- Making medicines safe for the young and old. Letters
Wednesday February 8, 2006 The Guardian
- Ritalin, extensively prescribed to calm hyperactive children in the UK,
should carry the highest-level warning that it may increase the risk of death
from heart attacks, US experts recommended yesterday. There have been 51
deaths among children and adults taking drugs for ADHD (attention deficit
hyperactivity disorder) in the US since 1999. Yesterday the UK licensing
authority, the Medicines and Healthcare Products Regulatory Agency (MHRA),
said nine children had died in this country among a smaller population on
medication. They declined to reveal the children's ages because of the
possibility of identification. Sarah Boseley, health editor
Saturday
February 11, 2006 The Guardian
- Psychiatric
shortfall puts children 'at severe risk'. Children with mental health
problems are being put at severe risk by long waiting lists to see a
psychiatrist and the closures of specialist units designed to treat them,
according to a survey by Pulse magazine. NHS trusts are cutting in-patient
beds for young psychiatric patients at a time when the number of children
suffering from mental illness is increasing. Youngsters are waiting an average
of more than six months to see a child psychiatrist. The survey of 1,300 GPs
by the medical magazine Pulse found that the average wait for an appointment
with a child psychiatrist was 188 days. Children had to wait 79 days before
even an initial assessment was made by the Child and Adolescent Mental Health
Service (CAMHS), and a further 102 days before treatment. There is also
criticism that children are being treated with a "chemical cosh" of
prescription drugs because of budget constraints on other therapies, such as
counselling. 93% of family doctors admitted they had to prescribe
antidepressants because of a lack of alternative therapies. Three of the
country's 13 specialist children's psychiatric in-patient units have closed
since 2003. A fourth, the Park Hospital unit in Oxford, is also threatened
with closure, despite being considered one of the best in the country. Doctors
at the unit were told a few months ago that it was being moved to new
buildings. They have now been told that the in-patient service is to be shut
due to the budget deficits of the local trust.
Summary by
Keep our NHS Public
of
Independent 2 March 2006
- Four children's hospitals have warned health
ministers they will have to cut specialist services because of miscalculations
in the new payments-by-results system championed by Tony Blair as part of his
NHS reforms. The threat to specialist services for children was revealed by
the Liberal Democrats, who released papers showing children's trusts have told
ministers they will have to cut services because they claim they are facing a
£22m shortfall in the new financial year. The letter was sent by the chairs
and chief executives of
Great Ormond Street,
Alder Hey,
Birmingham and
Sheffield hospitals. Together the four hospitals form the National
Children's Health Alliance, and they claim the proposed funding will damage
the provision of cardiac surgery, neurosurgery and spinal surgery.
Patrick Wintour, political editor
Tuesday April 18, 2006 The Guardian
- Children's
hospitals 'at risk' from
tariff system. Four children's hospitals
have warned health ministers they will have to cut specialist services because
of miscalculations in the new payments by results system that will see them
face a £22m shortfall in this financial year. The letter to ministers was sent
by the chairs and chief executives of
Great Ormond Street,
Alder Hey,
Birmingham and
Sheffield hospitals, who together form the National Children's Health
Alliance. It says: "We are extremely concerned that vital specialist
paediatric capacity, particularly in surgical specialities, will be lost at
regional and national level this year, which will lead to public concern. The
new opportunities presented by choice and through payment-by-results should be
benefiting young people and children, but quite the reverse seems to be the
case. Our trusts are increasingly the only place of choice for parents whose
children need specialist paediatric care." The trusts blame the "inaccurate
and highly insensitive tariff" under payments by results. To make ends meet,
they say, they will have to identify those services on which they stand to
lose most money and stop providing them. Obvious candidates include heart,
brain and spinal surgery. "We are extremely concerned that vital specialist
paediatric capacity, particularly in surgical specialties, will be lost at
regional and national levels this year, which will lead to public concern."
Summary by
Keep our NHS Public
of Times
18 April 2006
- Parents win ruling to
send doctors back to GMC over misdiagnosis. Daughter suffered
chronic fatigue, not child abuse. Spotlight on
secrecy in family justice system. Clare Dyer, legal editor
Monday May 1, 2006 The Guardian
- Bed loss for
sick children. Money pressures have led to the loss of a third of NHS
inpatient places for young children with mental
health problems according to psychiatrists. Young children are being placed on
wards with older adolescents and even adults as the last three years have seen
the number of beds for young mental health patients fall from 129 to 86. One
child psychiatrist in
Birmingham has threatened to resign over a planned merger of wards for
adolescent and younger patients.
Summary by
Keep our NHS Public
of Stoke Sentinel 27 May 2006
- An Observer story triggered an NHS doctor's decision to speak out on
discrimination against vulnerable pupils - and to return home early. Anushka
Asthana
Sunday July 30, 2006 The Observer
-
Union seek talks
with Blair on NHS job cuts. Health unions have sought an urgent meeting
with Tony Blair to complain about
job
cuts and
reduced services ahead of a raft of challenges to the government's NHS
reform agenda. Unions including Unison, Amicus, the Royal College of Nursing
and the British Medical Association have threatened strike action and plan
parliamentary lobbying as part of a campaign against "the
alarming pace of ill-advised change in the NHS". The Trade Union Congress'
annual congress is also likely to cause upset with its preliminary agenda
showing more motions opposing public sector reform than on any other issue.
Similar issues are likely to dominate the Labour party conference later next
month. The unions laid out their joint position yesterday saying: "We do not
believe that handing over the provision of services to
private providers and allowing individuals and shareholders to make a
profit from taxpayers is in the best interests of the NHS or the people who
rely on it now and in the future." Unison is already balloting 900 staff in
NHS logistics, which delivers medical supplies within the NHS, over their
proposed sale to DHL.
Recently the Department of Health has abandoned plans to extend its
payment-by-results schemes due to its "serious consequences to
children's hospital services" and the health select
committee has said the government has failed to demonstrate the benefits of
Independent Sector Treatment Centres: Facts which add credence to the
unions' claim that "many reforms are being implemented without being tested or
evaluated to assess their effectiveness or otherwise." The unions have
demanded that health trusts be given time to balance the books through
"managed efficiency savings rather than indiscriminate cuts" and attacked
private sector involvement as "allowing private companies to cream off profits
while leaving hospitals saddled with high levels of ongoing debts".
Summary by
Keep our NHS Public
of Financial
Times 1 August 2006
-
Most hospitals unsafe for children, report finds. Medical training
and child abuse safeguards lacking. Clinics may have to shut, says
healthcare watchdog. Three-quarters of NHS hospitals in England cannot guarantee
the safety of children in their care, the government's health watchdog warned
today in a "wake-up call" to shock doctors and managers into improving services.
The Healthcare Commission said nearly one in five NHS trusts did not provide
effective life support for children brought in for emergency treatment at night
last year. More than half of hospitals did not give staff adequate training in
child protection, ignoring procedures put in place after the death of the child
abuse victim Victoria Climbié in 2000. Many doctors in outpatient clinics and
day surgery units knew little about pain relief for children, and the majority
of NHS surgeons and anaesthetists lacked essential training in how to
communicate with children. An inquiry by the commission found too many hospitals
providing children's medical services lack specialist knowledge and a sufficient
throughput of cases to maintain doctors' skills. John Carvel, social affairs
editor
Wednesday February 28, 2007 The Guardian
- Children's
palliative care "patchy". The Children's Palliative Care review has found
a lack of information and patchy provision are leaving the families of
terminally ill children to fight for support. Often those in need fall through
the gaps in service provision and experts said that "hard-pressed parents were
exhausted". The inquiry, commissioned by the government and produced by
Professor Sir Alan Craft, a former president of the Royal College of
Paediatrics and Child Health, and senior civil servant Sue Killen, said that
parents found the system frustrating and that they were often passed between
council social services and NHS trusts. Parents particularly wanted community
teams to operate 24 hours a day, allowing them the choice of where their
children spend their final days instead of being forced into hospital because
there is insufficient specialist care in the community. The report also calls
for long-term funding arrangements for the sector. Hospices which currently
provide much of the care have been heavily reliant on lottery money which has
now come to an end. Ministers are giving £27m to help cover costs over the
next three years. Professor Craft said: "Overall, the review found a lack of
sustainable funding and strategic planning and unacceptable variations in the
provision of services and levels of spending." The government has as a result
pledged to produce a strategy by the end of the year. Health Minister Ivan
Lewis said: "We need to deliver a system that is fit for the future and
provides the right care in the right places at the right time." Lizzie
Chambers, of the Association of Children's Palliative Care, a support group
for parents, said: "Children with life-limiting or life-threatening conditions
deserve better. Their families are fighting to get the help they need and this
has to stop."
Summary by
Keep our NHS Public of BBC
17 May 2007
- Children's jail staff given wider powers of restraint. The rules
governing the use of restraint techniques based on inflicting pain in
privately-run children's jails are to be widened to allow staff to use them to
enforce everyday discipline, the Ministry of Justice confirmed yesterday. MPs
and penal reform campaigners have criticised the change, which comes before
the outcome of an inquest next week into the case of Gareth Myatt, 15, who
died after being restrained at a secure training centre in
Northamptonshire. Until now staff at the four privately-run secure
training centres have been legally allowed to use physical restraint
"distraction" techniques - including hitting a child's nose from underneath -
only to prevent children from harming themselves or harming others, or to
prevent damage to property. The use of restraint to secure compliance with
staff instructions, such as getting a teenage boy to go to bed or clean his
room, or as a punishment, has not been permitted in child jails until this
change in the rules. Three weeks ago a coroner called for an urgent review of
the use of restraint after a jury returned a suicide verdict on Adam Rickwood,
14, who became the youngest person to die in custody for 50 years after he
hanged himself with his shoelaces at Hassockfield secure training centre,
Co Durham. He had been forcibly restrained by four staff shortly before
his death. Alan Travis, home affairs editor
Tuesday June 19, 2007 The Guardian
- Paediatricians argue second cot death is rarer than study says. Two
cot deaths in a family may be rarer than has been claimed, says a study that
is set to reopen the fraught issue that was the key factor in several highly
publicised court cases over such deaths of babies. A British Medical Journal
paper re-analyses a study that was central to assumptions on multiple cot
deaths in families. The original study said the vast majority of second cot
deaths - 87% - were from natural causes. But a second analysis finds that only
43% of the deaths were "probably natural", while 13% were "probably unnatural"
and a further 43% were of undetermined cause. The paper, by Christopher Bacon
and Edmund Hey, senior paediatricians, now retired, says the original study,
by Carpenter and colleagues, published in the Lancet, defines some of the
second deaths as natural when there should be real questions about what had
occurred. Sarah Boseley, health editor
Friday
July 20, 2007 The Guardian [This is not important, as increasing the
uncertainty as this study does would not justify any legal proceedings.
It looks like an interest group trying to justify past readiness to prosecute
after the prosecutions have been discredited]
- Four times as many children prescribed antidepressants. The number
of prescriptions for antidepressants and other mind-altering drugs given to
children under 16 has more than quadrupled in the last decade, according to
official figures released today. Press Association
Monday July 23, 2007 SocietyGuardian.co.uk
- Reforms hitting
children's surgery, says royal college. Competition between hospitals is
hindering the collaboration required to provide better children's surgery,
according to the Royal College of Surgeons. The college has called for
children's surgery to be protected from competition and other reforms such as
payment by results. The college's report says that, although clinical networks
need to be expanded, the reform drive is damaging collaboration, and also that
more routine surgery must be available locally - although more complex
procedures should be centralised. Surgery for Children: delivering a first
class service says: "Current health policy reforms that introduce competition
can provide a disincentive for trusts to collaborate." It adds that payment by
results can make it difficult for parts of networks to get reimbursement. It
warns: "These reforms should not be allowed to jeopardise provision of safe,
local care for children." The college calls for the separate commissioning of
children's surgery and says an increase in tariff may be necessary to keep
surgery local. The report says: "When considered along with payment by
results, patient choice and contestability, the next few years will be
difficult in terms of sustaining local services for children." The report goes
on to say that the number of specialist children's surgeons needs to be
doubled by 2010. A Department of Health spokesman said the tariff arrangements
for the next financial year were being looked at. "We recognise that
paediatric surgery may have higher average costs than similar procedures for
adults and that is why the national tariff applies a top-up where the patient
is a child and if the procedure is specialised," he said.
Summary by Keep
our NHS Public of Health
Service Journal 26 July 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
- Babies dying due to NHS confusion. Scores of premature babies may
be dying unnecessarily across England because the NHS mismanaged a reform of
neonatal units in 2003, parliament's spending watchdog reveals today. Health
ministers provided £73m over three years to link up hospital neonatal units in
23 regional networks that could provide specialist services to save premature
and low birth weight babies. But the National Audit Office finds that the
Department of Health did not issue instructions for the units to be adequately
staffed. As a result the service was overstretched. Its specialist nursing
workforce was nearly 10% below strength. There were not enough cots to respond
to every emergency and there was a lack of specialist 24-hour transport to
move babies and mothers to other hospitals. Jacqui Smith, when health minister
in 2003, said she agreed with recommendations from the British Association for
Perinatal Medicine for minimum staffing ratios. But the government did not
order NHS trusts to implement them. The NAO says there was "confusion" over
whether staffing ratios were mandatory, making it difficult for unit managers
to convince NHS trusts they needed more staff. Half the 180 units providing
neonatal services did not meet the approved ratio for high dependency care of
one nurse to two babies. And only 24% met the intensive care ratio of one
nurse to one baby. The NAO acknowledges that the 2003 reform improved
standards, leading to fewer babies travelling long distances for suitable
treatment. But the improvement was not as great as ministers anticipated.
Every year about 60,000 newborn babies specialist care - about 10% of all
births. In 1975 half the premature babies with a low birth weight died and
many were stillborn. By 1995 the proportion had fallen to one sixth. In 2003
ministers said the reorganisation could save an extra 200-300 lives a year,
but by 2005 the mortality rate had fallen by only about 120. Units had to
close to new admissions on average about once a week in 2006-07, mainly due to
a lack of cots or staff shortages, the NAO says. A third of the units had a
cot occupancy rate of more than 70% - the maximum recommended to avoid harming
babies through increased risk of infection or inadequate levels of care. Only
half the units provided round-the-clock specialist transport services. Staff
often had to leave the unit to accompany a baby on a transfer, leaving
colleagues even more overstretched. Hospital managers had little idea of the
service's real costs. Intensive care cot charges varied from £173 a day to
£2,384. The NAO says it found wide variations in the death rates of the
networks, not all of which could be explained by the social characteristics of
their catchment areas. In 2005, the
south-west Midlands network had the highest death rate at 4.8 babies per
1,000 live births.
Surrey and Sussex had the lowest at 1.8 per 1,000. John Carvel, social
affairs editor
The
Guardian, Wednesday December 19 2007
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