Kent and Medway 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
          An inquiry into the botched operations of gynaecologist Rodney Ledward [William Harvey Hospital, Ashford, Kent] is expected this week to be severely critical of doctors and managers who knew for years that he was unfit to be operating. . Guardian, 30 May 2000
          The Medway trust in Gillingham, Kent, was named yesterday by the Department of Health as being way above the national average for patients readmitted as emergencies within 28 days of being released from hospital, with an increase of 18% in the past year.  Guardian Wednesday February 20, 2002
          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)]
          The government yesterday named and shamed hospital trusts where patients were most at risk of catching one of the most feared superbugs as part of a more aggressive campaign to reduce hospital-acquired infections in England. James Meikle, health correspondent Saturday December 6, 2003 The Guardian  [Acute NHS trusts with the highest rates of MRSA per 1,000 bed days for 2002/03: Lewisham Hospital 0.24, Epsom & St Helier 0.24, Dartford & Gravesham 0.24, Queen Mary's Sidcup 0.25, Countess of Chester Hospital 0.26, East & North Hertfordshire 0.26, West Middlesex University 0.27, Barnet & Chase Farm Hospitals 0.28, Ealing Hospital 0.29, North Middlesex Hospital 0.30, Weston Area Health 0.30 ]
  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
    3     Trust needs help, says Audit Commission. An Audit Commission public interest report has found that Maidstone and Tunbridge Wells NHS Trust has a cumulative deficit of £16.97m, which it will be unable to rectify without "very significant" help. Summary by Keep our NHS Public of Public Finance 27 January 2006
    3     Operation go-slow in Kent. South West Kent and Maidstone Weald PCTs have become the latest to tell doctors not to carry out any new elective operations or outpatient appointments apart from in the most urgent cases until the next financial year. Summary by Keep our NHS Public of BBC Online 30 January 2006
    3     NHS trust refutes overspend claim. Maidstone and Tunbridge Wells NHS Trust has defended itself after the Audit Commission said it has no plan to clear its £17m deficit. The trust says the deficit is carried over and the result of budget reductions. Summary by Keep our NHS Public of BBC Online 30 January 2006
    3     South East NHS trusts owe £110m. Of the 46 NHS trusts in Kent, Sussex and Surrey, 31 said they had overspent by between £267,000 and £32m, with only seven reporting a budget surplus. Surrey and Sussex Healthcare Trust has the biggest deficit. It has cut 300 jobs, postponed routine surgery and reduced the number of operating theatres in use. Swale PCT in Kent, with a £7.8m deficit, has axed thirty jobs and one ward at a community hospital. Summary by Keep our NHS Public of BBC Online 30 January 2006
    3     One of the government's most successful flagship hospitals has been forced to ban non-emergency surgery after doctors cut long waiting lists by carrying out 'too many' operations. Hundreds of patients have been told by Darent Valley hospital in Dartford, Kent, they will now have to wait longer for their operations. Surgeons performing gynaecological, urological and orthopaedic procedures have been told by local health officials that they have 'over-performed'. Jo Revill, health editor Sunday February 5, 2006 The Observer
    3     Cost-saving surgery ban is "short sighted". The widespread practice of delaying operations until the new financial year to reduce current deficits means PCTs will have to pay doctors for extra lists, or send patients to private hospitals to prevent them breaching waiting list targets after April. Some of the worst examples include Dartford and Gravesham NHS Trust, where 100 patients with appointments for elective surgery - some of which were booked as far back as October with pre-operative assessments - have had their operations cancelled. Medway NHS Trust will not give admission dates to any patients who joined the waiting list after 1 November until after April. A consultant said: "This time next year the trust will be in an even worse position, as it will have spent a good whack of next year's budget on waiting list initiatives to get this year's patients done in time." In both Medway and Dartford and Gravesham the referral system has been changed. Previously referrals were categorised as "urgent", "soon" and "routine", but the "soon" category has been removed and most of these patients are now treated as routine. In Essex, Colchester PCT has forbidden orthopaedic surgeons from treating conditions uncovered after a referral for a different problem - patients must be re-referred by their GP. Surgeons at Essex Rivers Healthcare NHS Trust have branded the demand unethical and refused to co-operate. In Kent orthopaedic, urology and gynaecology patients have been removed from waiting lists for Darent Valley Hospital on PCT instructions. They include patients who have already been given dates and attended pre-assessment clinics. The affected patients, who are selected by a non-medic, are referred back to their GPs - who have been to told to direct all queries to Dartford, Gravesham and Swanley PCT. A consultant at the hospital said: "It is not clear where responsibility now lies for these patients." Dr Jonathan Fielden, deputy chairman of the BMA's consultants committee, said of the general situation: "This is not the best financial management and goes against the principle of putting clinical need first."  Summary by Keep our NHS Public of Hospital Doctor 10 February 2006
          Healthy shopping. East Kent Hospitals NHS Trust has launched a scheme to give check-ups by midwives to expectant mothers at their local Sainsbury's supermarket. Summary by Keep our NHS Public of  Times 3 March 2006
    3     'Bored' gynaecologist blasts NHS. A gynaecologist at the Medway Maritime Hospital in Kent has said he is being left to "twiddle his thumbs" and do crosswords because his hospital cannot afford more surgery. David Penman says public money is being wasted at the hospital, which has a £1m deficit and is delaying procedures until the new financial year. Summary by Keep our NHS Public of  BBC Online 14 March 2006
        5 Community Hospitals at risk in Kent and Medway  SHA according to Public Finance 17 March 2006:
Sittingbourne Memorial Hospital
Edenbridge and District War Memorial Hospital
    3     Trust 'faces £35m debt' next year. The East Kent Hospitals NHS Trust has predicted that NHS reforms could push it into the red by up to £35m next year, resulting in job cuts and bed closures. Chief executive David Astley said: "We are facing a reduction in our income of approaching £20m as a result of the new tariff structure being introduced into the NHS, and that was on top of a challenge we were already aware of, of around £15m for next year." Summary by Keep our NHS Public of  BBC Online 23 March 2006
    3     Consultant's dismay over NHS cash. A consultant microbiologist has spoken out about fears over East Kent Hospitals NHS Trust's impending cost-cutting measures. Graeme Calver said: "We're talking about 10% less staff next year than we've got today… I really don't see how we can absorb this, something's got to give." He said MRSA testing in his department was at risk: "We have seen significant increases in expenditure in our department on testing for MRSA, to meet the government targets of MRSA reduction. We were anticipating we would get extra money for that this year but we're actually going to get less." Summary by Keep our NHS Public of  BBC Online 31 March 2006
    3     Hospital trust to lose 160 jobs. Medway NHS Trust has confirmed it is shedding 160 posts. It hopes to avoid compulsory redundancies. Summary by Keep our NHS Public of  BBC Online 4 April 2006
    3     Hewitt has visited only 11 hospitals in a year. Patricia Hewitt has visited only 11 NHS hospitals - and only two in 2006 - despite being Health Secretary for almost a year. A Department of Health spokesman pointed out that Hewitt had visited independent sector treatment centres. Meanwhile the Medway NHS Trust in Gillingham, Kent, became the latest health authority to announce that up to 160 jobs will go to save £11m. The total number of jobs lost in the NHS stands at 5,130. Summary by Keep our NHS Public of  Telegraph 4 April 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
    3     Secret plan to ration patient care. Patients are being denied appointments with consultants in a systematic attempt to ration care and save the NHS money. The leaked document - 'Pan London Demand Management Arrangements 06-07' produced by the London Transition Team, led by John Bacon, a senior NHS manager - shows that while ministers promise patients choice, a series of barriers are being erected limiting GPs' rights to refer people to consultants. Health trusts across London have drawn up plans to establish panels that will monitor how many patients are referred to hospital by GPs. Trusts have been told that they must cut GP referral rates to those of the lowest 10%, saving £25m a year. Consultant-to-consultant referrals are also being limited, in many cases denying patients a second opinion. A& E departments are being told to "redirect" 40-70% of patients back to GPs or walk-in centres. Hospitals that treat people who ought to have been sent to their GPs will not be paid. The bureaucracy needed to screen all the referrals will itself cost £1.6m. The Times says: "The language of the document makes no pretence that this will improve care, and emphasises cost savings throughout. 'It is imperative that London balances its books overall,' the first paragraph says." The BMA says similar schemes are running in Kent, Oxfordshire, Dorset, Wiltshire, Surrey, Sussex, Cornwall, Shropshire, Suffolk, Lancashire and Yorkshire, as well as London. Jonathan Fielden, deputy chairman of the BMA consultants committee, said: "It's clear that clinicians don't know how these referral management systems aid improvements in clinical care. To them they are purely cost-saving. The way they work is not transparent or clear. If clinicians don't know, patients cannot know either. That certainly flies in the face of the Government's Patient Choice agenda." Myfanwy Davies and Glyn Elwyn, of the Centre for Health Services Research at Cardiff, said the centres had "appeared overnight in an evidence-free zone". Summary by Keep our NHS Public of  Times 7 April 2006
    3     Trust approves moves to save £35m. East Kent Hospitals NHS Trust, which runs hospitals in Folkestone, Margate, Dover, Ashford and Canterbury, plans to cut 160 beds as part of efforts to save £35m. The trust has said it is being forced to make the savings because it is getting £20m less from the government. Summary by Keep our NHS Public of  BBC Online 11 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
          A patient occupied a hospital bed for more than four years after doctors decided the person was ready to leave, it emerged yesterday. The cost of the patient's care at an unnamed hospital in Maidstone and Tunbridge Wells NHS trust is estimated to have been more than £300,000. Paul Lewis Tuesday May 2, 2006 The Guardian
    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
    3     Consultant quits over op delays. A gynaecologist who spoke out over claims he was left with nothing to do because his hospital delayed non-urgent surgery has resigned. David Penman faced disciplinary action after saying public money was being wasted through the delays at Kent's £1m-in-debt Medway Maritime Hospital. He resigned because he could "no longer tolerate the way the NHS is being run". Mr Penman spoke out in March after the hospital imposed minimum waiting times of nine weeks for outpatient appointments and 20 weeks for non-urgent operations. Upon resigning he said: "I come from a long line of doctors and I was brought up to act and behave to my patients with honour, honesty and respect and all I see is spin, lies and deceit from the management. I don't feel I can work in a system like that. It is an important principle not to allow organisations to effectively gag people who, for the most honourable reasons, are wishing to expose dishonourable actions to public scrutiny." The hospital is continuing with disciplinary action against him despite the fact he has resigned. Summary by Keep our NHS Public of  BBC Online 5 June 2006
          Help health workers stop the sell off of NHS Logistics. NHS Logistics has been targeted for privatisation by the New Labour government under the guise of an "arms length body". But Unison's Maidstone branch, along with four other small Unison branches, in Alfreton, Normanton, Runcorn and Bury St Edmunds, are fighting the plans and are consulting their members for strike action. A recent consultative ballot saw 92% vote in favour. Over 2,000 people have signed a petition against the sell off, and now first rally in Maidstone for over ten years has been organised, under the banner of the national organisation Keep Our NHS Public. The rally is set to take place on Saturday 1 July, in Maidstone's Brenchley Gardens next to Maidstone East railway station. The rally will be joined by those fighting over 300 jobs losses in the Maidstone Hospital Trust and 160 at Medway. Summary by Keep our NHS Public of  Socialist Worker 7 June 2006
          Ministers miss key deadline for PBC as chaos dogs scheme. Practice-based commissioning is falling way behind schedule, with more than half of GPs shunning the scheme due to a catalogue of problems. Only two out of five GPs have so far signed up amid doubts over their ability to keep savings and unreasonable demands being set by PCTs desperate to save money. Even those GPs who have agreed local plans are claiming the process has been a worthless exercise. A Pulse survey of 61 PCTs covering 2,038 practices has found just 38% of GPs had agreed a local plan with their PCT by the end of June. The government target by this time was 100%. Despite having come nowhere near the target, health minister Lord Warner said the fact 3,454 practices were involved showed the NHS was "surging ahead" in adopting the Government's reforms. But in Kent, Hampshire, Somerset and Dorset, no GPs had signed up. Summary by Keep our NHS Public of Pulse 7 July 2006
          'Disastrous' failings led to patient's death. A consultant launched a scathing attack on his own hospital after an elderly woman brought in for a minor condition died from blood poisoning. Hugh Evans said that the hospital's chief failure had been to put Mrs Pruce on a ward where staff were not adequately trained to treat urological conditions. And he said that at the time that was a recurrent problem within the trust linked to efforts to meet waiting time targets. Summary by Keep our NHS Public of Kent Messenger 20 July 2006
    3     160 hospital jobs set to be axed. Employees at Medway Maritime Hospital have been sent letters about reducing staff. The NHS Trust plans to cut 160 jobs to save money. Staff are being offered voluntary reduction of hours or early retirement. The Trust has also put a freeze on non-urgent recruitment. Other reductions will be achieved through natural wastage as staff move on or retire. Summary by Keep our NHS Public of Kent Online 21 July 2006
          Nursing students in protest rally. Hundreds of trainee nurses have been protesting about the freeze on NHS recruitment across the South East. They estimate that only 20% of healthcare students are likely to find employment due to lack of funding. Summary by Keep our NHS Public of BBC Online 24 July 2006
        5 Hospital petition taken to Downing Street. A 13,000-signature petition presented to 10 Downing Street is the latest milestone in the Save Buckland Hospital campaign. In addition an eminent consultant, with 25 years' experience, is preparing to officially challenge the consultation process on where health services in Dover should be provided. The petition was presented for the attention of Tony Blair by hospital campaigner Pauline Major and MP Gwyn Prosser. Since the Dover Project consultations began, Mrs Major has taken to the streets, fearful that the review of services is another way of saying services will be cut from Buckland. Summary by Keep our NHS Public of Dover Mercury 7 September 2006
    3     NHS will spend £172m on private consultants. NHS trusts will spend £172 million on private management consultants this year despite being in the grip of the health service's biggest ever financial crisis. Figures today reveal that spending on the small army of advisers is now almost twice the £93 million that hospitals and surgeries were paying out two years ago. The huge increase comes at a time when hospitals across the country are cutting thousands of jobs after trusts ran up deficits totalling £1.27 billion last year. Despite the huge financial pressures, it emerged that many of the hospitals that spend the most on external advisers are axing hundreds of jobs because they have plunged deep into the red. Maidstone and Tunbridge Wells NHS Trust in Kent, for example, is expected to spend about £3.5 million on external consultants this year - even though the trust has a £16 million deficit and has announced 300 job losses. There is a similar picture at the United Lincolnshire Hospitals NHS Trust, which has cut 320 jobs in an attempt to tackle an £11 million deficit. However, the trust is set to spend just under £2.7 million on outside experts this year. Mansfield District PCT in Nottinghamshire spent £1,300 on the "design and facilitation of the prescribing team's away-day". This year, the trust is expected to spend about £175,612 on advisers. Ashfield PCT, Notts, which will spend about £150,000 this year, has paid for advice on "branding" as well as the "preparation and facilitation of governance time-out". Burton Hospitals NHS Trust, Staffs, said it had spent £58,000 for advice on "publicity". The Robert Jones and Agnes Hunt Orthopaedic Trust in Shropshire paid £33,000 on public relations and a further £16,000 on board training. Summary by Keep our NHS Public of Telegraph 12 September 2006
    3     Campaign to save homeopathy unit. Supporters of a Kent clinic which is one of just five in the UK to provide homeopathic treatment on the NHS have met to fight plans to close it. The Homeopathic Hospital, in Tunbridge Wells, treats up to 1,000 patients a year but the PCT which runs it needs to save £160,000. Summary by Keep our NHS Public of BBC Online 20 September 2006
          Health inspectors announced an inquiry yesterday into an outbreak of the hospital infection Clostridium difficile which contributed to the deaths of 20 patients at an NHS trust in Kent. The Healthcare Commission said C difficile had emerged as the most serious hospital-acquired infection, causing more deaths than the superbug MRSA. Its inspectors will look into an outbreak at Maidstone hospital, where 136 patients were diagnosed with the infection between April and June. Maidstone and Tunbridge Wells NHS trust said the infection was the definite cause of death of six patients. Another 14 died due to a range of medical problems including C difficile, but the infection was not deemed to be the main cause of death. A further four had C difficile, but it was unlikely to have led to their deaths. The commission said the infection was the major infectious cause of diarrhoea acquired in hospitals in the UK and may cause fatal inflammation of the walls of the intestine. In July the commission published the findings of an inquiry into three outbreaks of C difficile at Stoke Mandeville hospital near Aylesbury which may have killed at least 41 older people since 2003.  John Carvel, social affairs editor Wednesday September 27, 2006 The Guardian
          'We are striking to keep the NHS public'. Workers at NHS Logistics staged two 24-hour strikes over the past week. Paul Harper, Unison union branch secretary at the Maidstone depot, said: "Why is Mr Blair handing a company that works so well to private sector leeches ? It seems like Blair wants to privatise the whole NHS. However, I don't see Gordon Brown as the answer. Last weekend Brown floated the idea of an independent board to run the NHS. Who's going to be on the board ? People like DHL ? Many of those who are striking at NHS Logistics were Labour supporters. Some are Labour members who have talked about cutting their membership cards up. I'm not sure anyone there is going to support Labour anymore. Summary by Keep our NHS Public of Socialist Worker 30 September 2006
          The true scale of Britain's hospital superbug problems emerged today as a leading hospital trust admitted that a 'hypervirulent' infection had claimed the lives of at least 49 patients - and possibly as many as 78 people - in the space of nine months. The superbug Clostridium difficile (C. difficile), which can cause severe illness and death in patients who have undergone surgery, appears to be at unprecedented levels. It has turned into a more virulent strain, ironically as a result of antibiotics commonly prescribed to fight other infections. The increase in cases is partly due to dirty wards, but also to a shortage of beds. The bacterium has also become more deadly because it has mutated genetically, becoming resistant to other treatments. Three hospitals in Leicester admitted yesterday that the bug is likely to have caused 28 patients' deaths and contributed to another 21 since the beginning of this year. A further 29 suspicious cases have been referred to the coroner. One of the affected hospitals lies in the constituency of the Health Secretary, Patricia Hewitt, who has tried to prioritise infection control within the NHS. It emerged last week that at least 20 patients are thought to have died during an outbreak in Kent earlier this year as a resilient strain of C. difficile spread across the country. The Healthcare Commission, the NHS's independent inspection body, is to hold an inquiry into the outbreak at Maidstone Hospital, when 136 patients were diagnosed with the infection over a three-month period. According to the commission, C. difficile is the major infectious cause of diarrhoea acquired in UK hospitals. It can also lead to fevers, severe inflammation and death in around 5 per cent of cases. More than 51,000 patients in England were found to be carrying the infection last year, with experts warning that it is now more of a danger than MRSA. The use of detergents may also unwittingly have spread the infection. It is thought the chemicals used on floors and equipment may encourage the creation of bacterial spores that are much more resistant to attack. The only answer appears to be steam-cleaning wards and immediate isolation of infected patients, which will make it harder for hospitals to meet waiting list targets.  Jo Revill, health editor Sunday October 1, 2006 The Observer
    3     Doctors to slow down treatment to save money. Hospitals are being told not to treat patients "too promptly" because improvements made in meeting Government targets are costing too much money. GPs have been told not to refer non-urgent cases for hospital appointments within 8 weeks, and hospital doctors have been told not to provide in-patient or day-case operations within 20 weeks. A letter to all chief executives of primary care trusts and hospitals in Surrey, Sussex and Kent, from the health authority, NHS South East Coast, also tells hospitals that "capacity should be reduced" in specialities where many outpatients are being seen within the eight-week rule. This raises the prospect of cuts in doctors' and nurses' posts, not replacing people who leave and transferring staff to other duties. The rationing of patient care is a means of saving money in a health region which last year had the biggest deficit in the country. This year the region expects to be £94m in the red. The letter makes it clear that since the "minimum" waiting times were set earlier this year, confusion has arisen. The situation is another example of conflicting Labour health policies. The gradual introduction of the electronic "Choose and Book" system, which allows patients to choose their hospital and book the first appointment at their GP's surgery, is a key Government health policy. It seems to have revealed the availability of many, early outpatient appointments in the most efficient departments. But after the latest directive, hospitals in the South East are now fearful that if they advertise appointments which are then given to patients who have waited less than 8 weeks they will not be paid. As a result they have not been posting all free slots on the Choose and Book computer. This destroys the purpose of programme - to give patients a wide choice of hospitals. The letter lists 10 instructions to managers "in order to maximise the use of the Choose and Book system and ensure that routine patients are not seen too promptly". It confirms that the penalty for treating too many patients quickly will be no payment for the treatments they provide.  Summary by Keep our NHS Public of Telegraph 23 November 2006
        5 Hewitt backs maternity plans. Health secretary Patricia Hewitt has quashed the objections of an overview and scrutiny committee and upheld local NHS proposals on maternity services on the advice of the independent reconfiguration panel. Hewitt asked the panel to advise her on the proposals for Calderdale and Huddersfield after they were referred to her by a joint committee of local councillors. The IRP was set up in 2003 to provide advice to the health secretary on contested proposals for health service change in England. This was only the second referral, the first being in 2003 about changes proposed in East Kent.  Summary by Keep our NHS Public of Health Service Journal 12 October 2006
          Village GPs bidding for NHS work. The building of a village health centre has led to GP services in Staplehurst, Kent, being put out to tender. Public meetings have been held by NHS chiefs who said they "were not able to hand over the keys to existing GPs". West Kent Primary Care Trust manager Bill Miller said the process was not just about money but was also about providing high quality services. "We are already receiving good quality facilities in Staplehurst," he added. "We have public money we have to spend and we have to go through a process." He said the tendering process would take up to five months and the health centre would open next year.  Summary by Keep our NHS Public of BBC Online 29 November 2006
        5 Gagging campaigners is not our aim, insist NHS chiefs. Health bosses have denied they are out to stop campaigners speaking out over potentially controversial changes in NHS services across Kent. The accusation of a cover up has come from a campaign group after an internal briefing document produced by the newly-created South East Coast Strategic Health Authority appeared to reveal how it is anxious to stop public opposition disrupting plans that could follow from a wide-ranging review of health care. Campaigners say Kent and Medway NHS chiefs are desperate to avoid a repeat of the huge opposition there has been to health cuts in neighbouring Sussex and Surrey, where mass marches and well-organised campaigns have taken place to try to protect local services after a similar review. According to Health Emergency, the campaign group, the health authority intends to conduct its public consultation over a wide-ranging review of services under the slogan "Creating an NHS Fit for the Future". Part of the leaked document reads: "It is urgent to complete these [meetings] before the engagement process leads to heavy media coverage or any active campaigning so that it is relevantly [sic] easy to recruit a representative sample of the population who have not been affected by any previous public discourse."  Summary by Keep our NHS Public of Kent Messenger 30 November 2006
        5 Consultant speaks out at NHS cuts. A senior consultant at a Kent hospital has resigned his managerial post because of plans to downgrade services. Tony Hulse, a paediatrician for 18 years at Maidstone hospital spoke out at a rally aimed at retaining acute services at the hospital which was attended by around 2,500 people. The Maidstone and Tunbridge Wells NHS Trust, which has a deficit of £16.7m for this financial year, announced it was cutting 300 posts in May. Cuts were originally to be made in agency and bank staff but in June it emerged that the trust was planning to move maternity services to Pembury hospital and blue-light ambulances would switch from Maidstone Hospital to a new centre at Kent and Sussex Hospital in Tunbridge Wells. Chief Executive of the trust, Rose Gibb, said the proposals were down to a need to modernise services. Mr Hulse said: "The trust has huge financial problems which can't be denied, but if you look logically at where you should site your acute services they should be where the largest population is." Summary by Keep our NHS Public of BBC Online 4 December 2006
        5 Feared NHS cuts prompt more demos. A candle-lit vigil has been staged overnight at Westminster in protest over feared cuts at a Surrey hospital. Meanwhile in Kent, campaigners who fear for the future of Tonbridge Cottage Hospital have handed a 16,000-name petition and a coffin to NHS chiefs. Both protests were in response to two NHS reviews in the South East, although formal plans have yet to be revealed. Protesters at Parliament were campaigning to keep services at the Royal Surrey Hospital, Guildford. Guildford's MP Anne Milton, and Jeremy Hunt, MP for Surrey South West, joined campaigners in London. In Tonbridge, Reena Pope, from Friends of Tonbridge Hospital, said the cottage hospital was needed. Summary by Keep our NHS Public of BBC Online 13 December 2006
    3     Practices caught in 'referral wars'. More than 60 per cent of GPs are having hospital referrals regularly bounced back to them, Pulse's survey shows. A bewildering array of reasons are being cited for the returns, which have left GPs exasperated and worried for patients' wellbeing. One GP in three said they had had a referral bounced back because it had not been submitted in accordance with procedure. Almost 30 per cent cited cases where their referral had been deemed unnecessary and they had been asked to manage the patient themselves. Dr Lesley Taor, a GP in Orpington, Kent, was one of the 26 per cent to get a referral to a named consultant returned. 'It is ludicrous,' she said. 'We can't refer to named consultants, but when referrals reach the wrong person they get bounced back to us, even when the relevant consultant I wanted is in the same building. 'We have had patients with hand problems getting sent to the back chap. One letter I sent to the respiratory department ended up with rheumatology. I get incensed because it is just rationing by another name.' One GP in five had been told to re-refer because the procedure was cheaper elsewhere. Dr Claudia Webster-Smith, a GP in Purley, Surrey, said her practice was getting into 'referral wars' with hospitals. She said: 'Sometimes we have to refer the patient straight back because we just don't have the capacity in our practice. 'But what if something happens to the patient during this referral war ? It's not fair on the patient.' Summary by Keep our NHS Public of Pulse 14 December 2006
          Government push means many trusts will use private firms next year. Almost 60 per cent of PCTs in England could have brought in private firms to offer GP services by the end of next year, a Pulse survey reveals. A total of 29 per cent of trusts have either already tendered for Alternative Provider Medical Services (APMS) contracts or are in the process of doing so. A further 11 per cent have plans to tender next year and 21 per cent are considering it. Of those trusts to have already signed APMS contracts, more than three-quarters have brought in private providers rather than use existing GPs. The figures, from a survey of 51 post-reconfiguration PCTs, show the Government's push for more trusts to adopt APMS is having an effect. A similar survey by Pulse earlier this year (News, 8 June) found 10 per cent of PCTs had signed APMS contracts, 10 per cent were tendering and a further 12 per cent planned to do so by the end of 2006. Dr Richard Vautrey, GPC negotiator, said there was no need in the majority of cases for PCTs to use the APMS contract rather than GMS or PMS. He also criticised trusts for putting practices out to tender when incumbent GPs wanted to take them on. 'Individual GPs will put a lot of effort into turning a practice around,' he said. 'It's unfortunate when GPs find themselves in a situation where they have demonstrably provided good care but the PCT is not prepared to reward them.' Kent LMC is trying to persuade local PCTs to consider GMS providers as well as APMS for practices they are putting out to tender. Summary by Keep our NHS Public of Pulse 21 December 2006
  2       Equion awarded £300m Kent Hospital PFI. An Equion consortium comprising of John Laing, Laing O'Rourke and Interserve has been awarded preferred bidder status on the £300m Pembury Hospital PFI project. Equion beat off competition from Carillion and Bouygues to capture the deal. The 512-bed hospital and 42-bed mental health unit will be housed in a seven storey building. Final approval of the plans is expected in early spring 2007 with construction commencing in autumn next year. When operational the hospital will replace the existing hospitals at Pembury and the Kent and Sussex Hospital. Summary by Keep our NHS Public of thePFI.net 22 December 2006
          Healthcare that's fit for the 21st century? A 107-bed, three-storey building on the outskirts of Lymington is to be officially opened on Tuesday 9 January and will soon be the first complete NHS hospital to be run by the private sector. Lymington New Forest Hospital has been dubbed a "one-stop-shop", incorporating appointment, consultant, diagnosis and treatment services - all under one roof. Built by Ryhurst under the private finance initiative, health bosses took official ownership of the building last week. That came as the Department of Health announced it wanted Partnership Health Group (PHG), a private company, to run all services at the hospital from July in a first scheme of its kind in the country. Hampshire Primary Care Trust will run it until then. PHG will invest £21m. The project is set to include a new 20,000 patient a year treatment centre at Royal South Hants Hospital in Southampton from 2008. The six-ward Lymington hospital will employ about 400 staff and see about 45,000 patients a year through its 8am to 10pm minor injures unit, outpatient clinics and diagnostic treatment centre, which will carry fast, prebooked day and short-stay surgery such as cataract removal, hip and knee replacements and hernia repair. The hospital has two theatres, two endoscopy suites, a larger radiology department with a CT scanner from next month, two ultrasound suites, medical and surgical day units, stroke rehabilitation and a surgical ward. There will be also be an urgent care centre plus support services such as a pharmacy, education and training centre. Half of the beds will be immediately filled by patients who are being transferred from the existing Lymington hospital, in Southampton Road, which will be closed. The site is being sold off to a developer to build 41 houses. PHG - jointly owned by Care UK Plc and Life Healthcare - currently operates NHS treatment centres in Plymouth, Barlborough, near Chesterfield, and Maidstone. Summary by Keep our NHS Public of Salisbury Journal 8 January 2007
    3     Campaigners condemn plea for nurses to work unpaid. Health campaigners today condemned an NHS trust for asking its staff to resign, work for no pay or take unpaid leave in order to reduce its multimillion-pound deficit. Maidstone and Tunbridge Wells NHS Trust, which reported a £16.7m deficit last year, has sent staff a letter asking them to work unpaid for a day, take six months unpaid leave, take voluntary redundancy or defer taking five days of their holiday until next year to help balance its books. Staff and agencies Friday January 26, 2007 Guardian Unlimited
  2     5 £7.4m for surgery, but K&C is at risk. A new £7.4 million clinic could threaten the future of Kent and Canterbury Hospital. Plans are afoot to create the new facility which will provide a GP surgery, outpatient clinic and day surgery, and on-site diagnostics including X-ray, ultrasound, MRI and CAT scan facilities. If it goes ahead it would be built as a partnership between Whitstable Medical Practice and a private company which would contribute more than £5 million. The chairman of Concern for Health in East Kent David Shortt believes the new surgery could spell the end for Kent and Canterbury Hospital. He said: "The system is now based on payment by results which effectively means payment by activity. If procedures are taken away from the hospital, it will receive less money and eventually a point will be reached where the hospital will no longer be financially viable. We must also take into account that with the 'choose and book' system, whereby patients can pick where they want to be treated, patients might receive a gentle shove in the direction of the new surgical facility in Whitstable." Bunny La Roche of the Keep Our NHS Public campaign is disgusted by the possibility. She said: "If the scheme is allowed to get off the ground it will destabilise local NHS provision. Because of 'payment by results' the money follows the patient. Facilities like this will undermine current services. We don't want an NHS dominated by for-profit organisations. We want a universal and comprehensive system free at the point of use." Summary by Keep our NHS Public of icKent 26 January 2007
          'Appalling' delays for cancer patients. Seriously ill breast cancer patients are having to wait up to three months for vital radiotherapy because of a lack of funding, a consultant has claimed. And three women have gone on to develop the disease for a second time while awaiting treatment in the past few months, something virtually unheard of, according to Peter Jones. Mr Jones, a consultant breast surgeon at the Kent Oncology Centre at Maidstone Hospital, said he felt forced to speak out after one of his patients had to have a mastectomy while waiting for radiotherapy, which, he believes, she would not have needed had she been treated sooner. Bob Deans, director of commissioning for the West Kent PCT, one of the three Kent PCTs which funds the service, pledged that an urgent review would be ordered for funding of the service. Summary by Keep our NHS Public of Kent Messenger 29 January 2007
    3     Hospitals told not to operate until patients have waited 20 weeks. An NHS surgeon has exposed how cash-strapped hospitals are being barred from operating on cancer patients who have not waited long enough. In a withering assessment of the financial management of the health service, Mr Jaffe said that doctors were being restricted in getting waiting lists down by financial limitations and ever-changing targets. The consultant plastic and reconstructive surgeon said he and his colleagues are being prohibited from operating in non-urgent cases unless the patient has been waiting for a minimum of 20 weeks. This is because the hospital would not get paid - even if the patient and staff were ready for the operation. Mr Jaffe said the Prime Minister's pledge to have patients waiting no longer than 18 weeks between referral and treatment would be "impossible" unless more money was made available to primary care trusts. Mr Jaffe, who works at the University Hospital of North Staffordshire NHS Trust, said the 20-week ruling was a "global issue" within the NHS and not just a problem at UHNS. He claimed that he was unable to fill his evening lists because of the 20-week constraint, and that patients were having to wait longer to be seen than necessary. He said: "It's not the hospitals - these rules are being put in place by the PCTs to take them over the April 1 threshold, when the new financial year begins and they get their money from the Government. The way things stand, waiting lists will grow, not shorten, if operations have to be put back because of a lack of money. It's clearly a ridiculous way of doing business." His candid remarks come on the same day that radiotherapists reveal how other cancer patients are having to wait months beyond their recommended dates for treatment that can prevent the disease returning. Channel 4's Dispatches programme found that the waiting gap between operations to remove cancerous growths and radiotherapy treatment is at least three months in Kent, breaching the Royal College of Radiologists' guidelines. Three patients have seen the disease return during the long gap between their operation and radiotherapy. The programme found that five UK radiotherapy units have an average wait of 28 days, which means that many patients are waiting longer. In two centres, more than three-quarters of patients were not treated within 28 days. Mr Jaffe said Government proposals to increase operating hours into the night were "laudable". But he added: "We would need more doctors, more nurses, more staff. More, in fact, of all the people they keep making redundant. They are getting rid of people yet trying to impose regulations on us that mean we need more people. Nurses are qualifying yet no trusts are employing them because they have no money." Summary by Keep our NHS Public of Telegraph 26 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
    3     Protestors take to the streets over NHS cuts and closures. Thousands turned out last weekend to protest at cuts, deficits, and increasing private sector involvement in the NHS. The "Day of Action" was organised by NHS Together, a collaboration of health service unions, NHS staff organisations, and the Trades Union Congress. A series of events took place across the country. A "Rock for the NHS" concert took the stage at Woking, while in Crawley protestors marched in nightgowns and bandages. Other rallies were held in Brighton, Maidstone, Gloucester, Preston, Belfast, London, and Sunderland, where Dr George Rae, chairman of the BMA's northern regional council (left) took part. In Tunbridge Wells, a small crowd protested at the closure of the Homoeopathic Hospital. In Birmingham, Unison general secretary Dave Prentis said the protests were "testament to the growing number of people worried about the future of our NHS." Summary by Keep our NHS Public of British Medical Journal 9 March 2007
    3     PCTs consider alternative to homeopathic hospitals. One of England's four homeopathic hospitals is at risk of closure because of primary care trusts' reluctance to refer patients outside the NHS mainstream. Other homeopathic hospitals are also facing severe financial problems. Kent PCT, which runs Tunbridge Wells Homeopathic Hospital and also refers the majority of patients, is consulting on whether to vet all referrals made by GPs to the hospital. As part of cost-cutting measures the PCT announced at the end of last year, all referrals to the homeopathic hospital would be scrutinised by an individual treatments panel, which would decide whether or not the referral would go ahead. Campaigners claim this would have meant many referrals being refused, and the subsequent slashing of resources could have resulted in its closure. Following protests, Kent PCT has agreed to review its commissioning process for treatment at the hospital, and a decision is expected later in the spring. The Royal London Homeopathic Hospital is also experiencing a severe cut in funding, following the cancellation of contracts by commissioning PCTs. Brent PCT has terminated its contract with the Royal London, and Hammersmith and Fulham PCT has 'signalled an intention to stop direct GP referrals'. It is reviewing its position, but the PCT expects GPs will have to ask for approval for any referral for homeopathic treatment. Other London PCTs are also considering their position and look likely to reduce referrals. Royal London Homeopathic Hospital clinical director Peter Fisher said: 'A combination of bad press and financial turbulence in the NHS means we are seen as a soft target. There is a collision here between PCTs' financial imperative and the willingness to adhere to patient choice.' Summary by Keep our NHS Public of Health Service Journal 15 March 2007
        5 Health bosses approve controversial A&E plans. The Accident and Emergency department at Maidstone Hospital looks set to close to most 999 ambulance calls. The news that the unit will no longer see patients who need surgery being brought in by emergency "blue light" ambulance will come as a bitter blow to campaigners who fought to keep the service going. Board members of West Kent Primary Care Trust approved the plans by the Maidstone and Tunbridge Wells NHS Trust which will mean all trauma patients needing general surgery and surgery on broken bones will go to other A& E units. They instead gave the go ahead to a centralised emergency and orthopaedic centre at the Kent and Sussex Hospital, and for planned inpatient and day case surgery to be centralised at Maidstone. But they recommended the changes could not go ahead until the outcome of the county-wide Fit for the Future health service review is published, which is not expected until June. The PCT's professional executive committee (PEC) had found the public concerns that Maidstone Hospital was being "downgraded" and that the proposals were finance-driven unsubstantiated. Summary by Keep our NHS Public of Kent Messenger 16 March 2007
          Hospitals and schools on alert over listeria in sandwiches. Thousands of sandwiches were recalled from schools, hospitals and universities yesterday amid fears they could be contaminated with listeria, a potentially fatal food bug. The Food Standards Agency removed the sandwiches after listeria contamination was found in samples during routine tests carried out on behalf of Ashford local authority in Kent. The FSA said the sandwiches from Kent-based Anchor Catering, which were delivered to institutions across the south-east are labelled either Anchor or Pomegranate and had use-by dates from February 21 to March 14. Thair Shaikh Saturday March 17, 2007 The Guardian
    3     NHS crisis is forcing cuts to maternity care, charity warns. Support for pregnant women is being cut because of the NHS's financial troubles, a healthcare charity has warned. The National Childbirth Trust (NCT) says it is receiving "increasing reports" that NHS antenatal classes, breastfeeding services and postnatal visits are being cancelled. NHS antenatal classes have been cut or suspended in at least 10 areas in England and Wales, according to the NCT. These are Romsey in Hampshire; Worcestershire; Newham in London; Watford; Gwent in south Wales; south-west Kent; Nottinghamshire; Gloucestershire; Hemel Hempstead in Hertfordshire; and Wiltshire. The NCT said it also understood that postnatal home visits have been stopped or are facing cuts in Wiltshire and in east and north Hertfordshire, which would mean new mothers have to travel to a clinic in order to receive after-birth care.  Press Association Monday March 26, 2007 SocietyGuardian.co.uk
          Radiotherapy machines 'lie idle'. A report by the Royal College of Radiologists has found that 10% of Radiology machines were not being used. The total cost of the machines is 150m. The college said the findings were "no surprise" and the government acknowledged there was a problem. Maidstone Hospital was found to have two brand new machines that didn't work for a year and manufacturer Varian said that this was happening across the country. The report also found that more than 60% of the machines were not using software, IMRT, designed to focus the machines on tumours to avoid damaging healthy tissue. The Royal College of Radiographers' vice president Michael Williams said services have improved, but that they still are not up to scratch. "The present radiotherapy service is inadequate. People are reluctant to admit how bad the situation is because they say it's a lot better than it was," he said. The Department of Health has said that it is currently studying recommendations from the national radiotherapy advisory group on the future of radiography. Summary by Keep our NHS Public of BBC 7 April 2007
    3     NHS admits 17 trusts are mired in debt. The Department of Health last night named 17 NHS hospital trusts across England which are mired in debts worth hundreds of millions of pounds and cannot survive without a fundamental reorganisation. David Nicholson, the NHS chief executive, said 12 were not creditworthy enough to be lent money from government funds to cover an accumulated deficit at the end of the financial year last month. Five were permitted to take out loans, but acknowledged they could be repaid only over "a very extended timescale". His announcement was the first official confirmation of a Guardian inquiry in December which found at least a dozen trusts were technically bankrupt, with no prospect of repaying debts. The department removed Good Hope hospital in Sutton Coldfield, West Midlands, from its financial sick list after making arrangements in March for it to be taken over by Heart of England NHS foundation trust, with hospitals in east Birmingham and Solihull. The government hopes similar takeovers can be organised to rescue others on the list of 17, but they may not be suitable in every area and some facilities may have to close. The 13 trusts that could not afford to repay debts were: Hinchingbrooke Health Care in Huntingdon; Mid Yorkshire; Queen Mary's, Sidcup, Kent; Royal Cornwall; Royal Wolverhampton; Coventry & Warwickshire; West Middlesex; Weston Area Health, Weston-super-Mare; and three London trusts - Barking, Havering and Redbridge; Bromley; and Queen Elizabeth, Woolwich. The five that could not repay loans in the foreseeable future were: North Bristol; Royal United hospital, Bath; Surrey and Sussex Healthcare; the Royal West Sussex; and Whipps Cross, London. John Carvel, social affairs editor Thursday April 26, 2007 The Guardian
        5 A&E decision passed to government. Councillors made history when they referred a decision on the future of health services to the Health Secretary. Members of Kent County Council's NHS overview and scrutiny committee threw out the plans for changes to emergency general surgery and orthopaedic surgery at Maidstone and Tunbridge Wells during a lengthy debate. During the heated discussion, they voted instead to refer the matter to Secretary of State for Health, Patricia Hewitt, by a majority of eight to five. It was the first time the committee has exercised the right to refer a decision to her since it was given the power in 2003. The committee had questioned Maidstone and Tunbridge Wells NHS Trust chief executive Rose Gibb, whose trust put forward the plans, and Steve Phoenix, chief executive of the West Kent Primary Care Trust, which had voted to approve the plans in March. Councillors had reservations about the impact of plans on local people to create a specialist emergency orthopaedic centre at Tunbridge Wells, which would mean some emergency patients would no longer be seen at Maidstone A& E. Summary by Keep our NHS Public of Kent Online 14 May 2007
    3     Hard-up NHS trusts cut back on unproven homoeopathy treatment. The NHS is turning its back on homoeopathy and other unproven alternative medicines in the face of a financial crisis and pressure from doctors. More than half of the primary care trusts (PCTs) in England are now refusing to pay for homoeopathy or severely restricting access. Figures obtained by Les Rose, one of the doctors, and The Times under the Freedom of Information Act show that at least 86 of the 147 trusts have either stopped sending patients to the four homoeopathic hospitals, or are introducing strict measures to limit referrals. Another 40 trusts have yet to provide data. More than 20 have taken action since receiving a letter organised a year ago today by Professor Michael Baum, a cancer specialist at University College London, which argued that "unproven or disproved treatments" such as homoeopathy and reflexology ought not to be available free to patients. The move away from homoeopathy has been so significant that two homoeopathic hospitals are threatened with closure. West Kent PCT is consulting over plans to shut Tunbridge Wells Homoeopathic Hospital and the Royal London Homoeopathic Hospital (RLHH) has asked supporters to lobby trusts and MPs. Summary by Keep our NHS Public of Times 23 May 2007
          PFI prisons approved but health deal set to be axed. Two more prisons are to be built under the private finance initiative, but another big contract for the private sector to supply tests and diagnostics to National Health Service patients looks set to be scrapped. a £70m contract to provide tens of thousands of X-rays, scans and endoscopies to NHS patients across Kent, Sussex and Surrey - activity seen as crucial if the NHS is to meet its target of a maximum 18-week wait for treatment - looks set to be pulled, even though it has already reached commercial close. It will be the second sizeable contract to be dropped in two months, with the Department of Health having to pay millions of pounds in compensation on bid costs for the deals. The department would confirm only that the contract - like all the other unsigned central private sector NHS contracts - was under review with an announcement due later this month. The South East Coast strategic health authority, however, is understood to have lost patience with the department's delay on the deal, and said it needed to find other ways of providing the service to meet the 18-week deadline. That could include contracting with the private sector locally as well as using existing NHS provision more intensively. One private provider said the NHS contracts appeared to be "falling like dominoes" and the government risked seeing the overseas providers of NHS services that it had worked so hard to bring in after 2002 walking away from NHS provision. Already the US-owned Nation's Health has pulled out, selling its interest in three independent surgical centres set up to treat NHS patients. Summary by Keep our NHS Public of Financial Times 3 August 2007
          NHS patients who complain risk victimisation, say inspectors. NHS patients who complain about a poor standard of care are at risk of being victimised, health inspectors warn today after the first national audit of the complaints system in England. The Healthcare Commission said it launched the review after becoming increasingly concerned about how hospitals and primary care trusts respond when patients criticise the behaviour of staff or conditions in hospitals or GP surgeries. After a risk assessment of all trusts, it identified 32 hospitals, ambulance services and primary care trusts which appeared to have the least satisfactory arrangements. Inspectors found none had comprehensive safeguards to ensure that people who complained could be confident their care would not suffer as a result. They identified "significant lapses" at nine of the audited trusts. "The main concern was an absence of systems to monitor whether care had changed in any way as a result of a complaint," the commission said. Few trusts were using complaints to learn how to improve the service. The commission named 12 trusts where it found "significant lapses" in one or more of the national standards for managing NHS complaints. It said this would affect their marks in the annual performance tables. Another six were given formal warnings and 12 were told to make improvements. Only two got a clean bill of health. The commission investigates about 8,000 appeals a year from patients who have complained to a hospital or primary care trust and are dissatisfied with the response. Its report concluded: "Processes can be fragmented and applied inconsistently within individual trusts and across the NHS ... the emphasis remains on the process rather than seeking to find resolution for the person raising a complaint." It criticised trusts for doing little to help people from ethnic minority communities or patients with learning difficulties. Anna Walker, the commission's chief executive, said: "Given that the NHS provides 380m treatments a year, the number of complaints - 140,000 - is relatively small. But when someone does complain, trusts need to respond well. Patients want complaints resolved quickly and locally." The report praised one of the largest and busiest acute hospitals in the north-west for learning from a complaint about a patient who died after an MRSA infection. Relatives expressed concern about staff wearing uniforms outside the hospital, risking contamination. The trust devised a new dress code and invested in facilities for staff to change clothes. Peter Walsh, chief executive of Action against Medical Accidents, said: "This audit is further evidence, as if we needed it, that the way many NHS organisations handle complaints adds insult to injury and there is an urgent need for improvement."

John Carvel, social affairs editor Monday October 8, 2007 The Guardian. [The list is incomplete as it omits NHS bodies in the York area, despite the prolonged neglect of Sharon Wilson.]

          NHS superbug inquiry blames trust for deaths. Scores of NHS patients were killed during Britain's deadliest outbreak of a hospital superbug, a damning report by the government's health watchdog reveals today. The Healthcare Commission attributed the deaths of 90 patients at the Maidstone and Tunbridge Wells hospitals in Kent to infection from Clostridium difficile, which causes severe diarrhoea and has taken over from MRSA as the main threat to patients. Evidence will be referred to Kent police and the Health and Safety Executive (HSE) about how the trust's slack infection controls contributed to the deaths. They will decide whether to bring criminal charges, which could include murder, manslaughter or breaches of health and safety legislation, said Anna Walker, chief executive of the Healthcare Commission. John Carvel, social affairs editor Thursday October 11, 2007 The Guardian
  • Trust failed to warn of outbreak or improve hygiene. Commission says board had no antibiotics policy and misled public on cause. John Carvel Social affairs editor Thursday October 11, 2007 The Guardian
          Superbug hospital chief given £250,000 to quit. The NHS manager responsible for Britain's deadliest outbreak of a hospital superbug was given a payoff worth more than £250,000 to quit her job last week before the Healthcare Commission produced a damning report on her trust's mismanagement, the Guardian has learned. Rose Gibb, who earned £150,000 a year as chief executive of Maidstone and Tunbridge Wells hospitals, stepped down last Friday. Five days later the commission accused the trust of "significant failings in infection control" that caused the deaths of 90 patients between April 2004 and September 2006. The patients were the victims of two outbreaks of Clostridium difficile, which can be fatal, particularly for older people weakened by other medical conditions. Kent police and the Health and Safety Executive were reviewing the report on the deaths yesterday before deciding whether to press criminal charges against the trust. Alan Johnson, the health secretary, intervened last night after concern at the Department of Health about whether the payoff was appropriate. He said: "I have instructed the trust to withhold any severance payment to the former chief executive of Maidstone and Tunbridge Wells NHS trust, pending legal advice." John Carvel, social affairs editor Friday October 12, 2007 The Guardian
          The dirty truth on the wards. The debate over the poor treatment of elderly patients in Britain's hospitals will be reignited this weekend after an Observer investigation revealed that vulnerable people are being forced to use embarrassing portable toilets or wear incontinence pads rather than being taken to the bathroom. The investigation found that nurses and healthcare assistants no longer routinely accompany elderly patients to the toilet, particularly when wards are busy. The revelation comes days after Maidstone and Tunbridge Wells NHS Trust, where 90 people died of the C. difficile infection, was criticised for allowing patients to go to the toilet in their beds. Sunday October 14, 2007 The Observer
          A private matter. Attending the Paul Sieghart Memorial Lecture given in 2004 by Baroness Hale of Richmond made me realise that the key to improving care for older, frail people was through a better understanding and application of the Human Rights Act. The title of her talk was: "What can the Human Rights Act do for my mental health?" She described how providers of public services abused the human rights of frail older people every day by failing to recognise the need for privacy and dignity when providing personal care - for instance, with access to the toilet.
Watching older people losing their basic rights as soon as they entered hospital had made me increasingly frustrated. Four-hour trolley waits and the waiting list initiative led to major improvements for older people, but this has been achieved at the expense of their dignity, privacy and humanity. I have seen too many older people struggling to be heard and to have their basic needs met, particularly in mixed wards and in wards that are not run or designed with them in mind. Some managers have stated that privacy has to be sacrificed for safety. After the recent problems at Maidstone and Tunbridge Wells NHS Trust, this can no longer be acceptable.
We all take going to the toilet in private for granted, so why should our expectations change when we are admitted to hospital or to a care home? This premise led to the development of Behind Closed Doors, a multi-agency campaign spearheaded by the British Geriatrics Society. We chose toilet access as a marker of human rights and dignity.
We need to implement a major change of culture at every level. This can be done through use of our official standards, which highlight bad practice (such as ignoring requests for assistance to the toilet and telling people to use their pads) and good practice (such as ensuring privacy and modesty). We recommend that all people in hospitals or care homes, whatever their age and physical disability, should be able to use the toilet in private and that there should be enough clean toilets and equipment to achieve this. Designers, planners and architects need to understand that two-thirds of people admitted to hospital are over 65 and that the numbers of people over 80, who are more likely to be frail and require assistance, are expected to rise by two-thirds by 2026.
Our campaign will ensure that present and future generations of frail and vulnerable older people are aware of their rights. We need to continue to make the public and professionals aware that sensitive and humane care is part of effective care and can never be sacrificed in the name of efficiency and safety. Jackie Morris October 14, 2007 commentisfree.guardian.co.uk
          Superbug hospital chairman resigns. The chairman of the NHS hospital trust where 90 patients died from Clostridium difficile infection accused the government last night of singling it out for vilification when ministers knew scores of other trusts had worse infection rates. James Lee resigned as chairman of Maidstone and Tunbridge Wells NHS trust, after Alan Johnson, the health secretary, launched fresh inquiries into his role in organising a £250,000 pay-off for the chief executive, Rose Gibb. Mr Lee, a film executive and former director of the Financial Times, was already under investigation by the South-east Coast strategic health authority for the part he played during two outbreaks of C difficile between April 2004 and September 2006. The Healthcare Commission said last week that 1,176 patients were infected with C difficile during two outbreaks when 345 patients died. It said 90 of the deaths were definitely or probably caused by the infection and blamed slack management for failing to contain it. Last night Mr Lee released the text of a four-page letter to Mr Johnson admitting there was no excuse for what happened at the trust's three hospitals. He said: "I am deeply saddened by these terrible events and take full responsibility for my part as chairman of the board for the past five years. I apologise unreservedly." But he hit back at the unreasonable pressures imposed on the trust by the government. "We have been struggling with a state pretty close to bankruptcy," he said. The trust's clinical income last year increased by 1.5% in cash terms when staff pay rates were rising by over 5%. "We knew the Treasury was pumping money into the NHS, but quite frankly none of this seemed to be getting to the coalface." As income fell, hospital activity rose by 11%. The trust cut costs by more than £40m in an attempt to break even. It struggled to cut maximum waiting times to 18 weeks. But this was "never really achievable". Mr Lee said attempts to get rid of a small minority of poor nurses were ineffective because "NHS employment practices make it difficult to take action, even against transparent incompetence". He sent the letter, labelled strictly private and confidential, before he knew whether Mr Johnson would back him or accept his resignation. He denied any impropriety in the severance payment to Ms Gibb. The government was persisting in treating Maidstone as a "rogue trust", when it knew there were 83 acute trusts in Britain with higher C difficile rates in the first three months of this year. "We are now so discredited that we are no longer believed," he said, appealing to Mr Johnson to explain the facts to the public. He added: "The NHS is run on the basis of command and control. I personally have never experienced such centralised or detailed control ... This way of managing things is fundamentally incompatible with the whole concept of independent trusts ... I have done my best." Mr Lee broke his silence after Mr Johnson told MPs he had ordered a departmental review of the chairman's role in agreeing severance terms for Ms Gibb. John Carvel, social affairs editor Tuesday October 16, 2007 The Guardian
          Fly on the wall interviews: Local authority and primary care trust partnerships.  IDeA's National Adviser for Healthy Communities, Liam Hughes, introduces a compelling series of case studies that explore the relationships between councils and primary care trusts (PCTs);- Barnsley Council and PCT 17 October 2007; City of Bradford Metropolitan District Council 17 October 2007; London Borough of Brent 17 October 2007; Cannock Chase Council and PCT 17 October 2007; Croydon Council and Croydon's PCT 16 October 2007; Gateshead Council and Gateshead PCT  16 October 2007; Greenwich Council 17 October 2007; Herefordshire Council 17 October 2007; Kent Council and PCT 15 October 2007; Knowsley: joint appointment council and PCT;  15 October 2007 Lewisham Council and PCT 15 October 2007; Shropshire County Council 15 October 2007; Stockton-on-Tees Council and PCT 17 October 2007;