NHS WASTE

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Epsom and St Helier NHS, which needs to save £24m over 18 months, has removed around 40 light bulbs in hospital corridors to help money. A trust statement said, "We can confirm maintenance staff have removed some light bulbs from the main corridors and some communal areas in the trust, as part of our financial recovery plan." It added that it had been given funding by the strategic health authority to explore lighting and heating controls, so energy efficiency could be improved. Tom Brake MP said, "If our hospitals are scrimping money on light bulbs, how can they afford the latest drugs and high quality patient care?" (Source: BBC News, Feb/07)

Although NHS spending is up from £45billion in 2000 to £76billion this year, a study by think tank Civitas concludes there has been “little or no evidence of improvement in NHS performance, which ranks among the worst in the developed world”. The UK is the only developed nation not to improve stroke care between 1999 and 2003 and we rank 24th out of 27 countries for the number of doctors per 1,000 of the population. (Source: The Sun, Aug/06)

The Royal Free NHS Trust hospital is recruiting five clerical staff costing £190,000 just days after axing 500 medical jobs. The trust admitted it is massively in debt and must make savings of £25million in the next year to balance its books. That means dozens of patient beds will also be lost but now the trust has advertised for five recruits, including a £30,000 ‘performance management analyst’ who will monitor data. The other four are ‘risk management’ roles, with salaries of £41,000, being created to ensure health and safety regulations are followed. A hospital spokesperson said, “Any trust staff who are eligible for redeployment under the current savings plan are welcome to apply.” (Source: The Sun, Mar/06)

University College Hospital, which spent £70,000 on a boulder to adorn its main entrance, is to spend hundreds of thousands of pounds on more artwork. Guy Noble, the new £41,000-a-year arts curator, said his ambitious programme would improve patients' health and staff morale and create "a pleasing environment" for visitors. The Chelsea and Westminster hospital also has a large arts programme and Royal London Hospital has a new £36,000-a-year art director. Mr Noble is confident that the critics will be won over. "In five years' time, I think nearly every hospital will have an arts curator," he said. This comes at a time when beds and wards in some NHS hospitals are to close to help to make £1.6 billion of "efficiency savings". (Source: Daily Telegraph)

Taxpayers are pouring billions of pounds extra into the NHS, but less than half gets through to frontline medical services. From £33billion when Labour came to power in 1997, spending in 2005 will be £44.2billion. By 2007 we will spend £92BILLION. Yet experts say the huge increase allocated by Chancellor Gordon Brown is not reflected in improvements in the service. Pay rises of around 20% mean the public don’t get the payback they should and a huge 59% of your money now goes on wages. Out of £5.9billion extra spent in 2004, £1.8billion went on pay rises for existing staff and another £1.6billion on salaries and pensions for new staff. But “output”, cases completed by hospital specialists, has risen by only 1.9% a year.

The longest hospital waiting times have been eliminated, but centrally-imposed “targets” force patients with urgent conditions to wait longer. These stark facts, unearthed by independent analysts after eight years under New Labour, show the price we pay for a cradle-to-grave service in which patients have to take it or leave it. Yet there is good news. Where GENUINE choice is on offer from public and private sectors, quality and speed of care improve instantly. Small pilot projects have seen waiting lists evaporate, with one London hospital having to ADVERTISE for patients.

In one pilot scheme, 18,000 patients waiting more than six months were offered the chance of choosing another hospital. Two-thirds opted to go elsewhere in the NHS or to a private hospital. Waiting lists in the Barking, Havering and Redbridge, East London, area fell by half. The Heart Hospital, bought by the NHS to increase cardiac surgery capacity, ran short of patients. Now the Independent Sector Treatment Centres introduced by Health Secretary John Reid are mopping up backlogs for knee, hip and cataract cases. And bed-blocking has been slashed by penalties for slow-moving local authorities.

The NHS’s financial problems were revealed by two prominent health experts who both back the NHS vision. Nick Bosanquet, Professor of Health Policy at Imperial College London, is an adviser to the independent think-tank Reform. Professor John Appleby is chief economist with the King’s Fund. Prof Bosanquet said, “Since 2001, Government NHS spending in England has increased by around 10% a year in cash terms, about £6billion. It claims real spending has gone up about 7.5%, but after adjusting for changes in pay scales and staffing costs, the rise in real resources is nearer 3%.”

And Prof Appleby warned, “The NHS has to spend on pay rises, increased pension contributions, payments for clinical negligence. When you take that into account it cuts the real rise to just over 2%.” Yet hospitals are under such pressure to cut waiting lists that non-urgent cases are treated first to avoid missing a target. Hospitals and primary care trusts are £341million in the red, with wards and A&E units closing and non-urgent ops postponed to save money. John Sussex, of the independent Office of Health Economics, said NHS activity rose at only half the rate of increased spending. (Source: The Sun)

Patients who refuse to change their unhealthy lifestyles could be refused medical treatment. The controversial suggestion from the National Institute of Healthcare and Clinical Excellence would mean that a smoker in need of heart surgery might be denied the operation unless he or she promised to give up the habit. The proposal is contained in a document which sets out for the first time the social values that should underpin decisions by the institute on which treatments to provide on the NHS. It says all patients should be treated equally regardless of their age or social responsibilities and rules out discrimination on the grounds of gender, race or socio-economic status.

The only exception should be where a patient's age might affect the chances of success of the treatment. "Health should not be valued more highly in some age groups rather than others," it says. On self inflicted illness, that caused by "unhealthy lifestyles", such as casual sex, smoking, drinking or dangerous sports, it rejects the idea of "deservedness" in deciding who should receive treatment and says it would be impossible in many cases to determine which illnesses were self-inflicted.

It adds, "If the self-inflicted causes of the condition influence the likely outcome ... of an intervention, it may be appropriate to take this into account." A spokesman admitted there was a "grey area" between denying treatment on clinical grounds, because a patient might not benefit from it, and "blackmailing" them to change their behaviour in line with medically accepted health norms. "It was felt that it wasn't fair to punish someone because they were, say, a smoker, but if the success of the treatment might be affected because they refused to give up smoking then it might be appropriate to take that into account. It is not about how they ended up in that situation but given they are there what do we do now."

The recommendation carries echoes of the case of Harry Elphick, who was told by consultants at Wythenshawe Hospital, Manchester, in 1993 that they would not conduct a test to determine whether he needed heart surgery unless he quit his 25-a-day habit. He eventually agreed but died before he could have the test. The case provoked a dispute about rationing in the NHS which has erupted often since, mostly in relation to patients denied liver transplants because their lifestyle has been judged "unstable" when other patients - including the footballer George Best, have had a transplant and subsequently returned to drinking.

A spokeswoman for the BMA said, "We do appreciate the health service is not a bottomless pit. We would not be in favour of blackmailing a smoker to give up before he got his operation but if there is a strong likelihood that, because of his lifestyle, he will be back on the operating table in three months then you have got to take that into account." The spokesman added, "This is our first attempt at this. Of course it is bound to be controversial. We would be enormously surprised if everyone came back and said yes to it." (Source: The Independent)