London Strategic Health Authority

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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.

For archived material  see:

London SHA to 2006 (including Annual Health Check 2006)

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
    3     NHS trusts force patients to wait longer for operations. Patients in some parts of the National Health Service are for the first time facing minimum waits to be seen and treated as managers attempt to balance their books. Suffolk, Hertfordshire, North Yorkshire and Kingston are all imposing various forms of minimum wait, with some primary care trust chiefs saying their organisations may follow suit as the NHS battles to recover from last year's £500m-plus overspend. Hospitals treating patients from north, east and west Hertfordshire have been told not to book them in for non-urgent operations until the start of the new financial year in April. Similar restrictions will apply to new outpatient appointments from the end of January. Patients in Suffolk are having to wait a minimum of 14 weeks for routine surgery and York NHS Trust has been told by its local primary care trust not to operate on non-urgent cases until they have waited a minimum of 20 weeks - six weeks short of the government's guarantee that patients will not wait more than six months for an operation. Kingston primary care trust is operating a standard 10-week wait for outpatient appointments - three weeks short of the13-week maximum wait. Patricia Hewitt, the health secretary, has acknowledged that a slight rise in overall waiting times earlier this financial year was due to some parts of the NHS setting minimum waits on "patient referrals, diagnostic tests and treatment" to "negate the financial deficit". Michael Dixon, chairman of the NHS Alliance, which represents primary care trusts, said: "This is a direct effect of payment by results. In the old days of cost and volume contracts it wasn't an issue because hospitals didn't get paid any more if they treated more patients than planned." Now that they are paid for each patient they treat, "if a hospital brings its waiting list down rapidly it will do an awful lot of extra work and blow the primary care trusts' budget", he said. Summary by Keep our NHS Public of Financial Times 2 January 2007
        5 Outrage as school nurses are axed. Headteachers have been left outraged after being told their school nurses were being withdrawn - with just two working days notice. The cuts were revealed earlier this month when Wandsworth Primary Care Trust sent a letter to 16 of the borough's schools - 10 of which are in Battersea - to say that due to a large number of vacancies there would be a temporary closure of the School Nursing Service. The debt-ridden primary care trust will still carry out its statutory requirements for children such as immunisation programmes. It blamed a recruitment crisis for the withdrawal of the nurses, who are widely regarded as being on the front line in fighting issues such as domestic abuse and teenage pregnancy. The trust is currently trying to recruit three school nurses and one nursery nurse so the service can be resumed early next year, but Councillor Kathy Tracey, cabinet member for children, is unimpressed. "It's pretty catastrophic," she said. "We know they had problems with recruiting but it's absolutely bizarre that no notice whatsoever was given and that the schools all seem to be in very deprived areas. All the work we have done to bring children's services together in the last two years is in jeopardy." Summary by Keep our NHS Public of Wandsworth Guardian 5 January 2007
          Leading hospital did not reveal damning report into heart surgery. A Guardian investigation has led to calls for greater transparency in the NHS after it emerged that heart surgery patients at an elite teaching hospital were exposed to "serious clinical risk", according to a report that was not made public. The hitherto confidential report by Sir Bruce Keogh, one of the most eminent cardiothoracic surgeons in Britain, said facilities for heart patients at St Mary's hospital trust in Paddington in west London, were "almost certainly the worst in the country".John Carvel, social affairs editor Monday January 8, 2007 The Guardian
        5 'Job and bed cutter' is new NHS boss. The appointment of a new interim chief executive at Epsom and St Helier NHS University Hospitals Trust has sparked further speculation over its future. Graham Smith took over the position on January 4 after the departure of his predecessor Lorraine Clifton. The former chief executive left the trust after criticism from Surrey health scrutiny committee for planning significant changes without adequate public consultation. Mr Smith has filled the same position for brief periods at various trusts across the country over the past six years. Prior to accepting the job at Epsom and St Helier he was interim chief executive at South Warwickshire General Hospitals NHS Trust from May until September 2006. While there, he was challenged with saving £9m in a year to try and bring down Warwick Hospital's £23m deficit. At the time, the Warwick Courier reported that due to merging wards the medical unit only had four staff looking after 39 patients from midnight onwards. Geoff Martin, head of campaigns at pressure group London Health Emergency, said: "It's like he has been on a national tour. He's been all over the country and seems to go to trusts to cut jobs and beds." Mr Martin urged people to continue putting pressure on the trust to cease cuts and closures. Summary by Keep our NHS Public of Sutton Guardian 12 January 2007
    3     PCT hikes drug prices. A radical shake-up in prescribing medicine could mean some of the borough's sickest residents are forced to pay more for their drugs. Since January, doctors' surgeries in Sutton and Merton are being encouraged to prescribe regular medication to last for 28 days, which the primary care trust (PCT) says will cut wastage and allow for regular monitoring. But it could mean those on regular medication paying £6.65 a month, rather than the same charge for a longer-lasting supply. Geoff Martin, head of campaigns for pressure group, Health Emergency, and a Unison official said: "It sounds like the PCT is using this to claw back more money." One Merton resident used to pay £13.30 for a six-month supply of two types of drugs she has taken regularly since having cancer. She is furious and said: "I'll now have to pay £159.60 a year. I may have to do without one of the drugs now if I can't afford it. My GP is extremely angry and is concerned that residents have not been made aware of the new scheme and will only realise once they get to the chemists." The PCT insists that '28-prescribing' is a well-publicised and positive move. Summary by Keep our NHS Public of Sutton Guardian 12 January 2007
          Catalogue of abuse in NHS care homes. Learning disabled were physically and sexually assaulted in units. The NHS faces being stripped of its responsibility for learning disability services after inspectors today issue the second damning report in six months into the care of some of the most vulnerable members of society. People with learning disabilities had been subjected to physical and sexual abuse at a hospital in London, according to an investigation by the Healthcare Commission. One member of staff was jailed for six years last summer after being charged with rape of a woman resident who was considered unable to give consent due to her low mental age. A second staff member had been given a suspended sentence for a sex offence against the same woman a year earlier. The report by the official healthcare watchdog into conditions at units run by the Sutton and Merton primary care trust also reveals that inspectors found another woman resident "for many years" had her arm tied to a splint for most of the day, apparently to prevent her putting her hand in her mouth and developing sores. The investigation found people with learning disabilities living at Orchard Hill hospital in Carshalton, south London, and other units run by the trust had been treated in outdated and infantilising ways. Living conditions were impoverished, routines arranged for the convenience of staff and organised activities at the hospital provided for less than five hours a week. The commission's findings follow its report last summer on abuse of learning disabled people in services run by the Cornwall Partnership NHS trust. David Brindle Wednesday January 17, 2007 The Guardian
          Bleak house. A damning report into one of the last long-stay hospitals for learning disabled people could be the final nail in the coffin for NHS involvement in the service. When we sit down to eat, most of us do not have a large sheet of blue tissue paper wrapped around our shoulders as an outsized bib. Yet when healthcare inspectors came calling, staff at Orchard Hill hospital in Carshalton, south London, had no compunction about being seen to do this to some of the disabled adults they were caring for - and then to feed them "at a speed that would not allow for any enjoyment of the food". The episode encapsulates what the inspectors uncovered at Orchard Hill - which will shortly be the last remaining long-stay hospital in England for people with learning disabilities - and at other facilities run by the learning disability service of Sutton and Merton primary care trust (PCT). Institutional abuse was found to be prevalent in most parts of the service, but it was abuse largely of an unthinking kind, practised by staff who knew no better. "The overall model of care ... promoted dependency," the inspectors conclude in their inquiry report, published today. "The culture was such that staff concentrated on what people could not do, rather than what they might be able to do." By David Brindle Wednesday January 17, 2007 The Guardian
    3     NHS boss shock resignation: MPs predict 'slashing cuts'. The chairman of Epsom and St Helier NHS Hospitals Trust has announced his resignation, leaving the crumbling healthcare provider in "total crisis". News of Michael Doherty's departure - which comes just weeks after the sudden exit of its chief executive Lorraine Clifton - has led to increased fears that more cuts to health services are on the way. Sutton and Cheam MP Paul Burstow said: "To lose one NHS boss may seem a misfortune, to lose another NHS boss so soon looks more like a crisis. Staff morale at St Helier must be in free fall. Frontline staff - already concerned for their future after the trust announced that 470 jobs would go - now see the trust's senior managers departing on an almost weekly basis. Staff cannot be blamed for wondering just what sort of ship they are working on." Head of Campaigns at London Health Emergency Geoff Martin added: "Epsom and St Helier is a Trust in total crisis. It's a scandal that it's been allowed to descend into this level of chaos and clearly the strings are being pulled right at the top. We can now expect a wave of slash-and-burn panic cuts over the coming months with severe consequences for staff and patients." Summary by Keep our NHS Public of Sutton Guardian 19 January 2007
          Campaign groups combine to fight NHS cost-cutting. Two campaign groups are uniting against NHS cuts and privatisation after a national conference. Last weekend in Euston, London, 30 branches of the Keep Our NHS Public campaign from across the country voiced concerns over the effects the private sector will have on hospitals and services. Now the Greenwich branch of Keep Our NHS Public is to work with Bexley's Who Cares campaign to protest against proposed healthcare changes in their areas. These include the Department of Health's (DoH) proposal to create two independent treatment centres at Queen Mary's Hospital, Sidcup, and St George's Hospital, Tooting. The centres will be run by private company, Clinicenta, and will be supported by 10 community clinics, offering outpatient and minor procedure services in Bromley, Woolwich and Croydon. They are part of the second phase of the DoH's £3.75bn treatment centre programme. But the Keep Our NHS Public campaign believes it will further destabilise hospitals, such as Queen Mary's and Woolwich's Queen Elizabeth Hospital, because it will divert money from the NHS to profit-making firms. Members of the Who Cares campaign, run by manufacturing union Amicus, are also protesting against cuts in primary care services. They include cutting district nursing hours from 15 to 12 hours a day by cutting the twilight service and the scrapping of personal, social, health and education nurses from primary schools. Nurses will be replaced by normal teaching staff as part of the new sexual health service being implemented by the end of March. The group organised a public meeting last month which gained the support of Erith and Thamesmead MP John Austin. Bexley Who Cares campaigner Caroline Riddell said: "We are fed up with the lack of consultation and failure to listen to users of the service. We look forward to working with the Greenwich branch and launching some kind of regional campaign to save our NHS." Keep Our NHS Public chairman Frances Hook added: "I am excited to work with Bexley. It will make our campaign much stronger and we hope to work with the Lewisham group too. It's better to work together to stop the fragmentation and privatisation of the NHS." A Lewisham Keep Our NHS Public Campaign meeting will take place at 7.30pm on February 7 at the Civic Suite, Catford. Summary by Keep our NHS Public of News Shopper 24 January 2007
  2       MP's solution to hospital row. The Liberal Democrats have come up with a "five-point prescription plan" for Hornsey Central Hospital. Lynne Featherstone, Liberal Democrat MP for Hornsey and Wood Green, called for more GPs and clinic sessions for the hospital as well as better consultation with residents and small local pharmacies which may suffer if the hospital sets up its own large-scale "community pharmacy". She also called for better transport links and a halt to the selling of land on the site. Ms Featherstone said: "Like everyone else I want to see more money being invested in local health services. But it is vital that Haringey Primary Care Trust consults with local people and health professionals to get the project right. The development needs to expand health provision in Haringey - not just recycle the surgeries and clinics we already have in the area." A delegation of women, some in their 90s, is to present a petition to 10 Downing Street to protest against what they see as the neglect of the site in Park Road, the neglect of older people's services in Haringey and the poor level of consultation carried out by borough health bosses. Campaigners are also upset at the private-public partnership plans which will see private firm Elevate lease back a new building on the site to the NHS once it is built. Summary by Keep our NHS Public of Hackney Gazette 25 January 2007
        5 Hewitt rejects council's block on closure of mental health clinic. Health secretary Patricia Hewitt has overruled objections from local councils and agreed to the closure of a south London emergency clinic for people with mental health problems. Lambeth and Southwark councils referred the matter to the secretary of state when they did not agree with local NHS proposals to reconfigure mental health crisis services. South London and Maudsley foundation trust's proposals included closing the emergency clinic at the Maudsley Hospital. The clinic is the only 24-hour self-referral service of its kind in the UK and has been open since the 1950s. Lambeth and Southwark councils formed a joint health scrutiny committee which concluded that the changes were not in the interests of the local health service and that the matter could not be resolved locally. But in a letter to the committee, Ms Hewitt said that closing the clinic was 'in line with the mental health national service framework and other departmental policy, and therefore in the interests of the local health service'. Committee chair Angie Meader said: 'I think she's been very selective in the points we've raised that she's responded to. She's not looking at the whole - she's just looking at the words on paper rather than the reality of patients. When you lose one thing, it doesn't mean other things get better. It just means services are diminished.' Lambeth council's legal department will now 'read the small print of the Local Government Act' to see if there are any future areas of action. Summary by Keep our NHS Public of Health Service Journal 25 January 2007
          PCTs fight UCLH over data validity. Three primary care trusts are disputing the validity of a massive increase in activity at a flagship London hospital. Camden, Westminster and Islington PCTs are working together to challenge increases in activity at University College London Hospitals foundation trust. Camden and Islington have both withheld payment to the value of queried activity for the first three months of the financial year. The information was contained in the PCTs' commissioning performance reports from their last meetings in November. It has been confirmed that the problems have not been resolved. Islington's November board papers state: 'The over-performance at UCLH continues to grow at the same rate and is therefore the most significant risk to the PCT, and the biggest single obstacle to achieving financial balance in 2006-07.' The paper says UCLH is showing an 'over-performance of £1.5m' compared with PCT forecasts, and that 'strong challenges have been made to the validity of much of the increase in activity'. Summary by Keep our NHS Public of Health Service Journal 25 January 2007
  2       MPs lambast £900m PFI hospital fiasco.  Report urges rethink on NHS building programme.  Scheme abandoned after £15m and five years' work. The government will be urged today to rethink its controversial NHS building programme with the publication of a report which makes sweeping criticisms of the disastrous attempt to build a super-hospital in London. A watchdog group of MPs says the collapse of the £900m scheme in Paddington Basin was the result of incompetence, appalling planning, local staff who floundered and were out of their depth, and a lack of clarity from the Department of Health. The Commons public accounts committee says there are many lessons to be learned from the cancellation in June 2006 of plans to merge and renew three out-of-date hospitals, St Mary's, Harefield and the Royal Brompton, after five years and £15m had been spent on failed attempts to put together a robust business case. Its report criticises amateurish efforts from local NHS officials who were out of their depth and a failure on the part of the government to engage. It calls on the Department of Health to abandon its hands-off approach to private finance initiative schemes in favour of much more involvement and control. Sarah Boseley, health editor Tuesday January 30, 2007 The Guardian
  2       MPs want greater scrutiny of PFI hospitals to prevent waste. Private Finance Initiative built hospitals should face "closer and sustained scrutiny" to avoid wasting further millions of pounds, according to the public accounts committee. Estimated capital costs for 17 PFI schemes approved by the end of 2005 have more than doubled - up by some £4bn - to £13bn. The Department of Health blamed the rising bill on inflation in the construction industry, the need for more single rooms and expansion of planned services. However the committee's chairman, Edward Leigh said the department "must crack down" on the cost of schemes. His comments came as the committee published a report into the plan to build a £900m PFI project in Paddington, London that cost £15m before being scrapped. A review of big PFI hospital projects is under way with the capital programme set to be scaled back from £13bn to about £7bn-£9bn. The Department of Health claimed that this review would provide the additional oversight the committee wanted. However the committee said that it "remains to be seen" if the review will enable the department to "get a grip" on the programme. Summary by Keep our NHS Public of Financial Times 30 January 2007
          Health trust may hand over most roles to companies. Hillingdon primary care trust in London may become the first to hand over almost all its core functions to the private sector, including the commissioning of millions of pounds of care for National Health Service patients. The move, which is likely to provoke bitter opposition from the health service unions, would see the private sector taking over not just the provision of community services but the assessment, planning, contracting, procurement and performance management of £258m a year's worth of health care for its local population. The primary care trust would retain a few core functions, including patient and public involvement, emergency planning and the handling of contracts. The move would be a big step towards the government's goal of turning the NHS primarily into a commissioning organisation. Provision in future will come from a mix of foundation hospitals, the private and voluntary sectors and social enterprise, but with the independent sector able to take part in the commissioning of care as well as its provision. The trust has insisted the proposal is only one of a number of options that would be put to the board in April. Anthony Sumara, Hillingdon PCT's interim chief executive who was brought in to troubleshoot one of the NHS's worst financial problems in London, was not available for comment yesterday. But he told the Health Service Journal that essentially, "I want to get rid of everything - outsource it". The trust would not be giving up responsibility because it would remain the statutory body, responsible for the outcome of the contracts. It would reduce staff numbers from about 300 to about 30, he said. Hillingdon has an accumulated deficit of £54m on its £258m turnover and has been projecting a further £11m deficit this year. According to papers put to the board last week, "outsourcing the majority of commissioning functions . . . gives the greatest probability of success" in turning that round. He acknowledges, however, that having to pay off £54m in debt will make it difficult to draw up a contract from which private companies could make a profit, and that Hillingdon on its own may be too small to attract private providers big enough to take financial risk on the deal. The NHS is negotiating a framework contract with big UK and US health providers that would allow primary care trusts to access anything from help with number crunching to the sort of "end-to-end" commissioning service that Hillingdon is examining. Nigel Edwards, director of policy for the NHS Confederation, said a number of PCTs were considering enlisting private sector help with commissioning. "But I am not aware of anywhere else considering anything remotely this radical." With NHS commissioning in its infancy, drawing up such a contract would be "quite a challenge", he warned. Summary by Keep our NHS Public of Financial Times 2 February 2007
          PCT could slash 90 per cent of staff. A troubleshooter chief executive plans to strip an ailing primary care trust down to its core functions and reduce the number of staff from 300 to 30. Anthony Sumara, who has been interim chief executive of Hillingdon PCT since October, proposes to put three out of four commissioning support services out to tender, and to hand clinical services to a new provider. Under the proposals, the PCT would retain only its core functions like governance and emergency planning, as well as patient and public involvement. The move could see the PCT, which has £54m of historic debt, and is predicting an in-year deficit of £11m, reduced from a staff of '300 to 30', he said. But he said the chances of the board agreeing to the move were 50:50. The Proposal to Procure commissioning strategic outline case was published by the PCT on January 23. It states: 'Outsourcing the majority of the PCT commissioning functions gives the greatest benefit and the greatest probability of success,' when compared with three other options: doing nothing, building internal capability and developing synergies with other organisations. If the project gets approval in June the contracts will go out to tender. Mr Sumara told HSJ: 'I want to get rid of everything, outsource it - and we are distancing the PCT from its provider functions.' The government's commissioning framework allows PCTs to choose which areas they wish to outsource. The DoH is expected to publish its list of recommended commissioning experts within weeks. Hillingdon is looking at three of the four main categories identified in the framework: assessment and planning; contracting and procurement; and performance management to ensure better accountability. The organisation is currently working on defining what residual functions a PCT should hold. Mr Sumara said responsibility for monthly emergency planning, managing the outsourcing, governance of money, accountability and development of the market would remain with the PCT. 'You need a PCT because you need a statutory body to receive the money from government. We are also deciding what will happen to the provider side - should it come under the hospital or become a social enterprise ? We will keep public-patient engagement as we have a better idea on how to engage with the public locally and the voluntary sector than, say, [information analysts] Dr Foster,' he said. 'The PCT is not giving up responsibility. We are doing this as part of our recovery and to get some clarity around what a PCT should be doing. It's commercialising, not privatising and the public don't care - it's not about the provider services, it's about men in grey suits. It will still be free at the point of access.' The next step is to develop the outline business case for consideration by the board in April 2007 and appoint a dedicated project team. The strategic outline case states: 'Hillingdon PCT commissioning is currently weak and not fit for purpose. For example, acute providers will continue to over-perform by £9.8m in 2006-07, adding to the historic debt.' Mr Sumara said: 'At the moment it is 50:50 whether it will be approved but I do think it will save us money and I do think it will get the go-ahead. I don't think we are big enough for some companies but they will start with us with a view to providing a service across London.' Some of the risk factors considered in the proposals include: the supplier's set-up costs exceeding the potential gains of the contract; the delivery of financial balance for the PCT taking longer than currently planned; the requirement to repay the historic debt making the contract unattractive to outsourced suppliers; and an adverse reaction from the public. Summary by Keep our NHS Public of Health Service Journal 2 February 2007
          Questions over Hewitt's role in privatised NHS plan. The Keep Our NHS Public campaign is calling on Health Secretary Patricia Hewitt to stand by her word and call a halt to plans to allow private companies to take over the functions of NHS primary care trusts (PCTs). In a letter to the Guardian on 1st July 2006, following a media storm over a 'stealth plan' to allow private companies to take over the commissioning role of PCTs, Patricia Hewitt wrote: "Primary care trusts are and will remain public statutory bodies responsible for using their growing budgets to commission the best possible services for local people. They can never outsource this responsibility, or ask others to make these decisions for them." It has now emerged that Hillingdon PCT in London has proposed to do exactly that - to hand over almost all of its core functions to the private sector, including the commissioning of care for patients worth millions of pounds, and the provision of community services. The trust's chief executive, Anthony Sumara, said: "I want to get rid of everything, outsource it". This clearly goes far further than Hewitt indicated in her Guardian letter, when she played down the issue by saying that the government merely wanted to make it easier for PCTs to "buy in some management and support services, including the detailed data analysis that helps to underpin sound commissioning". The story first came to light in June 2006, when Keep Our NHS Public alerted the press to an advertisement placed by the Department of Health in the Official Journal of the European Union, inviting companies to bid for the chance to spend substantial chunks of the NHS budget. Following front-page headlines of 'Stealth plan to privatise NHS care' (The Times) and '£64bn NHS privatisation plan revealed' (The Guardian), the government withdrew the advertisement, saying that drafting errors had given the "false impression" that clinical services provided by PCTs would be phased out in favour of the private sector. But the advertisement was resubmitted two weeks later and now Hillingdon PCT plans to use the scheme to outsource its clinical services. This is despite the fact that Patricia Hewitt wrote in her letter to the Guardian: "Most PCTs also employ district nurses, health visitors and many other frontline staff who provide vital clinical services. They are not affected in any way." Alex Nunns of Keep Our NHS Public said: "This blows the lid on the government's plan to privatise the NHS by stealth. When this scheme was first uncovered Patricia Hewitt rushed to deny that the story was true. Now our worst fears are coming to pass. This is the patchwork privatisation of the NHS." Keep Our NHS Public recently released a report, The patchwork privatisation of our health service: a users' guide, which identified the outsourcing of PCT commissioning and care as one of the key threats to the NHS. Summary by Keep our NHS Public of Medical News Today 2 February 2007
          NHS volunteers 'not about cuts'. An NHS trust in Surrey says a hospital volunteer scheme which will see people helping to feed patients is not a cost-cutting exercise. Members of the Epsom and Ewell branch of Age Concern have adopted the Roseberry Ward at Epsom Hospital. It means trained volunteers can provide a "befriending service" and help with feeding. Health campaigners said they hoped it would not lead to staff cuts. Dr John Lister, from the pressure group Health Emergency, said he could "understand why public-spirited people want to help their local hospital", but he hoped their "good intentions and goodwill" would not be used to save money. Summary by Keep our NHS Public of BBC Online 3 February 2007
      4   Fears over NHS rationing. Cancerous skin conditions may be the first victim of a new list of low priority treatments banning GPs from referring some patients to hospital specialists. Patients groups and doctors fear those needing varicose vein or or a specialist opinion on asthma or skin conditions could have to pay for their own treatments at private hospitals when the plans come into force. GPs will be overruled if they refer patients that fall under the new low priority list to hospital specialists. Camden PCT revealed the list at a board meeting. The list includes: asthma, grommet surgery, carpel tunnel surgery, minor skin surgery, various cosmetic surgery, gender reassignment surgery, viral warts, eczema, acne and psoriasis. The list includes: asthma, grommet surgery, carpel tunnel surgery, minor skin surgery, various cosmetic surgery, gender reassignment surgery, viral warts, eczema, acne and psoriasis. Dr Jacky Davis, founder member of the Keep our NHS Public Campaign, said: "It's the thin end of the wedge. It looks like a huge amount of bureaucracy. It's the beginning of a very explicit rationing. While some of it may be appropriate who knows where it will end ?" She added: "It's going to be much more difficult to get a specialist opinion for any of these things. It used to be that if a GP thinks you deserve a second opinion they just referred you, now they have to jump through all these hoops. If your GP can't argue your case strongly enough you could end up having to go private." Last week the New Journal revealed how the Royal Homeopathic hosptial in Bloomsbury is under threat because of the new rules. Cosmetic surgery, including treatment for alopecia (hair loss) and correction of some facial deformities, are deemed inappropriate for NHS provision. Under the new plans, GPs will have to justify all referral decisions to a panel and if unsuccessful, patients will have to either see a nurse or GP with specialist knowledge in their condition. Patients unhappy with this may turn to private medicine to get a second opinion. Summary by Keep our NHS Public of Camden New Journal 5 February 2007
          All those who wish to see NHS remain a public service will oppose Hillingdon health trust's plan. Dr Peter Fisher, President of the NHS Consultants' Association, writes in a letter to the Financial Times: "If Hillingdon primary care trust hands over the bulk of its work, including commissioning, to the private sector there would be bitter opposition not just from the unions but from all those who wish to see the National Health Service remain a public service, not become a commercial market. It would also demonstrate the total incoherence of current health policy. After the expense of setting up and then reconfiguring PCTs they would become a mere shell, without significant function. What would happen to the much vaunted practice-based commissioning, or has it already been decided to scrap that ? Perhaps it indicates that despite all the inducements, referral management centres and the like, independent sector treatment centres are still under-used and can only be kept afloat by giving the private sector total control of the commissioning process." Summary by Keep our NHS Public of Financial Times 5 February 2007
    3     Surgery slashed to claw back cash. The amount of elective surgery in hospitals will be reduced by 6% next year under Kingston Primary Care Trust's plans to balance its books. Healthcare bosses have drawn up a plan to claw back £12m of debt next year, and cutting non-essential surgery in hospitals will help them do it. But they admit they have no idea how to deal with the rest of the £22.5m debt they expect to have incurred by April. Kingston Primary Care Trust (PCT), which pays for healthcare commissioning for Kingston's patients, has run up the debt over a number of years. This financial year to April it will overspend its budget by £11.9m, due in part to a £4m overspend by hospitals on patient treatment compared to agreed levels of care. The PCT hopes to record a surplus of £300,000 and that will leave only a historic debt of £10m. Bosses hope NHS London will allow that to be set aside for now. Summary by Keep our NHS Public of Wimbledon Guardian 5 February 2007
          Privatisation is at the root of the crisis. Up to 90 percent of workers at the Hillingdon Primary Care Trust in north west London could be slashed due to the privatisation of the NHS. "I want to get rid of everything, outsource it," trust boss Anthony Sumara told the Health Service Journal. The "outsourcing" will mean that NHS workers - including district nurses, health visitors and community health visitors - will find themselves working for private companies. "Our worst fears are coming true," said Alex Nunns of the Keep Our NHS Public campaign group and author of a new pamphlet on privatisation in the NHS. "What is happening at Hillingdon is a major escalation of privatisation. It's part of the government's plan to turn the NHS into a giant health insurance company. This new privatisation will mean that in Hillingdon private companies are buying health services for the NHS and selling them too - and now they are getting control of the budget. The ultimate goal for a private company is to make profits for its shareholders. It certainly isn't the wellbeing of the patients or the staff. The government is trying to disguise what is going on. It knows that most people don't want their health service privatised so it uses language and terms that most people, including many health professionals, don't understand. That is why Keep Our NHS Public has produced a pamphlet that explains what is happening. We wanted to alert people to the fact that there are dozens of schemes, which form a plan to get rid of the NHS. It will be turned into nothing but a logo. If your MP says that the local hospital is closing because of poor accounting or management, it is important to know how the market in healthcare has been the basis of the funding crisis and how the present government's policies have made matters worse." The "Patchwork Privatisation" Of Our Health Service: A Users' Guide is available from Keep Our NHS Public, c/ o NHS Support Federation, Community Base, 113 Queen's Road, Brighton BN1 3XG. Price £1 or ten for £5. Cheques payable to Keep Our NHS Public. Summary by Keep our NHS Public of Socialist Worker 7 February 2007
          3 March is a day to fight for NHS. The trade union day of action for the health service needs to be a focus for the anger of health workers and local campaigners fighting privatisation and cuts in the NHS. There is hardly an area of Britain that is not suffering the prospect of savage cuts to local health provision. In towns and cities there are protest rallies, marches and campaign meetings to save local hospitals and facilities. The need to provide a national focus for this anger and bring workers together with local campaigners could not be greater. The number of local and regional protests planned for 3 March is growing. Already the TUC's NHS Together campaign website (details below) lists 22 events outside the London area. Campaigners in London are also planning action in many parts of the city. A sign of the strength of feeling over health cuts could be seen in Waltham Forest, north east London, last Saturday where up to 2,000 people joined a demonstration against the downgrading of Whipps Cross hospital. Gillian Muir from the Waltham Forest Carers Association joined the march. She said: "They want to move many services provided at Whipps to the new Queen's hospital miles away in Romford. But they cannot tell us how older people, like the ones I represent, will be able to get there. I'm angry at the health authority making these proposals but I'm more angry at the government and I feel betrayed by it. Now they are telling us that maybe they won't move everything at Whipps but instead they will downgrade King George's hospital down the road in Redbridge. That is no answer, it will just put more pressure on the hospitals that remain." Summary by Keep our NHS Public of Socialist Worker 7 February 2007
        5 Maternity crisis: ministers who won't toe line. At least a dozen members of the Government are fighting NHS closures of maternity units, A& E departments, wards and cottage hospitals in or near their constituencies. Among the most prominent are Hazel Blears (Salford), the party chairman and a former health minister, and Ivan Lewis (Bury South), a junior health minister in charge of maternity services. He opposes the closure of the maternity unit at Fairfield Hospital, Bury, and was absent yesterday at the launch of the report on the future of maternity services in England, written by the maternity and child tsar, Dr Sheila Shribman. She had to strive alone to answer questions from journalists on the closures. Miss Blears has been on the picket line protesting over the closure of maternity services at the Hope Hospital, and Jacqui Smith (Redditch), the chief whip, has campaigned against the closure of maternity services at the Alexandra Hospital in the town. Two parliamentary private secretaries (PPS) have also been involved in protests. Kitty Ussher (Burnley), a former special adviser to Patricia Hewitt, the Health Secretary, led a campaign last year to save her local A& E department. Mary Creagh (Wakefield), the PPS to Andy Burnham, another health minister, has campaigned vigorously against the loss of maternity services at Huddersfield Royal Infirmary. Mike O'Brien (Warwickshire North), the solicitor general, has challenged proposals to close a special-care baby unit at George Eliot Hospital in Nuneaton, and Derek Twigg (Halton), a defence minister, is concerned about ward closures at Halton Hospital, Runcorn. Joan Ryan (Enfield North), the immigration minister, backs the fight to for children's services at Chase Farm Hospital. James Plaskitt (Warwick & Leamington), the work and pensions minister, wants to save the full range of services at Warwick Hospital. Tessa Jowell (Dulwich & West Norwood), the Culture Secretary, and Harriet Harman (Camberwell & Peckham), the constitutional affairs minister, oppose the closure of a 24-hour emergency clinic at the Maudsley Hospital, south London. Summary by Keep our NHS Public of Telegraph 7 February 2007
        5 Ministers protest over NHS cutbacks. Two senior ministers are lobbying Patricia Hewitt in protest against NHS cuts in their constituencies. Tessa Jowell and Harriet Harman have become the latest high-profile figures to campaign against the Government's health plans by appealing to the Health Secretary over closures at the Maudsley Hospital, south London. They have also written to the chief executive of their local NHS trust to ask him to save the emergency clinic and day centre for the elderly at the hospital's mental health unit, which are set to close as part of a plan to save £8m. Miss Harman, the justice minister, said: "I am determined that whatever happens there must be a separate distinct emergency unit for those with mental health problems to go to at any time of day or night." Miss Jowell, the Culture Secretary, and Miss Harman have justified breaking ranks by claiming that it was their duty as MPs to save services in their constituencies. Summary by Keep our NHS Public of Telegraph 10 February 2007
    3     Health reforms cause financial disarray at top eye hospital. An NHS hospital with an international reputation for medical excellence has been thrown into financial disarray by the government's health service reforms. After overspending by about £900,000 in the first half of the year, Moorfields eye hospital in London got a risk alert from the regulator and had its borrowing limits halved. The hospital is recognised as one of the world's premier centres of ophthalmic expertise. Last week it opened a new children's complex, the largest in the world for paediatric eye care. John Carvel, social affairs editor Monday February 12, 2007 The Guardian
          Faulty software puts child health at risk. The health of children is at risk because an NHS computer system wrecked 20 years of accurate immunisation records. Faulty software introduced in 2005 has left some primary care trusts (PCTs) unable to track whether children have been vaccinated and screened for genetic conditions, raising fears that many are unprotected against diseases. Parents are not being reminded when their children are due for jabs and check-ups. The Health Protection Agency cannot publish full statistics on the uptake of vaccines because the five worst-affected London trusts cannot provide accurate data. When the shortcomings of the Child Health Interim Application (CHIA) software were disclosed by The Times a year ago, the Department of Health stated that the problems were being addressed. But staff are said to be "in despair" at continuing difficulties with the system supplied by BT. Summary by Keep our NHS Public of Times 13 February 2007
    3     This is how NHS cash crisis is biting. Cash-strapped hospitals have been ordered to remove light bulbs in a desperate bid to save money. Secretaries may also be drafted in to weigh babies at one NHS trust, while newly-qualified nurses are so desperate for a job they are reportedly working for free or below the minimum wage. In another sign of the NHS financial crisis, it emerged that some hospitals are saving money by not paying bills for healthcare supplies. Ray Hodgkinson, the director general of the British Healthcare Trades Association which represents 400 medical supply firms, said: "I have been in this industry since 1960 and this is probably the worst it has ever been. It's very, very worrying." Within the past two weeks, the St Helier general hospital on the outskirts of London and the Epsom district hospital, in Surrey, have been removing light bulbs to help cut a £3 million annual electricity bill. The Epsom and St Helier University Hospitals NHS Trust said: "We can confirm that maintenance staff have removed some light bulbs from the main corridors and some communal areas in the trust, as part of our financial recovery plan." A spokesman defended the move, saying "no clinical areas" - such as operating theatres and wards - were affected. She admitted the savings would only be a tiny part of cost savings, with plans to discharge patients earlier and improve operating theatre "productivity" likely to yield much more. But Tom Brake, the Liberal Democrat MP for Carshalton and Wallington, said: "This is bonkers. You could not make this up." It also emerged that the Bexley Care Trust in Kent, which wants to save £12.3 million this year, is considering training up "a range of staff" to help with weighing babies. The Amicus union expressed fears that the plan would involve secretaries. The Community Practitioners and Health Visitors' Association warned that it could leave a health visitor liable to court action or being struck off the Nursing Midwifery Council register if something went wrong. The plan came to light as the Royal College of Nursing raised the alarm over newly-qualified nurses having to work for free or for below the minimum wage. The RCN said that the Co Durham and Darlington NHS Foundation Trust as well as the North Tees and Hartlepool NHS Trust were offering "honorary" preceptorship contracts to some nurses unable to secure other employment with them. The Co Durham scheme comes with a training allowance of £480 - an estimated hourly rate of £2.60 compared with the minimum wage of £4.45 for 18-to-21-year-olds and £5.35 for those aged 22 and over. There is no guarantee of a job at the end of the contract. Summary by Keep our NHS Public of Telegraph 14 February 2007
    3     Light bulb hospital 'is meanest'. St Helier Hospital has been dubbed "the meanest in Britain" by NHS campaigners after a number of measures including taking down light bulbs. Epsom and St Helier NHS Trust needs to save £24m and defended the light bulb step as a finance recovery move. However Health Emergency has claimed that management consultants are still receiving a "fat fee" while staff morale is "rock bottom". Geoff Martin, spokesman of the NHS pressure group Health Emergency, said: "St Helier is the meanest hospital in Britain and is an example of everything that is wrong in the NHS. Staff morale is at rock bottom and the trust is being run by management consultants getting paid a fat fee for dreaming up the most outrageous penny-pinching cuts." And Kevin O'Brien, spokesman for Unison, the union which represents health workers, said: "Staff are furious at the way their services are being ripped apart by wave after wave of cuts and threats of redundancy." The trust is aiming to cut 480 posts and close 200 beds over 18 months under savings plans. Summary by Keep our NHS Public of BBC Online 15 February 2007
          After Eden, things look rosy in the social enterprise garden. So far, relatively few social enterprises in the health and social care field have won contracts to deliver NHS services, although there are a small number of fairly well-established examples. South East London Doctors Co-operative, a non-profit-making limited company owned, managed and financed by 460 GP members, provides out-of-hours services for around 900,000 patients in Lambeth, Lewisham and Southwark. Sandwell Community Caring Trust is a charity that runs residential and respite care and supported living programmes for people with physical and learning disabilities in the West Midlands, and the Kath Locke Centre in Manchester was the first NHS primary care facility in the country to be run by a social enterprise. In September 2006, health secretary Patricia Hewitt (who worked in the not-for-profit sector before becoming an MP, and while trade and industry secretary established a new legal structure, the 'community interest company', to help such bodies) wrote a pamphlet setting out why social enterprises should play a greater role in 'unleashing the potential of staff within the NHS to deliver better services to patients'. The community foundation trust model, currently under discussion by the Department of Health and Monitor, could offer one means to redesign services. Another approach, Ms Hewitt suggested, was to find ways to allow the NHS to routinely contract with, or set up its own, social enterprises - for example to deliver services organised around care pathways such as stroke, diabetes or other long-term conditions, and perhaps to work in joint ventures with charities and voluntary groups. Already there is no shortage of social enterprises keen to enter the NHS market. In October the DoH's social enterprise unit invited applications to become 'pathfinder' social enterprise projects. It got more than 400 responses in six weeks. The 25 winners, announced at the January conference, will receive DoH backing up to a total of £1m to help them develop NHS-commissioned provision ranging from services for specific patient groups, like dementia patients, to wider activities encompassing primary and community care across whole districts. Ian Carmichael, a former primary care lead at South West strategic health authority, is now on secondment to set up one of the pathfinder social enterprises, the Forest of Dean Health Enterprise Trust, which aims to take over the running of two community hospitals and become an 'umbrella provider' for the area's 80,000 population. He said: 'To make our ideas into reality we need to employ a lot of staff, and we're going to need a way of giving them access to NHS terms and conditions or it won't work. As a temporary solution, secondment might be the answer but even that is fraught with problems so this is certainly something that needs sorting out from the centre.' At least one social enterprise - Central Surrey Health - has managed to find a way of keeping its staff in the NHS pension scheme while delivering services on a contractual basis, albeit without having gone through a formal tendering process. The nurse and therapist-led mutual limited company took over a three-year, £60m contract to supply community services including speech and language therapy to East Elmbridge and Mid-Surrey PCT in October 2006. Summary by Keep our NHS Public of Health Service Journal 15 February 2007
      4   Stopping needless operations could save £100m, says London Health Observatory. Stopping unnecessary operations could save London's NHS almost £100m, according to new research. The London Health Observatory has studied 34 selected procedures for which the clinical case is sometimes debatable, and drawn up 'access criteria', which would sharply restrict their use. Its report found 'significant and unexplained variation in planned surgical care in London for procedures where there is evidence that service access criteria should be in place'. Summary by Keep our NHS Public of Health Service Journal 15 February 2007
    3     Turnaround specialist recruited by London NHS. London's strategic health authority announced this week that Hillingdon Primary Care Trust interim chief executive Anthony Sumara would take the role of turnaround director. According to the latest figures, NHS organisations in London were forecasting the second biggest aggregate deficit in England - £135m against a planned deficit for this year of £90m. The biggest deficit was forecast by East of England SHA (£151m). NHS London chief executive Ruth Carnall said Sumara's experience in turning around the financial fortunes of NHS organisations would be invaluable. Summary by Keep our NHS Public of Public Finance 16 February 2007
          Nice dentists, shame about the quotas. If you want to understand the muddle facing NHS dentistry across England, try paying a visit to a practice near the Clem Attlee housing estate in Fulham, west London. But don't necessarily expect to get treatment after the end of this month. NHS Dentist, an expanding practice on North End Road, is about to "overperform" on its contract - so there will be no more public money available to treat further patients until the new financial year.  John Carvel Wednesday February 21, 2007 The Guardian
          Trusts may lose secure hospitals. Control of England's three high-security hospitals could be removed from local NHS control. Broadmoor, Rampton, and Ashworth hospitals could be controlled independently, in a return to a policy that was scrapped due to a series of high-profile scandals when they were managed separately by special hospital authorities. The potential change emerged as the three mental health trusts that currently run the hospitals were told by health secretary Patricia Hewitt that they would not be given foundation status. Mersey Care trust, which runs Ashworth Hospital, Nottinghamshire Healthcare trust, which runs Rampton, and West London Mental Health trust, which operates Broadmoor, have been told they cannot become foundation trusts because Ms Hewitt does not want to relinquish control of the hospitals. Summary by Keep our NHS Public of Health Service Journal 22 February 2007
        5 Not in our back yard, says health minister's hubby. Health Secretary Patricia Hewitt has been drawn into a row over plans for a new 100-hours-a-week chemist in Camden Town, which will dispense syringes, after her husband raised an objection. William Birtles, a senior crown court judge, has written to the Camden Primary Care Trust in protest at chain chemist ABC Pharmacy's plans for a new shop. The letter stated: "I write to oppose the opening of the new pharmacy at NW1. We have a serious drug problem throughout Camden which is well-known by the local police. I don't feel it's appropriate for a local pharmacy to do that (provide a needle exchange)." The objection is potentially embarrassing for Ms Hewitt, as 100-hour pharmacies were part of policies she introduced during her time as Trade and Industry Minister. Also in his letter, Mr Birtles said that the 100-hours policy was "something that needs to be looked at". Under Trust rules, a new chemist cannot open in Camden Town unless it uses a special 100-hours application and provides 'enhanced' services. Jagdish Vaghela and his wife Hansila, who run the Biotech Chemist, could face stiff competition from the new pharmacy as it would be located between their shop and the health centre. Mr Vaghela said the 100-hours system was allowing big businesses to bypass the rules and crowd out neighbourhood pharmacies. The new service would be bound by contract rules to stay open for 100 hours a week. Mr Vaghela said: "They will eat up the business - they can make a loss while they are doing it because they are a multinational." He added: "The PCT has received lots of objections." Hansila Vaghela added: "People have got sidetracked. The issue is about what the community in Camden want. They don't want a 100-hours chemist and needle service." Summary by Keep our NHS Public of Camden New Journal 23 February 2007
          Trust withholds quit information. The Epsom and St Helier NHS Hospitals Trust has refused to reveal how much its former chief executive was paid to quit amid claims the sum topped £500,000.The Sutton Guardian and the MP for Sutton and Cheam both lodged Freedom of Information requests with the trust to discover the circumstances surrounding Lorraine Clifton's sudden departure in December 2006. The trust witheld the information on the grounds that it will be published in their annual report in September. Paul Burstow MP has written to the trust to complain about the decision, saying it is in the public interest for the information to be released. Mr Burstow said: "It is clear from the information the trust has disclosed that Ms Clifton did not leave voluntarily. In the light of this, and the budget deficit which is set to force one in 10 hospital staff out of their jobs, the public have a right to know how much she was paid to go." Summary by Keep our NHS Public of Sutton Guardian 23 February 2007
        5 Deciding the future of Bolingbroke hospital's services. Wandsworth Council is to launch its own consultation on the short-term future of services at Bolingbroke Hospital. The council claims the NHS survey does not give respondents a chance to vote for services to be kept running at the hospital while its long-term future is decided. The NHS consultation, arranged jointly by St George's Healthcare NHS Trust and Wandsworth Primary Care Trust, gives people four options on the short-term future of health services currently provided at the hospital. However, none of these options offer the choice of retaining services on the Bolingbroke site. The trusts will include the option of keeping the Bolingbroke open when it launches a separate consultation in the summer on long-term provision for the area. The four short-term options offered by health chiefs include moving services to St John's, in Battersea, St George's, in Tooting, or even moving some to Queen Mary's, in Roehampton. The council want to add a fifth option of keeping services at Bolingbroke until long-term plans are drawn up. Councillor Ian Hart said: "Less than three years ago, an NHS review concluded the Bolingbroke was the best place to site a new local care hospital for Battersea. We have seen nothing since then to persuade us the review team got it wrong." Summary by Keep our NHS Public of Wandsworth Guardian 23 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
        5 'We've got to live in the real world'. Enfield's health boss has said that an irrational fear of change is behind opposition to cuts at Chase Farm Hospital. Sally Johnson, Chief Executive of Enfield Primary Care Trust (PCT) said: "No change to services at Chase Farm is not realistic." Ms Johnson was speaking ahead of next month's march against the reconfiguration programme. Opponents claim that change is being foisted upon Enfield's health care services and fear the community's needs have not been considered. Ms Johnson admitted that the case for change is grounded in national policy, and was adamant that borough health services must fit in with the recommendations of Government. Government expert, professor Sir George Alberti, national director for emergency access, is currently analysing the five options on the table for the future of the medical centre at the Ridgeway. Four propose that women and children's services be axed, while three advocate the closure of the casualty department. A recently added fifth stipulates no change at all. Ms Johnson dashed the hopes of opponents who believed Sir George might halt the scheme. However, she maintained that Enfield's population is insufficient to sustain a casualty department at Chase Farm, but conceded that changes would hit some residents. To counter the impact of cuts, Ms Johnson pledged to give the ambulance service as much cash as it needed to handle extra demand. She also announced a £6m investment programme in GP surgeries, but was unable to say where they would be located. The Save Chase Farm group has called on residents to march against closures on March 3. Organisers hope it will be the biggest display of dissent in Enfield's history. Summary by Keep our NHS Public of Enfield Independent 27 February 2007
  2       Seven more PFI hospitals to go ahead. Seven more private finance initiative hospitals, with a capital value of almost £1.5bn, were finally given the go-ahead but amid growing frustration among PFI providers at the time it is taking for the Department of Health to adjust hospital building plans to the new, more competitive, NHS market. The hospital PFI programme is being cut back from an original £12bn of additional schemes to something closer to £7bn-£9bn, according to the health department, as hospitals adjust to the uncertainty of a system that pays them for each patient they treat, in contrast to block contracts. The announcements in part reflect that. The value of the seven schemes given the go-ahead is being reduced by about 15 per cent, or by £248m on their original £1.63bn value. But although the go-aheads - for schemes at various stages of procurement - has now been given the first stage of the review was meant to be completed by late last year. And a reappraisal of 23 other schemes with a capital value of about £5.5bn, including some individual projects worth £500m and more, is unlikely to be completed before the autumn, the health department said - the better part of two years since the review of PFI projects was launched. To date, only a few PFI projects - the £1bn Paddington campus scheme, Whipps Cross and Essex Rivers - have been withdrawn. Three of yesterday's approvals - Peterborough, a rebuild in North Bristol, and a smaller project in the north-east, went through unchanged. Two more have undergone relatively minor revision. But the Maidstone deal has been cut back from a £269m scheme to £218m, while one in Mid-Essex is down from £199m to £143m. Unison, the health service union, protested that taxpayers will be "paying over the odds" for the new facilities for years to come because they have been built through the PFI. Summary by Keep our NHS Public of Financial Times 27 February 2007
        5 Calls for health cuts protest. Health workers have urged people to protest against NHS cuts outside Hackney Town Hall this weekend. The protesters, who fear patient care is being damaged by a series of cutbacks, will gather in Town Hall Square at twelve noon on Saturday before marching to Homerton University Hospital, circling the hospital, and returning to town hall to link up with protesters marching from the Royal London Hospital in Whitechapel. The protest is being organised by the Homerton Anti Cuts campaign and the joint trade union, Staff Side, and will coincide with the national day of action called by health unions. "The combination of cuts and privatisation across the country is putting the NHS in jeopardy and we urge everyone to make a stand," said Unison member, Diana Swingler. Health bosses argue the reorganisation will improve efficiency without damaging patient care. Summary by Keep our NHS Public of Hackney Gazette 1 March 2007
          NHS staff protest over job cuts. Health workers have been holding marches and rallies to protest about cuts to NHS jobs and services, and below-inflation pay increases. Demonstrations took place in a number of towns and cities, including London, Manchester, Preston, Bristol, Birmingham, Sheffield and Belfast. TUC general secretary Brendan Barber - who spoke in Sheffield - said there was "real concern" about NHS policies. Barber said there were several problems within the NHS. "Obviously there are immediate pressures with cuts and jobs disappearing, wards closing in too many trusts," he said. "People not able to find jobs when they've completed their training - nurses, physiotherapists. So all of those kinds of problems. But (there is) a feeling that the direction of policy is just not right. The privatisation, the fragmentation of the NHS is really threatening the whole integrity of the service. I think that's what people are saying today." Dr Peter Carter, of the Royal College of Nursing, said nurses were "angry and upset" over a number of issues. "Over the last year or so nurses have seen jobs frozen, redundancies, services closed, wards closed, student nurses not being able to get jobs on finishing their training, which is a pretty depressing state of affairs. And then you've had the announcement by the government that they were not going to fully implement the recommendations of the pay review body that nurses should get 2.5%. And so it's a combination of both of these things have led to an extremely frustrated nursing workforce." Health Minister Rosie Winterton said unions and staff signed up to the principles of the NHS Plan, which sets out reforms over 10 years. Summary by Keep our NHS Public of BBC Online 3 March 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
      4   Trust scales back many minor operations. Croydon's Primary Care Trust is slashing the number of minor operations it carries out in a bid to save money and resources. Surgical procedures such as hysterectomies, grommet installation and varicose vein treatments have been reduced by the PCT. New criteria has been set out by the trust which mean treatment for complaints such as tonsilitis will not be routinely available through GP referrals. Procedures will still be offered to patients where evidence shows it would be "of benefit" and the new arrangements - which have already been implemented - will not affect people who need specialist care, a PCT spokesman said. Dr Tim Crayford, medical director and director of public health at Croydon PCT, said: "It is, in part, due to money but it is more about wasting money on treatments that will not be beneficial to the patient. This does not mean it will be more difficult to get referrals. Neither does it mean people will have to wait longer for referrals, just that patients will be offered procedures if it will benefit them. If we have two treatments which do the same thing but have different costs we should be obligated to choose the cheaper one. We are, after all, a publicly-funded body." Cosmetic surgery may only be offered if there is an adverse physical side-effect to the complaint such as impaired vision, which could rule out birth marks and other skin complaints where a patient may benefit emotionally or mentally. Croydon PCT has reviewed its policy - called Clinically Effective Commissioning - along with other trusts in south west London following guidance from the National Institute for Health and Clinical Excellence. Summary by Keep our NHS Public of Croydon Guardian 9 March 2007
          Breaking down costs identifies loss-making services. The Eastman Dental Hospital is piloting Monitor's profit and loss approach. Part of University College London Hospitals, it has an international reputation. But it operates in an ageing building and has been struggling financially for years. By breaking down the costs of each type of service, it can identify which are trading at a loss and which make money, says Professor David Fish, UCLH's medical director for specialist hospitals. That was providing opportunities to increase activity in areas that do make money, such as orthodontics. But it was throwing up areas where the NHS was not paying enough to cover unavoidable treatment costs. That would lead to conversations with the hospital's primary care trusts, and with those who set the NHS tariff, in an attempt to secure more accurate prices and payments. Summary by Keep our NHS Public of Financial Times 12 March 2007
          Merger paves way for health science centre. The first foundation trust that provides hospital services, but is not part of the NHS, could be created following decisions by two NHS trusts to merge with part of the University of London. Hammersmith Hospitals trust and St Mary's trust, both in west London, have formally decided to merge, and then to create the UK's first academic health science centre with Imperial College London. Once the new organisation is set up, scheduled for autumn, the trusts have been given approval by NHS London to apply for foundation status, with Imperial College London as the sponsor. The new trust will aim to create a world-class centre for research and innovation, which would also provide standard hospital services, in a similar model to some of the best-performing US hospitals. But local NHS sources have expressed concern that Imperial College London's involvement in the project could be a 'Trojan horse', to develop cutting-edge research but at the expense of traditional acute hospital services. They question whether the new centre would want to carry out research into areas such as emergency care or care of the elderly, and suggest that the merger could limit choice for primary care trusts. Professor Stephen Smith, principal of the Imperial College London faculty of medicine, admitted combining academic expertise with the strengths of Hammersmith and St Mary's trusts would be a 'bold but critical challenge', but he said patients would benefit. Summary by Keep our NHS Public of Health Service Journal 15 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
          Doctors march in row over training reforms. Thousands of doctors marched in London and Glasgow yesterday in protest at reforms to medical training. The new process, called Modernising Medical Careers (MMC), has come in for widespread criticism from the BMA, royal colleges, senior medics and trainees. At least 30,000 junior doctors have applied for up to 22,000 specialist posts under MMC, which it was hoped would speed up training and offer a fairer way of placing junior doctors in oversubscribed training roles. The government has already bowed to pressure, announcing that 5,000 more doctors would now be interviewed. Amelia Hill Sunday March 18, 2007 The Observer
          London chief defends Corrigan and Warner's appointments. NHS London's interim chief executive has defended her new top team against claims they include political appointments meant to push through New Labour reforms. Ruth Carnall acknowledged that two appointments were always likely to be politicised, namely former health minister Lord Warner as chair of the new London Provider Development Agency, and Number 10 adviser Professor Paul Corrigan as the strategic health authority's director of commissioning and strategy. Carnall said: 'The notion that I have put in place a team with the aim of privatising the NHS in London is nonsense.' Her comments came after shadow health secretary Andrew Lansley wrote to senior officials at the Department of Health and to NHS London expressing his concerns. Mr Lansley alleges Lord Warner's appointment breaches the ministerial code of conduct and has written to permanent secretary Hugh Taylor to demand answers to a series of questions about the appointments process, its timing and whether permission has been sought. He argues that Professor Corrigan's appointment, which comes on the eve of a major shake-up of London health services, is 'deeply unwise' and should be abandoned. He said: 'These appointments of people who have been at the most senior level pushing the proposals for the reconfiguration of hospitals are unacceptable. They undermine the credibility and independence of the NHS in London for reaching its own view about what is in the best interests of patients in the capital.' Unison also has concerns about the appointments. London head of health Chris Remington said: 'I think they will use London as a test bed. We will see the wholesale shifting of staff into the private sector.' The new team in London includes: Ruth Carnall as interim chief executive; Professor Paul Corrigan, Tony Blair's special adviser on health and widely regarded as an architect of the current market reforms, as director of strategy and commissioning; Lord Warner, former health minister, now chair of London's Provider Development Agency where he will steer trusts towards foundation status; Malcolm Stamp, PDA chief executive, who was one of the first foundation chief executives; Paul Baumann, a finance director from Unilever, as director of performance and finance; Antony Sumara, turnaround director, known for his work in troubled trusts. Summary by Keep our NHS Public of Health Service Journal 22 March 2007
    3     Mentally-ill patients to be released early. Mental health patients will be released into the community earlier in a raft of cuts aiming to save £8m, it has emerged. Camden and Islington Mental Health and Social Care Trust (CIMH) is making sweeping money-saving changes because it is facing rising costs and mounting financial pressure from the NHS and Camden Primary Care Trust (PCT). Following the closure of Jamestown Day Centre, Camden's mental health patients are set to see the three-day hospitals Felix Brown, in the Royal Free, West Hampstead in Fordwych Road, and Jules Thorn in St Pancras Way, reduced to just two, with day places reduced from 85 to 65 and staff cut by seven. Documents reveal plans to reduce the average length of stay from six months to three and a half, despite fears patients may not be well enough. Mental health chiefs are due to discuss the changes to the service. And the cuts don't stop there. There are fears Mornington Ward, a Psychiatric Intensive Care Unit (PICU) in St Pancras Hospital, is also facing the axe. The trust plans to withdraw three remaining wards from St Luke's Hospital in Muswell Hill prompting fears the hospital will have to close. Summary by Keep our NHS Public of Camden New Journal 23 March 2007
    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
1         Hospital gives cheap parking to football fans. A leading NHS hospital has sparked outrage by charging football fans less to park than patients and their relatives. Chelsea and Westminster Hospital charges Chelsea fans attending matches at nearby Stamford Bridge £10 for four hours. But patients receiving treatment in accident and emergency and other departments are made to pay £12.50 to park for the same period. A spokesman for Chelsea and Westminster Hospital said: "We actively promote the car park to Chelsea fans attending games because they generate extra income that can be reinvested in front-line patient care." Summary by Keep our NHS Public of Telegraph 26 March 2007
          Demise of 'double deficit' prompts refunds to budgets as loans system is introduced. The Department of Health is to scrap the 'double deficit' accounting system for acute trusts and pay back deductions taken from them during 2006-07. The move will see the Treasury's resource accounting and budgeting system abolished from 1 April, as well as several trusts receiving rebates that significantly reduce their end-of-year deficits. Under the RAB system, introduced in 2001, trusts that run up an in-year deficit are penalised by the same amount the following year. Dismantling the system means that acute trusts that have been paying deductions this year for overspends in 2005-06 will get the money back; however, the DoH will not refund RAB deductions for previous years. A DoH spokeswoman told HSJ that, where RAB cash had been deducted before 2006-07, NHS trusts would have to 'agree with their auditors a "disregard" of RAB deductions for the purpose of meeting the statutory break-even duty'. A total of 28 acute trusts will benefit from the RAB rebate. The DoH has given back £178m to the trusts to be distributed by strategic health authorities. North West London Hospitals trust stands to gain the single biggest refund, getting around £24m and reducing its current deficit from £25.6m to just over £1.5m. London's Queen Elizabeth Hospital trust gets a refund of just over £23m, cutting its debt from £36m to £12.6m. Last July, the Audit Commission recommended trusts be reimbursed for RAB deductions from 2001 and called for the system to be scrapped. Its report, commissioned by health secretary Patricia Hewitt, said that RAB was incompatible with the NHS financial regime. However, the DoH delayed the decision to scrap it until it was confident that the NHS would balance its books this year. Summary by Keep our NHS Public of Health Service Journal 29 March 2007
  2       Controversial critical care centre axed. Hospital managers have scrapped plans for a £450m critical care centre and a network of community units across south London on the grounds of affordability. Plans had been bogged down in rows over cost and location, with accusations that health secretary Patricia Hewitt was 'gerrymandering'. Ms Hewitt was alleged to have intervened to favour a site in a Labour constituency. But last week the proposals were scrapped. Merton and Sutton primary care trust chief executive Caroline Taylor, who chairs the steering group of trusts and PCTs under the Better Healthcare Closer to Home umbrella, said 'capital and revenue costs are now not affordable'. Local service changes had reduced the projected number of patients that would use the new unit. The centre's feasibility was further damaged when NHS London introduced a £250m cap on capital spending. Now the consortium intends to revise plans for community services and a smaller general hospital serving around 300,000. Geoff Martin, head of campaigns at pressure group Health Emergency, said: 'Seven years of reviews and consultations have cost us millions in wasted fees for management consultants and planners and have got us nowhere. There is no site for a new hospital, no money to build it and no-one held to account for this expensive shambles. Summary by Keep our NHS Public of Health Service Journal 29 March 2007
    3     £8m cut in health budget. Mental health chiefs have approved £8m cuts in the run-up to becoming a foundation trust. The massive savings were voted through at a meeting of Camden and Islington Mental Health and Social Care Trust board. The cuts will mean closures of some acute wards and a day hospital. It is also planned to discharge some patients early from residential care. Patrick Dalton, acting chairman of Camden Mental Health Consortium, a patients' group, warned that the changes will mean short hospital stays and staff cuts. Trust chief executive Wendy Wallace defended the cuts, saying: "This is happening because, like all public sector organisations, we have to break even and we'll have less money next year." Summary by Keep our NHS Public of Camden New Journal 30 March 2007
          Free chief says more to be sold. Royal Free chief executive Andrew Way has admitted th