessary - they're not just some corner that axe-wielding managers can cut. We'll be battling to retain full neonatal services at Wythenshawe - and not at the expense of other facilities." Save Our Baby Unit has affiliated to Keep Our NHS Public. Summary by Keep our NHS Public of Wythenshawe World 5 July 2006
          Specialist trusts lobby ministers for change in tariff. Britain's five specialist orthopaedic hospitals say they could be forced to cancel operations and cut services unless the government adjusts the payment by results tariff. A briefing paper provided to MPs by the hospitals says: "The NHS's current financial situation is making financial balance a non-negotiable requirement and if the national tariff is not amended to recognise complex cases some trusts will have no way of avoiding serious financial loss. This situation could result in trusts being forced to end provision of vital specialist services: ones that are not available in normal acute trusts." London Royal National Orthopaedic Hospital chief executive Andrew Woodhead said the tariff system as it stood would mean his trust lost £5m a year: "We would be faced with a position where the only way to balance the books was to stop doing operations that lose us money. We could not continue to operate with a £5m loss of income." Robert Jones and Agnes Hunt Orthopaedic Hospital chief executive Jackie Daniel said the projected losses were hampering specialist trusts' efforts to gain foundation status. Some service cuts may have to take place before 2008 to convince regulator Monitor that the organisation is ready to become a foundation trust. Wrightington, Wigan and Leigh chief executive Sheena Cuminsky blamed independent treatment centres for taking less complex patients: "The more this happens, the more complex cases are left for us which are higher than tariff." Summary by Keep our NHS Public of Health Service Journal 6 July 2006
        5 PCTs oppose Manchester maternity shake-up. Plans for a shake-up of children's and maternity services in Manchester are under fire because one corner of the city could be left without inpatient services. Two primary care trusts in north-east Manchester are calling for an option to be devised which would keep inpatient paediatrics, obstetrics and neonatal care in the area. Fairfield General Hospital in Bury is the preferred setting. NHS organisations in Greater Manchester have just finished consulting on proposals which would leave the communities above the M60/ 62 motorway without inpatient maternity and children's services. Summary by Keep our NHS Public of Health Service Journal 6 July 2006
    3     Health trust loan after wages crisis. Pennine Acute Hospital Trust has requested a £17m loan to avoid not being able to pay wages from January to April next year. The trust, which covers hospitals in Bury, North Manchester, Rochdale and Oldham, has a forecast £21m end-of-year debt, and admits that any loan would not be the end of their financial problems. The trust announced a possible 800 job cuts earlier in the year and has already gone £3.5m in the red since April. Unison called for involvement in any binding recovery plan before it was submitted to the Greater Manchester reserve fund. Summary by Keep our NHS Public of Manchester Evening News 14 July 2006
          Fury as 'anti-competitive' £30m contract awarded. South African-owned private healthcare company Netcare looks set to win a £30m-a-year contract to provide clinical assessment services across Manchester, even though it owns and runs the Greater Manchester surgical centre. Netcare will be awarded preferred bidder status for the integrated clinical assessment and treatment services (ICATS) contract by the end of July. However, NHS sources close to the discussions have raised concerns over whether this is anti-competitive. If Netcare wins the five-year deal, the company will, controversially, be able to assess patients for surgery and then refer them to its own surgical centre for treatment. In January, private providers were invited to bid for the work to provide ICATS in general surgery, musculoskeletal, ear, nose and throat, gynaecology and urology services. A source close to the talks said the DoH's decision to award the contract to Netcare was "ludicrous". "By doing this, Netcare will be able to sew up the market, assessing patients to see if they need acute treatment and then advising and referring those patients for treatment at its own surgical centre." Sources close to the DoH said that in response to local concerns, the ICATS contract would be split and shared with another private provider, Partnership Health Group, in partnership with Alliance Medical. Both companies will have preferred bidder status by the end of the month. Last year, Netcare's Greater Manchester surgical centre was found to have lost the local health economy nearly £2m in its first six months. A confidential report revealed that the 14 PCTs commissioning from the centre had had to shell out £1.9m to Netcare, even though the centre was being underused by patients. ICATS contracts form part of the second stage of the DoH's independent treatment centre procurement programme for elective services. Summary by Keep our NHS Public of Health Service Journal 20 July 2006
    3     Crisis hospital can't give blood tests. A Hospital in Trafford is so short-staffed it cannot offer simple blood tests for patients referred by their GPs for a day. Bosses at cash-strapped Trafford Healthcare Trust have sent letters to all doctors in the area saying that, because of staff sickness, no blood will be taken at Stretford Memorial Hospital. The move means that dozens of patients across north Trafford will be unable to have their blood examined, as up to 40 patients a day are referred to the centre by their GPs. Because of the closure, patients in the area will have to travel to Trafford General Hospital, about five miles away. The staffing crisis comes after the trust shut two wards at Altrincham General Hospital, a move aimed at easing £9m debts. Summary by Keep our NHS Public of Manchester Evening News 4 August 2006
          PCT denies limiting choice to independent sector. Stockport PCT has denied claims that it is limiting patient choice for orthopaedic patients to the local private sector. In a move which appears to run counter to the government's choice agenda, the PCT has sent letters to orthopaedic patients informing them that it cannot offer patients in need of orthopaedic surgery the option of treatment at an NHS hospital. The letter warns patients that their surgery "may take place at an independent (private) hospital". It goes on: "At present we are unable to offer NHS hospitals as a choice for surgery at this point in the pathway." The local foundation trust is seeking clarification from the PCT on its processes after telling them that they did not feel patients were being offered "genuine choice". Stockport PCT chief executive Richard Popplewell said the PCT was not denying patients an NHS option. He insisted the letter had been sent to patients who had already opted to use the independent sector at the point they were referred by GPs. He said: "This is stage three or choice three of the patient pathway when the patients have already chosen to use the independent sector." After warning patients that the PCT is "unable" to offer NHS choices, the letter, penned by the PCT's senior patient choice nurse, goes on to say that patients can change their mind: "If you decide that you would prefer to be treated in totality at an NHS hospital then you need to contact me ASAP. You will then be given a choice of four or five NHS providers. We will then process your referral in the normal way to an outpatient appointment with a consultant." The foundation trust said it had not received a "satisfactory explanation" from the PCT. A spokesman said: "This letter and the PCT process seems to require patients to proactively opt out of a process that leads them into the independent sector. So far we do not feel patients are being offered a genuine choice." Foundation Trust Network director Sue Slipman expressed concern about what the letter appeared to suggest: "There was always a worry that commissioners would slow down the work going to hospitals because the contracts with the private sector are take-or-pay contracts. This is completely against patient choice." Summary by Keep our NHS Public of Health Service Journal 10 August 2006
    3     Just seven of these midwives found a job. Student midwives in Salford are jobless because hospitals cannot afford new staff. Just seven out of 35 graduates on a degree course at Salford University have secured work, some by offering to travel to the south. In a usual year all students would have found work locally by now, as the number of places on the three-year training course is dictated by local health bosses according to need. But this year 28 students have had replies from hospitals across the region telling them there is a recruitment freeze because of the massive debts they have built up. The move comes after Pennine Acute Trust in north east Manchester announced it would shed 325 jobs and Royal Bolton Hospitals Trust said 130 jobs will be axed. Sarah Davies, a lecturer in midwifery at Salford University, said: "This means there is going to be a shortage of midwives. This is the start of a crisis, and we are talking about mothers' and babies' lives." Summary by Keep our NHS Public of Manchester Evening News 11 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
          Help for GPs to compete on APMS. A PCT that is putting four practices it directly manages out to tender has pledged to help the incumbent GPs compete with major private providers. Salford PCT has promised that managers will assist salaried GPs in preparing a bid, including giving advice on how how they might be able to collaborate with other practices or providers. The trust, which plans to set up Chinese Walls to ensure impartiality, has also promised patients' views will be taken into account in deciding criteria to judge the bidders' proposals and in evaluating bids. It has made the pledges in order to avoid the accusations of bias that have plagued similar tenders in Sunderland and Derbyshire. Mike Burrows, chief executive of Salford PCT, said tendering was the best way to evaluate all models of care, including the private sector and social enterprise. He said he was acutely aware of the furore that occurred in Derbyshire and had deliberately taken a more even-handed approach. Summary by Keep our NHS Public of Pulse 11 August 2006.
          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 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
  2 3     Plans to use private sector money to build and maintain six NHS hospitals worth nearly £1.5bn were approved by health ministers yesterday, prompting anger among public sector unions that foreshadows a revolt at Labour's annual conference in Manchester next month. The six schemes, including facilities in health secretary Patricia Hewitt's constituency in Leicester, were scaled down to take account of the government's proposals for moving some services from hospitals into the community. This cut the cost by more than £400m. Unison, the biggest public sector union, said the decision to build the hospitals under the private finance initiative (PFI) would prove "a costly error", locking NHS trusts into inflexible repayment obligations that would burden their balance sheets for 30 years or more. The union is expected to be heavily critical of NHS privatisation at the Labour conference. The six developments took the hospital building programme since Labour came to power in 1997 to more than £10bn, almost all using using the PFI. But the clarity of the government's message about NHS expansion was muddied by the results of a BBC investigation of hospital cuts planned in other parts of the country. It said these may involve the closure or downgrading of at least 10 big hospitals, but the Department of Health said nothing was finalised and preparations for "reconfiguration of services" were at an early stage. The six schemes will be at:
· University Hospitals Leicester - a £711m development including a brand new women's hospital and a stand alone children's hospital at the Leicester Royal infirmary. The original proposals would have cost £906m.
· University Hospital North Staffordshire - £272m to build a community hospital and cancer centre.
· South Devon Healthcare - £163m to redevelop Torbay hospital, including a diagnostic centre offering MRI scans, more single rooms and day-case operating theatres.
· Walsall Hospitals NHS Trust - £140m for the complete redevelopment of the Manor hospital site.
· Salford Royal Hospitals - £112m for a new hospital with more single rooms, an enhanced A&E department and three new operating theatres.
· Tameside and Glossop Acute Services - £68m for three day-case operating theatres, new surgical wards and a 30- place day hospital for elderly mental health patients.
John Carvel, social affairs editor Saturday August 19, 2006 The Guardian
          14 private firms win place on choice menu in £200m deal. The Department of Health has signed a deal worth £200m with 14 independent healthcare companies to carry out thousands of additional elective care procedures. The contracts, signed last week, are intended to deliver an additional 150,000 procedures per year, on an 'ad hoc' basis, as part of the DoH's second wave of elective care private sector procurement. The 14 companies will be added immediately to the central extended choice menu, which currently consists of all foundation trusts and some independent treatment centres. Under the policy, patients awaiting elective care can choose from this list, as well as from at least four local providers. Seven of the big name private healthcare companies have won a large chunk of the work. BMI Healthcare, part of the Netcare group, is the biggest winner, securing 44 contracts across the country. Other contract winners include Bupa, Nuffield, Capio, Centres for Clinical Excellence, Mercury Health, and Nations Healthcare. Several small private companies are also understood to have won small contracts to provide local services to NHS patients. Each contract will run for five years and the private companies will provide NHS patients with a range of elective care services including general surgery, endoscopy, ophthalmology, plastic surgery and neurology. Unlike the first-wave elective care contracts, where PCTs had to pay for the number of procedures contracted - even if they did not use the capacity - the latest deals will [not] operate under a 'take or pay' arrangement, which means PCTs only pay for work carried out. Earlier this month, the DoH named Netcare and Partnership Health Group, in partnership with Alliance Medical, as preferred bidders for its controversial integrated assessment and treatment services in Manchester. At the same time the DoH also signed a deal with UK Specialist Hospitals, formerly part of the New York Presbyterian Hospitals group, to act as preferred bidder for a second-wave elective independent treatment centre in the South West. Last month Bupa was named preferred bidder for two elective independent treatment centre schemes in the North East and Cheshire and Merseyside as part of its wave-two elective care procurement programme. Summary by Keep our NHS Public of Health Service Journal 31 August 2006
        5 10,000 say 'no' to hospital stitch up. More than 10,000 people have signed their name in protest to threatened services at North Manchester General Hospital. The hugely successful campaigns prompted thousands to make their mark by signing petitions and sending letters of complaint. Due to the wealth of responses the decision, which was expected to be made by health bosses by September, has had to be postponed until December. The 'Making It Better' consultation could see accident and emergency services and maternity services moved from North Manchester General Hospital to hospitals in Bury and Oldham. A bitter battle has seen thousands of people rise up in protest to the changes which they believe would put hundreds of people at risk. Collectively, campaigns and petitions across the city have generated an unprecedented 50,000 responses from the public, patients and staff during the four-month consultation period between January and May this year. Summary by Keep our NHS Public of Middleton Guardian 1 September 2006
        5 NHS shake-up is facing legal challenge. An MP is threatening legal action which could derail an "urgent" reorganisation of regional health services. Health bosses are expected to agree provisionally to replace Rochdale Infirmary's emergency department with an urgent care centre and to stop emergency surgery at Rochdale and Fairfield Hospital, Bury, at a meeting on September 14. They have spent the past year reviewing services to 800,000 people in Bury, North Manchester, Rochdale, Oldham, Heywood and Middleton and Rossendale because they say specialist staff and resources are spread too thinly over the area's four hospitals. But Paul Rowen, MP for Rochdale, claims managers at Pennine Acute Hospital Trust are trying to pre-empt the review's outcome by closing some services at the infirmary before next week. Mr Rowen, who is now taking legal advice on bringing a judicial review and making preparations to gain legal aid, said: "The review has cost a huge amount of money and created a huge amount of responses, yet before the announcement of the outcome services are already being moved." Summary by Keep our NHS Public of Manchester Evening News 7 September 2006
          Report calls for 'radical action' to plug Manchester health gap. 'Concerted radical action' is required to plug the growing health inequalities gap across Greater Manchester, according to a report from the Audit Commission. The review found there is 'no clear leadership for the health inequalities agenda' in the region. It criticises 'constant' local and national reconfiguration for preventing progress in reducing the health inequalities gap and says reconfiguration in the NHS 'is damaging the potential for more successful joint developments'. The report concludes that leadership of the health inequalities agenda in Greater Manchester is often via the director of public health and says that changes to acute services are driven by new builds and clinical services without any 'explicit' expectation that change will lead to improved health. Faculty of Public Health president Professor Rod Griffiths said he was not surprised by the findings: 'A lot of this is to do with the government's manic desire to keep reorganising the health service it does not say much for the government's vision that health inequalities in Greater Manchester are still so bad.' Summary by Keep our NHS Public of Health Service Journal 7 September 2006
        5 Hospital crusader faces £80,000 bill. A pensioner is risking financial ruin to save wards at her local hospital. Former nurse Pat Morris has been warned she could have to pay up to £80,000 if a judge rules against her on Monday. She hoped to get Legal Aid in her battle to challenge the closure of two rehabilitation wards at Altrincham General Hospital, but now she has been told her application has been turned down. The Legal Services Commission, which administers Legal Aid, rejected the request by Health in Trafford (HIT) - a protest group headed by Morris. If she loses her case she will be handed a bill estimated between £70,000 and £80,000 for the legal costs of the health trust and the court for staging the judicial review. Morris's six-month battle is expected to end in the Royal Court of Justice in London when her barrister, acting for free, will argue Trafford Healthcare Trust (THT) "unlawfully" closed the last in-patient wards at Altrincham because they failed to carry out public consultation. Trafford hospital bosses closed the two wards in March, claiming they had no choice because patient safety was at risk - but admitted it would also save cash. At the last hearing, Mr Justice Collins ordered THT bosses to consider re-opening the wards, but they decided not to. Mrs Morris has so far funded the legal bid and a series of protest meetings herself, collecting only a few hundred pounds in donations. The HIT protest group is furious at the way the Legal Aid application was handled. HIT member Judie Collins has written to Vera Baird MP, who oversees Legal Aid, to investigate. She claims the aid was refused because of a mix-up over a phone interview and because Legal Aid officials over-estimated the amount of funds the protest group had. Ms Collins said: "This claim has been entirely mismanaged. It was rejected on the most surprising of grounds of inability to make contact at a pre-arranged conference call. Whatever the reason, I was surprised that a single bungled call could dismiss a case of such importance to an individual without a second opportunity. A second confusion is an assertion that HIT is a fully constituted organisation with substantial resources and membership. There has never been a formal group organisation, canvassing for membership or mechanism for collecting or soliciting funds." Summary by Keep our NHS Public of Manchester Evening News 8 September 2006
        5 Retired nurse risks her life savings to keep wards open. A former nurse has risked her life savings by launching a High Court action in an attempt to overturn the closure of two hospital wards. Pat Morris, 65, is funding the legal case herself and may be ruined financially if she loses. Mrs Morris is challenging a decision by the Trafford Healthcare NHS Trust to close two rehabilitation wards for the elderly at the Altrincham General Hospital near Manchester. She has sunk £80,000 of her own savings into a judicial review of the decision to close the wards. She was refused legal aid because her husband has a pension, even though she only has a state pension of £34 a week. If the pensioner loses the judicial review, she will be liable for the costs of the trust and the court, but her barrister, Anthony Eyers, is acting for her on a pro bono basis. If Ms Morris wins, the trust will be forced to reopen the wards. At the High Court yesterday, Mr Eyers said that the trust had acted unlawfully in failing to consult the public about the closure of the wards properly. He told the court: "It would open the door for other trusts to act first and ask questions later." Parishil Patel, for the trust, said he accepted the trust had failed to consult correctly over the closure but the trust was prepared now to start a series of meetings with the public. He said the decision had been taken originally because of fears over clinical safety at the wards, but the wards were also a serious fire risk. A decision from Mr Justice Hodge is expected next week. Summary by Keep our NHS Public of Independent 12 September 2006
        5 Lifeline for maternity units. Under-threat maternity, baby and children's in- patient services in Bury and Rochdale could be saved. As part of the Making It Better review, Greater Manchester health bosses want to cut maternity and children's beds from 14 to eight sites. Beds and clinics at Bury, Trafford and Rochdale have been earmarked for closure since last December. But fewer than half of the almost 55,000 people who responded to the plans backed any of the four proposed options. Bosses will now consider five more options, including in-patient services at Bury and Rochdale, and have delayed their decision on the reorganisation until December. The new options also include the possibility of Wythenshawe Hospital becoming one of three proposed super-sites. The threatened closure of maternity and children's services at Fairfield Hospital in Bury and Rochdale Infirmary sparked outrage from local people and MPs. The campaign group Fairfield Baby Lifeline Society marched through the streets and organised a 30,000-name petition. The campaign received a huge boost in May when bosses at Bury PCT rejected all four proposed options. Summary by Keep our NHS Public of Manchester Evening News 14 September 2006
        5 Closure planned for hospital A&E. An accident and emergency department at a hospital in Greater Manchester is to be closed, health bosses have decided. The unit at Rochdale Infirmary will be replaced with an "urgent care centre" dealing with less serious casualties. The provisional decision was taken by a joint committee of PCTs, who want the infirmary to become one of the UK's first "locality hospitals". It will mean Rochdale patients needing life-saving emergency treatment will use services at Fairfield Hospital in Bury, the Royal Oldham or North Manchester General Hospital. The plans are part of a wider "Healthy Futures" review of services. Summary by Keep our NHS Public of BBC Online 15 September 2006
        5 Nurse wins legal fight against ward closures. A nurse who quit in order to fight NHS cuts has won a legal battle over the closure of two wards. Pat Morris set up Health in Trafford and risked financial ruin to bring judicial proceedings against plans to axe two wards at Altringham General Hospital. The high court ruled that the cuts were illegal because Trafford Healthcare NHS Trust had faile