International Health Policy/Sources

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  • Britain Now Leading Europe On Public Health - Tessa Jowell.  Department of Health Press Release 98/165 Thursday 30th April 1998
  • Marianne Rigge and Graham Lister lament the failure of the Government to come up with a workable Patient's Charter and point to a system in the Netherlands which we would do well to copy. Guardian Tuesday January 19, 1999
  • Fidel Castro, who spent his first 30 years in power training tens of thousands of Latin American guerrillas, is today training doctors for the continent and playing the genial host to its leaders at their annual Ibero-American summit. Tom Gibb in Havana Tuesday November 16, 1999 The Guardian
  • From the viewpoint of most patients, the French health service is outstanding: they are free to go as often as they like to as many of the country's 94,000 GPs or 89,000 specialists as they like, ask for whatever treatment or medicines they like, and expect to get most of the cost reimbursed by the state. Guardian 21 June 2000
  • Cubans tell NHS the secret of £7 a head healthcare. Patient-centred and cost effective system could inspire NHS. Sarah Boseley, health correspondent, The Guardian Monday October 2, 2000 The Guardian
  • Health bosses propose sending patients to Germany.  Guardian Society Monday July 30, 2001
  • 35-hour week puts French hospitals at risk Jon Henley in Paris Guardian Unlimited Thursday September 6, 2001
  • Insurance policy for NHS.  Guardian letters Monday November 26, 2001
  • Life's healthier across the Channel. France's medical system is recognised as superior to the NHS. Anthony Browne in Paris reports on the lessons that Britain can learn.  Anthony Browne  Guardian Society Sunday November 11, 2001
  • Sick Britons could head for Greece. Sarah Boseley,  Guardian Unlimited Friday December 7, 2001
  • Britain gets more health for its money.  Tories will find spending alone is not key.  David Walker Guardian Unlimited Friday December 7, 2001
  • First patients ready for NHS ops abroad.  Ten people to have joints replaced or cataract treatment in Lille as initiative to reduce long term waiting lists begins.  Guardian Unlimited Friday January 11, 2002
  • Q&A: treatment abroad.  Guardian Society Friday January 18, 2002
  • First NHS patients arrive at French clinic Some 200 Britons will be operated on abroad in next three months but health service remains coy over cost of treatment.  Guardian Saturday January 19, 2002
  • It healed me - and it could cure the ills of the NHS.  Spain's system of public and low-cost private healthcare works well.  Peter Preston Guardian Unlimited Monday January 21, 2002
  • Generation of health tourists is born.  The successful treatment of national health service patients in a French hospital means the NHS faces a new challenge to its healthcare monopoly, writes Patrick Butler.  Guardian Society Monday January 21, 2002
  • NHS patients see the future in Lille.  Leader Guardian Unlimited Monday January 21, 2002
  • 'This is just not an issue in France...' Jon Henley in Paris.  Observer Sunday February 10, 2002.  My son Nathan was one last month and is, according to the handy vaccination calendar sent to all parents by the French national health service, due for the MMR jab. The shot is fully reimbursable, and while not compulsory is 'strongly recommended'.
  • French health minister offers beds to NHS patients.  Guardian Society Tuesday February 26, 2002
  • The health secretary, Alan Milburn, reached agreement last night with his French counterpart, Bernard Kouchner, on plans for a joint working group to explore opportunities for more patients to cross international borders to get quicker treatment.  Guardian Society Wednesday February 27, 2002
  • NHS heart patients could travel to SA.  James Meikle Guardian Friday March 22, 2002
  • Brown sees new NHS as model for developing world Michael White, political editor Guardian Friday April 26, 2002
  • Your reports (Finance Notebook; and interview with the World Trade Organisation's incoming director general, Supachai Pantichpakdi, May 25) suggest that developing countries could make balance of payments gains by supplying health services to foreign patients from the overstretched national health systems of Europe. This is an irresponsible suggestion..  Guardian letter Tuesday May 28, 2002
  • America sneezes, we catch a cold.  Importing the US model will undermine the health service.  Allyson Pollock Friday June 21, 2002 The Guardian
  • Milburn offers Europe slice of NHS.  Guardian Tuesday June 25, 2002
  • Milburn woos foreign health firms to UK.  John Carvel, social affairs editor Wednesday June 26, 2002 The Guardian
  • Patients ready to go abroad, BMA poll finds.  John Carvel, social affairs editor The Guardian Monday July 1, 2002 
  • NHS patients give approval to operations abroad.  Scheme to cut waiting lists to be extended over staff objections.  James Meikle, health correspondent Guardian Tuesday August 13, 2002 
  • Minister makes French hypochondriacs cough up for 'imaginary' medication. Jon Henley in Paris Thursday July 17, 2003 The Guardian
  • If you are retiring to a country permanently you cannot rely on form E111, which entitles travellers to free or cheaper emergency medical treatment in most European countries and some non-European countries. Mark King and Moira O'Neill Monday August 11, 2003
  • Doctors are set to revise ethical guidelines established after the fall of the Nazi regime to protect patients taking part in clinical trials - raising fears that a watering down of their language may lead to the exploitation of people in poor countries by drug companies. Sarah Boseley, health editor Wednesday September 3, 2003 The Guardian
  • Their methods may have come as a shock to one British family, but Spanish doctors operate within a transplant code that saves many more lives, argues Nick Cater. Friday September 5, 2003
  • Vital tests to diagnose infections and protect public health will be thrown into chaos under quality control measures being demanded by the government, the health protection agency warned last night. James Meikle, health correspondent Thursday September 18, 2003 The Guardian
  • A high court judge opened the floodgates yesterday for NHS patients facing "undue delay" on hospital waiting lists to have their operations elsewhere in the EU and claim reimbursement from the NHS. Clare Dyer, legal correspondent Thursday October 2, 2003 The Guardian
  • The case of Yvonne Watts tells us what is wrong with the law, not what is wrong with the National Health Service. Leader Friday October 3, 2003 The Guardian
  • The ruling that a patient can force the NHS to fund treatment abroad if UK waiting lists are too long could change the provision of healthcare more than any government initiative over the past 55 years (NHS to pay price in rush for EU surgery, October 2). Letter Monday October 6, 2003 The Guardian
  • An international trial of a drug that can prevent breast cancer recurring has been suspended because it had such high success rates it was decided that all the women taking part should be given the drug, it was announced yesterday. Sarah Boseley, health editor Friday October 10, 2003 The Guardian
  • John Reid, the health secretary, will today give his seal of approval to plans for the NHS to import methods used by private healthcare corporations in the US to reduce patients' stays in hospital by as much as two-thirds. John Carvel, social affairs editor Thursday October 23, 2003 The Guardian
  • US prescription is wrong. Letters Monday October 27, 2003 The Guardian
  • Inertia and opposition would stop the NHS from wholeheartedly adopting successful US healthcare practices, says Peter Davies. Friday October 31, 2003
  • Singapore's founding prime minister Lee Kuan Yew risks sparking a row with Britain following comments that his wife only received treatment after suffering a stroke in London once Downing Street intervened to get her preferential care at an NHS hospital. John Aglionby and Rebecca Allison Tuesday November 4, 2003 The Guardian
  • The health secretary, John Reid, today attacked critics of his plans to link-up with an American healthcare company and accused them of being "opposed to learning" and so committing the NHS to "steady decline". Helene Mulholland Tuesday November 4, 2003
  • This week, a team of US health experts who work for an organisation that excludes hundreds of thousands of low income and unemployed people from access to medical care will be touring England telling doctors, nurses and managers how to save the NHS. Wednesday November 5, 2003 The Guardian
  • Plans to permit doctors, nurses and social workers from other European countries to work unregistered in the UK have been rejected by the European parliament amid fears over public safety. David Batty Friday November 28, 2003
  • Doctors, trade unions and opposition MPs yesterday united to heap criticism on plans by the conservative French government to reform the country's widely praised but nearly bankrupt health service. Jon Henley in Paris Wednesday May 19, 2004 The Guardian
  • Ireland leads the way. The tobacco barons were right. The smoking ban in public places introduced in Ireland this year has had unintentional consequences, though not the dire economic ones predicted by the tobacco trade. The main aim of the ministerial ban was to protect bar and restaurant staff from the damage wreaked by passive smoking. Large numbers of non-smokers die every year - or suffer severe disabilities - from inhaling other people's smoke. The Irish ban has not only helped these people but smokers too. The number of smokers has fallen since the ban while others are smoking less. As 70% of smokers want to give up, this is good news. Even better are the signals from Scotland implying they intend to follow suit. Leader Friday September 3, 2004 The Guardian
  • The health secretary, John Reid, told his European counterparts yesterday that Britain's tax-funded NHS will be able to cope with the health needs of an ageing population better than their social insurance systems. His bullish speech at an informal gathering of EU ministers in the Netherlands showed growing confidence in the NHS after years of apologetic humility caused by failure to tackle long hospital waiting lists. John Carvel, social affairs editor Saturday September 11, 2004 The Guardian
  • Models for the NHS. Letters Monday October 4, 2004 The Guardian
  • The US-led war in Iraq has created a healthcare disaster in a country where 20 years of war, mismanagement and sanctions had already left public health in a fragile state, a UK-based medical charity said today. Medact reported that the health of Iraq's people had deteriorated since the 2003 invasion, both as a direct result of violence and through the collapse of medical facilities, public health provision and essential infrastructure such as water supplies. The report specifically blamed the tactics of the US-led occupying forces for exacerbating the country's health problems, particularly the decision to sideline the UN, which has traditionally handled humanitarian relief efforts. Sarah Left and agencies Tuesday November 30, 2004
  • A proposed EU directive that would let European health companies run clinics in Britain outside national regulatory controls threatens the safety of patients, the Royal College of Nursing said last night. John Carvel, social affairs editor Monday December 6, 2004 The Guardian
  • In the health trade. A controversial new European directive is in danger of placing the interests of business above the safety of workers and consumers. David Rowland Thursday January 20, 2005 The Guardian
  • British companies have been involved in the diversion of cut-price Aids drugs intended for people in poor countries, some of which have been sold at a profit to the NHS, it emerged yesterday. Sarah Boseley, health editor Monday April 25, 2005 The Guardian
  • The longest-serving health secretary of the United States has described healthcare provision across the developed world as "deeply dysfunctional" systems that are struggling to keep abreast of the fast pace of change. Hélène Mulholland in Birmingham Thursday June 16, 2005
  • The US is pressing the UN to block the use of needle exchange programmes in countries where drug use is driving the spread of Aids, arguing that the schemes encourage users to continue their habit. But critics, including Britain, believe that the fight against Aids in eastern Europe, central Asia and other parts of the world could be jeopardised if the US manages to water down the UN's policy. Sarah Boseley, health editor Tuesday June 28, 2005 The Guardian
  • Africa's health sector needs more resources, but preventing skilled workers from coming to Britain won't help resolve that, says Salil Tripathi. Tuesday August 9, 2005
  • Doctors in Asia fear western countries will grab the lion's share of vaccines and other drugs needed to fight an avian flu pandemic. James Meikle, health correspondent Friday August 12, 2005 The Guardian
  • The government will today invite the private sector to compete with the NHS for a contract to help rebuild the health service in Iraq. About 50 medical teams will be invited to come to Britain over the next two years to update their skills. But, in a sign of the times, ministers think this assistance need not necessarily be provided by the flagship hospitals of the NHS. John Carvel, social affairs editor Thursday August 25, 2005 The Guardian
  • The government was yesterday accused of burying a report into whether women who want late abortions are being encouraged to use clinics abroad. Julian Glover, political correspondent Wednesday August 31, 2005 The Guardian
  • Representatives of the world's richest countries meet today in London to decide how much each will put into the global fund to fight Aids, TB and malaria but while some look prepared to be generous, there are signs that the United States may not want to pay its full share. Sarah Boseley, health editor Monday September 5, 2005 The Guardian
  • Your article (Out of Africa, G2, November 18) reminds us of the enormous debt the NHS owes to some of the poorest countries in the world. It is vital that the NHS puts something back - and that's exactly what a growing number of hospitals and NHS trusts across the UK are doing through voluntary links with their counterparts in Africa and elsewhere.  Letter in The Guardian Monday November 21, 2005 The Guardian
  • Gran's test case could force state to fund surgery abroad. Gaby Hinsliff Sunday December 11, 2005 The Observer
  • UK kidney patients head for China. Britons are being targeted by an internet company offering the organs of dead prisoners in a trade condemned as 'disgusting' by surgeons. Jo Revill, health editor Sunday December 11, 2005 The Observer
  • The government will today for the first time confront the pharmaceutical industry over the high cost of new Aids drugs and call for lower prices for poor countries. Until now Britain has preferred to do business with the drugs industry behind closed doors, using its influence as a country with substantial pharmaceutical research, development and manufacturing interests. But today the international development minister, Gareth Thomas, will publicly signal the government's decision to take on the multinationals over the prices of newer Aids drugs. He will also point to the absence of drug formulations suitable for children.  Sarah Boseley, health editor Wednesday December 14, 2005 The Guardian
  • Maryland's medicine. The American state of Maryland is set to pass a law requiring corporations to pay 8% of their payroll to employee health benefits or pay any shortfall from this level into a state fund to help people without health insurance cover. With health costs rising companies have been steadily scaling back welfare benefits for their employees. The FT says: "It could be an economic mistake to put any more of the burden of welfare financing on to companies, as shown by the experience of France and Germany, where relying on payroll taxes to fund welfare systems has contributed to high unemployment…US businesses gripes about the advantage their Canadian rivals gain from having a national health system. Insurance is about pooling risk. The bigger the pool, the more efficient the insurance. The US solution has been to pool it at the company level, a role that business is increasingly reluctant to assume." Summary by Keep our NHS Public of  Financial Times 12 January 2006
  • Maryland puts health tax on big business. The American state of Maryland has passed a bill to force companies that employ over 10,000 staff to pay 8% of their payroll in health contributions. Wal-Mart is practically the only company affected. Meanwhile two Republican presidential hopefuls have sought advice from Bill Clinton's former health adviser in a sign of the growing awareness among US politicians that they must address rising healthcare costs. President Bush said this week that health care is becoming "an unmanageable cost", especially for small businesses. Summary by Keep our NHS Public of  Financial Times 13 January 2006
  • Prescription for a healthcare fiasco. President Bush's Medicare programme to subsidise the cost of drugs to the elderly has run into serious problems. Only 1 million of the 21 million eligible citizens have signed up for the scheme because it is too complicated. Crucial aspects of the plan are delegated to insurance and pharmaceutical companies. The FT says Bush "believed that private-sector involvement would promote efficiency and help control costs. But when it comes to healthcare, which is by its nature not a transparent consumer market, this assumption is not necessarily justified. Government is well suited to pool risk and provide insurance. The insistence on writing private insurers into the equation buys off a powerful interest group but adds expense and complexity." Summary by Keep our NHS Public of Financial Times 19 January 2005
  • Bush moves on Medicare costs. The Bush administration has been forced to intervene in the new Medicare prescription drug programme, following confusion and chaos in the system launched on January 1. The administration has had to promise to reimburse states for money they have spent to provide medicine to people whose benefits were delayed. Summary by Keep our NHS Public of Financial Times 25 January 2005
  • US health spending reaches a sixth of gross domestic product. Total spending on health care in the United States grew by 7.9% in 2004 and now accounts for 16% of the gross domestic product. Total health spending in the US in 2004 was $6280 (£3520) per person, or a total for the population of around $1.9 trillion. Most western nations' health spending is around the area of 8% of GDP. Summary by Keep our NHS Public of British Medical Journal 27 January 2005
  • Money-saving and efficient - on weekdays. The latest big idea for the NHS is nothing new in Europe. The concept of the polyclinic - where patients can see a range of specialists under one roof - owes its inspiration to a 19th century doctor who once treated Goethe, and to socialist East Germany. Luke Harding in Potsdam Tuesday January 31, 2006 The Guardian
  • Americans want a health service too. Just as Hewitt and Blair transplant American ideas and companies like UnitedHealth into the heart of the NHS, a new poll shows that a vast majority of Americans believe their system is in need of fundamental change and that the federal government should guarantee healthcare to the whole population. 56% of respondents to a CBS News/ New York Times poll believed the health care system needs fundamental changes, and 34% thought it should be completely rebuilt. Only 8% said that system works well and only needs minor changes. 62% said the federal government should guarantee health insurance for all Americans, while 31% thought that is not the government's responsibility. 61% said they were concerned "a lot" about the health costs they face.  Summary by Keep our NHS Public of PollingReport.com 10 February 2006
  • Supporters of Canada's health system express fears about new government. The appointment of Tony Clement as health minister by Canada's newly elected prime minister, Stephen Harper, has alarmed some supporters of the country's publicly funded national healthcare system. They regard Mr Clement, who was previously Ontario's health minister, as preferring a two-tier (public-private) system. Mike McBane, executive director of the Canadian Health Coalition, said: "It sends a very clear signal that the prime minister would appoint someone who is ideologically committed to privatising the delivery of the public healthcare system, someone who was aggressively involved in dismantling the Ontario healthcare system, in firing nurses and shutting down hospitals."  Summary by Keep our NHS Public of British Medical Journal 17 February 2006
  • Bush proposes cutting Medicare budget by $36bn. President Bush has proposed reducing the Medicare budget by $36bn (£21bn) over five years by reducing the rate of increase in payments to healthcare providers and by increasing the premiums for people on higher incomes. Until now all beneficiaries of Medicare - the federal health insurance programme for elderly and disabled people - have made the same level of monthly payments to cover doctors' and outpatient services - $88.50.  Summary by Keep our NHS Public of British Medical Journal 17 February 2006
  • Booked your hospital bed in India? Taj Hotels, Resorts and Palaces is poised to work alongside Apollo Hospitals in a partnership that reflects a surge in medical tourism to India for low-cost hospital treatment. The sector is expected to boom to £1.38 billion a year by 2012, from a current value of £180 million a year, according to the CBI.  Summary by Keep our NHS Public of Telegraph 20 February 2006
  • Wal-Mart to expand healthcare cover. America's biggest private employer is to expand healthcare cover for part-time workers, as it continues to battle criticism on the issue. It will reduce the two years that part-time workers have to wait to become eligible for health plans and extend healthcare cover to the children of part-time workers. Wal-Mart has been targeted by a new law in Maryland requiring it to pay more towards its employees healthcare, and is facing a string of similar bills in states across the US. But chief executive Lee Scott said: "The soaring cost of healthcare n America cannot be sustained over the long term by any business that offers health benefits to its employees." Summary by Keep our NHS Public of  Financial Times 24 February 2006
  • Controlling the costs of US health care. Poor uninsured Americans, and middle-class households upset at rising health-care bills, have long been arguing for health-care reform. Now, growing numbers of the most wealthy Americans - including many business leaders - are joining the campaign for change. With US health expenditure rising past 16% of the country's total economic output - a level almost 50% higher than in any other country - politicians and business executives are scrambling to avoid the bills for America's ragged patchwork of public and private health systems. A recent study by the Kaiser Commission on Medicaid and the Uninsured indicates that a reduction in mortality of 5% to 15% could be achieved if the uninsured were to gain continuous health coverage and that at least 18,000 Americans die prematurely each year solely because they lack health coverage. What is more America's privately managed system now relies more on public subsidies than the publicly managed systems in the UK, Canada, western Europe, and Japan, as the public's share of health care expenditures in the USA is now the highest in the world. Summary by Keep our NHS Public of  Lancet 24 February 2006
  • Whatever happened to the Sars pandemic? Iain Hollingshead Saturday February 25, 2006 The Guardian
  • Radical reforms may end Canada's public health service monopoly. Fundamental changes to Canada's public healthcare system are likely after Alberta became the latest province to propose opening up more services to the private sector. Canada is the only industrialised country where private clinics are not legally allowed to provide services covered by the public system. Summary by Keep our NHS Public of  British Medical Journal 10 March 2006
  • The £700m privatisation of the NHS agency that delivers food and medicines to hospitals across Britain is to be announced by the government tomorrow, despite one of the firms involved being investigated by the US Senate. The American medical supply company Novation is part of a consortium which will take over NHS Logistics Authority, the non-profit body that takes products, ranging from food and blankets to medical equipment, to hundreds of hospitals and clinics every day. Novation is the subject of a Senate investigation for alleged anti-competitive behaviour. The inquiry, which began in 2002, centres on medical supply companies that use a complex system of rebates and discounts to supply US hospitals. It is alleged that the federal-funded programme Medicare is being charged more than hospitals are actually spending. Smaller suppliers have claimed the company is so powerful it can squeeze them out of the market, even if the quality of their goods is better. Novation denies that it has violated any US regulations. Nevertheless, ministers have given the go-ahead to the deal, apparently persuaded that a private contract is likely to deliver more value for money for the NHS at a time when it is under serious financial pressures. The details of the contract have yet to be finalised. But the consortium, which also includes Exel Logistics, part of the German delivery giant DHL, will be expected to use its market muscle to drive down prices for everything from telephones to medical supplies. There are fears, however, that getting vital supplies to hospitals on time will be too demanding for a private company, raising the risk that services will be disrupted. Last month, there was consternation when vital oxygen cylinders failed to reach patients in their homes, resulting in a number of deaths of elderly people. The long delivery delays happened after the government had privatised the supplies of oxygen. Jo Revill, health editor Sunday April 2, 2006 The Observer
  • Bird flu around the world: a guide. James Sturcke and David Batty Thursday April 6, 2006
  • US healthcare. The American state of Massachusetts has passed a law requiring all citizens to have a health insurance policy, making it the first state to have comprehensive health cover. There will be subsidies for the poor to buy premiums, and companies that fail to provide health insurance for their employees will be charged fees. The Financial Times says: "Overall, the US has managed the feat of building a system that not only costs a lot, but also delivers a mediocre outcome for the average citizen. Partly, this is because the current patchwork of private provision and state-run programmes for the poor and the elderly leaves some 46m Americans uninsured… Making insurance mandatory, subsidising it for the poor and penalising companies and individuals alike if they still refuse to contribute, would solve the problem [of people opting out of insurance]. Unfortunately, it also risks increasing the cost of administration, which is arguably the main reason as to why US healthcare is already so inefficient in comparison with other countries." Summary by Keep our NHS Public of  Financial Times 6 April 2006
  • We can beat bird flu if Europe helps the world. Sunday April 9, 2006 The Observer
  • US lags in health care despite largest investment, survey shows. Ill people in the United States were more likely than those in other countries to report receiving the wrong drugs and incorrect or delayed test results, according to a survey of similar patients in six developed countries carried out by the New York based Commonwealth Fund, a private foundation that works towards improving healthcare coverage and quality. The US scored last in four of six categories - efficiency, patient centredness, equity, and patient safety - even though it spends upwards of $2500 (£1440) more per person on health care than the next highest spending country surveyed. The survey showed that the amount spent on health for each person in the US, adjusted for cost of living, was $5635. Summary by Keep our NHS Public of  British Medical Journal 15 April 2006
  • British surgeons yesterday condemned the use of executed prisoners' organs for transplants in China, saying that shortages in the UK were tempting British patients to travel despite the grave ethical issues involved.  Sarah Boseley, health editor Thursday April 20, 2006 The Guardian
  • Only two-thirds of people travelling to the UK from countries where tuberculosis is rife are being screened for the disease on entry, the Health Protection Agency says today. Sarah Boseley, health editor Friday April 21, 2006 The Guardian
  • Long live the NHS. A coalition of groups have sent a joint letter to the Times defending a tax funded healthcare system against attacks from groups like Reform. The letter is signed by the British Medical Association, the Chartered Society of Physiotherapy, Diabetes UK, the Family Planning Association, Macmillan Cancer Support, the New Health Network, the NHS Confederation, the Royal College of Midwives, the Royal College of Nursing, Unison, the Sainsbury's Centre for Mental Health, and Turning Point. It says: "In the week of the 60th anniversary of the second reading of the NHS Bill, we would like to take the opportunity to state our belief that the United Kingdom is fortunate to have one of the fairest health systems in the world where no one need fear becoming bankrupt because of their need to fund their healthcare. It has dedicated staff who are driven by a passion for patient care and has been transforming itself into a 21st-century healthcare system of which we can all be proud. The continued commitment of funding through tax ensures equity for patients but also makes economic sense because it is the cheapest way of collecting money. If a system is unaffordable through tax it is not affordable through any other funding system. International experience shows there is no necessary link between how systems perform and how they are funded. Any move to a health insurance system to charge patients for their care would increase bureaucracy and would leave those who need the most care with the greatest financial burden. We are not complacent. The NHS will need to respond to the tide of rising expectations and need by improving efficiency and responsiveness. With the dedication and commitment of staff we believe that the NHS can continue its transformation and be a model for other countries." Summary by Keep our NHS Public of  Times 27 April 2006
  • A few health insurers monopolise US market. Mergers between health insurance companies have created virtual monopolies that limit consumer choice, do not offer savings on premiums, and give doctors little or no bargaining power, a report from the American Medical Association has found. The past decade has seen more than 400 mergers among health insurance companies and managed care organisations. As of 2005, in 95% of these metropolitan areas, one insurer had at least a 30% market share. In 56% of areas, one insurer had more than half the market share. And in 4% of areas, one insurer had more than 90% of the market share. WellPoint and UnitedHealth Group now control a third of the US health insurance market and cover 61 million US citizens. Summary by Keep our NHS Public of  British Medical Journal 28 April 2006
  • The government has been forced to warn 14 countries that patients are in danger of developing the human form of mad cow disease as a result of contaminated British blood products sold abroad.James Meikle and Rob Evans Tuesday May 2, 2006 The Guardian
  • Americans 'sicker' than their English counterparts. A new study published in the Journal of the American Medical Association has shown that white, middle-aged English people are healthier than their American counterparts. The health of the richest people in the US is as low as that of the lowest-paid, least educated among the English. People in the US have far higher rates of diabetes, heart disease, stroke, lung disease and cancer in the 55-64 age group. In both countries people with higher socio-economic status, as measured by income and education levels, tend to enjoy better health. But because the national differences are so great, those at the top of the education and income scale in the US suffer diabetes and heart disease at a similar rate to those at the bottom of the scale in England. The study found that in England, 7.8% of people in the highest income bracket had heart disease, compared to 12% of the same group in the US. The lowest income groups in England and the US had heart disease rates of 11.6% and 17.1% respectively. The researchers' analysis shows that lifestyle factors, particularly people in the US being more obese, cannot account for the whole discrepancy but might provide a partial explanation. Different health systems might also be part of the story. The researchers note that the US spends $5,274 (£2,879) a head on medical care while in the UK, taking both nationally funded and private healthcare into account, that number is just $2,164, adjusted for purchasing power. But the NHS provides publicly funded medicine for everyone, while people in the US under the age of 65 have to rely on private insurance. Summary by Keep our NHS Public of  New Scientist 3 May 2006
  • Number of uninsured middle class US citizens grows. An increasing number of US citizens with modest to moderate incomes lack health insurance or have had gaps in coverage, according to a Commonwealth Fund study. In 2001, 28% of people with household incomes of $20 000 to $40 000 lacked insurance for at least part of the year. By 2005, the proportion was 41%. About 48 million US adults aged 19-64 lacked health coverage at some point in 2005. Most people (67%) who are uninsured are in working families. More than half of households (53%) with incomes below $20 000 did not have health insurance in 2005. Summary by Keep our NHS Public of  British Medical Journal 5 May 2006
  • Jack and Jill and the NHS. In a letter to the Times, Alex Nunns of Keep Our NHS Public writes: "Jamie Whyte suggests that healthcare should be privatised because "Jack smokes, drinks and overeats. Jill does not. Jack's behaviour means he consumes more healthcare than Jill. It would be unfair if healthcare cost Jack and Jill the same" ("You want fairness, you pay up", May 5). What happens when Jill gets breast cancer ? Is it fair that she should die if she can't afford the radiotherapy ? There is already a privatised healthcare system - it has had a perfectly fair test in the richest country in the world. Americans spend 16 per cent of their GDP on healthcare - twice what Britons spend. Yet 45 million Americans have no health insurance at all, whereas the NHS covers everybody. The inefficiency of a market system is shown by the astronomical cost of management and administration in the US - 30 per cent of total health spending. Perhaps this explains why Jack and Jill consistently say that the NHS is their most valued institution. Summary by Keep our NHS Public of  Times 9 May 2006
  • One in three German hospitals faces bankruptcy. Every third hospital in Germany is facing bankruptcy, according to a report from the consulting firm McKinsey. The main reason is the introduction of a new financing system by 2009, under which fixed uniform charges will be paid for a standard treatment per case. This will reduce the overall German hospital budget by £3.4bn. But it will mean that large hospitals receive the same money for an appendicitis case as small hospitals, which have potentially greater overhead costs. Summary by Keep our NHS Public of  British Medical Journal 12 May 2006
  • NHS patients have the right to be treated abroad at public cost if they face "undue delay" getting surgery at home, the European court of justice ruled yesterday. In a ruling centring on the case of a 75-year-old woman from Bedford, EU judges said health authorities had to pay the bill if one of their patients could establish urgent medical reasons for seeking quicker treatment in another member country. John Carvel and Clare Dyer Wednesday May 17, 2006 The Guardian
    • A suitable case for treatment. Leader Wednesday May 17, 2006 The Guardian
    • Patients 'should be repaid for care in EU states'. The FT says the victory of Yvonne Watts at the European Court "is likely to be seen as a further step towards the establishment of a single market for healthcare in the EU, despite the member countries' very different health systems. It will also oblige primary care trusts to assess individually each patient who claimed that a waiting list was too long and sought treatment overseas, rather than make blanket judgments on waiting times." Summary by Keep our NHS Public of  Financial Times 17 May 2006
  • NHS patients could win right to free dentistry abroad. British citizens frustrated by the lack of dentist provision might soon be able to receive treatments and check-ups throughout the European Union and charge the cost back to the NHS. Last month, in the case of arthritis patient Yvonne Watts, the European Court of Justice ruled that the NHS was liable to refund the costs of private medical treatment in the EU for UK citizens if their NHS treatment at home was subject to 'undue delay'. The judgment applies in the first instance to hospital treatment, but legal and dental sources say it opens the way for people unable to register with a health service dentist to seek NHS-paid for treatment in nearby EU countries. In order to inoculate dentistry against the legal precedent set by the Watts case, the government would be forced to argue that UK citizens have no right to free or subsidised dental check-ups and treatment. Summary by Keep our NHS Public of  Public Finance 9 May 2006
  • Merkel rejects plan for radical health reform. Angela Merkel has rejected a radical proposal by her coalition partner for a largely tax-financed health insurance system based on the Scandinavian model. The Social Democrats' proposal - a massive, €45bn tax rise to fund a halving of employer and employee health insurance contributions - would turn the funding of the system on its head. The current social insurance model has fuelled unemployment by making German workers among the most expensive in the world to employ. Because it would considerably reduce the cost of labour, economists think the SPD's proposal could come some way towards solving Germany's dramatic unemployment situation. Summary by Keep our NHS Public of  Financial Times 23 June 2006
  • Key NHS reform plans put on ice. The expansion of a key NHS reform has been put on ice after specialist services started to suffer. Payment by Results has caused cash problems in specialist children's hospitals due to the complex nature of their work. Ministers said they would get extra money to plug the shortfall and said there was now no timetable to extend it into other services not covered. It was originally envisaged that adult critical care would be incorporated this year. Mental health and other community services were also due to be covered by the funding system by 2008. But Lord Warner said the system would not be expanded at all next year. And he added: "We will not be specific about what comes after that." His announcement comes after the government was criticised for the way the tariff for this year was introduced. A government-commissioned report by John Lawlor, chief executive of the Harrogate and District NHS Foundation Trust, on the handling of the announcement said in the future ministers must publish it earlier, employ more staff to calculate it and even consider contracting out the process. He also agreed it should not be rolled out further in 2007-8 to give the system chance to "bed down". It comes after children's hospitals started to lobby government, warning services may have to be but because they were not receiving enough money under Payment by Results. The Department of Health has agreed to give the Liverpool's Alder Hey Hospital £4.9m this year, London's Great Ormond Street Hospital £3.4m and Sheffield's children hospital £900,000. The payments are likely to be repeated next year, Lord Warner said. The NHS system of Payment by Results has attracted controversy because it goes much further than its continental equivalents which tend to only cover elective operations. Summary by Keep our NHS Public of BBC Online 18 July 2006
  • Mental health PbR could cover 85 per cent of users. A new system of payment by results for mental health could result in care for 85 per cent of service users being covered by the system. Proposals being tested by the Department of Health would mean trusts were paid for an average treatment package in one of 13 'clusters' of care. The clusters would be designed according to how much care service users require under a needs assessment. The idea is being piloted in seven mental health trusts. Countries such as Australia and the United States have attempted to introduce systems similar to PbR in mental health, but have never succeeded. The wide range of presentations people with mental health can have and the number of intervention options are thought to have made them too complicated to run. Originally the DoH said payment by results would be implemented in mental health in 2008. The project is also exploring whether social care could be included under PbR, and whether this would be best pooled or decoupled from the healthcare costs, as well as how payment would be made for 'one-off' interventions. Summary by Keep our NHS Public of Health Service Journal 10 August 2006
  • The procurer. Novation, the private American outfit to whom Health Secretary Patricia Hewitt intends to award a £4bn contract to supply the NHS, has been involved in some disturbing events in the US. Medical Supply Chain, a Missouri company that develops software which enables hospitals to order supplies direct from manufacturers, has alleged that Novation and Neoforma, a dot-com company whose bubble burst in 2000 shortly after it went public in 2000 and in which Novation has a fifty percent stake, conspired with manufacturers, distributors and suppliers to charge $100bn in excess costs to US hospitals since 2002. As the largest Group Purchase Organisation (GPO) in the US, Novation was also recently involved in a $420m anti-trust judgment in a Los Angeles federal court over its reluctance over several years to provide doctors with a new kind of pulse oximeter that they wanted. It measures a patient's blood oxygen levels and is produced by Masimo Corp, but Novation had an agreement to purchase an inferior product from another company. Private Eye says: "Hewitt's decision is all the more surprising coming as US doctors are complaining that GPOs like Novation don't save hospitals money and don 't always procure the equipment staff believe is of most benefit to patients. In addition, America's largest trade union, the 1.6 million-strong Service Employees International union (SEIU), has also voiced concerns about Novation. Giving evidence to the US senate judiciary committee, the SEIU testified that it was 'concerned that questionable practices by the nation's largest GPO, Novation, lead to rising costs in the health care supply chain, while at the same time limiting provider choices in a way that risks the safety of both health care workers and their patients...' Hewitt does know what she's doing, doesn't she ?" Summary by Keep our NHS Public of Private Eye 16 August 2006
  • HIV treatment on rise but still falls short.  10-fold increase in number of Africans receiving drugs.  But total treated in world is well below WHO target. Sarah Boseley in Toronto Thursday August 17, 2006 The Guardian
  • Foreign op woman seeks NHS funds. A woman from Kent who spent her life savings on a hip replacement operation in France has said she hopes to get the NHS to pay towards her treatment. Jacqueline Baoudi, from Dover, needed special care because of a back injury, which was unavailable in the UK. She said she was offered NHS surgery but chose the £10,000 trip because of the lack of suitable aftercare. Summary by Keep our NHS Public of BBC Online 5 September 2006
  • Patients across the EU will be given the right to seek medical treatment in other countries if they face "undue delays" back home, under plans unveiled yesterday. Nicholas Watt in Brussels Wednesday September 6, 2006 The Guardian
  • More US citizens lack health insurance. The number of US citizens without health insurance reached a record 46.6 million this year - an increase of 1.3 million on last year. This is according to the latest US Census Bureau's survey. Almost one in six US residents lacks health insurance. The number of uninsured people has increased by seven million since 2000. Nearly all the new people without insurance were working adults aged 18 to 64, who might previously have had employer based insurance cover. The proportion of people covered by employer based plans, the most common form of insurance, fell from 59.8% to 59.5% of the population. The percentage of US residents with any form of private coverage, through an employer or otherwise, also decreased. The percentage of US residents who bought private health insurance, which is usually more costly than insurance through an employer, decreased as well. Summary by Keep our NHS Public of British Medical Journal 8 September 2006
  • NHS, tax and electable Tories. A letter from Alex Nunns of Keep Our NHS Public reads: "You report that the Tories will imminently adopt a policy which would force NHS primary care trusts to compete for business, emulating the US model of health maintenance organisations (HMOs), the insurance companies that vet doctors' clinical decisions. Before taking this leap, it would be wise for the Shadow Cabinet to assess the performance of HMOs in the States. Their original rationale was to stop the overuse of healthcare, because American doctors have a financial incentive to overtreat patients. But the result was an astronomical increase in bureaucracy and administration costs, leading to double-digit healthcare inflation. The US now spends 16 per cent of its GDP on healthcare, yet 46 million Americans are without any health insurance; Britain spends half that, and the NHS covers everyone. If the Tories adopt this proposal, it should provide Labour with an open goal. But with its NHS privatisation programme, the Labour Government has sadly forfeited its natural appeal as a guardian of the NHS and opened the door for the Tories to espouse such a disastrous policy. Summary by Keep our NHS Public of Times 5 October 2006
  • Uninsured Americans and the new Democratic Congress. At any point in time, around 45 million Americans have no health insurance. About another 20 million formally insured Americans have limited coverage, with many subtle exclusions and coverage caps. About a quarter of these people could probably afford private coverage if it were available on reasonable terms. Most of them, however, are in families headed by one or two low income workers, and they could not afford the $13 000 (£7 000) or so that it costs to provide an average family of four with good health care in the United States (and much more if anyone in the family is chronically ill).  Summary by Keep our NHS Public of British Medical Journal 1 December 2006
  • US cancer patients have problems with insurance and care, says survey. Patients with cancer in the United States are poorly served by their health insurance companies and healthcare systems and often suffer financially, says a national survey by the newspaper USA Today, the Kaiser Family Foundation, and the Harvard School of Public Health. Half of US cancer patients and their families had problems with coordination of care. Most patients were treated well by their employers, but 25% of families (including both the insured and the uninsured) said that the person with the disease used up most or all of their savings and some money borrowed from relatives. Having health insurance during treatment limited the financial consequences, but, even so, 20% of those who had always had insurance used up most or all of their savings, and some had to borrow money. Some people couldn't buy health insurance after their diagnosis, and some lost their health insurance during diagnosis and treatment.  Summary by Keep our NHS Public of British Medical Journal 1 December 2006
  • The free market must free, not restrain, research. In a comment piece John Sulston, who shared the Nobel Prize for medicine in 2002, writes: "The disadvantage of depending on the free market for research and development is that areas that do not have the potential to yield financial return are neglected. Such areas are extensive in human health. 90% of the disease burden of humanity is served by less than 10% of biomedical spending. This is a direct consequence of the huge differences in wealth between nations, which make diseases specific to poorer countries unreachable by the market. Are we heading towards a global health service that is free at the point of delivery, such as the NHS and other European systems, or towards a privatised system that is pay per treatment, such as that in the US ? In Europe, healthcare is a right; in the US, it is a commodity that is not equitably available. There is a battle over which system will prevail. For me the choice is clear: as a matter of principle I do not have private medical insurance and am dismayed by attempts to weaken the state system. The NHS model is the ethical choice, the US one is not. We must not allow the free market to become a bad master rather than a good servant. Summary by Keep our NHS Public of Financial Times 1 December 2006

  • DoH to contest free market proposal in health care. The Department of Health is to challenge a European Commission proposal to establish a free market in health care across the European Union. The commission's intentions are outlined in the document Consultation regarding Community action on health services. This follows the European Court of Justice's May 2006 ruling that NHS patients subject to 'undue delay' must be given permission to receive treatment elsewhere in the EU at the NHS's expense. But the commission has now taken that ruling a step further and states in its consultation document that non-hospital care - including dentistry, diagnosis and primary care - does not need prior permission and patients can receive it at any time and anywhere in the EU, at the NHS's expense. NHS professionals have also raised concerns that a free market could exacerbate health inequalities. Travel costs would not be reimbursable and so only the well-off could afford to travel aboard for care. The Commission's consultation closes January 31.  Summary by Keep our NHS Public of Public Finance 5 January 2007
  • US clinical guidelines often influenced by industry, NEJM says. Many clinical guidelines for doctors in the United States are influenced by the pharmaceutical industry and special interest groups, said an article in the New England Journal of Medicine last week. "The quality of guidelines varies considerably," and some are controversial, says a commentary by the journal's national correspondent, Robert Steinbrook. Summary by Keep our NHS Public of British Medical Journal 26 January 2007
  • NHS models. In a letter to the Times Professor Harry Keen writes: "Sir, The sentiments regarding healthcare expressed by your correspondent David Chandler (letter, Jan 24) remind me of the bitter objections raised in the mid and late 1940s against the basic concept of a National Health Service in which risks and costs were shared. The vast majority of the public enthusiastically supported the great social advance embodied in the NHS. Perhaps Mr Chandler seeks his model across the Atlantic where, despite an annual per capita spend on health approaching three times that in Britain, an estimated 40 million citizens have no insured health cover and a like number have only partial cover, so that serious illness means financial catastrophe. Few people now recall the economic anxieties that added to the fear of disease before the NHS, with people delaying and denying the need for healthcare. The NHS has its problems but it provides a level of care and protection to the public as a whole of which none of us need be ashamed. David Chandler can rely on his "safety net" if he wishes. The vast majority of the population want a sound, well-provided, forward-looking service which is primarily concerned with its patients, not its profits." Summary by Keep our NHS Public of Times 29 January 2007
  • The plague of bird flu will erupt out of Java, not Suffolk. The west has failed to back up its rhetoric by helping countries that will be on the front line of any human pandemic. Mike Davis Wednesday February 7, 2007 The Guardian
  • Hospital dumped man on Skid Row, police say. A hospital van abandoned a paraplegic man in Los Angeles 's Skid Row district, allegedly leaving him crawling in the street with nothing more than a soiled gown and a broken colostomy bag, the Los Angeles Times reported. Witnesses took the van's details and the police traced it to Hollywood Presbyterian Medical Centre. Police said it was a case of "homeless dumping". "I can't think of anything colder than that," said a detective, Russ Long. A hospital official said he was "very concerned". The city is prosecuting the Kaiser Permanente health group over a similar allegation. Summary by Keep our NHS Public of Guardian 10 February 2007
  • The World Health Organisation, the drugs company and the $10,000 funding offer.  Patients' group 'was asked to act as covert channel'.  UN body denies attempt to bend donation rules. The World Health Organisation is facing allegations that it attempted to secure a $10,000 (£5,100) donation from a drugs company by asking a patients' group to act as a covert channel for the funds, in the light of documents published today. The alleged arrangement would have broken the WHO's own rules on accepting money from the pharmaceutical industry. Emails between Benedetto Saraceno, the WHO's director of mental health and substance abuse, and the European Parkinson's Disease Association appear to suggest that the WHO was willing to take $10,000 from Britain's biggest drug company, GlaxoSmithKline, to help pay for the preparation of a report on neurological disorders, for which GSK makes drugs. However, Dr Saraceno made it clear that the money must pass through the coffers of the EPDA first because of the rules on WHO accepting drug industry funding. Michael Day and Sarah Boseley Friday February 16, 2007 The Guardian
  • US health system getting worse, says expert. The problems of the US healthcare system are growing, according to Karen Davis, President of the Commonwealth Fund. The United States is the only major industrialised nation without universal health insurance. Coverage varies widely between states and has deteriorated in recent years. The number of uninsured people has increased from 40 million in 2000 to nearly 47 million in 2005. Gaps in coverage lead to inequalities in access to care, poor quality care, lost economic productivity, and avoidable deaths. The Institute of Medicine estimates that 18,000 lives are lost annually as a consequence of gaps in coverage. It calculates the annual cost of achieving full coverage at $34bn - $69bn, which is less than the loss in economic productivity from existing coverage ($65bn - $130bn annually). Furthermore, expanding coverage would disproportionately help people on low incomes, who make up two thirds of the uninsured, thus increasing equity in access to health care and health outcomes, says Davis. Several states have enacted plans to make cover affordable for all uninsured residents, using state programmes to subsidise care for the poor and creating an insurance pool for small businesses and the self employed. Although these efforts are encouraging, most are taking place in states with relatively small uninsured populations, and there is little prospect that the federal government will legislate to make insurance affordable and mandatory for all. What is clear is that the problem is getting worse, not diminishing, she warns. The fragmented, uncoordinated healthcare system is plagued by high administrative costs and missed opportunities to control chronic conditions and prevent life threatening conditions. Summary by Keep our NHS Public of British Medical Journal 16 February 2007
  • Babies die as hospitals skip tests to save money. At least 350 newborn babies are dying in British hospitals every year because financial pressures are deterring doctors from checking for a life-threatening abnormality during pregnancy. Senior consultants have privately admitted they do not carry out the necessary scan for the condition - vasa praevia - to avoid the costs of caring for affected mothers. Other developed countries including America, Germany and Holland routinely check for the condition, which has a near-100% survival rate if diagnosed during pregnancy. In Britain, the mortality rate for otherwise healthy babies whose mothers suffer from it is more than 90%. The scandal has been exposed by a husband-and-wife team of lawyers, one an expert in clinical negligence. Daren and Natalie Samat have formed an action group to campaign for all mothers to be scanned. National Health Service trusts are understood to be resisting introducing checks as those diagnosed with vasa praevia must be funded to spend between four and 15 weeks under close monitoring in hospital before having a caesarean. A forthcoming study on vasa praevia is expected to show that fewer than 10% of NHS hospitals have guidelines requiring expectant mothers to be checked. Summary by Keep our NHS Public of Times 18 February 2007
  • Effective eye treatments - at home and abroad. In a letter to the Guardian, Simon Kelly, a consultant ophthalmic surgeon, writes: "Nigel Crisp's report to the prime minster on the UK contribution to health in developing countries (Report, February 13) should help us see Africa's healthcare problems and offer some solutions. Private sector surgeons and nurses from South Africa are doing rather nicely here in independent sector treatment centres - paid for by the NHS - while ministers and rock stars worry about health and poverty in Africa. Ophthalmic personnel from South Africa come here on lucrative short breaks to undertake NHS cataract surgery in ISTCs. This costs UK taxpayers more than if local NHS services undertook the same work. The irony is that there is a backlog of public sector patients blind from untreated cataracts or for want of spectacles in South Africa. Meanwhile, NHS eye departments are suffering from disinvestment due to this resource reallocation to the private health provider from South Africa, while schemes such as the National Refractive Error Program for South Africa are supported by international agencies and gift aid. Surely local eye healthcare staff are more needed in Africa than in ISTCs. Our needless mobile cataract units would be ideal for Africa's eye care. Perhaps Nigel Crisp would agree that such ophthalmic equipment not needed by NHS could be sent overseas ?" Summary by Keep our NHS Public of Guardian 19 February 2007
  • Prescription abuse outstrips illegal drug use, UN warns.  Counterfeit market has lethal consequences.  Crackdown on appetite suppressants urged. The abuse and trafficking of prescription drugs, including painkillers and stimulants, has overtaken the use of nearly all illegal drugs with the sole exception of cannabis, the United Nations drug control board warns today. The International Narcotics Control Board says the demand for painkillers, stimulants, sedatives and tranquillisers is so great that a global counterfeit market is rapidly developing. It also calls for a crackdown on the illicit availability of appetite suppressants, known as anorectics, which are fuelling a "slimming obsession" and led last year to the death of a Brazilian supermodel, Ana Carolina Reston. Alan Travis, home affairs editor Thursday March 1, 2007 The Guardian
  • UK nears European average in proportion of GDP spent on health care. Between 2000 and 2004 the increase in spending on health in the United Kingdom as a percentage of gross domestic product (GDP) was bigger than the increases in France, Germany, and Italy, says a new report from the Office of Health Economics (OHE). This means that the gap between the UK and other European countries such as Germany and France in total spending on health as a percentage of GDP has narrowed. Total spending on health care in the UK rose to an estimated £120bn in 2006, representing 9.4% of GDP, up from 7.1% in 2001. Summary by Keep our NHS Public of British Medical Journal 2 March 2007
  • Doctors attack Lancet owner's arms fair links. The publishers of The Lancet are under fire from leading doctors who are complaining about their escalating involvement in arms fairs. Across three pages of today's edition the medical journal publishes letters from top doctors, led by the Royal College of Physicians, who say that Reed Elsevier's commercial interest in the arms trade undermines the journal's efforts to improve health worldwide. Polly Curtis, health correspondent Friday March 23, 2007 The Guardian
  • Scottish university starts nursing college in Egypt. A Scottish university has increased its influence over shaping the future of nurse education in the Middle East. Queen Margaret University in Edinburgh yesterday revealed it had signed a deal to create a new nursing faculty at the University of Egypt in Cairo. The university has already worked in Saudi Arabia with businesses and the British Council to establish a college of nursing studies in Jeddah, which opened last September with 50 students. Debbie Andalo Friday March 23, 2007 EducationGuardian.co.uk
  • Report blames bureaucracy for UK cancer deaths. UK cancer patients are more likely to die from the disease than those in other developed countries as they are being denied access to the latest drugs, researchers said today. The study by the Karolinska Institute in Sweden found that the "excessive bureaucracy" involved in approving drugs for use in the NHS condemned British patients to an early death. Uptake in the UK of 67 drugs for breast, lung and colorectal cancers launched since 1985 has been "low and slow", according to the study, funded by the Swiss pharmaceutical giant Roche and published in the latest Annals of Oncology. More than half (51% to 52%) of patients in France, Germany, Italy and Spain have access to new drugs, compared with just 40% in the UK. French women with cancer are more than a third (34%) more likely to still be alive five years after diagnosis than their UK counterparts - 71% compared with 53% respectively. Meanwhile French men are nearly a quarter (23%) more likely to be alive after the same period - 53% compared to 43% respectively. David Batty Thursday May 10, 2007 Guardian Unlimited
  • UK 'worst' on cancer drug access. The UK has been criticised for its "slow and low" uptake of new cancer drugs by a Swedish study that has found massive inequalities in drug treatment for cancer across the world. The UK was ranked in the bottom group by the Karolinka Institute and Stockholm School of Economics research, with Austria, the US, France and Switzerland performing the best. They said that getting new cancer drugs to patients quickly and effectively was reflected in survival rates. France had the highest five-year survival rates. The research was funded by drug firm Roche. The greatest difference in uptake was found with bowel and lung cancer treatments. Lead researcher Dr Bengt Jonsson said: "It is our hope that this report will inspire policy-makers and decision-makers to take action to address these imbalances so that access to new innovative cancer drugs does not become dependent on the patient's country of residence. Cancer research continues to grow, with many new drugs and treatments expected to be introduced in the coming years. Countries need to address urgently how they are going to accommodate newer drugs into health care systems and pay for them." The National Institute for Clinical Excellence (NICE) has recently come under criticism for not assessing and approving new drugs for the NHS quickly enough. However a Department of Health spokesperson said that NICE was vital for ensuring the NHS had the most effective treatments and that the approval process for new drugs had been speeded up. "We are making good progress in ensuring cancer patients have access to the drugs they need," he said. "For example draft guidance was available within two weeks of Herceptin for early breast cancer being licensed." Summary by Keep our NHS Public of BBC 10 May 2007
  • 25 per cent of medicines used in Africa are fake.  Bogus medicines flood Africa - Conservatives propose EU “track and trace barcode“ to crush illegal trade. Care and Health 17 May 2007
  • Doctors call for ethical procurement. The NHS Purchasing and Supply Agency (PASA) and individual hospital trusts must develop ethical purchasing guidelines to stop the exploitation of poor workers in developing countries, the British Medical Association (BMA) has urged . Care and Health 17 May 2007
  • Drug firms and patient groups join in fight to overturn advertising ban. Drug companies in Europe, faced with declining sales and a shortage of new products, appear to be making ground in their attempt to enlist a major new ally in their struggle for profits - the patient. Sales soared in the US after companies were allowed to advertise their prescription medicines on TV and radio and in magazines and newspapers. Patients in America began demanding more drugs and specific, expensive brand-name drugs from their doctors. Now the firms want to target the UK in the same way, and are strongly challenging a ban on direct consumer advertising in the EU. Sarah Boseley, health editor Monday May 21, 2007 The Guardian
  • Labour contender calls for halt to privatisation in NHS. The 4 million Labour activists who have a vote in the deputy leadership election were offered their first real choice by candidates yesterday when Jon Cruddas, the former Downing Street aide financially backed by the union Unite, called for a halt to privatisation in the NHS. David Hencke, Westminster correspondent Monday May 21, 2007 The Guardian
  • GSK suffers as doctors avoid allegedly risky diabetes drug. GlaxoSmithKline took another hit yesterday amid signs that doctors in the US were avoiding its blockbuster diabetes drug Avandia after a study linked it to increased risks of heart attacks and death. Data from ImpactRX indicated that the drug's share of the market for newly prescribed oral anti-diabetics in the US fell to around zero from about 10% in the two days after the study was published on May 21st. ImpactRX, a market intelligence firm, tracks the impact of pharmaceutical promotion on the prescribing behaviour of physicians in the US. Marianne Barriaux Wednesday May 30, 2007 The Guardian
  • Formula milk is even more deadly in disaster zones. Support for breastfeeding during a humanitarian crisis should be a top priority, says Marie McGrath. Wednesday May 30, 2007 The Guardian
  • US to spend extra $30bn to fight HIV/Aids, pledges Bush.   Washington becomes campaign's biggest backer.  Critics praise president's commitment to fight. Ewen MacAskill in Washington Thursday May 31, 2007 The Guardian
  • Nigeria sues Pfizer for £3.5bn over 'illegal' child drug trials. The Nigerian government is suing the world's largest drug manufacturer, Pfizer, for £3.5bn in damages for allegedly carrying out illegal trials of an anti-meningitis drug that killed and disabled children. The children died or suffered serious side effects when the antibiotic Trovan was administered in Kano during a meningitis outbreak in 1996. The government of Kano, a northern state in Nigeria, also has civil and criminal cases pending against Pfizer. The Nigerian authorities say 200 children were involved in the Trovan experiment, without the approval of local regulatory authorities. They allege that as many as 11 died because of the treatment and that others developed deformities, including brain damage and paralysis. Trovan was approved in the US in 1997 for use by adults but not by children. Two years later the US Food and Drug Administration warned that the drug could cause liver damage. The medicine has since been discontinued. Chris McGreal, Africa correspondent Wednesday June 6, 2007 The Guardian
  • Contaminated Aids drug is recalled throughout Europe. An unprecedented emergency recall of all stocks of an Aids drug in the UK and the rest of Europe was ordered last night because the tablets contain a dangerously high level of a cancer-causing chemical. All those taking the drug Viracept are being asked to see their doctor immediately so that they can be prescribed an alternative medicine. Investigators are trying to find out what happened at the plant in Switzerland where Viracept is manufactured. It is understood that the contamination could have occurred in March and affected supplies of the drug for three months. That would mean large quantities of contaminated drugs have already been consumed. The European Medicines Evaluation Agency, which ordered the first all-Europe recall in its history, said they had no reason to suspect foul play. Sarah Boseley, health editor Thursday June 7, 2007 The Guardian
  • EU Health Strategy- consultation shows support for increased EU cooperation. There is general support for a new overarching European Health Strategy and a desire for more cooperation between the European Commission and EU Member States to further improve and protect health in Europe, the results of a public consultation process reveal. Care & Health 8 June 2007
  • Closing the Gap. The Wales Centre for Health has produced a report as part of the three-year Closing the Gap project calling for an end to health inequalities across Europe.  Care & Health 26 June 2007
  • Pregnant migrants are unfairly denied NHS treatment, says charity.  Report tells of lack of access to antenatal care.  Clinic says findings 'rebut myth of health tourist'. Pregnant women are being denied antenatal care by the NHS because of their immigration status, endangering mother and baby, a medical charity has found. Médecins du Monde, which normally works in deprived and developing parts of the world, set up a clinic in London a year ago because of concerns that some people were struggling to get healthcare in one of the world's richest cities. One year on, its experience shows that the NHS, intended to be free to all, is not available to some of those who need it and who, under the letter of the law, are entitled to medical help. Sarah Boseley, health editor Wednesday July 4, 2007 The Guardian
  • UK residents labelled as 'health tourists' have problems accessing health care. Some people in the United Kingdom are struggling to access routine medical care, including consultations with GPs and antenatal care, because they are wrongly being labelled as "health tourists," says a report. The report, from the charity Médecins du Monde UK, analyses the first year's activity of the charity in London, where it set up a clinic in the east end to improve access to health care for vulnerable people in and around the capital. The group says that regulations introduced in April 2004 to charge "overseas visitors" for NHS hospital treatment is making it difficult for some people who have legitimate rights to NHS treatment to get routine care. In 2006 a total of 349 people came to the Médecins du Monde clinic for 435 consultations. The most common request was for help to register with a GP. But worryingly, 39 pregnant women came to the clinic, half of whom had had no previous antenatal care, and nearly a quarter of whom were at least 20 weeks pregnant. Late access to maternity services is a risk factor for maternal death, says the report. But it found that 70% of the pregnant women who had come to the clinic had had difficulties in accessing primary care or antenatal services. At least 30% had not been tested for HIV. Instead of saving money, as was intended, the policy is likely to lead to increased costs because "those who are denied care become so ill that they need to access emergency treatment," said Susan Wright, director of Médecins du Monde UK. Paul Hunt, United Nations special rapporteur on the right to the highest attainable standard of health, says in a foreword to the report that "the rules governing entitlement to free NHS care in England, which introduced new and greater restrictions on access to health care for some migrants, seem to be taking us in the wrong direction. The legislation appears to be incompatible with fundamental right to health principles." Médecins du Monde, which generally provides health services to people in regions of conflict, poverty, and natural disasters, is calling for the restrictions on accessing UK health care based on immigration status to be removed, especially to maternity services. In a joint statement, the heads of nine campaigning groups, including Crisis, Doctors for Human Rights, Medact, and the Terrence Higgins Trust, backed the charity's demands. "Any restrictions on access to NHS health care based on immigration status pose public health problems, violate international law, compromise the independence of health professionals, and are likely to cost more than they save," they say in a statement. "We urge a return to NHS principles to ensure that everyone living in the UK has access to medical care, free at the point of need." Summary by Keep our NHS Public of British Medical Journal 13 July 2007
  • NHS doctors challenge high drugs prices. British doctors are to rebel against high prices set by pharmaceutical companies for their products by giving patients a cheap but unlicensed drug that prevents blindness, the Guardian has learned. Unable to afford to treat all those losing their sight with a licensed and extremely expensive drug, Lucentis, some primary care trusts are giving NHS doctors the green light to use tiny shots of a similar drug, Avastin, which is marketed for bowel cancer, but costs a fraction of the price. Avastin is widely used for eye complaints in the United States. A call from the former health secretary, Patricia Hewitt, for Avastin's manufacturer to put the drug through trials for wet age-related macular degeneration went unheeded. Now the NHS is funding a groundbreaking trial which will compare Avastin directly with Lucentis. Both drugs are manufactured by Genentech. The moves represent the first real challenge in this country to high prices set by drug companies. There is growing unease at the cost of new drugs and high prices have led to the banning or rationing of some medicines in the NHS by the National Institute for Health and Clinical Excellence (Nice). The companies say they need billions of dollars in sales to recoup their research and development costs, but critics accuse them of profiteering. Meanwhile, in the developing world, unaffordably high drug prices have brought the pharmaceutical industry into disrepute, forced their prices down and led to successful campaigns to allow generic copycat companies to sell cheap versions of drugs. Sarah Boseley, health editor Monday July 30, 2007 Guardian  
  • Britain launches plan to improve developing countries' healthcare. A radical strategy to help developing countries improve their healthcare and retain desperately needed doctors and nurses was launched by the prime minister, Gordon Brown, yesterday. While increasing amounts of money and effort have gone into initiatives to fight specific diseases such as HIV/Aids and immunise children against polio, it has become clear that the fight against disease in poor countries is being lost. Of the UN's eight millennium development goals (MDGs), the health targets - such as cutting the deaths of babies and women in childbirth - are the least likely to be achieved. One woman dies giving birth every minute and 28,000 small children a day die of largely preventable causes. Yesterday Mr Brown launched an international health partnership bringing together donor countries, non-governmental organisations and international agencies who pledged to work together to improve the flow of aid into health. They will work initially with seven developing countries which have undertaken to improve their healthcare systems - the delivery of care in hospitals and clinics, the numbers and training of medical staff and the supply of drugs. Sarah Boseley, health editor Thursday September 6, 2007 The Guardian
  • First world results on a third world budget. According to Michael Moore's latest film Sicko, Cuba's medical care puts America's to shame. Rory Carroll investigates. In pictures: healthcare in Cuba. Graphic: Key health statistics in Cuba, the US and UK (pdf) Wednesday September 12, 2007 The Guardian
  • Case for going Dutch on NHS monitoring. David Brindle Wednesday September 19, 2007 The Guardian
  • Campaigners attack UK over Aids funding. The British government was yesterday accused of breaking its G8 pledge to help defeat Aids when it revealed it would only marginally increase its contribution to the Global Fund for Aids, Malaria and Tuberculosis. The international development secretary, Douglas Alexander, promised £1bn over the next eight years to the fund, but campaigners said this fell far short of the G8 pledge to treble contributions by 2010. Sarah Boseley, health editor Wednesday September 26, 2007 The Guardian
  • Boy's death highlights US health debate. George Bush is set to veto congressional health legislation that would extend health care to 4 million children, saying it goes beyond its remit of providing care for low-income families. The case was highlighted in February by the death of Deamonte Driver, a 12-year-old boy who died because his parents could not afford private dental care. One Thursday the boy complained of toothache, the following Saturday he had emergency surgery because an abscess had spread to his brain. He died a few weeks later. Deamonte's mother could not afford private health insurance and, although there is free Medicaid for the poorest, not all dentists or doctors accept it and Deamonte's mother could not afford to have his tooth removed. Some 45 million Americans are without health insurance, nine million of them children. Many consider the issue to be America's national scandal and Washington political opponents have come together on the issue with both Democrats and Republicans coming together to support a bill that would help fund insurance. The bill passed 67 - 29 in the Senate but did not achieve the two-thirds majority in the House of Representatives necessary to override the presidential veto. The proposed bill extends the State Children's Health Insurance Programme (Schip) that subsidises insurance for families who may not be the poorest, but who cannot afford private insurance. Supporters propose to pay for the bill by increasing tax on cigarettes. Mr Bush says the move goes against the principles of private health care and to provide care would create a disincentive for people to purchase care themselves. Mr Bush says he supports tax breaks for poorer families purchasing care and that the legislation "directs scarce funding to higher incomes at the expense of poor families". One Democratic Congressman, Elijah Cummings, from Maryland has gone further in proposing "Daemonte's Law" to ensure all children have access to dental care. "It's shocking, it's sad," Mr Cummings said of Deamonte's death. "It provides a wake-up call to us all that we have to do better." Summary by Keep our NHS Public of BBC 29 September 2007
  • Only dogma and corporate capture can explain this. It beggars belief that US health privateers straight out of Michael Moore's Sicko are being lined up to run core NHS services. Seumas Milne Thursday October 18, 2007 The Guardian
  • EU Considers Greater Integration of Health Services. On the 20 November this year, the EU is to release a draft directive setting out proposals for cross border healthcare. This follows on the back of a series of cases in the European Court, most notably the case of Watts where a UK resident sought to recover from her Primary Care Trust, the costs of a bilateral hip replacement operation she had undergone in France.  Care & Health 31 October 2007
  • What's the verdict on Sicko? Let us know what you think about Michael Moore's film on US healthcare. Michael Moore's latest film, an appraisal of the US healthcare system, opened in cinemas this weekend - and if you've seen it, we'd really like to hear from you. Sicko compares healthcare provision in the states with our national health service. Guardian blog October 29, 2007
  • The fruits of Kiwi health reform. Slowly but surely, the health reform tide in England is turning. Gordon Brown and health ministers have signalled their intention to place much greater emphasis on public health than their predecessors, alongside a continuing commitment to improve the performance of the NHS. Lord Darzi's interim report on the NHS specifically highlighted the need to make more progress in tackling health inequalities. With a boy born in Manchester likely to die almost 10 years earlier than a boy born in Kensington and Chelsea, a concerted drive to improve health by focusing on people most in need seems certain to loom large in the next stage of health reform. Last week's announcement that the government is planning 10 eco cities, designed to make it easier for people to exercise, is an indication of the way in which ministers are thinking. The risk with this approach is that it will become just another initiative unless it is part of a well-designed public health strategy. Ministers should look to New Zealand for lessons on how to avoid risk. Recent analysis showed that the widening of health inequalities there has been stemmed and, to some degree, reversed. Although the precise reasons are not fully known, inequalities in New Zealand appear to have been tackled successfully as a result of a long-term commitment to public health and primary care. Under prime minister Helen Clark, New Zealand turned its back on the failed internal market experiment of the 1990s, and set up health boards - integrated organisations whose members are made up of some people elected by the public and others appointed by the health minister - with responsibility for planning and providing health and disability support services. Health inequalities in New Zealand are most evident in the poorer health experienced by Maori and people from the Pacific Islands. To address these inequalities, Clark's government developed a health strategy in 2000 in which public health received as much attention as healthcare services. The strategy included health boards working with public agencies and third sector organisations to implement population-wide programmes to address risk factors such as unhealthy diet and lack of exercise. A major focus of these programmes has been to target support at hard-to-reach groups by working with Maori and Pacific Island organisations. In the case of people from the Pacific Islands, health boards have capitalised on the role that religious life plays in these communities, by delivering health advice and medical care with and through churches. Similarly, tribal structures have been engaged to reach the groups most in need among Maori. Equally important has been the emphasis on primary healthcare. Concerned at the adverse effects of charging patients to see a GP, Clark's government developed a primary care strategy that has resulted in an investment of NZ$2.2bn (£0.81bn) over seven years. The fees paid by patients and the costs of prescriptions have fallen considerably, making it easier for families on low incomes to get care. This has contributed to a stronger emphasis on prevention in primary care, with a particular focus on the management of people with diabetes. Patients in New Zealand find it much easier to make an appointment than their counterparts in the UK because GPs lose income if patients seek primary care from a practice other than the one where they are registered. The Brown government would do well to consider how to adapt this arrangement. An option would be to claw back funds GPs receive from the government where practices have higher than expected use of services by patients out of hours. This could be done while maintaining care free to patients at the point of access - an aspect of the NHS superior to that found in New Zealand. Another lesson from New Zealand is the value of local people involved in health boards. The two-thirds of members elected by the public are chosen every three years, with elections held at the same time as those for local authorities. Turnout is around 40%, and most candidates stand as independents. New Zealand's system has the twin virtues of engaging the community directly and avoiding the risks of overcentralisation to which the NHS is so prone. There is a greater willingness to deal with the challenges of the health system at a local level, instead of pulling these challenges in to the government in Wellington. At a time when the NHS is entering a much more difficult financial climate, Brown and health ministers may well be attracted to an arrangement where the blame for the NHS no longer gravitates towards Whitehall, but is dealt with by locally-accountable bodies. Chris Ham The Guardian Wednesday November 7 2007
  • Competition in a publicly funded healthcare system. A report by Steffie Woolhandler and David Himmelstein in the British Medical Journal begins:
    Why would anyone choose to emulate the US healthcare system? Costs per capita are about twice the Organisation for Economic Cooperation and Development average. Forty seven million people are completely uninsured. Many others with insurance face high out of pocket costs that hinder care and bankrupt more than a million annually. Mortality statistics lag behind those of most other wealthy countries, and even for the insured population, clinical outcomes and patient satisfaction are mediocre. This dismal record arises, we contend, from health policies that emphasise market incentives. Even as the public share of health spending in the US has risen to 60% investor owned firms have eclipsed the public, professional, and charitable bodies that previously managed the financing and delivery of care. The development and effect of US policies that mix public funding and private management has wider relevance because politicians in Europe and beyond are pushing analogous schemes.
    Summary by Keep our NHS Public of British Medical Journal 30 November 2007
  • EU promises free care for health tourists. Patients will be able to travel to hospitals across Europe for health treatment and claim back the costs on the National Health Service under proposals introduced by the European Commission. Care & Health 19 December 2007
  • EU delays move allowing patients to travel for care. The European commission yesterday postponed publishing a plan to give NHS patients access to free treatment in any EU member country. The proposal sparked a row in Westminster where it was welcomed by the Conservatives as an extension of patient choice but Labour MPs and health unions feared it might subvert the NHS by allowing wealthy patients to jump the queue for treatment. John Carvel, social affairs editor The Guardian, Thursday December 20 2007
  • Setback for NHS patients' treatment abroad. Patients hoping to receive treatment abroad paid for by the National Health Service received a setback. The European Commission postponed at the last minute a draft directive that would have made it easier to seek healthcare in other EU member states. The commission claimed the delay, until the new year, was caused by "congestion" and "purely for agenda reasons". But it left British health ministers and others with reservations delighted. Recent versions of the draft directive would allow patients to travel to other countries and be reimbursed domestically, without prior authorisation, up to the cost of the treatment in their own health system. Summary by Keep our NHS Public of Financial Times 20 December 2007
  • Humana sued in federal court over incentives for doctors. Humana Inc., one of the nation's largest managed-care companies, was accused in a Federal lawsuit of misleading health plan members by failing to disclose financial incentives to doctors and case reviewers intended to keep down costs by limiting or denying care. The suit, filed on behalf of workers in Florida and Texas, asked a United States District Court in Miami to certify a class action on behalf of more than 6m customers of Humana health plans nationwide. The plaintiffs say they did not get the health coverage that they thought they were selecting because the company did not disclose incentives to doctors to deny care. The suit contends that there was a ''breach of trust'' because plan members thought that medical guidelines would solely determine their treatment. Shares of Humana fell 6.25 cents, to $7, on the New York Stock Exchange. Shares of the three biggest managed-care companies, Aetna Inc., the United Health Group and the Cigna Corporation also declined. These stocks have been battered recently after reports that several big law firms across the country were planning class-action suits against the health care insurers as well as uncertainty about proposed legislation that could open the health plans to malpractice lawsuits. A Supreme Court judge in New York recently refused to dismiss a lawsuit that accused a Prudential health plan of relying on guidelines from an actuarial firm in deciding questions about medical care. On another front, the United States Supreme Court is reviewing a Federal appeals court decision that said managed-care plans violated their duty to members when doctors withhold or delay treatment to obtain bonuses or financial rewards from the companies. Summary by Keep our NHS Public of New York Times 9 January 2008

See International recruitment for articles on the recruitment of staff, in particular from under-resourced countries.

American Health Care Model

From Keep our NHS Public

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