Health matters / FRFI 198 Aug / Sep 2007

Job losses and fudged figures
The Homerton hospital in East London no longer has a children's asthma clinic. The senior specialist nurse with decades of experience and who has a driving interest in the subject, the children and their families, has been pushed to resign. This follows a decision to 'disestablish' her post in a money-saving exercise presented as a fait accompli by senior clinicians and managers. The loss of such a nurse will go down in the column 'natural wastage'.

In April, as its conference opened, a Royal College of Nursing (RCN) study reported that a combination of redundancies, recruitment freezes and post closures had led to a reduction of 22,300 nurses over the previous 18 months. A poll of 807 specialist nurses interviewed for the study found that one in five were at risk of redundancy and half knew of cuts in their specialist area. This came just as the government announced that the NHS was to finish the financial year with a £13 million surplus, despite one in three hospitals and primary care trusts predicting deficits.


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Health matters / FRFI 199 Oct / Nov 2007

Labour’s promises
Every year, over 1,600 people die from MRSA in England and Wales and over 3,800 people die from clostridium difficile. An investigation into two outbreaks of clostridium difficile at Stoke Mandeville Hospital in 2004 and 2005 that killed 30 people determined that the deaths were avoidable. The report found a lack of side rooms, a shortage of nurses, poor infection control practice and a poor ward environment. It concluded that the Trust compromised the care and safety of the patients due to the priority it gave to controlling finance, reconfiguring services and meeting targets.

Prime Minister Brown has promised to rid all hospitals of MRSA and clostridium difficile over the next twelve months by restoring their original state of cleanliness. His idea of a ‘deep clean’ does not address understaffing, reduced bed capacity and bed over-occupancy, staff education or clinical practice, all critical to attaining the objective.


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Health matters - Infection control crisis

Infection control crisis
In FRFI 199 we reported on the spread of MRSA and Clostridium difficile infections which resulted in the deaths of 30 people in Stoke Mandeville hospital in 2004. Now in a further scandal, a lengthy report from the Healthcare Commission on deaths related to Clostridium difficile at the Maidstone and Tunbridge Wells hospitals in Kent found that 1,100 patients contracted Clostridium difficile at the Trust’s three hospitals between April 2004 and September 2006. 345 mainly older patients with multiple medical problems died. The Commission concluded that 90 patients ‘definitely or probably’ died as a result of the infection and blamed the hospital trust board for paying too much attention to balancing the books and meeting government waiting time targets. The Commission said the trust failed to protect patients because the trust board was unaware of the first outbreak and slow to react to the second. Inspectors found contaminated bedpans, overflowing buckets of needles and sharp instruments, and food stored in medical fridges.


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HEALTH MATTERS / FRFI 201 Feb / Mar 2008

Health Secretary Alan Johnson and Prime Minister Gordon Brown have announced a new NHS constitution which will mark the July celebrations for its 60th anniversary. Johnson says that this would commit the NHS to providing ‘equal access to care, available at the point of need, regardless of ability to pay, personal to the individual patient and achieved within a tax-funded system that demonstrates value for money’.

Johnson has also declared that competition is good for the NHS and that he intends to continue the expansion of the private sector into primary care with plans for 250 GP-led health centres, many run by private organisations with GPs as employees. Such business opportunities were discussed at a recent meeting with representatives of 400 private companies, of which Richard Branson’s Virgin group was one.


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Privatising the NHS: Labour steps up the pace

‘NHS hospitals can advertise to attract patients’. ‘Anger at plan for private surgeries’. ‘Pledge to battle Virgin NHS plan’. ‘NHS chief reaffirms commitment to private primary care providers’. These are just a handful of newspaper headlines in March – welcome to Labour’s Sicko NHS. Michael Moore’s film (see review FRFI 199) is a warning of what is to come. The wholesale privatisation of health care services is now underway, and with it will inevitably come rationing and a two-tier service. Robert Clough reports.


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Privatising the NHS in Newcastle

As part of Labour’s privatisation drive, housing, education and healthcare are all for sale in Newcastle-upon-Tyne. In 2006, Newcastle Hospitals NHS trust was awarded Foundation Trust status, giving it unlimited powers to enter into joint ventures with the private sector. Construction has already begun for the largest ever PFI health project in the North East and the closure of the General Hospital draws nearer. SAM MAGILL reports.

Between 1990 and 2000, Newcastle City Trust greatly cut its hospitals maintenance budget, allocating just £200,000 in 2000 for building work. This was despite reports of cash deficits (£7m for the Royal Victoria Infirmary (RVI) in 1997 alone!). Investment in much-needed refurbishment at the General Hospital (£6m) and RVI (£15m) was offered to the private sector. Then in 1998, plans were laid to close the General Hospital in order to build a new centre at the RVI providing emergency, trauma and intensive care, and neuroscience and infectious diseases services. This was due to be finished in 2002 alongside a new renal and cancer care unit at the Freeman hospital.


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Say no to a two-tier health system


60 years ago the then Labour government set up the NHS as a universal health system free at the point of use. Now Labour is dismantling it and replacing it with a two-tier system that will provide a minimal service for the poor, and an adequate one only for those who can afford to pay extra.

Fresh from awarding United Health the management of three GP practices in April, Camden PCT is now in discussions with the likes of Virgin Healthcare to set up and run a Darzi polyclinic on the University College Hospital site. This will replace four existing GP practices.


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NHS: No to two-tier health service

In 1948 the National Health Service brought to an end a system where those who could pay necessarily got better treatment. Except in so far as prescription charges applied, care was to be provided on the basis of clinical need, not the ability to pay. However, Health Secretary Alan Johnson, anticipating the results of an independent review scheduled for October, has indicated that it is very likely that the rules about top-up will be overturned and the ban on people topping up their care by paying privately for medicine while being treated on the NHS will be lifted. Yet another step is being taken towards turning the NHS into a two-tier system.


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Health matters: Inequality in the NHS

Primary care
• In 1971, Dr Tudor Hart wrote in The Lancet that ‘…the availability of good medical care tends to vary inversely with the need of the population served’. This still applies: for instance, there are still twice as many primary care professionals per head of population in Cambridgeshire as there are in Manchester. Residents of Cambridgeshire will on average live six years longer. The Office for National Statistics released life expectancy figures recently showing that a child born in the South East and South West of England in 2005 had a life expectancy of 78.9 years for males and 82.9 years for females. This compares with Scotland, where it is the shortest, 74.8 years for males and 79.7 years for females.


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Attacking the NHS

nhs for sale 

There is no reason why a wealthy nation such as Britain cannot afford a good system of healthcare, with services freely available to young and old alike. But in six months’ time the NHS will face a funding crisis of unprecedented proportions, one which will intensify in the following year.

This is the inevitable consequence of the Tory spending plans which Labour will support if it wins the election. The facts are clear: spending on the NHS has risen on average 3.5% each year in real terms over the last 17 years. Because NHS inflation is higher than the general rate, savage cuts in services and rationing are still required.


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