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Top health stories 02.09.11 How can you help the PA? Click here
Welcome to all of our new members and E-members This week... Update from the PA This Week in Westminster Policy News: 1. Internet Campaign group 38 Degrees issues warning over Health and Social Care Bill 2. Former NHS boss says that more hospitals should be closed 3. Red tabard scheme for nurses on drugs rounds 4. Health reforms risk doctors putting wealthy patients first warns British Medical Association Snapshot of Health news

Update from the PA Denial of services We have been hearing increasingly from callers to our Helpline that some patients are having greater difficulty accessing services than before. We are therefore conducting a survey of patients to find out how widespread this problem is. We would be really grateful if you could take the time to fill out a short survey on access to NHS services. The link to the survey is https://www.surveymonkey.com/s/ZRP9MGG Back to the top

This Week in Westminster Parliament continues to be in recess but is due to return on Monday next week. The Health and Social Care Bill is due go before the House of Commons for its third reading on Tuesday and if successful it will pass to the House of Lords to repeat the process. The Government have tabled its final amendments before the third reading of the Bill next week. Over a thousand amendments have been tabled although it has been reported that almost three quarters of these are to change the name of GP consortia to Clinical Commissioning Groups and other name changes. Others deal with changing the role of Monitor and competition in the NHS. John Healey, Shadow Secretary of State for Health, said that, "having allowed so little time for the health bill committee to scrutinise the repackaged NHS plans, this again shows David Cameron and his ministers looking to railroad their legislation through the Commons. MPs will get only two days to debate these amendments next week, as the prime minister and his deputy hope to square everything off before their party conferences." There has also been unease within the Liberal Democrats over the Bill as it goes back before the House of Commons. Liberal Democrat MPs will be meeting on Monday to discuss how they will respond to the Bill and whether they will vote to allow it to pass to the House of Lords. Andrew George, Liberal Democrat MP for St Ives, who has already said he will vote against the Bill, said "I have got a number of amendments going down and if it does not improve I will be voting against it. It is a missed opportunity to reform health and social care, and I have no qualms about voting against it as it [the Bill] tears up the coalition agreement anyway." Conservative MP, Mark Pritchard, responded saying, “Not content with gutting the original Health and Social Care Bill, some Liberal Democrats now want to completely dismember it. The NHS needs reform not romantic retrospection”. However, some Liberal Democrats have pledged to vote for the Bill and have been trying to persuade their party colleagues to vote in favour. Norman Lamb, who earlier this year threatened to step down from his position in the party if significant changes were not made to the proposed reforms, has now said that he will vote for the Bill. He said, "Above all else, let's get the legislation through. Let's give some certainty to the NHS, so it can achieve the efficiency savings that are so important. Of course we've got to get it right and ensure that the amended clauses meet the objectives set by the listening exercise. The mass of opinion now recognises it's not in the interests of the NHS to obsess on a continuing basis about the minutiae of this bill." This week is the 25^th Anniversary of the landmark “Don’t die of ignorance” campaign run in 1986 to raise awareness of HIV and AIDS. To mark the anniversary, the House of Lords Select Committee on HIV and AIDS have published a report warning that more still needs to be done to address the issue of HIV and AIDS in the UK. The Chairman of the committee, Lord Fowler, who was the health minister who commissioned the original campaign commented saying, "Awareness of HIV and Aids in Britain has fallen below the public radar. Today the common question is 'Is it still a problem?' Perhaps because the scale of the epidemic in Africa is so vast, the undoubted challenge here is pushed to one side. Yet HIV in Britain has not gone away. In recent years, in fact, the number of new diagnoses has been more than double the annual rate seen in the mid-1990s." The report also found that the number of people being treated for the disease in the UK has trebled in the last decade and the cost of managing the disease has risen from £500 million in 2006 to £760 million 2010. The Committee has called for more to be spent on prevention and for a new awareness raising campaign. Back to the Top

Policy News 1) Internet Campaign group 38 Degrees issues warning over Health and Social Care Bill The Internet campaign group, 38 Degrees, have warned that the Health and Social Care Bill could allow the Secretary of State for Health to “wash his hands” of responsibility for the NHS. This warning was issued after the group sought independent legal advice on the Health and Social Care Bill. This is spite of assurances from the Secretary of State for Health, Andrew Lansley, that this would not be allowed to happen. There has been widespread concern over certain “hands off” clauses in the Bill since it was introduced in January. Now the 38 Degrees’ legal team have confirmed that these clauses giving greater autonomy to local commissioning groups could remove the Secretary of State for Health responsibility for the provision of NHS services. The legal opinion also warns that EU laws governing competition in business could apply to decisions about the NHS, giving private companies with experience of these an advantage. The Leader of the Opposition, Ed Miliband, questioned the Prime Minister about this several months ago but was told that this would not happen. David Babbs, Executive Director of 38 Degrees, said "The so-called 'hands off' clause … removes political accountability, which is the only real control voters have on the way the NHS is delivered. We won't be able to fire people on regulatory bodies or private healthcare companies when things go wrong. None of us voted for these fundamental changes to the NHS. They weren't in any party's manifestos, or the coalition agreement, so 38 Degrees members have clubbed together to get legal advice to convince MPs that the changes shouldn't be pushed ahead and that the public's concerns need to be taken seriously." The Chair of the Royal College of General Practitioners voiced her concerns, saying, "Having seen these legal opinions, they raise serious concerns for GPs. As family doctors, we want to ensure any changes to the NHS safeguard its future and benefit patients. The advice of these legal experts brings this into question. That is worrying and the government needs to respond." A second legal opinion was sought from Rebecca Haynes of Monkton Chambers who said, “The complexity of the regime and the administrative burden in complying with the rules (which are constantly evolving through a rapidly expanding body of case law) cannot be underestimated … The relative ease with which bidders can bring claims in the high court at any stage of the procurement has led to an increased appetite for litigation and administrative challenge." The Department of Health have issued a statement saying, the Secretary of State will retain responsibility for "promoting a comprehensive health service". The NHS is there to serve patients and the public and must be accountable to people locally and nationally. We are concerned that under current proposals, local commissioning groups are not accountable to local people. If the Secretary of State cannot be held responsible for the provision for NHS services, who can be held accountable when things go wrong? For too long, Trusts, Hospitals and even Secretaries of State have passed the buck and avoided responsibility. There needs to be someone responsible for the provision of NHS services, ensuring that all patient receive the care they deserve. For more information, please visit http://www.guardian.co.uk/society/2011/aug/29/nhs-bill-lansley-wash-hands Back to the top

2) Former NHS boss says that more hospitals should be closed In his new book, “24 Hours to Save the NHS”, Lord Crisp, who was Chief Executive of the NHS between 2000 and 2006, has said that hospital would need to close to cope in the future. He warned that there was overcapacity in some areas and that there were also too many senior Consultant doctors, putting a strain of resources. Lord Crisp has recommended that the health service should be overhauled, integrating and consolidating hospitals into “centres of excellence” which would be better able to provide care for a growing elderly population. Lord Crisp also warned that local MPs who join campaigns to save local hospitals may be doing their constituents a disservice by not ensuring that they have access to the best healthcare. He said, "In the late 1990s waiting lists, A&E and standards in cardiac care were the big issues and we dealt with them. But the challenge now is dealing with the numbers of older people and those with long-term conditions. They need supporting in the community. That means a shift away from hospitals. There will be less need for large hospital outpatient departments and some services and whole hospitals will need to close or be merged with others." Lord Crisp went on to note that mistakes were made during his tenure when too many hospitals were built or revamped. He said, “By 2005 there was no hospital that was not thinking it was going to grow. We had major problems with very bad facilities, [but] perhaps we could have built smaller or consolidated on fewer sites. We missed that opportunity and this government needs to grasp that. We can't keep services going just because there is a nice building." A spokesman from the Department of Health said that ministers agreed with the principle that more care should be moved into the community, but added that changes must be made for the right reasons. Labour said patients had benefited from its investment and reforms during its time in office. The current Chief Executive of the NHS, Sir David Nicholson, has already said that the NHS should reduce the number of Acute Beds and that it would be up to politicians to sell this to people. Katherine Murphy, Chief Executive of the Patients Association said, “The majority of patients want to be treated as quickly as possible in hospital and then be back in their own homes, amongst family and loved ones. With a move to local control of health and the rise in the elderly population, we need to make sure the NHS adapts to fulfill this need. Inpatient care and local services must serve the needs of patients so that they receive the best treatment possible and appropriate follow up community care. It may be beneficial to integrate and consolidate services into fewer sites and centres of excellence, as long as this does not restrict services available to patients. We must never forget that by merging services to be provided from one site, there will be patients who may struggle to get to them because they are too far away. It is vital that services reflect the need of the community and are available in a variety of formats including respite care and community hospitals. However, as is so often the case, political wrangling got in the way of the changes that needed to be made. Now we are faced with an NHS which is being forced to make cuts to services across the board. What is the point of having brand new hospital buildings if there are not enough funds to treat people in them? The Department of Health must not be afraid of making difficult decisions that will ultimately mean better and more efficient services for patients.” For more information, please visit http://www.bbc.co.uk/news/health-14729191 Back to the top

3) Red tabard scheme for nurses on drugs rounds A scheme intended to reduce the number of mistakes made during drugs rounds in hospital wards by giving nurses red tabards has been introduced in several hospitals. Some Trusts had introduced tabards with “do not disturb” written on them but these have been modified after criticism from patient groups. According to the National Patient Safety Agency (NPSA) the proportion of the 1 million safety incidents in the NHS are down to medication mistakes. Drugs rounds take on average half an hour and happen around three times a day. It has been a common practice to ask patients not disturb nurses on drugs rounds but this is the first time nurses will have had to wear the tabards. Some Trusts have estimated that nurses are interrupted up to 6 times during their rounds. One of the hospitals who have introduced the scheme, Aberdeen Royal Infirmary, found that nurses were still interrupted on 95% of their drugs round but the average number of interruptions had dropped. The research also found that most patients and healthcare professional approved of the move. Dr Peter Carter, Chief Executive of the Royal College of Nursing, said, "Medication rounds can be complex and we would support measures which ensure that staff are able to concentrate when carrying out this task on a busy ward. However, let us be very clear: schemes like this must never become a cheaper substitute for having enough fully trained staff on every ward." Patients Association trustee, Celia Grandison-Markey, commented saying, “Patient safety is vitally important and we have heard from patients phoning our Helpline about mistakes being made with medicines in hospitals. We welcome any initiative that seeks to improve patient safety. However, we feel it is an extreme measure to force nurses to ignore patients who are speaking to them. How can they ignore a patient who is telling them that they are still in pain even when they have been given medication? What do they do about patients who have some flexibility in the prescription from their doctor? There must always be nurses on the ward who are able to speak to patients when they need help and these “do not disturb” measures cannot be allowed to get in the way of real nursing care.” For more information, please visit http://www.telegraph.co.uk/health/healthnews/8728093/Nurses-wear-do-not-disturb-signs-during-drug-rounds.html Back to the top

4) Health reforms risk doctors putting wealthy patients first warns British Medical Association Hamish Meldrum, Chairman of the British Medical Association, today claimed that the Government’s Health and Social Care Bill would lead to a ‘market-based health system’ which would allow those with insurance, or who are able to pay, being offered much better service. The criticism comes in the wake of the BMA launching a public campaign opposing the bill, something it is now doing in conjunction with the Royal College of General Practitioners and Royal College of Nursing. A former Chair of the Royal College General Practitioners, Professor Steve Field, has already been called in during the bills hiatus to review the proposals. This led to over 1,000 amendments, but the BMA have not dropped their opposition. Dr Meldrum’s expressed his concerns by saying “Trusts are being encouraged to concentrate on profitable areas of work rather than the most essential...like mental health, accident and emergency and care for the elderly. These are not profitable.” In addition he has written to every MP, urging that they withdraw or significantly amend the bill. He continued his concerns saying it led to an unbalanced health system with “those who are articulate and shout loudest [tending] to get better care. The less well-off patient will not. This will see an increase in health inequality.” John Healey, Shadow Health Secretary, has backed the calls for the bill and all reorganisation plans to be scrapped, considering the strength of feeling from health professionals. He said “the chorus of concern among health service professionals is as loud as ever”. The Department of Health has responded by saying that they were disappointed with the BMAs campaign as they had previously been ‘pleased’ that there were to be significant revisions to the bill following the NHS Future Forum. http://www.guardian.co.uk/society/2011/sep/01/nhs-plans-put-wealthy-first Back to the top

Snapshot of Health news Leading cosmetic surgeons warn against hair transplants too young One of the country’s leading hair transplant surgeons has warned men in their 20s to wait before having operations carried out. Doctor Bessam Farjo has said that young men should be warned of the long term risks before consenting to the surgery and that men should wait until they are closer to their 30s. The risks include it looking worse than when you started as patients continue to lose their hair and you no longer have enough to keep “chasing the hair loss”. He added that if this became the case not only does it not look good, but it “is also hard to fix”. Male baldness can start affecting men in their teens and nearly a quarter of men will suffer with it during their twenties. At present however there is no code of conduct or regulation guiding a minimum age for procedures. Dr Farjo has said that whilst “there’s no concrete way to stop clinics putting money before the wellbeing of patients...He thinks that surgeons should work together to educate each other and their patients about risks”. http://www.bbc.co.uk/newsbeat/14747894 Back to the top

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