South West Peninsula Strategic Health Authority

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The summary articles in the table below related to the strategic health authority area are copied from the following pages, indicated in the table by key numbers.

  1. Charges
  2. Construction projects
  3. Resource shortfall Sources
  4. Treatment approval or not
  5. Withdrawal of Local Facilities - Sources
    Other
1 2 3 4 5

Summary articles
          Breast cancer patients given wrong doses.  Guardian Tuesday January 8, 2002 [Derriford Hospital, Plymouth]
        5 The biggest street protest for decades in Cornwall - between 15,000 and 20,000 people, according to police - has raised the prospect of a new mass revolt against hospital cuts, along the lines that cost Labour its Wyre Forest seat in the last election. Judith Cook of Newlyn is among residents fearful of the consequences in western Cornwall if Penzance's accident and emergency services move away to Truro.  Society Thursday April 18, 2002
        5 A citizens' revolt is brewing in western Cornwall: plans to downgrade the hospital emergency service in Penzance have just provoked the biggest street protest in the region for decades. Judith Cook of Newlyn wonders if new tax money will make a difference.  Guardian Monday April 22, 2002
        5 Update: 'It looks like Penzance protesters have saved hospital A&E'.  Adamant popular opposition to cutting emergency services at West Cornwall hospital has, at last, got through to the health authorities, Judith Cook of Newlyn reports.  Society Tuesday August 6, 2002
    3     A consultant surgeon yesterday denied making threats to retaliate against anyone who reported that he threw a dessert spoon at a nurse after being given it to use in a hip replacement operation.  Rebecca Allison Friday February 21, 2003 The Guardian [Derriford Hospital, Plymouth]
          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]
    3     While the south-west's primary care trusts are suffering from inherited debts and managerial pressures, Patrick Butler discovers they can still make a huge change to how the region's healthcare system is developed. Wednesday June 4, 2003 The Guardian
    3     A local authority is planning to lend £8m to its local NHS organisations, using new financial flexibilities in the first move of its kind. Cornwall county council, a top-performing authority, aims to make the loan to bail out community health services that face drastic cuts. Linda Jackson Wednesday July 23, 2003 The Guardian
          Where the treatment centres will be. The health secretary, John Reid, today announced details of the government's controversial programme of privately run fast-track diagnostic and treatment centres, and a number of new mobile ophthalmology units. This guide explains where they will be. Friday September 12, 2003 [South-west peninsula (Mercury Health Ltd), Lincolnshire (Mercury Health Ltd), Horton hospital, north Oxford (Mercury Health Ltd), North-east Yorks (Mercury Health Ltd), Southampton (Mercury Health Ltd), Northumberland (Mercury Health Ltd), East Berkshire (Slough, Bracknell, Maidenhead and Windsor/Ascot) (Mercury Health Ltd), Didcot, Oxfordshire (Mercury Health Ltd), Ashford, Surrey (Mercury Health Ltd), Maidstone (Care UK Afrox), Barlborough Links, Nottinghamshire (Care UK Afrox), Derriford, Plymouth (Care UK Afrox), Chase Farm, Barnet, London (Anglo Canadian), King George hospital, Redbridge (Anglo Canadian), Royal National throat nose and ear hospital, Kings Cross, London (Anglo Canadian), Bradford (Nations Healthcare), Burton (Nations Healthcare), Daventry (Birkdale Clinic), Trafford, Greater Manchester (Netcare UK), Royal National Orthopaedic Hospital, Stanmore (New York Presbyterian), Shepton Mallet, Somerset (New York Presbyterian).
Two mobile units will offer ophthalmology services in the following areas: Cheshire and Merseyside (Netcare UK), Cumbria and Lancashire (Netcare UK), Horton, Oxfordshire (Netcare UK), Wycombe, Bucks (Netcare UK), North Tyneside (Netcare UK), South-west Oxfordshire (Netcare UK), North-west peninsula (Netcare UK), Dorset/Somerset (Netcare UK), Kent/Medway (Netcare UK), Hants and Isle of Wight (Netcare UK), Surrey and Sussex (Netcare UK), Thames Valley (Netcare UK)]
        5 Plymouth students are condemning the decision to close the university's on-campus sexual health clinic. Polly Curtis Friday September 26, 2003
  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
          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
  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)
    3     Hospital keeps two-speed waiting list. Some patients needing operations will have to wait twice as long as others at the Royal Devon and Exeter Hospital, in Exeter. Exeter PCT (predicted deficit £1.75m) and Mid Devon PCT (£1.65m) have asked the hospital to extend the waiting times for their patients to four and a half months. The average wait is currently just a few weeks. In contrast East Devon PCT, with no overspend, is able to have its patients seen at the hospital as quickly as possible and will benefit form its neighbours' difficulties. Summary by Keep our NHS Public of  Times 25 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
    3     NHS in Devon and Cornwall struggles under debt mountain. A £10.3m debt in the region has led to services being slashed, with minor injuries units closed and cottage hospital beds lost. North Devon PCT (£4.052m deficit) cut 21 community hospital beds in December and closed minor injuries units at South Molton and Torrington hospitals in January. North and East Cornwall PCT (£1.392m deficit) is proposing to reduce the opening times of five minor injuries units at Launceston, Liskeard, Bodmin, Stratton and Saltash. More than 5,000 people have signed a petition demanding the Stratton Unit stays open for 24 hours a day. Teignbridge PCT has reduced opening times at Dawlish, Teignmouth, Ashburton and Bovey Tracey minor injuries units and increased the opening times at Newton Abbot. Central Cornwall PCT is consulting on closing 37 beds in three cottage hospitals. South West Peninsula SHA has ordered all trusts to cut the use of agency nursing staff. Royal Cornwall Hospitals Trust has been subsidising the cost of running an MRI scanner by allowing private patients to use the machine. It has also implemented an operation go-slow.  Summary by Keep our NHS Public of BBC Online 30 January 2006
1         NHS hospital charging for private MRI scans. The Royal Cornwall Hospital in Truro offers MRI scans to fee-paying private customers, whilst there is reportedly an 11-month waiting list for NHS patients who need to use the facility. The hospital claims it needs the money from private treatment to subsidise the cost of NHS scans. Lack of funding has meant the scanner has been underused since it was installed in September. Now the hospital has slashed the fee to private patients in a bid to attract more custom. It has denied it is involved in a price war with other NHS centres. Summary by Keep our NHS Public of BBC Online 31 January 2006
          Transfusion needed after IS-TC hip op. Maurice Cardew, 79, from Helston, Cornwall, needed an emergency blood transfusion after being discharged just three days after a hip operation at the privately-run Peninsula NHS Treatment Centre in Plymouth. He then had to spend a week at the Royal Cornwall Hospital. An orthopaedic surgeon who saw Mr Cardew at there said his early discharge was "shocking". He knew of three operations carried out at the Peninsula centre from which major complications had arisen. Maurice Cardew started losing large quantities of blood on the drive home from the treatment centre. The Peninsula Centre said policies on discharging patients have been revised.   Summary by Keep our NHS Public of BBC Online 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
        5 Injuries unit to close at night. The minor injuries unit in Newquay will be closed during the night, Central Cornwall PCT has decided. Plans are also expected to be approved for four more Cornish towns to lose minor injuries cover in Bodmin, Launceston, Liskeard and Saltash. Meanwhile a unit at Stratton has been reprieved and is likely to continue a 24-hour service after 5,500 people petitioned against planned changes in its opening hours. Summary by Keep our NHS Public of  BBC Online 28 February 2006
    3     Health trust plans 300 job cuts. Three hundred jobs are to be cut at the Royal Cornwall Hospital Trust. Secretarial and managerial jobs are set to go through voluntary redundancies, with theatres and wards also to close in a move to tackle an £8.1m deficit. Summary by Keep our NHS Public of  BBC Online 8 March 2006
          MPs hear how Labour's reforms are undermining the NHS. Royal Cornwall Hospital Trust - which is to axe 300 jobs because of a £8.1 million funding shortfall - is losing £6m of its income next year because of the government's use of privately-run treatment centres. It will perform 6,000 fewer operations next year with the patients being switched to ISTCs. Summary by Keep our NHS Public of  Telegraph 10 March 2006
    3     'Over-efficient' surgeon must delay operations. Peter Cox, a general consultant surgeon at the West Cornwall Hospital, has made a public apology to patients whose operations are being postponed because he has been too efficient. Royal Cornwall Hospitals Trust - which announced 300 redundancies and an £8 million deficit - has treated 4,600 patients more than were budgeted for in this financial year. Peter Cox said: "This is all about finance. The thing that really annoys me is that I cannot see how this will really save any money. All they are doing is deferring the payments to a later date." Summary by Keep our NHS Public of  Telegraph 10 March 2006
    3     Hospital trusts reduce deficits. Bill Moyes, chairman of the foundation trust regulator Monitor, expects 28 hospitals to be awarded foundation status by next March - meaning the total number will double. Bradford, Peterborough and Stamford, and Royal Devon and Exeter foundation trusts have cut their deficits this year, but UCHL's has grown. Summary by Keep our NHS Public of  Times 14 March 2006
        5 Community Hospitals at risk in South West Peninsula  SHA according to Public Finance 17 March 2006:
Moretonhampstead Hospital
Okehampton Community Hospital
    3     200 posts to be cut at hospital. Up to 200 posts are to be cut at Derriford Hospital in Plymouth - the biggest hospital in the South West. Managers have taken the decision because of a £22m budget shortfall. Losses will include redundancies. Summary by Keep our NHS Public of  BBC Online 21 March 2006
        5 Patients who face trips of torment. Health chiefs were yesterday presented with a damning dossier, which lays bare the suffering endured by hundreds of cancer patients in remote corners of the West. 300 heartbreaking tales were presented to health chiefs to show them the human cost of decisions to centralise services in centres of excellence. So patients have to make 200-mile round trips for cancer care in Cheltenham. Summary by Keep our NHS Public of  Western Daily Press 29 March 2006
    3 4   The financial crisis in the NHS forced a Cornish hospital to divert patients 35 miles for emergency services over the weekend, because the trust could not afford a locum to cover for a casualty doctor who was off ill. West Cornwall hospital in Penzance has a £9m deficit, and decided not to replace the duty doctor when he called in sick on Friday. Ambulance crews were told to take seriously ill patients to another hospital 35 miles away at Treliske, Truro. Sandra Laville Monday April 3, 2006 The Guardian
    3     Union will fight health job cuts. Unison has vowed to fight any compulsory redundancies at hospitals in Devon and Cornwall. It described the 200 proposed job cuts at Derriford Hospital in Plymouth and 300 at the Royal Cornwall Hospital in Truro as "ridiculous".Ian Ducat, the regional secretary for Unison South West, said: "I shall expect the resignations of NHS Trust chairs and chief executives and dismissal of finance directors before a single nurse, technician, porter or secretary is sacked." He said if the union was notified of a single compulsory redundancy, it would immediately ballot its members. He vowed Unison would not stand back and watch workers sacked and said the health minister was ultimately responsible and would be in the union's firing line. Summary by Keep our NHS Public of  BBC Online 7 April 2006
    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     Out-of-hours health jobs at risk. It is feared as many as 30 jobs could be cut from Cornwall's out-of-hours doctors' service. The NHS contract for out-of-hours cover was transferred to private company Serco last month. The new provider has confirmed that some posts among the administration, finance and personnel teams are to undergo restructuring. Summary by Keep our NHS Public of  BBC Online 11 April 2006
          Up to a third of dentists won't sign NHS contract. Nearly a third of dentists in some parts of England have refused to sign new NHS contracts - contradicting a recent statement by Tony Blair that "about 90 to 95%" of dentists had signed up. A leaked government document, showing exactly how many dentists in each area have taken up the contracts, reveals that in the south west, 29% of dentists have refused to sign up; in the Thames Valley, 15%; in Hampshire, 18%; in Yorkshire, 23%; and in the West Midlands, 24%. In south-west London, the figure is 12%; in Manchester, 11%; in Kent, 14%; and in Dorset, 15%. In Avon, Gloucestershire and Wiltshire, 23% have not signed up. Of the 9,419 contracts offered in England, 1,096 have been rejected, including some covering more than one dentist - a national average of 12% more than Mr Blair's claim.  Summary by Keep our NHS Public of  Telegraph 16 April 2006
          Treatment centre programme in disarray as contracts axed. The DoH has been forced to scrap a large swathe of its second-wave independent treatment centre programme nearly a year after it invited private sector organisations to bid for the lucrative contracts. Seven of the 24 local schemes have been axed, with the rest being delayed by up to a year. Those axed include two of the most high profile schemes, in South Yorkshire. The climbdown came after the DoH was forced to acknowledge claims by SHAs and PCTs that more elective capacity was not needed in their regions. Companies bidding for the work received letters from the DoH's commercial directorate saying: "It has become clear for a variety of reasons that the detailed make-up of the schemes needs to be reviewed and that these schemes will not go ahead as part of the phase-two procurement programme. We are currently exploring options to replace the capacity of these schemes." The DoH has told private providers that the monetary value of the schemes - £550m worth of work per year - will still be guaranteed. Meanwhile the other 17 remaining schemes have been delayed for up to a year. NHS Confederation policy director Nigel Edwards said: "What is becoming increasingly clear is that the level of surgical elective capacity is enough, if not too much. The problem is now one of patient flow rather than capacity, and there has been a growing anxiety that too much capacity had been procured and this has become a big issue." The second part of the wave two contract, known as the 'extended choice network', under which the DoH was set to buy elective services on top of the initial national schemes, has also been delayed indefinitely. However, the diagnostic element of the second wave is unaffected. The cancelled projects are: County Durham and Tees Valley - multi-specialty treatment centre; Birmingham and the Black Country - Birmingham City treatment centre to be housed on site at Sandwell and West Birmingham Hospitals trust; South Yorkshire - cardiology treatment centre; South Yorkshire - general surgery treatment centre; South West Peninsula - multi-specialty mobile unit; West Yorkshire - plastic surgery unit; West Yorkshire - multi-specialty treatment centre. Summary by Keep our NHS Public of  Health Service Journal 27 April 2006
          Controversy over PCTs' out-of-hours selection. Three PCTs appeared to change the process by which they chose a new out-of-hours provider for Cornwall in a way that favoured a private firm, according to an internal audit. Central, North and East, and West of Cornwall PCTs altered the way they weighted bidders' responses to a quality control questionnaire which formed a key part of the evaluation of potential providers. At an initial meeting late last year, the existing provider, GP co-operative KernowDoc, was ranked first. Serco, the eventual winner of the contract, was placed fifth. But different systems were then used to calculate the weightings in advance of a meeting a week later, after financial and service delivery risks were identified as main issues. The internal memo said: "the methodology followed was altered or modified during the course of the evaluation, which tends to undermine the objectivity of the process. Unfortunately, to an uninitiated observer, this may appear that the process was amended to give the desired result." Dr Robert Harvey, vice-chair of Cornwall and Isles of Scilly LMC, said: "We remain concerned decisions on large amounts of public money and the employment of local GPs are made behind closed doors and information is withheld on grounds of commercial sensitivity." Summary by Keep our NHS Public of Pulse 28 April 2006
          Government scientists found evidence of bird flu in poultry in October but did not report their concerns to the public, the Guardian can reveal. The scientists placed movement restrictions on a bird rescue centre in south-west England after finding evidence that 13 free-range geese had been exposed to an H5 virus, one of two types of virus most likely to become deadly to birds and a group known to be a health risk to people. The restrictions, which lasted at least a week until further tests ruled out any infection, came shortly after the highly dangerous H5N1 strain had been found in imported birds kept in quarantine. No mention was made of the incident by the environment department, Defra, either then or during last month's scares caused by the dead swan at Cellardyke, Fife, which had H5N1, and by the outbreak of H7N3 on three farms in Norfolk. The incident is referred to in one paragraph in the annual report on animal health by the government's chief veterinary officer, Debby Reynolds. The government insisted that it did not report the incident before because subsequent tests had not confirmed disease. James Meikle Thursday May 18, 2006 The Guardian
          Sweet count NHS trust criticised. An NHS trust in Cornwall has been criticised for telling nurses to record the number of boxes of chocolates left for staff by grateful patients. Managers at the Royal Cornwall Hospital NHS Trust said they used the procedure, dubbed by staff as a "chocolate audit", to assess patient satisfaction. Figures for the trust, which is responsible for hospital sites at Treliske, Penzance and Hayle, showed that in 2005 there were 8,000 gestures of gratitude, including boxes of chocolates and thank-you cards and letters, compared with 316 letters of complaint for the year. Jono Broad, of the North Devon Patient and Public Involvement Forum, said: "It's sheer lunacy - management madness in the extreme. It's all because the rules say nurses cannot accept gifts from patients - even if it is just a box of Quality Street. They have to record how much the gift is worth and who it came from. Then the sweets are shoved into a cupboard." Summary by Keep our NHS Public of  BBC Online 15 May 2006
          Hospital trusts faced criticism from Britain's biggest trade union yesterday over a scheme to send tens of thousands of confidential patient records to be transcribed in India, the Philippines and South Africa under a new form of outsourcing that will save the NHS millions of pounds. Hospitals in London, the south-east, the Midlands, Hull and the south-west are replacing their medical secretaries with staff employed overseas by private British dictaphone companies who pay 6.5p a line to transcribe doctors' notes and email them back to hospitals. Unison accused hospital trusts of putting lives at risk because of typing errors by staff thousands of miles away who are not able to cross-check the information by accessing a patient's medical history or talking to a consultant. David Hencke, Westminster correspondent Thursday June 22, 2006 The Guardian
          DoH throws down gauntlet on APMS. The pace of private sector involvement in primary care has accelerated, with ministers trumpeting the first in a series of Government-backed private provider deals, allowing a private company to run a traditional GP practice in east London. Health Minister Lord Warner said private provider Care UK would run a new 7,000-patient practice and walk-in centre in Barking and Dagenham. The DoH said similar contracts that would "challenge the existing monopoly of independent GPs" were close to agreement in Hackney, Liverpool, Lancashire, Plymouth and Yorkshire. PCTs have also begun planning to put directly managed practices out to tender to avoid the cost of running them. Sunderland PCT has opted to put out to tender a practice run by two GPs for the past two years. Dr Ashley Liston and Dr Tracey Lucas, who transformed the struggling practice, had hoped to take it over. He said: "We are disappointed but not surprised by the outcome. We're keen to continue the work we've started here, so we will be putting in a bid. We recognise the challenges of competing with large multinational companies, but we will give it our best shot." GPC Medical Practitioners Union representative Dr Ron Singer said: "PCTs will get Brownie points from the Government by involving the private sector. They are beginning to realise that they don't want salaried practices." Dr Chaand Nagpaul, a member of the GPC sessional GPs subcommittee, called on the Government to make it a legal requirement that salaried GPs keep their NHS contracts when APMS providers take over a practice: "We need to ensure the private sector is not seen as a cheap option with doctors on lower rates. The worry is we will see a downward trend in employer and employee terms." Dr Richard Fieldhouse, chief executive of the National Association of Sessional GPs, told salaried doctors not to sign alternative contracts if their practice is taken over: "It's like a civil servant moving to become part of McDonald's." Summary by Keep our NHS Public of  Doctor Update 30 May 2006
          ISTC chaos ignored. The Government is ignoring local concerns over the national ISTC programme as evidence emerges of more schemes being scrapped or put on hold. At least eight of 24 schemes in the £2.5bn wave two ISTC procurement have now been dropped and another put on hold after commissioners said they were not needed. But the DoH is not only insisting that Norfolk, Suffolk and Cambridge SHA spends £38m on a elective surgical ISTC, it has also rejected its proposals for case-mix of patients treated there. A recent report by Cambridge City and South Cambridgeshire PCTs said the DoH had "modelled that we need this capacity" without factoring new NHS capacity into the model. It said "there will be high risk to local providers because the aim is for the [ISTC] to fill up first". The PCTs are also under pressure to buy more scans under the national diagnostics procurement. Most of the commissioned scans would substitute for work done in the NHS rather than supplement it, the report says. Essex SHA has been ordered to spend £45m on independent sector schemes, despite the collapse of two ISTC projects in 2005. A paper presented to Colchester PCT's board in January said the SHA had "identified a number of concerns" with this but the scheme was going ahead anyway. A surgical scheme for Leicestershire, Northamptonshire and Rutland SHA has been halted. The SHA said that a PFI project to upgrade three hospitals and an ISTC could lead to over-capacity. The SHA is negotiating to leave the national private diagnostics procurement. The DoH has allowed the scrapping of a surgical ISTC in York, which already has a surgical treatment centre, at Clifton Park. Birmingham City Hospital's ISTC had been dropped and it has been reported elsewhere that a further six schemes have been abandoned. These are: County Durham & Tees Valley, South Yorkshire (both cardiology and general surgery), South West Peninsula, and West Yorkshire (both plastics and multi-specialty centres). Dr Paul Miller, chairman of the BMA's seniors' committee, said: "There's clear evidence that wave one schemes are surplus to requirements - spare capacity is being hawked around like soft fruit at the end of market day. Rather than imposing wave two schemes where they are not wanted the DoH should stop now. It should not sign another contract before it has reviewed the whole policy." Summary by Keep our NHS Public of  Hospital Doctor 8 June 2006
          PCTs rush to bring in private providers to run GP services. One in three PCTs will strike a deal with a private company to run GP services by the end of this year, according to a major Pulse survey. The survey of 104 trusts shows the rush towards privately run NHS GP surgeries is surging ahead at a far faster pace than expected. Ten PCTs said they had already signed alternative provider medical services contracts, 10 had contracts out to tender and 12 planned to tender before the end of 2006. Far from being restricted to the deprived under-doctored areas envisaged by ministers, APMS contracts are already spreading into leafy affluent shires. Just four of the 32 trusts forging ahead with APMS were among the 36 under-doctored areas ordered by ministers to bring in private providers. Trusts with contracts already sealed ranged from deprived areas like Barnsley, and Wednesbury and West Bromwich to leafy shires including Herefordshire, and East Elmbridge and Mid Surrey. GPs accused PCTs of rushing into APMS schemes in a bid to gain political "brownie points". The issue is set to be a flashpoint at next week's LMCs conference, with delegates voting on a demand to restrict APMS to areas where there is "an identified need" and existing GPs cannot deliver the service. Dr Chaand Nagpaul, chair of the GPC commissioning and service subcommittee, said PCTs must not be allowed to stray beyond the original remit for APMS - adding GP capacity in under-doctored areas. Dr Peter Jolliffe, Devon LMC chair, said there was no justification for South Hams and West Devon PCT's plan to use APMS to establish a practice in a new town: "We don't have any problems attracting doctors here." Professor Allyson Pollock, head of health policy at University College London, urged the Department of Health to stick to its commitment to pilot APMS in six PCTs before rolling it out nationally. Summary by Keep our NHS Public of  Pulse 9 June 2006
          New vision for the future of local hospital services. A consultancy firm hired to look at the future of North Devon's hospital-based services has recommended that they be scrapped and redesigned from scratch. Durrow Consultants advised getting rid of the debt-ridden North Devon District Hospital. Instead of a district general hospital, they want to see a "clinical plaza", combining many different health services with leisure and possibly retail and conferencing facilities. The health super park could even be "owned" by the local community - schemes run in America involve residents investing in bonds to support their local hospital. Management consultant Andy Black described a "health mall", where all acute services, including consultants, operating theatres, emergency assessment, GPs, therapies, dentistry and emergency and ambulance services would be based under one roof. An emergency physician, or general consultant, would deal with emergencies.  Summary by Keep our NHS Public of  North Devon Journal 12 June 2006
          Clinical standards of paramount importance to scheme. Durrow Consultancy was brought in by North Devon PCT, which commissions all local health services, to look at the future of North Devon's health service. The trust is £20m in debt. North Devon MP Nick Harvey said of the management consultants' suggestions: "my concern is fanciful schemes about buildings will distract attention... It seems all back to front. We need to identify what we are trying to do in clinical terms and the other issues will flow from there."  Summary by Keep our NHS Public of  North Devon Journal 12 June 2006
    3     Fix the debt issue by spending more money? A North Devon Journal leader criticises the plans drawn up by management consultants Durrow Consultancy as fanciful: "Lets spend a few more million and put the hospital in the town centre. Let's bring in the well people and have a plaza: it sounds a bit like a hotel and shopping mall - with blood pressure monitors and a bit of day surgery going on for good measure. There is nothing wrong with having a vision for the future; nothing wrong with some blue-sky thinking. But it's hard to see how spending the sort of money that would inevitably be involved in this type of development will help a service that is struggling because of a lack of resources."  Summary by Keep our NHS Public of  North Devon Journal 12 June 2006
    3     Hospital workers warned of big changes and job losses. North Devon NHS Primary Care Trust has told staff at North Devon District Hospital to be prepared for changes and job losses as the hospital is transformed into a 'clinical plaza'. The trust, which has debts of £18m, brought in Durrow Consultants at a cost of half a million pounds to come up with plans that include the new development. Jac Kelly, chief executive of the trust, said: "It was a requirement placed on us to get this work commissioned. We had no option." Summary by Keep our NHS Public of North Devon Journal 16 June 2006
          Another "kick in the teeth" for hospital. Plans to centralise sterile services at North Devon Hospital have been described by one of its technicians as "another kick in the teeth." The service cleans and sterilises equipment collected from around the hospital, however in hospital services are to be closed, and a new centre built to serve the area. The technician, who did not wish to be named, claimed that those who require specific equipment could wait for up to an hour for it to be delivered. He also pointed out that although the process had been in place for a couple of years, surgeons were only told in October. Northern Devon NHS Trust confirmed plans for the new "super-centre" which it hopes will both achieve economy of scale and be equipped with state of the art equipment. The trust said they were in the process of tendering for the contract though have not yet found a "preferred bidder." Summary by Keep our NHS Public of North Devon Journal 23 June 2006
          NHS staff persistently abused a blind and deaf man with a low IQ by tying him up for 16 hours a day, government inspectors revealed today in a damning report on services for people with learning disabilities. Carers employed by the Cornwall Partnership NHS trust bound his arms together with cloth bandages and fastened them to his bed or wheelchair, to stop him slapping himself in the face. The prolonged use of restraint was illegal, the Healthcare Commission and Commission for Social Care Inspection said. John Carvel, social affairs editor Wednesday July 5, 2006 The Guardian
          Horror stories.  Investigations at institutions in Cornwall for people with learning disabilities have revealed appalling levels of abuse. Alison Benjamin investigates how this was allowed to happen and what is being done to stop it. Full text: Healthcare Commission report (pdf). Wednesday July 5, 2006 The Guardian
          It is disturbing that widespread abuse of people with learning disabilities was allowed to continue for so long in Cornwall. But, it was not just care staff and managers who failed these vulnerable adults. The Strategic Health Authority in Cornwall did not hold the primary care trusts accountable, and the NHS collectively failed to act on the abuse that was taking place.  Letters Friday July 7, 2006 The Guardian
          Choose and Book storm. Choose and Book is being cynically manipulated to ensure 18-week waiting time targets are not breached, according to a GP. Dr Charlie Daniels, a GP in Torquay, said popular hospitals in the region were being removed from the system to ensure they were not overloaded with patients, particularly ENT and cardiology. Summary by Keep our NHS Public of Pulse 30 June 2006
    3     Sixty jobs to go at debt hospital. Sixty staff, about half of whom will be nurses, are to lose their jobs as Northern Devon Healthcare Trust says it has no other option but to cut staff at North Devon Hospital in tackling a £7.9m debt. A spokesmen for the trust said: "We are under a great deal of pressure to review our working practices and so changes to the workforce are necessary." Summary by Keep our NHS Public of BBC Online 7 July 2006
          Most NHS trusts in England have admitted they are failing to achieve basic standards of safety and quality of care that all patients are entitled to expect, the Guardian can reveal. Their deficiencies will be exposed today by the Healthcare Commission in the first assessment of whether hospitals, ambulance services, mental health organisations and primary care trusts are achieving the official minimum standards of care. Self-assessments by the 570 trusts are showing widespread non-compliance with government guidance to ensure that treatment is safe, effective and well managed. The most common breaches included:
· Failure to decontaminate reusable medical equipment;
· Lack of systematic control of patient records;
· Inability to conform with national guidelines on diagnosis and treatment;
· Uncertainty about whether staff have taken part in mandatory training.
Only a third of trusts claimed to be meeting all the commission's 44 core standards of basic competence. A quarter admitted lapsing on at least four standards and 10 trusts were below par on at least 14 - the yardstick used by the commission for declaring a trust to have failed overall. One of the most flagrant breaches of standards was Northern Devon Healthcare in Barnstaple. Last year the trust was awarded the top grade of three stars in the government's annual performance review. This year, under the self-assessment procedure, it found itself to be falling short on 22 of the 44 minimum standards.  John Carvel, social affairs editor Monday July 10, 2006 The Guardian 
The hospital that placed itself on the critical list
        5 Hospital closure plan considered. St Michael's Hospital in Hayle could be closed under plans being considered by the Royal Cornwall Hospitals Trust. The proposals also include ending emergency work at West Cornwall Hospital in Penzance and creating a "nurse-led" minor injuries unit. The Trust, which is facing a £31m deficit this year, has already decided to cut 300 jobs and trim costs. Now a memo leaked to the BBC talks about closing the 70 beds St Michael's "in the shortest possible time". The document, from the Trust director of planning Mike Coupe, asks what effect any possible reduction of services at West Cornwall Hospital would have on the decision. Separate documents released last month under the Freedom of Information Act revealed the future of the West Cornwall Hospital in Penzance and St Michael's Hospital was under discussion. Summary by Keep our NHS Public of BBC Online 13 July 2006
        5 MP moves to oppose hospital cuts. Andrew George (Lib Dem, St Ives) is opposed to plans being considered by the Royal Cornwall Hospitals Trust to shut St Michael's Hospital in Hayle. The Trust is cutting costs and 300 jobs to reduce a potential £31m deficit. A memo leaked to the BBC revealed plans to close St Michael's 70 beds. In a statement, the Royal Cornwall Hospitals Trust said its smaller sites were contributing a "significantly larger proportion" of the overall deficit. Summary by Keep our NHS Public of BBC Online 18 July 2006
        5 Mental health unit faces closure. Patients and their families in Devon have said they are upset over proposals to close a unit for people with severe and long-term mental illness. They said the rehabilitation service at Watcombe Hall in Torquay offered a calm haven that aided recovery. The Devon Partnership Trust will decide next week whether to close the unit to cut costs. Summary by Keep our NHS Public of BBC Online 19 July 2006
    3     Brutal self-assessment and 60 job losses at hospital. 60 job losses - including 30 nursing posts - have been announced at Northern Devon Healthcare NHS Trust (NDHT) - which runs the the Barnstaple hospital. The trust also gave itself the worst self-assessment out of all 570 NHS trusts in England. Summary by Keep our NHS Public of North Devon Journal 19 July 2006
        5 Anger over 'legality' of NHS cuts. A Cornish district council boss is questioning the legality of an NHS trust's plans to cut health services. Penwith Council chief executive Jim McKenna has written to the Royal Cornwall Hospitals Trust over proposals for hospitals in Hayle and Penzance. He has questioned plans to close St Michael's Hospital and cuts at the West Cornwall Hospital given that the county council has not been consulted. McKenna said he had heard about the plans for West Cornwall Hospital via the media. He said: "A couple of years ago the government introduced a requirement on the NHS to consult with local authorities on major service changes. I would say, and we are investigating the legal position as we speak, that they are not legally empowered to make such cuts until such time as they have consulted on them." Summary by Keep our NHS Public of BBC Online 21 July 2006
        5 Campaigners join health cuts demo. Campaigners against health cuts in Cornwall travelled to Cheltenham on Saturday to join a protest about health service cuts in the region. Stuart Roden, Unison representative in Cornwall, said: "We want to stop the privatisation of the NHS, stop the redundancies and stop the cuts." On Friday 400 administration staff at the Royal Cornwall Hospitals Trust were told their jobs were at risk. Summary by Keep our NHS Public of BBC Online 24 July 2006
        5 Hospital plan to cut £31m deficit. Cornwall's three main hospitals may be significantly re-structured so the local NHS can tackle a £31m projected debt. One option proposes withdrawing services from West Cornwall Hospital or St Michael's and consolidating all their services on the other site. The second suggests cutting facilities and wards at the Royal Cornwall Hospital in Truro and using it as an emergency treatment base. Managers said they would carry out a consultation into the options. Emergency surgery is already to be stopped in Penzance from the end of August. Summary by Keep our NHS Public of BBC Online 11 August 2006
          Choice of hospital exposed as a sham. Patients are being denied treatment at their chosen hospital to ensure Government waiting targets are not breached. A Pulse inquiry has uncovered numerous examples of PCTs deleting popular hospitals from the menu of choices available to GPs using Choose and Book to ensure no patient waits longer than 13 weeks. The move has left GPs increasingly unable to book slots at patients' preferred hospital, forcing people to travel long distances to less popular clinics even when they would prefer to wait longer. The clinician in charge of Choose and Book has even revealed PCT chief executives could be at risk of the sack if they allowed patients to book slots past 13 weeks. Dr Mark Davies, clinical lead for Choose and Book at Connecting for Health, said the system allowed slots to be booked up to 180 days ahead - but commissioners had the power to take hospitals off menus if they could not offer a booking inside the 13-week target. He said: "It would be unusual for any chief executive that wants to remain in post to release slots that can be booked past 13 weeks." Areas and specialities where choice is being restricted include orthopaedics in Bristol and Exeter; ENT and cardiology in Cornwall; foot and ankle surgery in Leeds; ENT and orthopaedics in Liverpool and Swanage; and various specialities in Milton Keynes. Summary by Keep our NHS Public of Pulse 11 August 2006. [This seems to force patients to accept an offer involving long travelling even if they would prefer to wait slightly longer for the local hospital]
          One in five ambulance trusts systematically misreported response times, making it look as if they reached serious life-threatening emergencies within government targets, the Department of Health disclosed yesterday. An audit of 31 ambulance services in England found six did not follow official guidance about how response times should be recorded. Some did not start the clock as soon as a 999 call was received. Others did not synchronise the clocks on the emergency switchboard with those used by paramedics. In some cases, ambulance trusts recategorised the urgency of the call after the job was done to make it fit the response time achieved rather than the priority given when the original call was made. This would have allowed staff to downgrade an emergency if the ambulance arrived late. The department said the six trusts were West Yorkshire, South Yorkshire, Cumbria, West Midlands, Staffordshire and the West Country ambulance service. John Carvel, social affairs editor Tuesday August 15, 2006 The Guardian
    3     At least 10 major hospitals are facing closure or cut-backs, with some facing the end of emergency care, the BBC said. The sites in London, Surrey, Sussex, Lancashire and Cornwall will either close or have their facilities downgraded to handle basic care in order to get back into financial health, after an unprecedented level of NHS debt was revealed earlier in the summer. Nearly a third of NHS trusts ended the year with a combined gross deficit of pounds £1.27bn. Hélène Mulholland and agencies Friday August 18, 2006 Guardian Unlimited
        5 Future of 10 hospitals 'in doubt'. At least 10 major hospitals in England face potential closure or a downgraded role, according to a BBC investigation. Talks are under way about removing emergency care from hospitals in London, Surrey, Sussex, Greater Manchester, Lancashire and Cornwall. The sites will either close or be left to handle basic care, with "super" regional centres seeing the most ill. There are concerns people will have to travel miles for life-saving treatment. Over 30 hospitals could be affected by the reviews - including those losing services and others left to bear the brunt of that work. NHS bosses involved in the reviews have said the measures are part of a push to provide more care in the community, either with hospital doctors setting up local clinics, GPs providing extra specialist services or medics treating patients in their own homes. However, they also acknowledge deficits and new European working time restrictions are forcing them to reconsider how services are provided. Dr Jonathan Fielden, deputy chairman of the BMA consultants' committee, said: "In some of these cases we have to ask whether this is being driven by financial reasons. If this is the case, it is likely not to be in the best interests of patients." The areas under review are: London - Talks under way over Harrow's Northwick Park and the nearby Central Middlesex hospitals. Project board set up to review services across the four north central trusts - Barnet and Chase Farm, Royal Free, Whittington and North Middlesex Surrey and Sussex - Widespread discussions have been followed by the creation of focus groups to discuss future of the 15 hospitals run by nine NHS trusts. Formal consultation to start in the autumn. Greater Manchester - Committee set up to decide the future of four hospitals run by the Pennine Acute Hospitals NHS Trust. Decision due end of September. Lancashire - Changes to the University Hospitals of Morecambe Bay Trust's three centres - spread across Cumbria and Lancashire, planned, with the Westmorland threatened with losing its acute facilities. Cornwall - Two proposals have been discussed by Royal Cornwall Hospitals NHS Trust, one of which involves withdrawing services from two of its three hospitals. Summary by Keep our NHS Public of BBC Online 18 August 2006
    3     Staff want health boss to resign. Health workers at the biggest hospital in the South West have called for the resignation of the chief executive. A spokesman for the GMB union said members wanted Paul Roberts to step down over plans to cut up to 400 jobs at Derriford Hospital in Plymouth. Plymouth Hospitals NHS Trust is trying to make savings of about £25m to balance its books. Staff have also been told that some hospital wards will be closed. Summary by Keep our NHS Public of BBC Online 18 August 2006
  2 3     Plans to use private sector money to build and maintain six NHS hospitals worth nearly £1.5bn were approved by health ministers yesterday, prompting anger among public sector unions that foreshadows a revolt at Labour's annual conference in Manchester next month. The six schemes, including facilities in health secretary Patricia Hewitt's constituency in Leicester, were scaled down to take account of the government's proposals for moving some services from hospitals into the community. This cut the cost by more than £400m. Unison, the biggest public sector union, said the decision to build the hospitals under the private finance initiative (PFI) would prove "a costly error", locking NHS trusts into inflexible repayment obligations that would burden their balance sheets for 30 years or more. The union is expected to be heavily critical of NHS privatisation at the Labour conference. The six developments took the hospital building programme since Labour came to power in 1997 to more than £10bn, almost all using using the PFI. But the clarity of the government's message about NHS expansion was muddied by the results of a BBC investigation of hospital cuts planned in other parts of the country. It said these may involve the closure or downgrading of at least 10 big hospitals, but the Department of Health said nothing was finalised and preparations for "reconfiguration of services" were at an early stage. The six schemes will be at:
· University Hospitals Leicester - a £711m development including a brand new women's hospital and a stand alone children's hospital at the Leicester Royal infirmary. The original proposals would have cost £906m.
· University Hospital North Staffordshire - £272m to build a community hospital and cancer centre.
· South Devon Healthcare - £163m to redevelop Torbay hospital, including a diagnostic centre offering MRI scans, more single rooms and day-case operating theatres.
· Walsall Hospitals NHS Trust - £140m for the complete redevelopment of the Manor hospital site.
· Salford Royal Hospitals - £112m for a new hospital with more single rooms, an enhanced A&E department and three new operating theatres.
· Tameside and Glossop Acute Services - £68m for three day-case operating theatres, new surgical wards and a 30- place day hospital for elderly mental health patients.
John Carvel, social affairs editor Saturday August 19, 2006 The Guardian
    3     MPs scrutinise mental health cuts. The Commons health select committee has promised to investigate claims that more than £30m has been plundered from mental health budgets to bail out deficits in other sectors. The committee has taken evidence from mental health charity Rethink which has been running a campaign highlighting areas where mental health budgets are being slashed. Cuts are being reported across England from Suffolk, Cambridgeshire, Cornwall, Nottingham, London and Sussex. Gloucestershire Partnerships trust has recently concluded a consultation on proposals to make over £9.3m savings. Cheltenham town council has written to Patricia Hewitt complaining about the package, which means reductions in older people's services on 12 sites and at six sites for adult services. Hertfordshire Partnership trust, which has run at a surplus for four years, has been asked to contribute over £5m to help pay off debts in local acute trusts. The trust is planning to achieve this by closing an acute ward, a day unit, the early intervention team and making staff reductions across community mental health teams, as well as in psychology, older people's services and learning disabilities. In May, Hertfordshire county council's health overview and scrutiny committee rejected the proposals and referred them to the secretary of state for a decision. Three months on, staff are voting with their feet, leaving at-risk posts. As a result, the trust has already been forced to temporarily close a 22-bed acute admissions unit at St Albans City Hospital. Summary by Keep our NHS Public of Health Service Journal 31 August 2006
        5 'You can't sell off Tyrrell hospital' says ex-mayor. Fears for the future of the Tyrrell Hospital in Ilfracombe have prompted Mayor Janice Donovan to call an extraordinary meeting of the town council. Standing orders will be suspended at the meeting in order to give the public a chance to voice their opinions. The meeting is held ahead of a meeting of the North Devon Primary Care Trust when the future of the cottage hospital will be decided. Local councillors fear that with the creation of the Devon PCT in place of the North Devon PCT, management of the hospital would be handed over to the "cash-strapped" North Devon Healthcare Trust, which currently runs North Devon District Hospital in Barnstaple. There are further concerns that following bed closures at the end of 2004, this could be the beginning of the end of the Ilfracombe service. Summary by Keep our NHS Public of North Devon Journal 8 September 2006
          PCT withdraws from APMS pilot. One of the six PCTs involved in the Government's pilot for Alternative Provider Medical Services contracts has withdrawn from the scheme. Plymouth Teaching PCT had tendered for a service for 2,000 patients living in nursing and residential care homes. It has now withdrawn the tender because it can no longer afford to set up the scheme. Only two of the six PCTs involved in the pilot, designed to improve services in under- doctored areas, have actually struck deals with alternative providers since the schedule was announced in July 2005. Summary by Keep our NHS Public of Pulse 8 September 2006
    3     Thousands join hospital cuts demo. Thousands of staff at south-west England's biggest hospital have taken part in a march and rally against planned cutbacks. About 3,000 protesters marched from Plymouth Hoe to the city centre objecting to job losses and ward closures at Derriford Hospital. Plymouth Hospitals Trust is proposing to close 50 beds and 400 posts to bridge a projected £25m cash gap. The trust rejects claims that patient care will be compromised. Summary by Keep our NHS Public of BBC Online 10 September 2006
        5 Hospital should be scrapped for a new health centre, report suggests. A long-awaited report on the future of NHS services in North Devon has recommended the Barnstaple hospital be scrapped and that a smaller "state-of-the-art" health centre be built elsewhere. The report was produced by private consultancy firm Durrow at a cost of about £50,000. It suggests the loss of senior medical staff is the most frequent cause of "loss of viability" for Northern Devon Healthcare Trust, which runs the hospital. The report was commissioned by North Devon Primary Care Trust to help NDHT reduce a £20 million debt. The South West Peninsula Strategic Health Authority loaned NDHT £18.6 million on the understanding the trust found a way of balancing the books. Employing external consultants was one condition of that loan. Health bosses will now enter a period of consultation about the proposals. The report makes a distinction between elective and emergency services, suggesting the former are "relatively secure" and that existing services could be sustained or enhanced. But it states emergency services should move away from having doctors-in-training on the front-line to a consultant-led service. In addition to integrating GP practices with hospital services, the report also advises that the trust should adopt the "emergency physician" role, a new type of consultant job, to attract medics to North Devon. The report suggests that ties with other trusts should be strengthened and made clearer. Summary by Keep our NHS Public of North Devon Journal 22 September 2006
        5 Cornish NHS cash crisis discussed. Plans to deal with the £31m cash crisis facing the NHS in Cornwall are being discussed by county councillors. The county's four primary care trusts have drawn up a plan for redesigning healthcare services. But serious concerns about proposed cuts have been expressed by the county council's health committee. Penwith District Council has also said it will consider legal action against the NHS for not consulting over the possible withdrawal of services. Summary by Keep our NHS Public of BBC Online 27 September 2006
          Health changes "wasted millions". The creation of new, mostly county wide primary care trusts in the south-west have been slammed by family doctors as wasting millions on red tape merely to bring the structure back to what it was pre 2001. Dr Andy Stewart of the Cornwall Local Medical Committee said: "I would have liked that money spent on healthcare personally…You might as well have put it on a bonfire and set fire to it, to be honest." Summary by Keep our NHS Public of BBC Online 3 October 2006
          Private OOH firm draws complaints. A privately run out-of-hours service in Cornwall has received about 80 complaints from patients since it took over from a GP co-op in April. The service, run by Serco, had been provided by KernowDoc since the 1990s but the co-op lost out in a competitive tender. GPs have expressed concern about the length of time it now takes for patients to receive home visits or to be called back. Dr Mark McCartney, a GP in Pensilva, Cornwall, said: 'The level of complaints seems to be at least three times what one might expect for a similar-sized organisation, and this does worry me.' Summary by Keep our NHS Public of Pulse 6 October 2006
          Hospital jobs 'may go to India or United States'. Hospital staff say hundreds of local jobs could be threatened by the outsourcing of secretarial work to foreign workers in India or the United States. Fears that the Oxford Radcliffe Hospitals NHS Trust might transfer a hefty slice of clerical and administration work overseas has raised the spectre of a second wave of NHS redundancies in Oxfordshire. In the West Country hospital workers are threatening industrial action to stop redundancies because of the Royal Cornwall Hospitals Trust's plans to send typing work abroad. Unison this week called for a campaign to resist any outsourcing moves, saying up to 500 jobs at the John Radcliffe, Churchill, Radcliffe Infirmary and Horton in Banbury could be affected, with medical secretaries, personal assistants and audio typists seen as vulnerable. In a message to its members Unison's Oxfordshire health branch warns: "The trust is right to be concerned how its staff could react. Members are already coming forward to say if outsourcing takes place they want to take action just like their counterparts at the Royal Cornwall Hospital." With rumours circulating that an outsourcing deal with the US-owned company Dictate IT was being lined up, Unison officials called on the trust to "come clean". The ORH trust is well into the process of shedding 600 jobs across its hospitals, along with 160 beds. Summary by Keep our NHS Public of BBC Oxford Times 6 October 2006
        5 Mass demonstrations against NHS cuts. Thousands of people have been marching today against the ongoing NHS cuts that are part of 'cost saving' privatisation measures designed to create a for-profit health service. Police said that 7,000 turned out in Haywards Heath, West Sussex, where local press and even Tory MPs have been publicly speaking out in support of the march against cuts at the local hospital. In Brighton - where 500 NHS jobs are being lost - over 250 people marched chanting "public health not private wealth", despite no prior media coverage and the massive march 12 miles away in Haywards Heath. A similar-sized demonstration to the Brighton one was also held today in Oxford. Today's demonstrations follow a sizeable march in Worthing recently involving up to 10,000 people. In September 3,000 people including NHS workers marched in Plymouth and last week 1,000 marched against cuts in Huntingdon, Cambridgeshire. NHS cuts and creeping privatisation are being pursued under the banner of 'patient choice', yet the proposals mostly involve hospital closures, regional centralisation and job cuts in an attempt to turn healthcare into another source of profit. Organisers of the 'Keep our NHS public' campaign have vowed to make the cuts into "Labour's Poll Tax".  Summary by Keep our NHS Public of Libcom.org 14 October 2006
        5 How Middle England turned into a nation of reconfiguration rebels. A wave of protests has swept across the country over the past few months, bringing thousands on to the streets. It has been sparked by increasing public anger over cuts, closures and service changes in the NHS that has erupted on a huge scale. Geoff Martin, head of campaigns at the pressure group Health Emergency, says there has been 'nothing like it since the poll tax'. The level of public anger seems to have taken the Department of Health by surprise. Public anger over NHS 'cuts' has seen 10,000 marching in Worthing, 7,000 in Haywards Heath and another 5,000 in Hastings, Sussex. Banbury in Oxfordshire has seen a protest by 5,000 people, with a similar number on the streets of Surrey commuter town Epsom. The wave of anger is something quite new in these places: none is known as a hotbed of militancy. In Huntingdon, police put a limit of 300 on the number of demonstrators, but 1,000 turned out anyway. The protest has taken in a 3,000-strong gathering in Nottingham, a march of 4,000 in Ludlow and - most remarkable of all - a demonstration of 27,000 people in sparsely populated Cornwall. It is not the easiest time to be an NHS manager. Elsewhere, the protesters have taken their grievances to the ballot box, with hospital campaigners elected to local councils in Kirklees and the London borough of Enfield. In the wake of Dr Taylor's 2001 election win in Kidderminster, the government introduced measures aimed at making reconfigurations more acceptable to the public - and less dangerous politically. The independent reconfiguration panel was set up to advise on contested changes, and new guidance, Keeping the NHS Local: a new direction of travel, specified that options for change must be developed 'with people, not for them' right from the outset, 'before minds are made up'. But somewhere along the line, the smooth new mechanisms seem to have broken down, and the public unrest shows no sign of abating. Lee Billingham, chair of Worthing Keep Our NHS Public, says: 'Kidderminster at that time was a fairly isolated example. The difference now is it's a national attack, with up to 60 accident and emergencies going.' The situation is different for other reasons, too. This time the banners have been raised against a background of widespread public concern at the effects of NHS deficits. Billingham agrees that public anger over the NHS is increasingly generalised, linking reconfiguration, financial deficits and 'broader issues: the market and privatisation'. He describes Worthing as 'Middle England'. But 10,000 people marched through the town in August to protest at moves to downgrade its hospital, while 6,000 people linked hands in a human chain around the buildings last month. 'As far as I know there's never been a demonstration of that size in Worthing, ever. Nothing on that scale.' And in Worthing at least, managers have not succeeded in persuading the public of their arguments. A rally at the end of the August protest was 'the angriest public meeting I've ever seen', he says. 'The chief executive of the SHA and her assistant came to address it. They were barracked and heckled - they were visibly shaken. I don't think they were expecting how angry people would be. They said it was OK, it was modernisation, there would be services in the community - and people were laughing. They were in fits of laughter.' The Kidderminster effect still haunts Labour, leading government members to join their opposition counterparts on the NHS protests. Chief whip Jacqui Smith, a former health minister, recently helped deliver a 16,000-strong petition in favour of retaining maternity services in Redditch. In north London's Enfield public anger over moves to remove A& E and other services from Chase Farm Hospital has made the political situation more complicated than ever. Enfield councillor Kate Wilkinson is one of two Save Chase Farm candidates elected in May, when nine health campaigners picked up 12,500 votes between them. She says there have been attempts to close the hospital's A& E under both Labour and Conservative governments, but the entire council has unanimously rejected all four options for reconfiguration now under discussion in a pre-consultation engagement phase. 'None retains a fully functioning A& E or women's and children's services staying at our hospital,' Wilkinson explains. 'It really is incredible. Everyone's up in arms. We are planning another large protest in December - the anniversary of the one last year [with 5,000 people].'  Summary by Keep our NHS Public of Health Service Journal 23 November 2006
        5 NHS 'cuts' inspire new breed of protester. Middle England is coming out to protest against NHS cuts in places such as Haywards Heath, Banbury and Ludlow. The safe Surrey town of Epsom has had a dose of protest fever and even in sparsely populated Cornwall, 27,000 people took to the streets. In genteel Worthing, 10,000 demonstrated over plans to reconfigure local hospital services and one campaigner says a public meeting in the town was the angriest he had ever seen. NHS managers are having a difficult time persuading protesters that changes are about reconfiguration rather than money. As a Department of Health source says: "There does seem to be a reluctance to get to grip with these things."  Summary by Keep our NHS Public of Times 28 November 2006
          Business primed to expand GP role. BBC News has learnt that the government will soon extend proposals to get businesses to run GP surgeries in areas which have struggled to recruit doctors. An initial scheme has had only limited success - but ministers are planning a wave of advertisements next year in an effort to attract big companies and smaller organisations to fill gaps in 30 parts of England which are short of family doctors. The government says the scheme will help tackle health inequalities and strike a good deal for the NHS - but some campaigners disagree. Campaigners in the quiet Liverpool suburb of Maghull are fighting a low-budget but determined battle against plans for a new GP surgery in the area, which would be run by a company. Some local people are suspicious about the move - including Peter Crowder, a retired psychiatric nurse and chairman of the campaign group. "We want the opportunity to have a fair say. From our point of view, that means stopping the negotiations that are going on with a particular private company and going back to the public. Give us our voice and let us have our say." GPs have in effect always been independent operators - but Peter Crowder says that's very different to companies who may be answerable to shareholders. He said: "We accept our GPs as part and parcel of our local area so they're more than just a faceless entity. They have an investment in this area and they re-invest in this area." Leigh Griffin, who runs Sefton Primary Care Trust, said: "What's happened is that from an open tendering process, the Department of Health has identified a preferred provider and almost married us up with them, and we are talking to them." He would not confirm if that provider is Care UK. When challenged that not being able to confirm who the PCT was dealing with at this stage was bound to fuel a feeling of discontent among the local campaigners, Griffin said: "I've got a lot of sympathy with those concerns." The Merseyside scheme is part of a wider programme launched by the government last year, to boost coverage in areas short of doctors. It's led to two new surgeries in north and east London signing up fifteen hundred patients. But the programme has run into problems in other areas. In Plymouth and in Accrington, NHS managers decided none of the bids to run a new service was affordable. And in Bradford, an NHS board decided recently it was ending its participation in the scheme - again because the bidders' proposals cost too much. But the government says it is determined that the gaps in these and other areas will be filled, and so new advertisements will be placed for 30 areas next year. A Department of Health spokesman said: "The schemes will be advertised in tranches with advertisements placed in the local and national media. Taking forward the programme in a series of local procurements should help ensure a level playing field for big companies, smaller organisations and social enterprises. PCTs in under-doctored areas deciding not to take part in the national programme will be expected to take forward their own local procurements." And with ministers demanding that other GP surgeries, not just those in under-served areas, open up to different providers, we can expect to see more of these schemes in the future. Summary by Keep our NHS Public of BBC Online 20 December 2006
          Student nurse places cut by 100. A Devon university is cutting 100 places on its nursing training courses because it says NHS demand for such trained staff has dropped. The University of Plymouth said changes in the local provision of healthcare had prompted the cut. Hospitals in Devon and Cornwall are freezing nursing posts and closing wards as part of measures to tackle large projected deficits. The Royal Cornwall Hospital in Truro has closed two wards and plans to close two more. Derriford Hospital in Plymouth has also been closing wards and freezing nursing posts. The university said it was expected that its campus in Exeter would close from September 2008 as a result of the cut in course places. Summary by Keep our NHS Public of BBC Online 20 December 2006
    3     Patients kept waiting in car park as hospital 'too busy to cope'. Patients were left waiting for up to an hour in ambulances in a car park, being looked after by paramedics, because a hospital was so busy over New Year. Campaigners said the Royal Cornwall Hospital in Truro was swamped with admissions on New Year's Eve and the early hours of New Year's Day. They pointed out that two wards were closed last year and hundreds of staffing posts axed under cost cuts. Geoff Martin, head of campaigns at pressure group Health Emergency, said: "We have warned that hospital capacity is being cut to dangerous levels in many parts of the country and that is clearly the case in Cornwall as the hospital comes under government pressure to balance the books. Having ambulances stacked up outside A& E departments waiting for a bed to become available takes vital blue-light capacity off the streets and puts lives at risk. This is the consequence of Government cuts and closures at the sharp end of the service and is a bleak New Year reminder of what's at stake in 2007 for the NHS." Summary by Keep our NHS Public of Mail 3 January 2007
    3     Operations cancelled as NHS runs out of money. Patients are being denied basic operations, including treatments for varicose veins, wisdom teeth and bad backs, as hospitals try frantically to balance the books by the end of the financial year. NHS trusts throughout the country are making sweeping cuts to services and delaying appointments in an attempt to address their debts before the end of March. Family doctors have been told to send fewer patients to ho