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  • Three leading NHS hospitals risk being downgraded for failing to give information on the death rates of their heart surgery patients, the Guardian has learned. The trusts are the only ones in the UK not to have provided key data for the Healthcare Commission, which has been gathering information on mortality rates linked to individual surgeons. The information will be published today on a groundbreaking website designed to enable heart patients and their families the chance to make informed choices about where to have surgery. Last night one of Britain's top heart surgeons warned that the commission might penalise the three trusts - St Mary's in Paddington, west London, Glenfields in Leicester, and Morriston in Swansea - by downgrading them in their annual performance ratings. "I think it is utterly unacceptable in a modern health service that units no longer have the discipline or facility to collect good outcome data," said Sir Bruce Keogh, president of the Society of Cardiothoracic Surgeons. After a Guardian investigation last year, the commission asked all hospitals performing heart surgery to provide data on operations such as bypass grafts and aortic valve replacements. The aim was to help patients assess a surgeon's track record before having an operation. In a historic move the commission will publish data on death rates at almost all the 33 hospitals performing this complex work in England and Wales. It will disclose risk-adjusted mortality rates for individual surgeons at 17 cardiac units, and the aggregated results for 13 units. John Carvel and Sarah Boseley Wednesday April 26, 2006 The Guardian
  • Wales aims to avoid job cuts. Wales is expected to escape almost entirely the job losses plaguing England, the director of the Welsh NHS has claimed. Ann Lloyd said: "We have been discussing what has been happening over the border". She said she would take a dim view of any body that laid off staff to cut costs. Summary by Keep our NHS Public of  Health Service Journal 11 May 2006
  • Doctors toughen position against reforms. Doctors at the BMA Annual Representative Meeting have taken a stance of almost complete opposition to market reforms of the NHS. The decision went against the BMA leadership, which had argued for maintaining a dialogue with ministers, calling instead for no further involvement of the private sector, a potential end to the split between providers and purchasers, and a halt to the private finance initiative. The move means the BMA now officially "actively opposes the government's plans". The statement was referred to the association's council for action, rather than as a formal passage, and as such leaves the leadership room for manoeuvre. However the BMA's leaders will oppose core parts of government policy when they meet Patricia Hewitt next week at a time when the government is hoping to get health professionals to acquiesce to the reforms. The statement calls for the council to campaign for "an integrated, publicly provided, health service in England", and refers to Scotland and Wales where there is no division between purchasers and providers. The doctors also stated that the fundamental values of the NHS "cannot be maintained if the NHS is broken up and tendered to private corporations", and that "there should be no further involvement of the commercial private sector in providing NHS care". Andy Burnham, health minister said the BMA "are entitled to their views" but the department would maintain "constructive dialogue" with clinicians. Summary by Keep our NHS Public of Financial Times 29 June 2006
  • Hospital reform plans may stall. Plans to reorganise hospital services across mid and west Wales may be stalled because of fierce opposition from the public. Proposals to centralise NHS services in Pembrokeshire, Ceredigion and Carmarthenshire have brought protests from patients and staff. A four-month public consultation has now taken place and the review board is to publish its recommendations. But plans for a new Swansea hospital are still expected to go through. The idea of centralising services to one main "super hospital" halfway between Withybush in Haverfordwest and the West Wales General in Carmarthen triggered marches in Haverfordwest and Aberystwyth, uniting staff and patients. Community health councils (CHCs) in Carmarthenshire and Pembrokeshire criticised the proposals, saying they lacked "meaningful and significant detail". They said many patients would travel greater distances and predicted strong and vocal opposition from the public ahead of the public consultation. An action group, Save Withybush Action Team, promised to continue the fight against downgrading. In the face of such strong opposition, it is thought the review board cannot do anything but pass on the Dyfed question for now, which could delay any decision by months, if not years. Summary by Keep our NHS Public of BBC Online 10 September 2006
  • Wales exceeds forecast debt. The Welsh health service went over its forecast debt of £20m last year, ending £24m in the red. Summary by Keep our NHS Public of Health Service Journal 5 October 2006
  • Staff lobby over hospital closure. Staff at Fairwood hospital are to lobby health watchdogs over the possible closure of their site, and one ward at Hill House, if a £12m recovery plan at Swansea NHS Trust goes ahead. The original plan to shut Fairwood, a convalescence hospital, failed last year when 7,000 signatures were presented in opposition to the closure. A spokesman for Unison said Swansea Community Health Council (CHC) was opposed to the closure and that protesters would be urging them to maintain the same view. The local health board has proposed alternative services at the city's Singleton Hospital and improved services in the community. However Unison regional organiser Jeff Baker said: "we are not at all convinced that the alternative they have put forward will be able to provide the same quality of care that is presently carried out in Hill House and Fairwood Hospitals." The union has proposed running the services in parallel to assess any impact. Swansea Council has also opposed the plans as it is concerned about additional pressure being placed on its social services department. Summary by Keep our NHS Public of BBC Online 9 October 2006
  • Private firms take cut of Welsh ops. Up to £8m worth of elective surgery is being outsourced to the private sector in Wales, in a move that will provoke comparisons with England's independent sector treatment centre (ISTC) programme. The Rhondda Cynon Taff Local Health Board (LHB), acting on behalf of all LHBs and NHS trusts in Wales, has signed contracts for surgical services with five providers with another contract being finalised. Under the 18-month contracts, the providers will carry out up to 4,000 surgical procedures, most of which will be orthopaedic. Until now the Welsh Assembly has rejected the DoH's policy of increasing private sector involvement in NHS provision, under which billions of pounds worth of services are being outsourced to ISTCs. An Assembly spokesman denied its stance had changed. She said the contracts were part of the 'second offer' scheme, in place since 2004. This offers patients an alternative place for treatment if it cannot be provided locally within a certain time. The spokesman said: 'These contracts are not like the ISTC programme in England. They are just short-term measures as we reduce waiting times.' The advertisement inviting companies to tender said they should submit bids for 'call-off' contracts with no volume or revenue guarantees. But it suggested companies also provide 'variant bids' on a guaranteed volume basis. The Welsh contracts do not include 'additionality' clauses like those in the DoH's ISTC contracts, which prevented providers from employing staff who had worked in the NHS in the previous six months. The five providers are: Nuffield Hospitals; BUPA Hospitals; The Hospital Management Trust at Sancta Maria Hospital, Swansea; Interhealth Care Services at Kidderminster treatment centre; St Joseph's Hospital, Newport (independent). Summary by Keep our NHS Public of Hospital Doctor 13 October 2006
  • Bed push protest by doctors. A group of Mid Wales doctors, led by Dr James Wrench, were completing a 52-mile bed push from Bronllys Hospital in Brecon to Cardiff today to demonstrate against planned cuts in the NHS. The group is aiming to join a rally to launch the Welsh branch of Community Hospitals Acting Nationally Together. Powys Local Health Board has proposed cuts at Llanidloes, Knighton, Bronllys and Builth Wells Hospitals, which campaigners believe will lead to their closure. Summary by Keep our NHS Public of Shropshire Star 23 November 2006
  • Prescriptions free for everyone…But only if you live in Wales. Anger is growing over Britain's two-tier health service after prescription charges were abolished in Wales. Anyone registered with a Welsh GP will get their drugs and medical supplies free from April 1 but patients in England and Scotland will continue to be charged £6.65 for each item. There is already resentment over the decision by the Scottish Parliament to provide free care for the elderly while councils in England are warning services will be slashed and fees raised. It emerged last week that Englishman George King is moving 105 miles from his home near Middlesbrough to Melrose in the Scottish borders to get life-saving treatment for bone marrow cancer. Prescription charges in Wales have been gradually reduced in line with a 2003 Labour promise. Welsh Health Minister Dr Brian Gibbons said: "The vast majority of ordinary working-class people will benefit substantially and, for us in Welsh Labour, that's what we are proud about." Summary by Keep our NHS Public of Express 26 January 2007
  • Alarm at loss of NHS beds. Over a third of hospital beds have been lost in Powys over the last five years, according to Mid Wales Assembly candidate Nerys Evans. A Mid Wales doctor also said that community hospitals in north Powys were full and hospitals overloaded. However Powys local health board said the lost beds were unnecessary. Ms Evans said the figures were "truly shocking". "The percentage of beds lost in Powys is more than three times as much as any other trust in Wales, and I cannot see how the quality of service for the people of Powys can be maintained if we continue to cut the number of beds in our hospitals," she said. A spokesman for the local health board defended the reduction saying: "The purpose of 'Doing More, Doing Better' is to reconfigure services to ensure we provide the right services and treatments to meet the changing needs and demands of the 130,000 people who live in Powys." Dr Andy Raynsford, of the Llanidloes GP practice, said: "The health board should be considering developing existing units, rather than closing them. Community hospital beds across north Powys are full and, although individual hospitals are making their best attempts to discharge patients into the community, their medical conditions mean it can't be done at the drop of a hat." Summary by Keep our NHS Public of Shropshire Star 8 February 2007
  • NHS surgeon from cardiac unit 'riven by bullying' worked in Italy during sick leave.  Trust paid locum to work while specialist was away · Absentee holds key post at hospital in Palermo. An NHS heart surgeon who was on sick leave was working at a private hospital in Sicily as director of cardiac surgery, the Guardian has discovered. Vincenzo Argano, who worked at a troubled cardiac unit in Wales which was riven by allegations of bullying and harassment, took a six months' sabbatical followed by more than eight months' sick leave, said to be due to stress. But for most of the time he was away from the Morriston cardiac unit at Swansea NHS Trust he has been listed as a member of staff at the Villa Maria Eleonora hospital in Palermo. Sarah Boseley, health editor Tuesday March 6, 2007 The Guardian
  • Anger over GPs service. Fed-up patients who have encountered problems with the out-of-hours doctors service used in Powys have been inundating councillors with complaints. Anxious patients have had to wait for a response and sometimes for hours to see a doctor when they call the Shropdoc service, it has been claimed. A report dubbed the UK out-of-hours system "shambolic", sparking a debate in Welshpool when the county council's Montgomeryshire committee had a meeting with John Howard, chief executive of local health watchdog the Montgomeryshire Community Health Council. Montgomeryshire AM Mick Bates said out-of-hours provision for health care in Mid Wales should be "re-thought", after the report was issued. He suggested a system that would place rapid response vehicles alongside ambulance services, to deal with emergency and non-emergency calls between them. Summary by Keep our NHS Public of Shropshire Star 16 March 2007
  • Assembly minister claims PFI wasting millions. A Welsh Assembly member has claimed that PFI deals are wasting millions of pounds. Owen John Thomas, Assembly Member for South Wales Central, has claimed that PFI deals were a 'scandalous' waste of money when patients are having to take out loans to pay for treatment privately. The members comments came after it was revealed that a former soldier had taken out a loan to pay for treatment for prostate cancer because the NHS refused to fund it. Finance Minister Sue Essex yesterday suggested the Assembly Government was flexible on the role of private finance initiatives as she faced questions in the chamber about why there had been fewer PFI projects in Wales than in England under Labour. Ms Essex said PFI had been used to build roads, schools and hospitals, but she was happy to look at 'other mechanisms rather than PFI if it doesn't fit the proposal". Plaid Cymru Assembly Memeber Alun Ffred Jones asked, "What advantage is there in borrowing money in the private sector at higher interest rates than the public sector can borrow the funding, and therefore increase the payment ?" Summary by Keep our NHS Public of PFI.net 20 March 2007
  • Hospital parking 'a stealth tax on illness'. The NHS may be free at the point of delivery, but patients and their families paid hospital parking charges in England totalling £95m in 2005/06. The figures, released under the Freedom of Information Act, show that 12 hospital trusts each raised more than £1m in charges. Government guidelines on car parking charges in December "strongly recommended" that NHS bodies introduce some kind of "season ticket" arrangement, allowing free or reduced-price parking for patients with a long-term illness or those with serious conditions who require daily or regular treatment, and their prime visitors. It also suggested a weekly cap on parking charges. Macmillan Cancer Support, which is campaigning for all cancer patients to get free hospital parking and help with travel charges, says the figures are shocking. Judy Beard, the charity's acting chief executive, says: "When the government announced its revised hospital car parking guidance, Macmillan expected NHS trusts to exempt cancer patients. However, we have yet to see this happen." Research by the charity last year found a postcode lottery of hospital car parking costs, with patients in Scotland spending an average of £636 on travel and parking throughout their cancer treatment compared with patients in Wales who spent £318. In south-west England, the average bill was £477, in the south-east, £424, and those in the north paid £371. Some patients were found to have spent more than £1,000. The charity called the charges "a stealth tax on illness". Alison Benjamin Wednesday March 21, 2007 The Guardian
  • 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
  • Wales drops prescription charges. All patients in Wales are now entitled to free prescriptions, although the cost rose to £6.85 in the rest of Britain. The decision of the Welsh Assembly in Cardiff to scrap prescription charges, which it had already reduced to £3, raised the prospect of a two-tier NHS. Prescription charges rose by 20p in England, Scotland and Northern Ireland. Three million patients registered with a Welsh GP and 15,000 Welsh patients who have an English GP, will qualify. Summary by Keep our NHS Public of Telegraph 2 April 2007
  • Open or shut case as service shake-ups hinge on SNP result. The bruising process of NHS reconfiguration in Scotland could be repeated as NHS reforms are reversed if the SNP comes to power in the Scottish Parliament elections on May 3rd. The SNP, which is ahead in the polls, has promised to reverse the decision to close two accident emergency wards and adopt a "presumption against" further centralisation of services. Although there is little space between the SNP and Labour on the health service - both propose different methods to achieve shorter waiting times - the centralisation issue is what separates them. During the last parliament, all parties in Scotland signed up, in principle, to the National Framework for Service Change, better known as the Kerr Report. There was also support for the Scottish Executive's response, Delivering for Health. However the SNP has broken from this path. The SNP also hold an anti-PFI stance, though it is not yet clear how this will apply in practise. Although the party has been vocal on the issue, its manifesto is more much cautious. Professor Allyson Pollock, head of Edinburgh University's centre for international public health policy and a leading critic of PFI, hopes the election will provide an opportunity re-evaluate the situation. "Servicing PFI debt is already having a financial impact in Lanarkshire and Lothian and there are big plans for PFI projects elsewhere in Scotland." Workforce issues may also show up differences, the Scottish Executive has already broken with Westminster in awarding the full pay increase to healthcare workers and providing a more generous resolution to the furore over applications for specialist training. But BMA Scotland chair Dr Peter Terry calls this "small-scale stuff". "The big differences are that the NHS in England is performance managed, usually through financial systems, while the health service in Scotland is run much more on partnership. I'd hope that consensus building would continue whoever is in power." Meanwhile if Labour wins in Wales then there is likely to be increased scrutiny and a "get tough" approach to costs. The party's manifesto promises independent analysis of managerial capacity and administrative costs to underpin a drive to move as much money as possible into frontline services. Research from BBC Wales was forecasting a £33m NHS overspend for the last 12 months, added to historical debts of £84m. However the most likely outcome is coalition government, the shape of which no one is certain of. If so, any policy will be the result of negotiation over manifesto pledges between the partners. The Conservatives are likely to hold on to their policy of replacing 22 existing health boards with one all-Wales commissioning body. The Lib Dems want to introduce "health hubs" bring services together and introduce nurse-led walk-in centres. Plaid wants to halt proposed closures and require health boards and local authorities to share budgets to ease bed blocking. Labour's proposal, which wants services to be based on co-operation, not competition, should probably be remembered by all who make up any coalition. Summary by Keep our NHS Public of Health Service Journal 26 April 2007
  • Stroke patients die needlessly in care lottery, study reveals. Hundreds of deaths of stroke sufferers could be avoided if disparities in treatment were remedied, new figures suggest today. More than a third do not receive treatment on a stroke unit where their prospects are considerably better, a national audit found. Research, funded by the Healthcare Commission, found large disparities in the quality of care offered across England, Wales and Northern Ireland. Patients in Wales are more likely to die, or if they survive suffer higher levels of disability, than elsewhere. Fewer than three in 10 (28%) patients there are treated in a stroke unit, compared with an average across the three countries of 62%. Meanwhile, two out of three (64%) patients in England and seven out of 10 (73%) patients in Northern Ireland can expect to visit a specialist unit. Press Association Wednesday May 9, 2007 SocietyGuardian.co.uk
  • The Complexities Of Bed-Blocking. Cardiff and Vale NHS Trust is the largest NHS trust in Wales, providing health services to half a million people in Cardiff and the Vale of Glamorgan. It also provides specialist health services – such as paediatric, renal, cardiac, neurological services and bone marrow transplantation – to patients from across Wales. It has a total income in excess of £576m and it employs approximately 13,500 staff. The trust runs two acute hospitals – the University Hospital of Wales and Llandough Hospital – both of which bear the brunt of bed-blocking. The trust has consistently had some of the highest levels of delayed transfers of care – the figures for March show that 8.3% of its beds are currently blocked.  Care and Health 22 May 2007
  • Bird flu outbreak confirmed at Welsh farm. An outbreak of bird flu at a country estate in north Wales was confirmed today but does not involve the deadly H5N1 strain of the virus. Christianne Glossop, Wales's chief vet, made the announcement after tests were carried out at the unnamed farm in Denbighshire. She said the strain is H7N2 low pathogenic avian influenza, which is different from the highly pathogenic H5N1 strain currently circulating in Asia. James Orr and agencies Thursday May 24, 2007 Guardian Unlimited
  • Two tested for bird flu after farm outbreak. Two adults were last night tested for bird flu after Welsh authorities confirmed an outbreak on a remote smallholding in north Wales. However, they reassured the public that this was not the H5N1 strain, which is potentially deadly to humans and which resulted in 160,000 turkeys being slaughtered this year in Norfolk. Police cordoned off the road about a mile from the farmhouse in Llanfihangel Glyn Myfyr, near Corwen, Denbighshire. It is understood that all the 45 chickens and two geese on the farm were slaughtered and everyone entering the site was offered the drug Tamiflu as a precaution. John Vidal, environment editor Friday May 25, 2007 The Guardian
  • More patients getting into stroke units but 21st century care still lacking. The results of the 2006 National Sentinel Audit for Stroke show that patients are spending more of their time on stroke units, but there are still unacceptable waits for brain scans and starting treatment. Results from Wales are still falling behind those from England, and are a major cause for concern. A separate release on the Welsh results is available. The Audit, funded by the Healthcare Commission, was carried out on behalf of the Intercollegiate Stroke Group by the Royal College of Physicians’ Clinical Effectiveness and Evaluation Unit (CEEu), and covers 100% of eligible hospitals in England and Wales. Care & Health 7 June 2007
  • Record-breaking Ambulance service hits new heights. The performance of the Welsh Ambulance Service is the best its ever been since it was formed in 1998 - and its getting better all the time. Care & Health 8 June 2007
  • Decision over nurses' pay 'creates disunited kingdom'.  Pressure was increasing today for English nurses to be given their pay award in full after politicians in Northern Ireland opted to give their nurses the entire 2.5%. Scottish and Welsh ministers had earlier agreed to give their nurses the full rise and campaigners said the decision left English nurses the poor relations.  The Royal College of Nursing (RCN) wants the government to scrap plans to stagger the pay award in England and instead to implement the independent pay review body's recommendation to give nurses the full rise.  The Northern Ireland executive decided last night to do just that, and to backdate the rise to April.  Sara Gaines Tuesday July 10, 2007 SocietyGuardian.co.uk  
  • Hospital campaigners say it big. Visitors to the Royal Welsh Show will find it hard to miss one huge protest statement against hospital cuts. Campaigners have mown the name of their action group into a hillside in a sign stretching 200m (656ft) in letters 100m (328ft) high and 40m (131ft) wide. The massive BACH (Builth Against Closing Hospitals) near Builth Wells in Powys is intended as a reminder to Royal Welsh-goers in nearby Llanelwedd. It is the latest stunt by the group, which opposes plans by Powys Local Health Board (LHB) to cut services at Builth Wells, Knighton, Bronllys and Llanidloes hospitals. The group is fighting plans by the LHB as it faces a £3.5m deficit. But the LHB has said the hospital buildings are outdated and patients deserve better. Last month, First Minister Rhodri Morgan called a temporary halt to changes to Welsh hospital services. Summary by Keep our NHS Public of BBC 21 July 2007
  • Scots suffer highest cancer rate. Scotland has the highest cancer rates in the UK, with Scots 15% more likely to die from the illness, according to figures published today. National Statistics figures covering the years 2002 to 2004 revealed that there were 446 new cases per 100,000 men and 379 cases per 100,000 women in Scotland. That compares with rates of 450 (men) and 366 (women) in Wales, and 394 and 338 in England. Press Association Thursday July 26, 2007 SocietyGuardian.co.uk
  • Action call on hospital parking costs. Cancer patients are paying up to £1,000 a year to travel to park at hospitals while they undergo life-saving treatment. One of the hidden costs of the disease has been revealed by Macmillan Cancer Support, which is encouraging people to email Health Minister Edwina Hart and other Assembly Members to demand free parking at Welsh hospitals. The move comes after the Scottish Executive issued strengthened guidance to NHS boards, recommending that they offer free parking to cancer patients attending treatment. The One Wales document agreed by the Labour-Plaid coalition Assembly government includes a commitment to reform charges for hospital parking. But, to date, there has been no action taken. Summary by Keep our NHS Public of icWales 13 August 2007
  • Health debt experts join team of 50. City health bosses have asked for help to find ways of saving money. It has been revealed there are already 50 or so people in the unit trying to balance the books. Consultants will be spending the next couple of months closely scrutinising the finances of both Swansea NHS Trust and Swansea Local Health Board to help the books balance and find the £15.5m in savings it needs. The trust already has 50 people working in its finance department, while the LHB employs around four financial staff. Both Swansea NHS Trust and Swansea Local Health Board, in a joint statement said the Assembly expert would be there for a limited amount of time. The troubleshooters will also be looking at the scheme to re-shape services for the future, including pushing forward the city's £500m super hospital blueprint. It is predicted that the LHB will end the year £10.8m overspent, and bosses at Swansea NHS Trust have to find a major £15.5m of savings. Swansea Local Health Board is also saddled with £3.5m of debt and it is still forking out around £600 a day on top management consultant Terry Tonks after it failed to find a new director of resources. Meanwhile, the row over the 3,000 or so Swansea health workers waiting for back pay for up to three years as a result of re-gradings is rumbling on. There is growing discontent at the time delay in paying back hundreds of thousands of pounds owed to them. Summary by Keep our NHS Public of South Wales Evening Post 13 August 2007
  • Blood shipped to hospitals by taxi. Blood is being shipped to Swansea hospitals by taxis, according to a city health worker. He says he fears lives are being put at risk by the decision to have private hire vehicles carry the precious cargo. The warning comes in the wake of a decision by Swansea NHS Trust to end its link with the health courier service - part of the Wales Ambulance Service - for emergency blood supplies at night from Cardiff. The health worker, who does not want to be identified, said he feared taxis were not properly equipped to carry blood specimens and, if there was a spillage, it could put future passengers at risk. It is understood the courier service had offered on-call support for the NHS Trust during the past 20 years, without any problems being reported. There are also fears that, if a blood sample was urgently needed late on a Saturday night, no taxi would be available to rush the blood to either Swansea's Morriston or Singleton hospitals because of the pressure on the service from revellers enjoying a night out in the capital. The health worker said a security risk would also be posed by having taxi drivers arrive with blood samples at the city's hospital sites. "These drivers are going to be able to walk through the hospital with just their passes. It is not right that taxi drivers are doing this work." Nobody from Swansea NHS Trust was available to comment. Summary by Keep our NHS Public of Swansea Evening Post 13 August 2007
  • Trust warns of £15m hospital debt. Swansea NHS Trust has said it must cut 750 jobs and close 86 beds to avoid going £15.5m into the red. However, health officials say they will treat the same number of people by cutting the amount of time they spend in hospital. The BMA and Amicus say the move is needed to safeguard services and patient care, but Unison, which has called a mass meeting of its members for Tuesday, described it as "unacceptable" and "driven by financial cut-backs and not any planned improvements in health care". The trust said jobs would be cut through "natural wastage" and there would be no redundancies. In a letter to Unison acting trust chief executive Calum Campbell said: "Independent reports have made it clear that Swansea's hospitals have too many beds and we have been inefficient in the way we have managed care. Increasing our day case rates and reducing lengths of stay means patients are in hospital for shorter periods of time. We realise that what may lay behind the proposals is . . . what may be the unnecessary use of acute hospital beds. However, this can only be done when it is safe to do so - when community services are in place and with alternative uses found for any unused beds."A spokesperson for the Welsh Assembly Government said that they had been assured that patient care would not suffer and that: "staff can be absorbed through normal staff turnover and reduced use of agency cover". The trust is currently considering plans to merge with its neighbour Bro Morgannwg. Summary by Keep our NHS Public of BBC 11 September 2007
  • A foreigner’s view of the NHS in Wales. The Welsh Assembly Government wants Wales to have a world class health service. But how does the rest of the world regard NHS Wales? Care & Health 14 September 2007
  • Anger as talks ruled out. Health workers say they are angry that Swansea hospital chiefs are refusing to consult the public over controversial plans to axe 86 beds and around 750 jobs. They say both patients and visitors have the right to have a say because the changes will affect them in the long term. But trust bosses say the decision to reduce bed numbers has come about because the length of patient stays has been reduced and the 740 jobs will be lost through natural wastage. Swansea NHS Trust has said it does not believe a formal public consultation is needed because it is not a service cut. But Jeff Baker, regional organiser for Unison, said staff were angry. He said: " Swansea NHS Trust has flatly refused to get involved in any sort of public consultation regarding the proposed bed closures. Unison has made a formal request for public consultation, and I understand the community health council has done the same. I understand that the statutory NHS service change regulations require trusts to publicly consult over what is termed 'significant service changes'. While obviously this is open to interpretation, it is difficult for our members to understand why Swansea NHS Trust has decided the permanent closure of 86 beds does not amount to a significant service change." Trust bosses have continued to warn that unless the changes go ahead, there could be cuts in hospital services and compulsory redundancies. Nursing, medical and administrative posts are among those due to be lost over the next three years by natural wastage. The reductions are part of the trust's savings strategy, which aims to save £15.5m over the financial year. Summary by Keep our NHS Public of Swansea Evening Post 21 September 2007
  • Opposition to health trust merger. Plans to unite health trusts in Pembrokeshire and Ceredigion with Carmarthenshire are facing opposition from community health councils concerned that it won't save money and may affect services. The Welsh Assembly government claims the move will save £2m and is already in the process of merging other trusts across Wales. Any move to merge the three trusts will follow consultation between the trusts, community health councils and staff associations. Managers at the west Wales trusts said the merger would allow them to pool skills and safeguard services as well as making efficiency savings Carmarthenshire Community Health Council favours the merger but Ashley Walker from its equivalent in Pembrokeshire said:@It may well lead in the longer term to an erosion of local services. I know this is very much an organisational change and not a service change but there is a great fear a new grand merged trust would lead to a downsizing and erosion of local services in the periphery." In Ceredigion, Jack Evershaw from the community health council said that the new trust would have to cope with 37m in debt that his trust had "little part" in creating. "We are also worried that such an organisation is doomed to not succeed with that level of debt." However Meirion Hughes, char of the area's NHS merger review board said the move was really abut enabling the trust to deal with changing demands. Summary by Keep our NHS Public of BBC 26 September 2007
  • Edwina Hart orders rethink on hospital closures. Health minister Edwina Hart ordered a review of plans to close community hospitals and downgrade services across North Wales. A leading GP was also appointed to re-examine plans to develop primary and community health services. The announcement, welcomed by AMs from all parties, followed Mrs Hart's decision to commission a re-assessment of proposals to shut community hospitals at Prestatyn and Blaenau Ffestiniog. Plans for major re-structuring of North Wales hospital services, Designed for North Wales, prompted widespread opposition and became a key campaigning issue during the Assembly elections. Mrs Hart offered closure-threatened services a potential lifeline after widespread criticism of the public consultation process previously adopted. The closure of Flint Cottage hospital is on hold pending the review of community services, while an independent report on clinical governance at Abergele hospital will be undertaken by the Academy of Royal Colleges in Wales. Summary by Keep our NHS Public of Welsh Daily Post 17 October 2007
  • A&E gridlocked as bed cuts bite. Patients in need of emergency hospital treatment in Swansea have instead been left stranded in ambulances for hours because of a beds shortage. The queues outside Singleton Hospital have been seized upon by protesters in their fight to stop 86 city beds being axed. Ambulance crews claim they were told there were no beds available anywhere. It led to some paramedics being forced to wait around from 9.40pm until around midnight - meaning they were unable to attend other emergencies. A health worker highlighted the "dangerous" situation. He said: "There were five emergency ambulances stuck outside Singleton Hospital waiting to offload - there wasn't a bed anywhere. They were there for hours. It meant an ambulance from Whitland had to go to a call for an incident at Fforestfach. The trust must know there are not enough beds." It is understood there was a similar situation outside the hospital site the previous night. Last winter sparked chaos at hospitals across South West Wales - at one stage in February, 12 ambulances were lined up outside Morriston Hospital's A & E department. A lack of beds was also blamed for the problems then, although health chiefs said it was due to the high level of patients needing emergency treatment along the M4 corridor. Now hospital bosses say they no longer need the same level of beds, because they have reduced the length of patient stays. And they have said there is no need to consult the public over plans to reduce bed numbers. Swansea NHS Trust is looking to lose 740 jobs through natural wastage, as part of the £15.5m cost-saving strategy. Nursing, medical and admin posts are among those to go over the next three years. Trust bosses have warned that without the changes, there could be cuts in hospital services and compulsory redundancies. Summary by Keep our NHS Public of Swansea Evening Post 17 October 2007
  • Midwife father. A father had to deliver his own baby after his wife was twice turned away from an NHS hospital because it was full. Elizabeth Jones, 24, gave birth after coming home for the second time from the Princess of Wales hospital in Bridgend, South Wales. Her husband dialled 999. The paramedics who attended supervised him until the baby was born. Summary by Keep our NHS Public of Times 18 October 2007
  • 'Too many' health bodies in Wales. There are too many bodies commissioning health services, leaving patients to get "lost in the gaps", Health Minister Edwina Hart has said. Care & Health 23 October 2007
  • NHS Reconfiguration in Powys and North Wales. Welsh Assembly Government Statement by Edwina Hart, Minister for Health and Social Services on the NHS Reconfiguration in Powys and North Wales Care & Health 23 October 2007
  • Summary care record launched in Bolton. The first 48,500 summaries of patient records have been uploaded to the NHS Spine and out-of-hours staff in the Bolton pilot area will start using them over the next few weeks, Connecting for Health announced. Bolton in North-west England was the first primary care trust to take part in the NHS Care Records Service Early Adopter Programme. There is local scepticism about the exercise. A recent survey by the Bolton Local Medical Committee (LMC) was sent to all 169 GPs in the area, and from 98 responses, just 20 said they were in favour of proceeding with the SCR. These results indicate that almost 70% of GPs working in Bolton are not in favour of the SCR being turned on. The creation of SCRs for England runs parallel similar moves in Wales and Scotland. Scotland has the Emergency Care Summary which available to staff in emergency and unplanned care. Wales is developing the Individual Care Record, currently being piloted in Gwent, which is designed to assist clinicians working in OOH and emergency settings. Summary by Keep our NHS Public of eHealth Insider 24 October 2007
  • Even GPs say patients are getting a raw deal when it comes to out-of-hours care. Family doctors will admit that out-of-hours care has dramatically deteriorated since they were allowed to opt out of working at evenings and weekends. Nearly two-thirds of GPs think standards have slipped since Primary Care Trusts took over the service in 2004, a survey reveals. Only just over half of those who become ill outside office hours now see a doctor. The rest are visited by nurses or are given advice over the phone. One family doctor interviewed by the GPs' magazine Pulse said that sending nurses to patients was "inappropriate" and amounted to "conning the public". Many surgeries no longer provide out-of-hours care. One in five patients questioned in a separate poll said they received "poor" or "very poor" out-of-hours care. Richard Hoey, deputy editor of Pulse, said: "The Government keeps insisting out- of-hours care is improving, but that's not the message we're getting from doctors or patients. The fact is that ministers hugely underestimated the size of the task in running out-of-hours services, so when trusts took over responsibility many lacked the funding or expertise to do so adequately." Trusts have employed a mixture of in-house teams and private firms to plug the gaps but complaints have soared. An investigation also revealed that the amount spent by trusts on out-of-hours care varies widely across England and Wales. While Birmingham East and North trust spends just £2.43 per patient per year, Pembrokeshire spends £17.62. It has also emerged that rising numbers of patients are ringing 999 or turning up at overstretched A& E departments. Summary by Keep our NHS Public of Mail 31 October 2007
  • Delays in hospital ‘compromise patients’ independence’. Auditor General of Wales identifies a 'whole systems' problem that needs changing. The independence of vulnerable people, and the treatment of others, is being compromised because of delayed transfers of care, according to the Auditor General for Wales.  Care & Health 6 November 2007
  • Costly legacy of PFI projects. A Welsh hospital which cost £66m to build will end up costing taxpayers more than £300m. The size of the eventual repayments on Neath Port Talbot Hospital can be revealed for the first time today as one of the biggest of all Wales' Private Finance Initiative (PFI) schemes. Information compiled by National Assembly officials and passed to the Western Mail shows that the capital value of such projects has now passed £1bn.  Care & Health 6 November 2007
  • Wales told to cut bed blocking.  Delayed discharge from hospital is compromising the health and independence of vulnerable older people and damaging wider health service delivery, according to a hard-hitting report by the Wales Audit Office. Care & Health 12 November 2007
  • Nurse shortage for sick baby care. Care for sick and premature babies is at "breaking point" because of a shortage of nurses, a charity has said. A report by Bliss said demand for care in neonatal units in Wales had jumped by 13% in 2006, while the number of specialist nurses rose only by 2%. It also said overcrowding meant some new admissions were turned away. The Welsh Assembly Government said Bliss had been advising it on neo-natal facilities and developing specialist services for children and young people. The charity for premature babies said no unit in Wales currently met the recommended nursing levels. It said more than 100 specialist nurses were needed - increasing the workforce by 27% - to meet recommended minimum standards in Wales. The study said services were being "stretched to breaking point" and said the units had to close their doors for an average of 24 days in a six-month period. It said that this meant mothers and babies sometimes had to travel long distances to access the care they need. Summary by Keep our NHS Public of BBC 4 December 2007
  • Review after laptop theft from Welsh GP practice. Health bosses in Wales have written to 950 patients whose details were on a laptop computer stolen from St Julien's GP surgery in Newport last month. Cardiff and Vale NHS Trust said the laptop contained patient retinopathy images together with the details of the patients' names, addresses, dates of birth and phone numbers. The data was part of a screening problem for diabetic people with eye problems run by the Diabetic Retinopathy Screening Service (DRSS), which screens patients across Wales. The trust says that it is possible further patient records were held on the laptop. When the DRSS holds clinics in various locations in the community, including GP surgeries, staff record patient information onto laptops, later uploaded to a central database. The trust has also ordered an investigation into data and computer security measures, and says rigorous security measures are in place. Summary by Keep our NHS Public of E-Health Insider 18 December 2007

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Sheila Porter-Williams
Campaign for Health Service Democracy
Green Haven, Halfway Lane
Dunchurch
Rugby, Warwickshire CV22 6RD
sheilaCHSD@porter-williams.freeserve.co.uk