London SHA to 2006

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The London Strategic Health Authority was formed by merging five old strategic health authorities.  This page has always covered the whole of London.

This is the archive to 2006.  For more recent material see:

London Strategic Health Authority

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
          Long waits in casualty blot Whittington's good marks. Report found fault in 'privacy and dignity'.   Guardian Unlimited Friday January 25, 2002
          The writer, who has asked not to be named, is an Australian operating theatre nurse who has worked at nearly a dozen London hospitals, placed there on short-term contracts through nursing agencies. Most of these hospitals are well-known and in the state sector. Guardian Society Thursday April 4, 2002
          Hospital trust 'failures' led to breast cancer errors.  Society Monday April 15, 2002 [Hammersmith Hospital]
          Mix-up on cancer screening 'avoidable'.  Sarah Boseley, health editor Guardian Tuesday April 16, 2002
          A casualty in need of intensive care.  Shamed in the tables, Chase Farm's patients remain loyal.  Sarah Boseley, health editor Guardian Tuesday April 23, 2002
  2       NHS chiefs in Enfield are working on three huge private finance initiatives (PFIs) that could make or break the local health service.  John Carvel Monday October 21, 2002 The Guardian
          Hospital makes 135 drug errors a week.  Thursday December 5, 2002 [London]
          When hospital consultant Leyla Sanai became a patient herself, she was shocked by the state of Britain's wards - and not in the least surprised to catch a superbug.  Tuesday January 21, 2003 The Guardian [Scotland, with adverse mention of Birmingham and favourable mention of Royal Free]
    3     London: A five-month wait for surgery. Sunday May 25, 2003 The Observer
          Virus danger shuts down hospital labs. Inspectors act to prevent deadly germ leaks after safety lapses. Antony Barnett, public affairs editor Sunday June 1, 2003 The Observer [Royal Brompton, Hammersmith, Truro and Warrington]
          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)]
  2       A Swedish consortium is likely to win a £900m deal to redevelop St Bartholomew's Hospital in London - despite there being insufficient bidders for the contract under government private finance initiative guidelines. Terry Macalister Tuesday November 11, 2003 The Guardian
    3     Walk-in unit a godsend to those with no GP. With its new drop-in unit and extra GPs Enfield is tackling its primary care crisis. Sarah Boseley and John Carvel Monday November 17, 2003 The Guardian
  2       The private consortium made preferred bidder for the £900m redevelopment of St Bartholomew's and the Royal London hospitals has been accused of a conflict of interest. Terry Macalister Monday December 1, 2003 The Guardian
          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       The government yesterday chose a Swedish-led consortium to undertake Britain's first £1bn hospital redevelopment scheme after ministers dismissed allegations of a conflict of interest. Tash Shifrin and John Carvel Thursday December 11, 2003 The Guardian [St Batholomew's}
  2       Halliburton, the American construction group, is being wooed by British government officials seeking new capacity to take on hospital schemes under the private finance initiative. The Department of Health is alarmed by the absence of domestic firms queuing up to take on new schemes which has already forced a dilution of the PFI competition rules. The latest trouble surrounds the £300m Vanguard hospital project in Plymouth, which has been falling behind schedule because of a lack of interest from the private sector. This follows the £620m redevelopment project for Barts and the Royal London hospitals, for which only two companies bid. Terry Macalister Monday April 5, 2004 The Guardian
          Just six months after opening, Britain's first private walk-in casualty unit has expanded to offer day surgery services, the company announced today. Casualty Plus has opened two new operating theatres and is offering fixed price day surgery procedures at its site in Brentford, west London, because of its unexpected success. Roxanne Escobales and agencies Friday April 16, 2004
          Conventional cleaning has "little impact" in eliminating the so-called superbug MRSA in hospitals, according to research published today.  The study at Guy's and St Thomas' hospital in London found rooms occupied by patients with MRSA (methicillin-resistant staphylococcus aureus) contaminated with the infection after the walls had been mopped and the furniture cleaned.  Thursday April 22, 2004
          Reports of the hospital superbug MRSA went up another 3.6% last year, Department of Health (DoH) figures revealed today, with Guy's and St Thomas's trust showing the highest infection rate. Tash Shifrin Wednesday July 14, 2004
  2       London's mayor, Ken Livingstone, is set to veto Britain's first £1bn hospital under the private finance initiative after its design was today severely criticised by the government's architecture watchdog. The project to rebuild the Royal London hospital in east London as an 18-storey block "recreates mistakes made in the 1960s", according to the Commission for Architecture and the Built Environment (Cabe). Matt Weaver Tuesday August 3, 2004 The Guardian
          More than 550 patients who underwent shoulder investigations over seven years have been offered blood tests to establish whether they were accidentally infected with diseases such as HIV or hepatitis. A procedure used as part of research at the London outpatients' clinic of the Royal National Orthopaedic Hospital involved probes that were sometimes reused on NHS and private patients. Cleaning with alcohol would not have been sufficient to offer 100% protection against all viruses, hospital officials admitted yesterday, two years after they were first alerted to the problem, which has been reported to the General Medical Council for investigation. James Meikle, health correspondent Wednesday September 8, 2004 The Guardian
  2       One of the government's biggest hospital building projects is in jeopardy after a damning review of its financial management. The Paddington Health Campus, a plan for west London which includes redeveloping St Mary's Hospital, the Royal Brompton and Harefield, which are both heart hospitals, and Imperial College, has seen costs rise from £382 million to £800m last year after a series of planning blunders. Jo Revill, health editor Sunday October 3, 2004 The Observer
          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
          What really bugs NHS patients: the dirt. A 'lively' public meeting in Enfield changed government thinking on hospitals. Sarah Boseley and John Carvel Monday February 7, 2005 The Guardian
        5 Veteran campaigner (Jean Brett) leads fight to save Harefield hospital. Mark Gould Wednesday February 16, 2005 The Guardian
    3     Great Ormond Street Hospital in London has had to close up to one-fifth of its its beds, cancel operations and turn away dozens of critically ill children because of the severe financial problems it faces. The news that the world-famous children's hospital is having to close its doors to patients will highlight the serious cost pressures on the NHS and re-ignite the political debate over where the extra billions of pounds earmarked for hospitals has been spent. Jo Revill and Gaby Hinsliff Sunday March 6, 2005 The Observer
    3     Great Ormond Street is one of the wealthiest hospitals in the world. It is now in the middle of a multi-million pound redevelopment. Its fundraising campaigns are backed by celebrities and its old wards will be transformed within the next five years. Its pioneering care for sick children and authoritative expertise on anything from leukaemia to depression continues to win national and international acclaim. Yet despite all that the hospital doesn't have the money it needs to keep its beds open. The millions of pounds raised for the new development cannot be spent on daily running costs as the NHS does not allow such transfers of money. Many hospitals facing deficits would do as Great Ormond Street is - cancel operations, close beds and cut the nursing bill. They may not be so high profile, but every trust must balance its books. Great Ormond Street's deficit - £1.7 million - is tiny compared with the £184m spent each day on the NHS. But it must make itself as financially lean as possible to win the approval of the Health Secretary, John Reid, for it to become a foundation trust, cherished status that brings some independence. Jo Revill, health editor Sunday March 6, 2005 The Observer
        5 Showpiece hospital faces axe. Jo Revill, health editor, reports on how plans to close a major London teaching hospital in a marginal Labour seat are being kept secret until after the general election.  Sunday April 10, 2005 The Observer
        5 Nothing is more difficult for a politician or a health administrator than to close a hospital. Conservative proposals to close or merge several hospitals in London in the early 1990s proved to be the undoing of Virginia Bottomley, then Health Secretary, who failed to understand how passionately attached people were to their local NHS. Jo Revill Sunday April 10, 2005 The Observer
          The health secretary, John Reid, yesterday ordered urgent special measures at a hospital maternity unit where 10 mothers have died in the past three years. He intervened at Northwick Park hospital, north London, after NHS investigators said they were extremely concerned that women's safety was being compromised. James Meikle, health correspondent Friday April 22, 2005 The Guardian
  2       An ambitious plan to build a £1 billion state-of-the-art hospital for London, replacing the Harefield and Royal Brompton heart hospitals, has fallen through, and developers are privately accusing civil servants of scuppering the deal because of alarm over costs and possible political fallout as the election looms. The proposal was to create the 'Paddington Health Campus', taking Harefield and the Royal Brompton and redeveloping them with St Mary's Hospital on land near Paddington station. But the consortium that owns the land, Paddington Development Corporation Ltd (PDCL), has withdrawn from all negotiations. Jo Revill, health editor Sunday April 24, 2005 The Observer
          The government was yesterday celebrating an apparent downturn in the figures for MRSA infection in hospitals, which have dropped by 6% in the last six months by comparison with the same period last year. But opposition critics claimed the figures - published for six months rather than 12 as has been the norm - gave a misleading impression, and it is clear that good progress on fighting hospital acquired infection in London is not matched in all parts of the country. League tables, published on the government website, revealed widely varying rates of infections at different hospitals. Sarah Boseley, health editor Tuesday March 8, 2005 The Guardian
          An NHS trust was fined £28,000 yesterday for a series of systematic failures which led to a psychiatric nurse being battered to death by a schizophrenic patient. An Old Bailey judge fined South West London and St George's Mental Health NHS Trust, and ordered it to pay £14,000 costs, after the trust admitted neglect which contributed to the death of Eshan Chattun. Mr Chattun, 34, was beaten to death in June 2003 while working at Springfield hospital in south London. Faisal al Yafai Friday May 6, 2005 The Guardian
  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
  2       It was flagged as one of the most ambitious hospital projects in Europe. But with costs spiralling out of control, the canalside Paddington Health Campus is set to be sunk. Mark Gould reports on a PFI flop. Wednesday June 15, 2005 The Guardian
  2       The NHS will axe its biggest ever hospital investment today, scrapping plans for a private finance initiative to build a £1.1bn healthcare and research campus in west London. Patricia Hewitt, the health secretary, will approve an independent inquiry into how the scheme for a super-hospital in Paddington wasted eight years of effort and almost £14m in project costs before being cancelled without a brick being laid. Mark Gould and John Carvel Tuesday June 21, 2005 The Guardian
          Fifteen hospitals have been hit by outbreaks of the new strain of the hospital superbug Clostridium difficile which has so far contributed to 25 deaths, ministers have admitted. So far there have been 75 cases confirmed by scientists at the specialist laboratory in Cardiff - the only one in the UK equipped to analysis the new strain - health minister Jane Kennedy said yesterday. The statistics reveal the outbreak of the new strain, which last week was confirmed at a second hospital in the UK, is much wider than originally believed. Hospitals where the strain has appeared are in: Preston, Birmingham, Winchester, Bristol, Romford, Southampton, Truro, Carshalton, High Wycombe, South Tyneside, Newcastle, South Tees, Sunderland, Stoke Mandeville and Exeter. Debbie Andalo Thursday June 30, 2005
    3     A London NHS trust has imposed an indefinite recruitment freeze on nursing and medical staff in order to balance its books, SocietyGuardian.co.uk has learned. St George's Healthcare NHS Trust was unable to comment on the duration of the freeze, which a trust insider claims has been set at three years. Hélène Mulholland Monday August 8, 2005
  2       A legal challenge from local residents that threatened to stall the biggest ever private finance initiative (PFI) hospital building project in the UK has been abandoned, after protesters were warned that they could be liable for the legal costs of the local council and the hospital trust. The crumbling Royal London hospital in the East End dates back to 1752 and has a Grade II-listed 19th-century facade. It is being rebuilt as part of a £1.2bn PFI project that also includes St Bartholomew's Hospital in the City. Mark Gould Wednesday August 10, 2005 The Guardian
          Patients on the NHS are staying in a four-star luxury hotel while they receive treatment for leukaemia and other malignant blood disorders at a leading London hospital. Ensuite double rooms with buffet English breakfast at £168 a night at the Radisson Edwardian Grafton Hotel in Tottenham Court Road are proving a boon for patients seeking privacy and family support. After daily treatment at University College hospital (UCH), 100 yards away, they can relax in the quiet of their hotel room with family and friends, without the risk of hospital acquired infection, and without the £3.50 charge that hospital patients have to pay to watch television. James Meikle, health correspondent Saturday August 20, 2005 The Guardian
    3     A London NHS trust is cutting 300 jobs on top of an indefinite recruitment freeze in a desperate bid to plug a multi-million pound deficit. Around 70 staff at St George's healthcare NHS trust face redundancy, with the remaining cuts expected to come from a reduction in the use of expensive agency staff. Hélène Mulholland Friday September 23, 2005
  2 3     A flagship NHS hospital which opened four years ago under the government's private finance initiative admitted last night that it has become technically insolvent. Senior managers of Queen Elizabeth hospital NHS trust in Woolwich, south-east London, spoke to the Guardian after a warning from auditors that the annual deficit will climb to £100m by 2008-09 unless the government restructures a crippling PFI debt. The problems cast doubt on assurances from Patricia Hewitt, the health secretary, that the NHS's financial difficulties can be resolved by "turnaround teams" of management consultants which she sent out this month to correct a £623m forecast deficit across England. John Carvel, social affairs editor Friday December 16, 2005 The Guardian
    3     A world-famous London teaching hospital has become the latest victim of a financial crisis in the NHS. University College hospital was given a maximum risk rating yesterday by Monitor, the foundation trust regulator, after posting a £17.4m loss over the first six months of the financial year. It blamed part of the deficit on the terrorist bombings in London in July, which resulted in the loss of four days of normal activity, adding £2m to the deficit. UCLH already had clearance to declare a £6m deficit for 2005-06 to cover the cost of moving its main hospital. But Monitor was alarmed at an unexpected deterioration of the balance sheet between October and November, when not enough patients were treated and cost savings did not materialise. It declared the trust to be "failing to exercise its functions in an effective, efficient and economic way". The failings, it said, were "significant". John Carvel, social affairs editor Saturday December 17, 2005 The Guardian
  2       Hospitals feel pain of funding problems. The FT says the Department of Health's decision to review the St Bartholemew's and Royal London PFI project "is a symptom of a deeper malaise affecting large-scale PFI hospital projects". Patricia Hewitt has hinted that in future there will be more reliance on "LIFT" (local infrastructure trusts) and fewer big PFI hospitals. An NHS executive said: "My guess is that Birmingham, and Barts and the London, will go ahead. But they will be the last of the mega-deals". Other PFI projects that could be in doubt include the £700m rebuild of University of Birmingham Hospitals. Minutes from a board meeting of financial regulator Monitor show that the DoH asked Monitor to approve the scheme's affordability - a request that was refused on the grounds that the guarantor, not the regulator, should carry the commercial risk. Treasury officials are known to be sceptical about four big projects in Liverpool worth £1bn. Schemes in Bristol, Plymouth, Hertfordshire and Leicester could also be in question. Summary by Keep our NHS Public of Financial Times 27 December 2005 (subscription needed to access FT articles)
  2       The health secretary, Patricia Hewitt, has imposed a review of the biggest hospital rebuilding project in Britain, casting into doubt Labour's multibillion pound private finance initiative in modernising the NHS. Ms Hewitt has not only questioned the affordability of the £1bn plan to rebuild the Royal London hospital in Whitechapel and partly rebuild St Bartholomew's in Smithfield - founded in 1123 and England's oldest hospital, but is also asking whether projects on this scale will best serve patients' needs in an age of rapidly-changing healthcare. Ms Hewitt's decision to question the scheme reflects growing concern about the ability of hospital trusts to bear the huge annual costs of servicing 25-40 year PFI deals at a time when hospitals' guaranteed incomes have been plunged into uncertainty by the new payment-by-results policy. Michael White, political editor Wednesday December 28, 2005 The Guardian
          Serious shortcomings in the rescue operation after the London bombings were revealed by emergency staff yesterday. Hospitals complained of being starved of vital information and of having radios that only worked "10% to 15% of the time". Hugh Muir Thursday January 12, 2006 The Guardian
  2       A thousand doctors from St Bartholomew's and the Royal London hospitals have protested at the health secretary's refusal to approve a £1.15bn rebuilding scheme, weeks before contracts were due to be signed. Patricia Hewitt ordered a review of the project amid growing concerns that hospitals rebuilt under the private finance initiative will not be able to service their debts. The review will consider whether cancer and cardiac services at Bart's, in Smithfield, could be relocated elsewhere. But the trust believes that changes at this late stage would threaten a scheme that has taken years to develop. Tania Branigan, political correspondent Monday January 16, 2006 The Guardian
  2       Billion-pound hospitals plan faces collapse. Ministers are considering scaling back or cancelling about ten PFI hospital building schemes, including projects in Bristol, Liverpool and Newcastle, due to concerns over cost. Under payment by results, hospitals do not have a guaranteed income and due to patient choice they could potentially close, leaving the Department of Health worried about the viability of the PFI. 24 PFI schemes with a total capital spend of £2.1bn have been completed. 14 more schemes, worth £3bn, have been approved. A further £12.1bn worth of projects are awaiting approval. A DoH source told the Times "Ministers are considering how to make it clearer that PFI schemes have to make financial sense. They are looking at how we got into this position and how to avoid it happening again." Patricia Hewitt ordered a last minute review of the St Barts and Royal London PFI project in December. If a decision is not made by the end of January the contract with private partner Skanska will lapse and the consortium will be entitled to walk away with costs of £100m paid, or to continue and be paid more. Summary by Keep our NHS Public of Times 16 January 2006
  2       Doctors' concern for cancer care. 1,000 doctors at St Bartholomew's and the Royal London hospitals, including 450 consultants, have signed a letter to The Times protesting at government plans to renege on a £1.15 billion deal to rebuild the two hospitals. They say: "These hospitals have some of the best clinical outcomes for the treatment of cancer and heart disease. They serve Europe's most ethnically diverse population. The loss of any of these services would be damaging to the health of this vulnerable population and irretrievably damage our medical school…It would be a cruel injustice to the population of East London if 13 years of planning for the new hospitals were ended by the collapse of the scheme." Summary by Keep our NHS Public of Times 16 January 2006
  2       Aborting PFI project could cost £100m. The cost of aborting the St Barts and Royal London PFI project - currently being reviewed by the Department of Health - could be £100m. If it is not approved by 31 January, construction company Skanska will be entitled to leave the project and charge £100m to cover its costs. Alternatively, the firm could continue on the basis that it will be paid more. Summary by Keep our NHS Public of Hospital Doctor 19 January 2006
  2       Can PFI climb up off its sickbed? After the Bart's brouhaha, what's next for the axe? High costs and the uncertainty of hospital income under payment by results have put large-scale PFI projects in doubt. Industry insiders are now looking to the smaller LIFT scheme for the future of health building projects. Summary by Keep our NHS Public of Independent on Sunday 22 January 2006
  2       East End hospitals have a crucial role. Members of the Patient and Public Involvement Forum for Bart's and The Royal London Trust have written to the Guardian to call for the £1,15bn PFI project, currently being reviewed by the Department of Health, to be put back on track. Summary by Keep our NHS Public of Guardian 23 January 2006
    3     The hospital that will lose £35m this year (Hammersmith Hospital). Jacqueline Maley Thursday January 26, 2006 The Guardian
    3     Nine in ten say NHS will not break even next year. Only 13% of NHS chief executives surveyed by HSJ expect the NHS to break even by April 2007, as Patricia Hewitt has demanded. 32% forecast their own trust would still be in debt. King's Fund chief economist John Appleby said: "'There has got to be much better costing of current policies. What impact is patient choice going to have on demand ? We have no idea. I do not think they have thought it through. The major policy this government has pursued since Labour came to power has been to improve access to hospitals by cutting waiting times, but we have never seen a figure on how much this has cost the NHS." The full 18 trusts named by Hewitt as being the worst performing are: Acute - Hammersmith Hospitals; Barnet and Chase Farm Hospitals; Mid Yorkshire Hospitals; The Royal West Sussex; Surrey and Sussex Healthcare; Brighton and Sussex University Hospitals; University Hospital of North Staffordshire; Shrewsbury and Telford Hospitals; George Eliot Hospital (Nuneaton). Primary Care Trusts - Hillingdon (London); Selby and York; Cheshire West; West Wiltshire; Kennet and North Wiltshire; Sheffield PCTs (four organisations). Summary by Keep our NHS Public of  Health Service Journal 26 January 2006
    3     Staff shortages force closure. The Barnet Psychiatric Unit was closed until further notice on 6 January, without consultation. An internal memo from Barnet, Enfield and Haringey Mental Health trust said the closure was due to a "critical staff situation" following a recruitment freeze. The trust is predicting a £600,000 deficit. Pressure group BPU Action said just £600 a week would be saved by the decision not to employ two agency staff to retain the service. 18 patients will now have to travel to Edgware Hospital for care. Summary by Keep our NHS Public of  Health Service Journal 26 January 2006
          Primary care opened up to commercial operators. The health white paper will announce six pilot schemes to open up the primary care market to companies such as United Health and Care UK. The projects will be centrally procured "to get economies of scale and to tempt new providers with significant capital backing". PCTs will then decide which services they want, including services in high streets and supermarkets, nurse-led practices and diagnostic centres that combine health and social care. The pilots will operate in London, Liverpool, Bradford, Plymouth and Ribble Valley, with ten more areas lined-up. Hewitt will also launch a "social enterprise unit" to aid professionals in setting up not-for-profit businesses. The FT says: "This is aimed, over time, at creating a purchaser/ provider split under which PCTs will chiefly purchase from a growing range of independent providers." Department of Health sources say the shift from hospitals to community care will move 5% of activity out of hospitals over a decade, about £2.5bn a year. This would force reconfiguration and in some cases closures. Meanwhile the increase in payment for treatments will only be 1.5% next year. This below inflation rise is intended to save £3bn in order to eliminate trusts' structural deficits and overspends and increase efficiency. It has been described by John Appleby, Kings Fund chief economist, as "very challenging if not impossible". Summary by Keep our NHS Public of Financial Times 28 January 2006
1         NHS patients pay cash for superior care. Health Service patients are paying for enhanced levels of care and operations that are no longer available free at hospitals across England, in initiatives that are being criticised as the creation of a two-tier health service and privatisation by stealth. Harrogate and District NHS Foundation Trust is to open the Foundation Skin clinic, described by managers as a "halfway house" between state and private care. The clinic will carry out procedures like the removal of moles and warts, screening of moles and Botox injections to reduce heavy sweating - all for a fee. Trust managers admit that the initiative is a response to funding shortages. Some of the services were offered free by the trust until 2003. Queen Charlotte's and Chelsea NHS hospital in London recently began to offer one-to-one midwife treatment for £4,000. Professor Allyson Pollock, director of the Centre for International Public Health Policy at Edinburgh University, says the most vulnerable patients are suffering as a result of fees being widely introduced. "It is shocking that NHS patients can pay for a higher level of care. They are getting priority treatment and are able to pick and choose." Summary by Keep our NHS Public of Sunday Times 29 January 2006
    3     Health trust debts more than £1bn. An investigation by the BBC has found that NHS trusts are more than £1bn in debt. Every trust was asked for its financial position and the total for the whole country showed a debt of £1.07bn. The government has said it expects deficits to be less than £200m by April. Half of trusts told the BBC they are in debt, compared with government claims that it is a quarter. London and the Home Counties carry much of the debt, with London responsible for a quarter of the total. Hammersmith Hospitals NHS Trust has the largest single debt, at £35.3m. Management there have cut 300 jobs. Summary by Keep our NHS Public of BBC Online 30 January 2006
    3     NHS in London is £240m in debt. Of London's 75 NHS trusts, 16 have a debt of above £5m or more, 10 of £10m or more and six of at least £15m. Hammersmith Hospitals NHS Trust had the biggest debt at £35.3m, followed by Hillingdon Primary Care Trust (£25.6m). North West London Hospitals NHS Trust has the third highest debt at £25.5m, Kensington and Chelsea Primary Care Trust (PCT) has a debt of £20.9m, Queen Elizabeth Hospital NHS Trust is £18.9m in deficit and University College London Hospitals NHS Trust is £17.4m in the red. Hillingdon PCT introduced a recruitment freeze for several months but had to lift it when it caused a service to be clinically unsafe.   Summary by Keep our NHS Public of BBC Online 30 January 2006
  2       Ministers balk at Barts' £1.15bn development project. John Carvel, social affairs editor Wednesday February 1, 2006 The Guardian
  2       'Gerrymandering': Hewitt accused. A health scrutiny committee has invited Patricia Hewitt to explain a decision to overrule NHS managers on the location of a new hospital. Hewitt rejected plans to build a new critical care hospital in Sutton, opting instead to situate it in St Helier in Carshalton on the grounds that it could do more to reduce health inequalities in this more deprived area. Epsom and Ewell Conservative MP Chris Grayling said her decision was "party political" and a "blatant act of gerrymandering", because it came after representations by a Labour council and a Labour MP. He said the decision had caused a "stand-up row" between Hewitt and Sir Nigel Crisp. Summary by Keep our NHS Public of Health Service Journal 2 February 2006
  2       Deadline for Bart's as Hewitt rethinks £1bn hospital plans. The Independent on Sunday reports signs that Patricia Hewitt has caved in to pressure from the Treasury over the £1.1bn PFI project for rebuilding St Barts and the Royal London hospitals. The Treasury fears the scheme is unaffordable, and now Hewitt is thought to be preparing to postpone half the work, most likely the St Barts side of the project. A Department of Health source said: "Patricia Hewitt needs to convince herself totally that the business case for this project stacks up if she's going to take on the Treasury." Summary by Keep our NHS Public of  Independent 5 February 2006
  2       Stealth plan to redevelop Barts may herald its break-up. The Government may decide to give the green light to half the £1.1bn PFI rebuilding programme for St Barts and Royal London hospitals, and defer funding on the second half. The second phase of the project involves 50% of the redevelopment of Bart's, including all cardiac services, as well as refurbishment of the dental hospital and outpatient buildings at the Royal London Hospital. Meanwhile the delays are currently costing an estimated £500,000 a day and Skanska Innisfree, the PFI consortium, has threatened a £100 million claim against the trust if the deal does not go through. Summary by Keep our NHS Public of  Times 6 February 2006
  2       The head of Barts hospital in London last night warned the health secretary, Patricia Hewitt, against an "unlawful" proposal to withhold approval for part of its £1.1bn redevelopment scheme. John Carvel, social affairs editor Monday February 6, 2006 The Guardian
    3     Trusts told: ask tax office if you can delay tax and NI. North West London SHA has requested that all its mental health, primary care and acute trusts ask local tax offices if they can withhold PAYE payments for February until the next financial year. The health authority is £94m in debt and has even asked trusts in surplus to apply the measure. So far at least one trust, West Middlesex University Hospital trust, has been given permission by its local tax office to delay payment, but others, including St Mary's trust, which is estimating a £2.45m surplus, and Royal Brompton and Harefield trust, have refused to go along with the scheme. Last month the Treasury said trusts were legally obliges to pay their taxes on time. Summary by Keep our NHS Public of Health Service Journal 9 February 2006
1         Fears over £4,000 midwife scheme. The Royal College of Midwives has criticised a scheme offering mothers-to-be one-to-one care from a midwife for a £4,000 fee. Queen Charlotte's and Chelsea Hospital in London offers 24-hour access to the same NHS midwife throughout pregnancy and labour to women who can afford it. The RCM said it compromised the belief that everyone is entitled to "high quality, one-to-one care", and that it created a two-tier system. The RCM called for "more working midwives, not extra charges for mothers". Hammersmith Hospitals NHS Trust, that runs Queen Charlotte's and Chelsea Hospital, said more than £160,000 had been generated from the scheme so far. Summary by Keep our NHS Public of BBC Online 14 February 2006
  2       The cost of ministers' indecision: £600,000 a day. · Hewitt accused of stalling over signoff deadline · Workers paid on retainer racking up daily costs. Sandra Laville Thursday February 16, 2006 The Guardian
  2       Group out to protect the NHS. Greenwich Keep Our NHS Public has been formed to campaign against the marketisation of the NHS. Of particular local concern is the Queen Elizabeth Hospital in Woolwich, where the new PFI hospital costs £9m a year more than a traditionally financed hospital of the same size, causing huge financial problems. Summary by Keep our NHS Public of  News Shopper 16 February 2006
    3     PCT chair resigns citing declining funding. The chair of Hillingdon primary care trust has resigned, citing its deteriorating finances as one of the reasons for her decision. In a letter to staff, Sarah Pond delivered a parting shot at government funding of the PCT, which she said had contributed to a predicted deficit of £27.3m for the end of the financial year. Summary by Keep our NHS Public of Health Service Journal 16 February 2006
    3     London's health authorities warn overspend of up to £400m likely. London's five strategic health authorities, and the five that surround them, are currently projecting an overspend of at least £378m based on December's figures, with some saying the numbers could rise. This means the figure for the London area alone is twice what the Department of Health ordered the entire NHS to reduce its overspend to - £200m. Surrey and Sussex is projecting an £87m deficit, North West London is projecting a £106m deficit (up almost £10m on the September figure), South West London £30m and South East London more than £39m. Hertfordshire and Bedfordshire predicts a £95m overspend, and while the figures for other London and home counties authorities are lower, only one, North Central London, expects to break even. None is forecasting a surplus. Further afield, the Audit Commission has issued public interest reports on Suffolk's PCTs, warning they are heading for a £33.6m overspend and that their "immediate financial viability is placed in doubt". Meanwhile, Tony Blair has met the NHS Partners Network, a new body representing 11 private sector organisations that are supplying operations and diagnostic procedures to NHS patients through IS-TCs. This has led to the effective collapse of the private sector's trade body, the Independent Healthcare Forum, which included insurance companies who called for tax breaks on private medical insurance. In contrast the Partners Network has issued a document declaring that "we support the NHS - in principle and in practice" and that they have a "commitment to [its] future success".  Summary by Keep our NHS Public of Financial Times 17 February 2006
1         Minister "uncomfortable" about charges for enhanced NHS services. Health Minister Jane Kennedy told the Commons health select committee that the government will investigate extra services provided at a charge by NHS hospitals, including a special service for pregnant women at Queen Charlotte's and Chelsea hospital, who can pay £4,000 to have a named midwife working with them through to the birth. She said such a service should be offered free on the NHS, and the only thing preventing it was a lack of midwives. Summary by Keep our NHS Public of Western Daily Press 20 February 2006
  2       Right to review Barts. A letter to the Guardian from health minister Jane Kennedy says: "The cost of a rash judgment on the redevelopment of Barts would have had far more serious implications than our decision to carry out a review. Given the scale of the proposals, the large sums of taxpayers' cash involved and the significant reductions in waiting lists in recent years, it would have been reckless to go ahead without proper scrutiny…The NHS is not contractually bound to pay any increase in building costs and the final figure is open to negotiation. Our policy has successfully delivered new hospitals in the past and there is every reason to believe it will continue to do so." Summary by Keep our NHS Public of  Guardian 21 February 2006
  2       Is the PFI empire crumbling? As well as large PFI projects at St Barts, Plymouth and Birmingham being put on hold, regional health bosses are due to carry out reviews in the coming months into the value for money, affordability and need for about a half a dozen other schemes. Summary by Keep our NHS Public of  BBC Online 23 February 2006
  2       Hospitals decision. The Treasury has reportedly balked at the cost of the Barts and Royal London PFI scheme, and agreed to proceed only after substantial cuts have been made. Summary by Keep our NHS Public of  Times 01 March 2006
  2       Hospital to mothball 250 beds. Managers at Barts and the London NHS Trust revealed that they have struck a deal with the Government that will allow the PFI hospital to be built, but leave it with fewer beds than they have now. Wards will be left empty to save £20m from the original scheme. Two floors at the Royal London Hospital and one at Barts will be mothballed once building work is complete. According to figures from the trust and the developers, Skanska Innisfree, the delay caused by the government's decision at Christmas to review the project has added an extra £35 million to the bill. Summary by Keep our NHS Public of  Telegraph 5 March 2006
  2       Doctors yesterday welcomed the long-awaited approval of the scheme to rebuild two teaching hospitals in London in the biggest private finance initiative within the National Health Service. Patricia Hewitt, the health secretary, approved the redevelopment of St Bartholomew's hospital and the Royal London after delays which patient groups and the hospital trust claimed had added £35m to the £1.1bn cost. The decision to go ahead with the redevelopment of Barts will saddle the local healthcare trust with a 30-year financial commitment. Across the NHS, PFI schemes, which form the backbone of new hospital projects, are being re-examined over growing fears about the ability of trusts to repay the private companies over 25 to 40 years. Sandra Laville and Terry Macalister Thursday March 9, 2006 The Guardian
    3     London health trusts get cash warning over treating patients. Hospitals in the capital have been told to slow their work rate and turn away patients referred by GPs, unless their treatment has been approved by their primary care trust. London trusts have been ordered to cut 5% from their pay bill, by reducing the use of agency staff, and will have 3% of their cash allocation for next year held back to provide a cushion for the leaner years to come. The memos to London PCTs, issued from the office of John Bacon, NHS finance manager, warn trusts against "unexpected over-achievement" in their efforts to cut waiting times. "PCTs will expect trusts to co-operate in these difficult times. In particular, trusts should not assume 'referral' is 'authorisation to treat' in these circumstances. If they do so, having received a request to assist a PCT in managing workload, they should not presume payment will be made for activity that could have been delayed, without breaching maximum waiting times." Summary by Keep our NHS Public of  Independent 9 March 2006
    3     Trusts do better than most of NHS. Foundation trust regulator Monitor says that foundation trusts are performing better than the NHS as a whole. The 32 foundation trusts, which between them provide about 20% of all hospital treatment, had a £9m deficit in December at the end of their third quarter. This debt is largely due to University College Hospitals London, which is facing a rising overspend of more than £29m. Summary by Keep our NHS Public of  Financial Times 14 March 2006
    3     Flagship foundation £29m in the red. University College London Hospitals foundation trust hit a deficit of £29.4m by the end of December, has breached its licence and could be subject to a Monitor intervention if it fails to improve. It has only avoided such a fate so far by voluntarily calling in consultants KPMG. Elsewhere Moorfields Eye Hospital foundation trust could also face intervention after it became the only trust to be rated red for governance risk. A further 19 foundations were rated amber and in danger of not meeting all national targets. Summary by Keep our NHS Public of  Health Service Journal 17 March 2006
    3     A wave of redundancies across the NHS in England gathered force yesterday when a London teaching hospital announced that nearly 500 posts will be axed in an attempt to dig the trust out of deficit. The Royal Free hospital in Hampstead, north London, said about 480 jobs would be lost under plans to achieve savings of £25m in the next year. The trust said it would do everything possible to ensure redundancies were kept to a minimum. Its announcement was followed by further job cuts at Queen Mary's hospital in Sidcup, where 103 nursing and midwifery posts are being cut. John Carvel, social affairs editor Thursday March 23, 2006 The Guardian
    3     Nurses fired as bosses are hired. The Royal Free Hospital in London, which is axing 480 jobs and 100 beds, is at the same time advertising for four risk managers with salaries of up to £41,000. The total bill would be enough to pay for eight nurses. The move has been condemned by the RCN and Unison. The Tories say that since 1997 the number of managers in the NHS has increased at three times the rate of doctors and nurses, meaning there are more administrators than there are beds. At the NHS SOS conference, organised by the NHS Support Federation and Keep Our NHS Public, former health secretary Frank Dobson is calling on the government to suspend further NHS reforms for fear that they will just worsen the service's financial problems: "The main cause of deficits, cuts, closures, job losses and reductions in patient care in the NHS is the latest round of re-organisation. If the Health Department pays out hundreds of millions of pounds of taxpayers' money to private hospitals and management consultants then it's not available for the NHS. Even more damaging is the paper chase and bureaucracy of the new system which is costing upwards of £12 billion - three times what it cost under the old system. The payment by results experiment threatened from 1 April is just that - an experiment. The NHS is too important to be experimented on - people's health is at stake." Summary by Keep our NHS Public of  Express 26 March 2006
    3     'Brown to blame for crisis in the NHS'. A YouGov poll for The Daily Telegraph shows that Gordon Brown is being blamed for the financial crisis in the NHS. There is a growing impression that he is not spending enough on the health service, and his own personal popularity ratings are falling. 64% of those questioned believe that there is a financial crisis throughout the NHS, with hospitals having to cut back on patient care. Asked which should receive any extra money, education or the NHS, a large majority favoured the health service over schools. Meanwhile the Queen Elizabeth Hospital in Woolwich, which has admitted it is technically insolvent due to it's PFI debt, has announced it will lose 100 posts. It has debts of £100m. Summary by Keep our NHS Public of  Telegraph 31 March 2006
    3     Up to 100 jobs to go. Queen Elizabeth Hospital in Woolwich is to cut up to 100 jobs, including nurses, as part of plans to save £10m. Cuts will include closing the hospital's Hippos Day Care children's unit, which has seven beds, and axing six posts on the ward, putting five nurses at risk of redundancy; closing six beds on the stroke unit in July to save £75,000, plus a further 19 bed closures; and reducing "unnecessary" tests carried out on patients. One nurse who works on the Hippos Day Care children's unit, who asked not to be named, said: "We are going to fight this. The nurses on this ward are trained in important skills, such as taking blood from children, and there are not many nurses on the main children's ward trained to do this." Another nurse said: "We're already understaffed… I feel I can't do my job properly because I can't give patients the level of care and attention they deserve. This will lead to complaints and patient care will definitely be affected." Summary by Keep our NHS Public of  News Shopper 31 March 2006
    3     Out-of-hours cash crisis set to force GPs into opting out. More than 500 GPs who chose to provide out-of-hours services under the new contract are considering opting out because of worsening NHS funding problems. PCTs in south-east London have withdrawn £1m of funding from local GP co-op Seldoc, forcing it to hike charges by 50% from 1 July. The co-op has written to GPs asking them to consider whether it would be more economic to opt out of the scheme. Summary by Keep our NHS Public of  Pulse 3 April 2006
  2       Hospitals plan. Capital Hospital is to raise £1.025bn in index-linked bonds secured against future NHS funding to finance the redevelopment of three London hospitals - At Barts, the Royal London and the London Chest Hospital. Summary by Keep our NHS Public of  Financial Times 4 April 2006
    3     The Government has insisted that patient care remains of paramount importance in the NHS amid reports of secret plans to ration GP referrals and save money. According to The Times, patients are being denied appointments with consultants in a systematic bid to ration care and balance the books. It cited leaked documents showing that, despite the Government's Patient Choice agenda, barriers are being erected, limiting GPs' rights to refer people to consultants. The documents reveal plans by health trusts across London to establish panels to "monitor" how many patients are referred to hospital by doctors, it reports. Local trusts have been told they must cut their referral rates to those of the lowest 10% nationally - saving £25 million a year in the capital, it added. Consultant-to-consultant referrals are also being limited, denying many patients a second opinion. Further targeted are patients who use accident and emergency services for care that could be provided by GPs. The Times reports that emergency care staff in A and E departments will "redirect" up to 70% of patients back to GPs or walk-in centres. And payment will be withheld from hospitals who treat patients who should have been sent to GPs. The leaked paper, Pan London Demand Management Arrangements, is still in draft and was produced by the London Transition Team, led by senior NHS manager John Bacon.  Friday April 7, 2006 8:23 AM
    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     A dentist has said he has been told to get rid of hundreds of NHS patients because there is no longer funding for his practice. Dr Jaideep Prashar has 1,200 NHS patients at his clinic in Hampstead in north London, which opened in November. He claimed he was a victim of the government's new dentists' contracts which were signed last week. The local Camden Primary Care Trust (PCT) said Dr Prashar opened his practice without discussing funding. BBC Online 9 April 2006
    3     Cash-strapped NHS hospital clinging to life. As well as cutting 480 jobs, the Royal Free Hospital in Hampstead has already lost 127 beds, and another 84 will go soon. That amounts to seven wards. Summary by Keep our NHS Public of  Independent 9 April 2006
          Hospital's deal with US group will boost income. University College London Hospital foundation trust has formed a joint venture with Hospital Corporation of America to provide an international cancer centre that will boost the hospital's private patient income. HCA is the US's largest private hospital operator, which runs more than 270 hospitals and surgery centres worldwide, including six private hospitals in London. HCA will take over private patient operations on the 15th floor of the new UCLH tower in London's Euston Road to provide a specialist blood and bone cancer centre aimed at international and UK patients. The centre will draw on UCLH's teaching hospital expertise. HCA will lease the space, pay for services and share profits with UCLH, with NHS patients being given access to the services at standard NHS prices. The FT says "such joint ventures might, in time, provide a way round the cap on private patient income that NHS foundation trusts face. Under the rules, they are not allowed to earn a higher proportion of income from patients than they had when they acquired foundation trust status." Summary by Keep our NHS Public of  Financial Times 13 April 2006
    3     Half of London trusts on red alert over finance recovery plans. Almost half of London's acute and primary care trusts have been given a red traffic light rating in an assessment of their financial recovery plans. Traffic light ratings have been given to acute and PCTs to work out which are eligible to apply to borrow funding from London's risk pool, £300m of which was created by top-slicing all PCTs by 3%. Only about a dozen organisations have been rated 'green', meaning that they had put forward credible plans which would allow them to hit balance next year. A further 23 were amber, meaning that they had delivered plans but these had been assessed as 'not deliverable', while 25 had been flagged as 'red', unable to provide a plan for balance or target deficit recovery. Summary by Keep our NHS Public of  Health Service Journal 13 April 2006
    3 4   Huge referral cuts could be enforced. London's transitional leadership is drawing up proposals that could require primary care and acute trusts to make dramatic cuts to their referral rates to meet 'best practice' requirements. Draft proposals are understood to suggest that cutting referral rates to those of the lowest 10% nationally would save £25m across London, and to recommend that PCTs which cannot achieve this set up 'review panels' of GPs and other clinicians by specialty. The guidance from the team running the London cluster, headed by John Bacon, stressed: "PCTs will expect trusts' co-operation in these circumstances. In particular, trusts should not assume 'referral' as 'authorisation to treat'." Summary by Keep our NHS Public of  Health Service Journal 13 April 2006
    3     Four children's hospitals have warned health ministers they will have to cut specialist services because of miscalculations in the new payments-by-results system championed by Tony Blair as part of his NHS reforms. The threat to specialist services for children was revealed by the Liberal Democrats, who released papers showing children's trusts have told ministers they will have to cut services because they claim they are facing a £22m shortfall in the new financial year. The letter was sent by the chairs and chief executives of Great Ormond Street, Alder Hey, Birmingham and Sheffield hospitals. Together the four hospitals form the National Children's Health Alliance, and they claim the proposed funding will damage the provision of cardiac surgery, neurosurgery and spinal surgery.  Patrick Wintour, political editor Tuesday April 18, 2006 The Guardian
    3     Children's hospitals 'at risk' from tariff system. Four children's hospitals have warned health ministers they will have to cut specialist services because of miscalculations in the new payments by results system that will see them face a £22m shortfall in this financial year. The letter to ministers was sent by the chairs and chief executives of Great Ormond Street, Alder Hey, Birmingham and Sheffield hospitals, who together form the National Children's Health Alliance. It says: "We are extremely concerned that vital specialist paediatric capacity, particularly in surgical specialities, will be lost at regional and national level this year, which will lead to public concern. The new opportunities presented by choice and through payment-by-results should be benefiting young people and children, but quite the reverse seems to be the case. Our trusts are increasingly the only place of choice for parents whose children need specialist paediatric care." The trusts blame the "inaccurate and highly insensitive tariff" under payments by results. To make ends meet, they say, they will have to identify those services on which they stand to lose most money and stop providing them. Obvious candidates include heart, brain and spinal surgery. "We are extremely concerned that vital specialist paediatric capacity, particularly in surgical specialties, will be lost at regional and national levels this year, which will lead to public concern."  Summary by Keep our NHS Public of  Times 18 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
    3     A leading NHS trust has been plunged into financial crisis after managers failed to enter at least £6m in unpaid bills on to the books, according to a report due to be published by the Audit Commission today. The discovery of a stockpile of unaccounted invoices was made after a senior manager went on maternity leave and her replacement began sifting through the files at Kensington and Chelsea primary care trust, the trust's former chairman said last night. The auditors PricewaterhouseCoopers will say in a public interest report on the trust's financial standing that it experienced "a major failure in corporate, particularly financial, governance". They conclude that the trust is unlikely to meet its statutory duty to break even. John Carvel, social affairs editor Friday April 21, 2006 The Guardian
    3     Concern over Gateshead 'breach'. Gateshead Health foundation trust 'might be in significant breach of its authorisation', according to independent regulator Monitor, which has has 'serious concerns as to the trust's liquidity'. The trust is 'stretching its creditors' and is not 'adhering to best practice' in paying back lenders. Meanwhile, University College London Hospitals foundation trust is failing to operate 'in an effective, efficient and economic way', according to Monitor. The regulator has so far decided against intervention, but the trust has to submit a recovery plan by the end of April that must show the 2006-07 deficit will not exceed £10m, and that it will have broken even and improved its financial risk rating from 1 to 3 on a scale of 1-5 by April 2008. Summary by Keep our NHS Public of  Health Service Journal 20 April 2006
  2       Hospital delay costs NHS £50m. The NHS trust that is responsible for Bart's and the Royal London hospitals says that the delays to the project caused when Patricia Hewitt ordered a last minute review have added an extra £1.5m to the annual fee that it will pay the project developers. The trust calculates that the delay will cost around £50m over the life of the project. It expects to pay up to 20% of its annual projected income to meet the PFI fee. Summary by Keep our NHS Public of Telegraph 21 April 2006
  2       Doctors' protest. GPs from Limehouse assembled on the steps of the Royal London Hospital at midday on Wednesday to protest against NHS reforms in an event organised by Keep Our NHS Public. Maggie Falshaw, manager of the Limehouse Practice, said: "We are pleased that the rebuild of the London hospital is going ahead. However, because it's going through on a PFI scheme it will be very expensive. Once the London Hospital is rebuilt there will be two empty floors in the London Hospital, and one empty floor at Barts Hospital, because they won't be able to afford to fit those floors out. Experience of PFI schemes in other parts of the country shows that it's an expensive way of rebuilding. The NHS leases the hospital from the private company, then has the opportunity to buy the hospital at a later date - so it's basically paying for the hospital twice." Summary by Keep our NHS Public of The Wharf 21 April 2006
          Three leading NHS hospitals risk being downgraded for failing to give information on the death rates of their heart surgery patients, the Guardian has learned. The trusts are the only ones in the UK not to have provided key data for the Healthcare Commission, which has been gathering information on mortality rates linked to individual surgeons. The information will be published today on a groundbreaking website designed to enable heart patients and their families the chance to make informed choices about where to have surgery. Last night one of Britain's top heart surgeons warned that the commission might penalise the three trusts - St Mary's in Paddington, west London, Glenfields in Leicester, and Morriston in Swansea - by downgrading them in their annual performance ratings. "I think it is utterly unacceptable in a modern health service that units no longer have the discipline or facility to collect good outcome data," said Sir Bruce Keogh, president of the Society of Cardiothoracic Surgeons. After a Guardian investigation last year, the commission asked all hospitals performing heart surgery to provide data on operations such as bypass grafts and aortic valve replacements. The aim was to help patients assess a surgeon's track record before having an operation. In a historic move the commission will publish data on death rates at almost all the 33 hospitals performing this complex work in England and Wales. It will disclose risk-adjusted mortality rates for individual surgeons at 17 cardiac units, and the aggregated results for 13 units. John Carvel and Sarah Boseley Wednesday April 26, 2006 The Guardian
        5 Save Chase Farm group takes to road in ambulance. The Save Chase Farm Hospital campaign group - fighting to save threatened A& E and other major services at the hospital - have been touring the borough in an ambulance. The group are fielding 9 candidates in the local election for Enfield Council, where the Tories currently have a 15 seat majority. It is conceivable that they could come out of the race holding the balance of power. Candidate Robin Somerville said: "We need to make sure that as many people as possible know about the threats to services and what they can do to help prevent the cuts. Amber, our campaign ambulance, is an eye-catching way of getting close to the public. She looks terrific sporting our logo and slogans." Summary by Keep our NHS Public of Enfield Independent 28 April 2006
        5 Making a stand for pensioners. A former mayor of Enfield who left the Labour Party disillusioned by the war in Iraq is standing as an Independent candidate in the local elections to stand up for pensioners. Stanley Carter said he would fiercely oppose the closure of departments at Chase Farm Hospital. "Many of the illnesses to which older people are prone require prompt attention and a journey to Barnet General Hospital could prove fatal," he said. Summary by Keep our NHS Public of Enfield Independent 28 April 2006
    3     'Dark forces' harm commissioning. Primary care trusts' unwillingness to let go of local NHS purse-strings is scuppering GPs' attempts to get practice-based commissioning off the ground. GPs are reporting trusts adopting a heavy-handed approach, including insisting specific doctors take clinical lead posts and rejecting proposed groupings of practices. Some PCTs have also demanded GP commissioning groups use a compulsory referral management system. In London, budgets for commissioning have been set at 2004 levels and elsewhere PCTs have been advised to top-slice 3-5 per cent from budgets to act as a contingency fund. Dr Hamish Meldrum, GPC chair, said there was 'in- creasing scepticism, anger and frustration about the implementation' of commissioning. Summary by Keep our NHS Public of Pulse 28 April 2006
    3     Salary hikes for health trust chiefs. Chief executives at debt-ridden NHS trusts have been awarded pay rises up to 12 times the rate of inflation. The average pay for a hospital chief executive last year was £125,000. The Sunday Telegraph survey of pay reports, compiled by the analysts Incomes Data Services for the financial years 2003-04 and 2004-05 and based on audited NHS accounts, found that. among the largest pay awards was that given to Derek Smith, the chief executive of Hammersmith Hospitals NHS Trust, which has a deficit of £15 million and is shedding 300 jobs through freezing vacancies. He received a 35% increase in 2003-04, taking his pay from £157,500 to £214,000. His 2005 salary was £197,500, meaning he enjoyed a 25% rise over two years. At University Hospital of North Staffordshire, the former chief executive David Cowley, who left the trust last summer, enjoyed an 18% pay rise in 2004-05, from £127,700 to £150,700. The trust is facing a £15m deficit and has announced 1,000 job cuts. At the Royal West Sussex Hospital, the chief executive Andrew Liles received a 16% increase in 2004-05, from £90,000 to £105,000. The trust is facing a deficit of £13.9 million. At James Paget Healthcare NHS Trust in Norfolk, the chief executive David Hill received a 16.9% increase, from £118,000 to £138,000. There is no deficit, but 100 jobs are likely to go through a vacancies freeze. 115 executive directors of NHS trusts are flouting Department of Health guidance on openness and refusing to reveal their salaries, citing the Data Protection Act. Summary by Keep our NHS Public of  Telegraph 30 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