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- NHS - National Health Service
- Dentists charging extortionate fees for private work -
By Jeremy Laurance Health Editor -
27 March 2003
Trivia Time: Claim 1 - The UK NHS accidentally kills 20,000 people a year
- Simon Carr: The Sketch : A simple question but an answer of glorious dullness : 16 November 2001
- Plus: Simon Carr: The Sketch : Dull debut boy has little to say: a big improvement on his predecessor : 18 October 2001
- "We've drifted away from Mr Duncan Smith. His second group of
questions. Quite powerful questions, actually. Why do a quarter of all
doctors want to leave the NHS? Why do nine out of 10 think the new plan
won't work? And what about his constituent who had lain on a trolley for
nine hours, died, been ignored for three days, and when the family
turned up the body had been lost?"
- Plus: House of Commons Hansard Debates : Mr. Duncan Smith: 17 Oct 2001 : Column 1167
- Mr. Iain Duncan Smith (Chingford and Woodford Green): Why does the Prime Minister think that more than a quarter of all family doctors now want to leave
The Prime Minister: There are huge strains on family doctors at the moment because they are going through a period of enormous change. We are moving the
whole of primary care to primary care trusts. However, I think that family doctors believe that primary care trusts are the right way forward. They also believe, as the
right hon. Gentleman will see from the survey on which he based his question, that the services that they offer to their patients today are greatly improved compared
with a few years ago.
Mr. Duncan Smith: "If that is the case, why does the same British Medical Association survey show that nine
out of 10 GPs believe that the Prime Minister's reforms are unachievable, and two thirds think
that his plans will do nothing to improve care for patients?
It is not only the doctors. A constituent of mine--[Interruption.] They do not like
it. A constituent of mine recently died in hospital after waiting nine hours on a
trolley. His family were not aware that he had been admitted or, for a further
three days, that he had died. When they came to pay their respects, they found that the
body had been lost. Does not the Prime Minister think that all his promises of a
better tomorrow will sound hollow to such people?
- Plus: The Sketch: Simon Carr : Ask the same old questions - and you'll get the same old answers : 08 November 2001
- "The Tory leader still hasn't quite got the hang of this question time thingy.
It's early days yet, of course, but it's not too early to realise that Tony Blair's
been giving the same answer to most questions for the last - what? how long has he
been Prime Minister? Ten years? For health his all-purpose answer is: the Government
wants to put the money into health, and your party wants to take it out.
How long, oh Lord, how long will it be before the Tories either neutralise
that point, or failing that, ask a different question. Goodness knows, it's
only rocket science (which is to say very, very simple). But week after week,
they put their heads down and run full tilt at the wall and fall backwards
reaching, more in hope than expectation of success, for their brains.
Why do we hear so little of the waiting list targets that forced varicose veins ahead of
cancer operations? Clinical distortions that have been imposed on doctors and patients by
vile politics? What about the dead? What about the waste? What about tracking the money
and finding out exactly where it evaporates?"
- The Sketch: Simon Carr - Duncan Smith, minus the growl and scowl, lands a telling blow on Blair - 20 December 2001
- "The National Audit Office had investigated the mechanics of hospital waiting lists
and uncovered a scandal. Under pressure from the Government, the Mr Duncan Smith put
it to the Prime Minister, hospital administrators had waited until potential patients
went away on holiday and then offered them an operation slot.
"This was a major breach of public trust!" he declared.
And because he didn't growl it, or scowl it, or accompany it with one his
gruesome rhetorical flourishes, the Government claque did something very
odd. Which was nothing. Normally they roar at this sort of thing. They
bellow. They wave and jeer. They pick up his tone and amplify it in a
bestial feedback system - this continues until it is impossible to hear
what is being said.
So Iain Duncan Smith achieved his first parliamentary victory by creating
the mood of the House. It was factual information that shut them up on the
Government back benches. He cowed them. They were unable to jeer him down.
Only 4,000 or 5,000 places were misallocated, the Prime Minister claimed;
yes, but only nine hospitals were investigated, IDS rebutted. There was
a hush at that. Yes, and each hospital had their own rules. It appeared
one had sent out a letter saying "we will contact you in 93 weeks".
There was a deeper silence at that. Ninety-three weeks!
Here's the rule for a successful Tory attack on Tony Blair:
no raised voice. No growling.
No overt aggression, even. People seem to like Tony Blair (look at the polls).
Attacking him attacks the electorate. So just show us the scandal; allow the
audience the luxury of indignation. The artist prepares a cup for others to
drink from, he doesn't slobber it off himself."
- The Sketch: Simon Carr : Loud cries of 'disgraceful!' from both sides - for different reasons : 24 January 2002
- "When you brush the cobwebs off Erskine May, the holy writ of parliamentary practice,
you find that MPs are forbidden to quote from newspapers on the floor of the House. Stupid
book. No wonder it's ignored. As Matthew Parris pointed out, newspapers used to report what
happened in parliament: now parliament reports what happens in newspapers.
Iain Duncan Smith took up the Evening Standard story of the blood-encrusted 94-year-old
grandmother who spent two days on a trolley in Accident and Emergency. He wondered whether
the Prime Minister would care to apologise to the old lady? The Prime Minister replied that
the newspaper report was strongly disputed by the hospital, that the Tories were to blame,
and that things were going to change.
In the ensuing hubbub, he demonstrated a mastery of parliament by dropping his voice to be
heard. "Rather than trying to denigrate everything, let him applaud, for once, people
working to deliver excellent standards of care."
This leitmotif will run for months, I fear. Smith castigates Blair for failing to apologise;
Blair castigates Smith for failing to pay tribute. I'm sick of it already.
"Paying tribute" is the last refuge of the ministerial scoundrel, as we know, so we can say
that the exchange was a score draw. That is, a win for Mr Duncan Smith."
- "Mr Blair is one step ahead (that's not enough steps). He can diagnose the Tory strategy
but doesn't disable it. "The reason he wants to run down the NHS is to make the political case
to get rid of it." There may be a few operations that go wrong, he admitted, but "the vast
majority" found standards to be "excellent".
Even the Prime Minister's abilities in the arts of sincerity can't carry that one off. There
are 100,000 people from the past five years who don't believe it - mainly because they're dead,
killed by the bug that lives in unwashed, unswept wards.
Then you hear him say: "They kept her in a medical assessment unit. Perfectly properly." The
unit turned out to be a chair in a corner of A&E which had been reclassified as a Medical Assessment Unit.
We must all want to believe the Prime Minister - his ratings remain high as a kite, after
all. But how difficult it is when you listen to him."
- The Sketch: Everyone appears to be Scottish, whether they need to be or not : By Simon Carr : 13 February 2002
- "The minister may be the single most important reason why Scottish
tourism is declining. She's got a big, Stalinist presence with hair like
Futurama's Mom. Any criticism of the way Scotland is being run she
evades by saying: "That is running Scotland down!" It's the most
disgusting thing a minister can say which is why , they all say it. It
started in Health (Question: "Why are wards so dirty that 20,000 people
a year die of infections?" Answer: "Stop running down our hardworking
doctors and nurses."). It spread to Home, and thence to everywhere else.
- The Sketch: It's Kafka, cried Ian Thing. Yes, oldies are being turned into cockroaches : Simon Carr : 21 March 2002
- "There were no operations because there were no beds, and there were no beds
because there were no homes. "That's Kafka care!" he cried. Whether the elderly
were being dragged into a kangaroo court to be tried without being charged or
whether they were all being turned into cockroaches he didn't make clear.
The Prime Minister said £300m had been allocated to alleviate delayed discharges.
And so successful was the spending that 1,000 beds had been freed up. Thirty
thousand pounds a bed seems a bit steep, doesn't it? How does £300,000 a bed
sound, when you've done the math for the second time? Even those of us who
no longer expect to take seriously anything the Prime Minister says were
- The Sketch: Hoo hoo! I don't want to ape Mr Smith but his sums are a bit off-balance : Simon Carr : 12 April 2002
- "A fragrant pot-pourri of parliamentary points. Desmond Swayne said that
Scottish health spending had reached Mr Blair's target but hadn't done a
wretched thing for Scottish health. David Ruffley puzzled over the
Chancellor's adviser's repudiation of "post-classical endogenous
growth theory". Tony McWalter mentioned a billionaire who was not
paying any tax, but was rather getting benefits out of the Treasury.
And Tim Loughton gave us the ratio of beds to managers in the
NHS (1.15 managers to every bed.)"
- Health care in Europe shames the NHS; is there really nothing to learn? : 16 April 2002
- "For it is axiomatic that, as Mr Duncan Smith says in the foreword to the document, "the problems of the NHS are not just a matter of money. It is the system that is failing". Indeed, there is evidence to suggest that the NHS is incapable of sensibly spending even the 7 per cent annual increase in funding that it has received recently.
To see the sort of dramatic change in the quality of NHS provision that matches the rhetoric on all sides about a "world-class service", there has to be a dramatic shift in the balance of power towards the patient. Only by ensuring that cash follows them through choices, exercised inside or outside the NHS, can there be any hope of such a radical improvement.
Despite the 10-year plans, the targets and the exhortatory speeches by ministers, the structures of the NHS remain deeply unfriendly to the interests of the patient. Alan Milburn, the Secretary of State for Health, and his colleagues appear well aware of that but seem unwilling to take on the vested interests. If the pre-Budget spin is to be believed, they will try to make the NHS work through piecemeal, modest reforms linked to a vast infusion of money."
- "This is why it is so short-sighted of the Government to insist that we have nothing
to learn from the experience of other countries. Backed by the findings of the Wanless
report, ministers say that we have the most equitable system of funding for health care;
yet the World Health Organisation (WHO) places us only seventh in the league table
of developed economies for the "fairness" of the way we fund the NHS. We lie 17th
for the responsiveness of our system, rating poorly for "respecting the dignity
of the individual". An NHS that is only slightly less fair in the way it is funded
but that can treat many more patients quickly and relieve much more suffering
is surely worth thinking about.
Why not learn from abroad? Why not look at the German system of social insurance, judged fairer
by the WHO than our tax-based approach? Why not examine the Dutch tradition of
independent hospitals, which stimulates competition? Why not a larger role for the
private sector, smaller in Britain than most other developed countries?
The NHS is not the envy of the world, if it ever was, and we will not make it so until we drop our chauvinism and admit that other countries do things differently - and sometimes better."
- Jeremy Laurance: Can the NHS learn to treat patients as customers? : 'Money is not the problem ? and this explains Treasury jitters ? it is capacity' : 13 April 2002
- Angry nurses want 10 per cent pay rise : By Jo Dillon Political Correspondent : 28 April 2002
- ""Nurses are certainly in no mood to accept a poor pay deal. They want to see the colour of the Government's money and they want us to get on and pull this deal together."
There is, as yet, no threat of industrial action. But nurses are setting up a fighting fund to tide them over in case they are forced to go on strike.
The Government argues that they have improved nurses' pay since 1997 and will continue to do so.
But a source said: "In the past there has always been an attitude that says let's pay our Florence Nightingales properly. I think the mood is slightly different now. There have been some substantial increases in nurses' pay and there is not the level of public support for more money to go on pay, because people want to see this money going on heart monitors and new beds."
Trust chief executives have also expressed concern that the money announced in the Budget for the NHS might be swallowed up by huge pay demands.
But the nurses have vowed to make their case. And there is a persuasive body of evidence to back their claim, especially against a background of nurse shortages, continuing problems with retention, and a market for British-trained nurses overseas.
Jacque Stanway, 32, a student nurse from Belfast, struggles to bring up her daughter Clare, three, and train as a nurse. She is paid a bursary of £679 a month. After her £200 mortgage, regular bills, and childcare costs of £300, she has £2.70 a month to live on. Child benefit of £15.75 a week has to stretch to feed and clothe both mother and daughter, along with money from extra night shifts. "It is a very dire situation," she says.
Further up the pay scale things are not much better. Andy McGovern, 34, works at the Royal London Hospital as a paediatric nurse on a cancer ward. His take-home pay is £1,200 a month. After £500 rent, £60 travel costs, and £80 for bills in his shared house in Stratford, he ends up with £60 a week for food, clothing and living.
Even after 30 years as a nurse, Gareth Phillips, 50, from Ynys Mon, Wales, cannot make ends meet on £1,200 a month as a regional specialist in forensic psychiatry. He has a wife and two teenage children. He said the situation had put nurses in a "militant" frame of mind."
- NHS Direct calls cost taxpayer more than visits to GP : By Ben Russell, Political Correspondent : 17 June 2002
- "Each call to NHS Direct, the 24-hour helpline launched to ease the burden on the health service, costs the taxpayer about 25 per cent more than a visit to the doctor.
Official figures have revealed that the average cost of each call to NHS Direct was almost £18 last year - £4 more than the estimated £14 cost of each visit to a GP.
The revelation has provoked calls from the Conservatives for a full review of the service, which was launched in a blaze of publicity to take pressure off GPs and hospitals' accident and emergency units by giving advice over the telephone.
The Liberal Democrats also criticised the low-cost helpline, warning that four out of five of the 1,150 nurses working for NHS Direct had moved from jobs elsewhere in the health service. NHS Direct has faced repeated criticism since it began four years ago amid fears that experienced nurses are leaving vital hospital posts empty to join the telephone and internet helpline."
- High Security Hospitals: Janet's been in for 22 years. If she admits she's mad, they'll let her out :
By Sophie Goodchild, Home Affairs Correspondent : 16 June 2002
- "Janet Cresswell, like other patients held in Broadmoor, is not allowed glass in case she harms herself. On her 71st birthday this year, the writer had to use a plastic chamber pot to display the bouquet of freesias and carnations from her daughter.
For 22 years, she has lived amid child killers and serial murderers. Ms Cresswell
has killed no one. She was sent to Broadmoor after taking a vegetable knife to
her psychiatrist's buttocks; a serious crime but not one that would normally carry a life sentence.
Ms Cresswell's name does not appear on the hospital's list of patients deemed
eligible for transfer to a bed in a medium secure unit. She refuses to go
under the supervision of a Home Office psychiatrist. She refuses
because, she says, she is not mad.
In a case reminiscent of Catch 22, as long as she insists she is not a
dangerous psychiatric case, she will be detained as a potentially threatening mental case.
When this newspaper highlighted her case two years ago, Ms Cresswell was
receiving neither medication nor psychotherapy. However, just days after
the story was published, the grandmother was taken to the intensive care
wing at Broadmoor and forced to take anti-psychotic medication against her will.
Since then, her privileges and those of other patients have gradually been
eroded, beginning with a Home Office ban on patients in secure hospitals
owning computers, a draconian measure imposed after male inmates at
Ashworth hospital on Merseyside were found downloading internet pornography.
Before her word processor was confiscated, Ms Cresswell wrote letters, essays
and a play, The One Sided Wall, which was performed at London's Bush Theatre.
She won the Arthur Koestler prize for an essay on the history of Bedlam, the notorious lunatic asylum.
Until recently, one of Ms Cresswell's favourite hobbies was bowls. When Broadmoor
officials decided that men and women could not mix socially, her matches on the hospital's
bowling green came to an abrupt end.
In letters to mental health campaign groups, the hospital authorities have
justified Ms Cresswell's continued incarceration by telling them she is
suffering from "classic symptoms of a major mental illness".
Independent medical experts disagree. Professor Alec Jenner, a retired professor of
psychiatry at Sheffield University, who has corresponded with Ms Cresswell, says
she is "quite harmless". Her flaw, he says, is that she is stubborn.
"If she had played ball with the authorities then she could have been released
a long time ago," he said. "I can't see any need for her to be staying there.
But neither side is prepared to compromise enough for her to be released."
Until a compromise is reached, her daughter Jane, a nurse, must tell her
teenage grandchildren that Broadmoor is their grandmother's home.
"They just want people to rebel and then have a reason for keeping them in
there," she said. "I've tried everything but I'm banging my head against a brick wall.
"It is so awful that I do not take my children. They are doing exams. I don't
want them to have stress. They speak to her on the phone and they just know that is where she lives."
At Christmas in 2000, Ms Cresswell tried to commit suicide by hoarding her pills,
but her daughter was not officially informed. Instead, she found out from night staff at Broadmoor.
"It's going from bad to worse," Ms Johnson said. "I got friendly with one of the nurses
who had left the hospital. She told me someone had written a report to say my mother
had smashed up the kitchen, but the nurses refused to sign it because it was untrue.
"They have to have a reason for keeping her in there."
The Independent on Sunday approached Broadmoor for a comment on Ms Cresswell's plight but the hospital refused to give one. "We are unable to comment on individual cases," said a spokeswoman.
The poetry of privation
WHAT NEXT ?
people were dumped and stuck in the bin
Found they couldn't get out so kicked up a din
'Can't stand that' said the minders,
And found other jobs - like scouts for odd bobs.
So the minders' minders got grim.
They searched through their statute books
For old tricks with new looks,
Try this and try that,
How tiresome of people to see through old hat.
Trying, tribunal, tri's three and bin all.
No, not Triad, tribunal, try gooning for all, annually.
Shut everyone away, but make them all play.
And when they're tired of the game turn away.
When tiredness wins out,
It's the time to get out
And start up the game a new way.
Broadmoor Special Hospital
Leading voices call for change
Erin Pizzey, founder of the first women's refuge:
"Unless you are prepared to grovel to the authorities you are punished. If she [Janet Cresswell] had been assessed today, she would never have been sent to Broadmoor. I hope they see sense and let her out. I had a breakdown for three months; if you're a woman people say you're mad.""
- High-Security Hospitals: Scientist attacks 'gutless' mental health policy : By Sophie Goodchild, Home Affairs Correspondent : 16 June 2002
- ""The Government are either totally ignorant or intellectually dishonest. It's all about spin for them, and I find that nauseating," said the broadcaster, a self-confessed depressive and user of the anti-depressant Seroxat.
Last week, The Independent on Sunday revealed that more than 400 patients in Britain's high security mental hospitals should have been released years ago but remain locked up because beds cannot be found for them outside.
The paper is campaigning for the transfer of these people to accommodation where they can be treated properly. Some forgotten prisoners have languished in places such as Broadmoor, Ashworth and Rampton for more than 20 years."
- "One case that highlights the plight of patients held in secure hospitals is that of Janet Cresswell, a writer who has been held in Broadmoor for more than 20 years.
Her word processor was confiscated under a Home Office ban on patients in secure hospitals owning computers, after internet abuse. The draconian measure was imposed after male inmates at Ashworth hospital on Merseyside were found downloading internet pornography.
Joan Smith, chair of the Writers in Prison Committee and a columnist for this newspaper, said Ms Cresswell's case was particularly disturbing:
"She appears to have been punished for somebody else's misdemeanors and denied a basic human right. If you've taken away someone's liberty, one of the few things they have left is freedom of thought and expression," Ms Smith said. "For many people in prison, writing is one of the most important things that they can do.""
- Wednesday, 4 December, 2002, 10:59 GMT : UK has 'Third World' TB levels
- "Tuberculosis rates in some parts of the UK are at 'Third World' levels, experts are warning.
Some London boroughs, as well as other places in Europe, have rates which are higher than those in China and parts of India and Africa.
The Stop TB Partnership, which includes a range of organisations campaigning for more recognition of the rise in TB, said the increase in cases in western Europe was caused by increased travel and population movement.
It says billions of dollars of investment is needed to identify and cure more patients with the disease.
Two separate studies from the British Thoracic Society (BTS) highlight concerns about TB treatment in the UK.
One suggests up to half of patients attending A&E departments with TB are "slipping through the net" and not being diagnosed correctly.
The research, carried out in Newham Chest Clinic, east London and the Middlesex Hospital,
suggests that as many of those affected are homeless, refugees or asylum seekers, staff
can face language difficulties when trying to make a diagnosis.
A second BTS study found Bangladeshi patients with TB were often reluctant to discuss their
diagnosis outside their close family.
The high level of stigma linked to the disease even led to one in eight feeling TB could
affect the sufferer's prospects of marriage.
At a Stop TB Partnership briefing of Westminster MPs, Dr Chris Dye of the World Health
Organization, said: "London is a snapshot of the global epidemic."
Paul Sommerfeld of UK-based charity TB Alert added: "Rates of TB in Britain are at a 10-year high.
"Rates in London have doubled in 15 years with rates of TB in some London boroughs now at Third World proportions and cases of its most dangerous drug-resistant form on the rise.
"Already 50 people a week develop TB in London and TB in Britain has increased by more than 20% in the last decade."
The rate rose by 80% across London over that period.
The borough of Brent has the highest rate of TB in the capital with over 116 cases per 100,000.
These rates compare with 113 per 100,000 in China and 64 per 100,000 in Brazil.
Across Europe, the highest rates are 42 per 100,000 in Portugal and 20 per 100,000 in Spain. "
- Documents expose farcical response to nuclear attack - 15 December 2002
- "A top-level exercise to simulate a jumbo jet crashing into a nuclear power station ended in high farce, an unpublished report obtained by the Independent on Sunday reveals.
Designed to test Britain's readiness to respond to a large-scale terrorist attack, the operation focused on Bradwell atomic power station in Essex, and exposed an astonishing series of failures in emergency responses.
Warnings about the disaster were incomplete, key staff could not find the control room, phones did not work, there were long delays in controlling the catastrophe and protecting the public. At one stage, officials were even dealing with the wrong power station. It was found planning was based on "assumptions", and there was little data on the nature of the release of the radioactivity.
Instructions from the Nuclear Installations Inspectorate caused "a considerable delay in putting out the reactor fire" and there was a delay of more than five hours before the public was given potassium iodate tablets to protect against radioactivity.
The failure to cope with the simulated attack further undermines confidence in the Government's ability to handle a catastrophic terrorist attack. As reported in last week's IoS, confidential Downing Street documents disclosed that the nation's civil defence "effectively no longer exists".
The power station simulation, codenamed Operation Isis, supposed a 747 cargo plane crashing into the reactor, 30 miles north-east of London, setting it alight and causing many deaths and evacuation of the public.
The ordering of the simulation over-rode opposition from the owners of the reactor, British Nuclear Fuels,who claimed that the scenario was unrealistic.
Yesterday BNFL confirmed that a thousand people from 60 organisations had been involved, in 20 different locations around the country.
The report on the exercise, however, describes it as a chaotic shambles.
Last night, Stewart Kemp, chief executive of the Nuclear Free Local Authorities, group blamed the fiasco on "decades of underfunding" of the emergency services.
Norman Baker, the Liberal Democrats' environment spokesman, called the exercise a "grotesque farce". "
- Nuclear catastrophe test descends into farce as services fail to cope - 15 December 2002
- "It was like a day-long episode of The Keystone Cops when Britain's elite emergency nuclear squad struggled to cope with the simulated effects of a 747 cargo jet being flown into a nuclear reactor, setting it alight.
Operation Isis – specifically ordered "at the highest political level" to reproduce a terrorist attack, and the biggest exercise for five years to address the effects of a nuclear catastrophe on the public – began at 6.40am on Friday 10 May, when Essex police reported "a major incident at Bradwell power station".
However, the confidential official report admits, "there was no information on the type of incident, wind direction, wind speeds, etc", all vital for working out how to tackle the accident and to protect the public.
Five minutes later, further notification was received from the Essex ambulance service but "the on-call doctor could not contact the ambulance paging service to confirm the veracity of the information". Another alert "left an incomplete message" on an automatic system at the Department of Trade and Industry, the owner of British Nuclear Fuels which operates the reactor.
Confusion descended into farce when yet another alert to the Food
Standards Agency led officials to concentrate on the wrong nuclear power
station, thinking that the disaster was at Sizewell, 45 miles away. Yet
another alert turned up, "not for the first time", at "the wrong place".
It got no better when around 50 emergency experts – from government departments, key official agencies, local authorities, the nuclear industry and the police, fire and ambulance services – had trouble in finding their way to the "main strategic co-ordinating centre" at Essex police headquarters at Springfield, in Chelmsford.
"The direction maps were difficult to follow," says the report. "When
the HQ was found, it was not clear where anyone was supposed to go."
Alarmingly for security, "there was no identification check on
Once there, the experts were soon caught up in a shambles in "very cramped" and "noisy" conditions, where people had difficulty even finding the lavatories. Some key officials were not allocated phonelines and other telephones "kept being cut off". Fax messages "were not picked up" and "some replies from the fax machine were not getting through until several hours after they had been sent".
Papers "became disorganised", notice boards "were not updated frequently enough", and lettering on the computer screens was in white, making it "invisible when printed".
The quality of the operation reflected the chaos in the control room. A direction from the Nuclear Installations Inspectorate caused "a considerable delay in putting out the reactor fire. There was "very little information about the nature of the release" of radioactivity, and meteorological information, particularly vital to determine where the fallout would go, was "lacking until late in the day".
There was "little communication" with the health authority early in the day, and it was often advised too late that radioactive emissions from the reactor had increased.
But most alarming of all, there was a delay of more than five hours before the public could be given potassium iodate tablets, which must be taken immediately to protect the thyroid against radioactivity.
The report says: "Decisions to protect the public were made by the health authority at 0900 hrs when Essex ambulance service requested to order stocks of potassium iodate from the Department of Health/ NHS Logistics.
"Significant delays in the response from the DoH/ NHS Logistics resulted in access to the tablets being agreed at 12.20 hrs, with their despatch at 12.30 hrs and their delivery to Ambulance HQ at 14.20hrs."
But there was some good news. The report says: "There were plenty of refreshments throughout the day".
The report, written by BNFL, concludes that the exercise was "a successful demonstration of the ability to extend existing detailed emergency arrangements". "
- NHS managers up 17.6 per cent - By Jeremy Laurance, Health Editor - 28 June 2003
- Grey suits are replacing white coats in the NHS, according to official figures published yesterday
The number of NHS managers expanded by 17.6 per cent last year, compared to a 5 per cent growth in hospital consultants, 4.9 per cent in nurses and 1.6 per cent in GPs.
The Department of Health, which published the figures, said it was asking NHS organisations to reducespending on "all areas other than patient care". A spokesman said: "An organisation as big and complex as the NHS needs good management. But it needs to reduce bureaucracy."
Opposition parties claimed the NHS was becoming over-bureaucratised and the extra billions of pounds being invested risked being swallowed up by administration costs.
Liam Fox, the shadow Health Secretary, said: "These figures are truly shocking. It is startling enough that the number of managers and senior managers increased by 17.6 per cent in just a year. It's simply appalling that the number of new managers far outstripped the number of extra doctors."
The NHS Confederation, which represents managers, said that despite the rise, the number of managers was still small at 30,900 in 2002, and that as a proportion of the NHS it had fallen from 3 per cent in 2001 to 2.6 per cent in 2002.
Gill Morgan, its chief executive, said: "Staff are the lifeblood of the NHS. Years of under investment [have] left the service not just short of doctors and nurses, but lacking the management and support needed to drive improvement."
The figures show 1,288 more consultants, 497 GPs and 17,100 nurses joined the NHS in the past 12 months, but the British Medical Association said the Government was not on course to meet targets for doctors set out in the NHS Plan.
The UK and Ireland are more reliant on recruiting nurses from the developing world than any other Western nation, a report by the International Council of Nurses, the World Health Organisation and the Royal College of Nursing, said.
- Revealed: How GPs cheat on their patients - By Andy McSmith, Political Editor - 29 June 2003
- Doctors' surgeries are deliberately obstructive to patients who want to book appointments because they interfere with the drive to meet government targets, according to a leaked NHS memo.
Patients are being told they will have to ring again another day, so that when they eventually see a doctor, they can be listed as having been seen within 24 hours. Documents seen by The Independent on Sunday show that health ministers are aware of the ruse, but are powerless to order doctors to stop doing it.
Although only a few surgeries are known to be involved, they have provoked what civil servants label a "significant level" of outrage from patients, much of it heaped on the heads of local MPs. One caught in the firing line, ironically, is the Health minister responsible for GPs, John Hutton, MP for the Cumbrian town of Barrow-in-Furness. One of the surgeries which has generated the largest number of complaints is in Cumbria.
By refusing to allow patients to book appointments, surgeries can show that, on paper, they are making progress towards the so-called "24/48" target set out by the Department of Health in the NHS Plan, which says that "by 2004, all patients will be able to see a primary care professional within 24 hours and a GP within 48 hours". Last year, the department set aside more than £83m to help surgeries towards this target.
The Government set up a network of centres run by a National Primary Development Team (NPDT) to make sure they had the necessary technology and administrative training to cope with patients' demands. There were also offers of payments of up to £5,000 for surgeries which could show progress.
The official statistics soon showed improvements, with 90 per cent of patients reportedly being seen on the day of their choice. Yet some MPs were deluged with complaints from members of the public being told they were no longer allowed to book an appointment.
Now, an internal memo written by the deputy head of NPDT, Guy Rotherham, has warned that a few surgeries risk discrediting the campaign. "We are aware of some practices which have sought to deliver the 24/48 hour access target by simply restricting pre-booking and forcing people to be seen on the same day. While this satisfies the 24/48 hour target, it is not patient-sensitive. Restricting pre-booking is not only unhelpful to patients, it takes out the benefits to the practice of applying the true principles of advanced access.
"It only takes a small number of practices to generate a significant level of complaints. We are aware of three practices which have refused to stop embargoing pre-bookable appointments, one of which is in Cumbria. While we will continue to encourage them to be more flexible, there are no formal mechanisms to stop the practice."
The Tories blamed a target-hungry government for creating the problem. The Shadow Health Secretary, Liam Fox, said: "This shows the amount of emotional blackmail which those working in the NHS are now routinely subjected to. Ministers' pathological obsession with targets now leaves no part of the NHS untouched."
A department spokesman said: "It is not the case that doctors' appointments must be made only on the day of the visit, or only up to 48 hours in advance. Patients should be able to make appointments in advance, and this must remain the case in a modernised and responsive service."
From someone claiming not to be in the know: Querying how to transfer NHS registration from "up North" to London
Date: Wed, 18 Jul 2001 11:10:59 GMT
From: [The One Who May Not Be Named]
Subject: Re: NHS? Re: I'LL TAKE IT!! Re: Any news on XXXYYYZZ Road?
I probably know less about the awful NHS system than you! I have still
never seen my official doctor in 10 years. Transfer is very easy. I presume
you have a paper NHS card. You simply go to the new doctor with the old
card and doctor's name on it, and reception completes the new details
and posts it off to Timbuktoo (may be to Newcastle?). A new card then
comes back to your current address. (I have only used the NHS system
twice, and on one of those occasions is was only to get referred to
a private consultant so that I followed the private health insurance
rules, and the 2nd it was for some eye-drops that needed a prescription.)
I have to say that compared to France (which beats the USA when it comes
to health care), the UK is distinctly third world at times - some of the
hospitals here hardly differ from those I have seen in rural China!
Will keep you informed as to progress,
Cheers, [The One Who May Not Be Named]
- Wednesday, 19 December, 2001, 20:01 GMT : Crackdown on waiting-list 'fiddles'
- Wednesday, 19 December, 2001, 14:19 GMT : Hospitals respond to 'fiddling' report
- Wednesday, 12 December, 2001, 17:59 GMT : Tory chief says Blair 'clueless' on NHS
- Friday, 7 December, 2001, 11:43 GMT : Top surgeon: 'NHS dreadful'
- 'Chaotic NHS cannot improve' : Mathematical rules mean that Gordon Brown's plans to pump vast sums into the health service will have little impact, says a surgeon.
- NHS delays 'causing blindness' :
Thousands of people are losing their sight every year because they are not receiving prompt treatment on the NHS, according to eye charities.
- NHS buildings fail on safety :
A report finds a third of NHS buildings in Wales fail health and safety standards
while millions is wasted due to bad management.
New hospital menus are 'slop' :
New hospital menus devised by TV chef Loyd Grossman have been described as "slop" by NHS nurses.
NHS blasted for 'same old errors' :
The NHS makes the same mistakes again and again, despite warnings from the Health Service ombudsman, the watchdog says.
How can the NHS be turned around? :
BBC Correspondent Karen Allen on the implications of the damning Audit Commission report into A&E waiting times.
War veteran 'let down' by NHS :
A hospital in Plymouth apologises after a war veteran has his hip operation cancelled for the sixth time.
Diabetic died after 'flat lemonade' advice
An inquest hears how a Devon woman slipped into a coma after an NHS Direct nurse advised treating her with flat lemonade.
Analysis: How to beat NHS 'gridlock' :
BBC Health Correspondent Karen Allen looks at the problem of "bed-blocking" in the wake of government plans to tackle it.
NHS 'medieval' says French minister :
The French health minister says that the UK spends far too little on its health service.
Heart patient dumps NHS for South Africa :
A heart attack victim worried he will die while waiting for his heart operation has sold his house to pay for treatment in South Africa.
Report damns NHS complaints :
Pressure to reform the ailing NHS complaints system is mounting following the second stinging official report inside a week.
NHS 24th in world health league :
The UK ranks just 24th in the world when it comes to the efficiency of its health system, World Health Organisation analysts say.
Ministers blamed for NHS failings :
Health leaders say ministers are to blame for the failure of the NHS always to treat those patients most in need first.
Medical profession welcomes report :
Despite wide-ranging criticism of the NHS, the medical profession welcomes the report.
Milburn gives NHS pledge :
Health Secretary Alan Milburn steps into the row over private funding of public services by pledging NHS principles "are not up for sale".
Lack of NHS resources 'no excuse' :
The health service ombudsman accepts a link between poor health care and resources, but says it is not an automatic excuse.
Braces 'to be rationed on the NHS' :
The number of children receiving free orthodontic work on the NHS is to be slashed, say specialists.
More people 'will pay for healthcare' :
Even people who may struggle to afford private health care will consider paying to skip lengthy NHS waiting lists, a survey says.
Doctor quits 'shabby' NHS :
A GP who has resigned from his practice in rural practice in Kent says it is impossible to provide proper care.
NHS trust refuses cardiac cash donation :
A health trust turns down a "substantial" cash gift for a cardiac unit in an area with some of Wales's worst heart problems.
NHS trust refuses cardiac cash donation :
A health trust turns down a "substantial" cash gift for a cardiac unit in an area with some of Wales's worst heart problems.
NHS 'failed' suicidal daughter :
A woman whose husband killed their manic depressive daughter to end her suffering blames medical staff for repeatedly failing her family.
NHS unveils 'Masterchef' menus :
New hospital menus devised for the NHS by top chefs have been unveiled.
NHS negligence claims soar :
The cash-strapped NHS is facing clinical negligence claims totalling £3.9bn, 10% of a single year's budget.
Cancer test blunders report due :
A report from the NHS inspectorate into mistakes by one pathologist is expected to look at the use of freelance doctors across the NHS.
Lib Dems reveal health plans :
The Liberal Democrats say the top priorities for the NHS must be to recruit more staff and to prevent people getting ill in the first place.
MS sufferers 'let down' by NHS :
Multiple sclerosis sufferers say they are being "badly let down" by the NHS, according to a survey by the MS Society.
NHS arthritis care 'inadequate' :
Four out of five people with arthritis are unhappy with the standard of care they get from the NHS, a leading charity has revealed.
New NHS menus 'too expensive' :
New hospital menus devised for the NHS by top chefs are too expensive to work on existing NHS budgets, warn hospital caterers.
NHS aims to improve patient safety :
All medical mistakes will have to be officially reported, whether or not the patient has been harmed, in a bid to improve safety in the NHS.
Matrons back on the wards :
Matrons are to be brought back onto the hospital wards for the first time in 30 years to improve standards in the NHS.
Hepatitis ruling to cost NHS millions :
The health service faces a bill of at least £7m after a ruling that patients infected by hepatitis-contaminated blood should be compensated.
Grim reality of the NHS :
Long waits in A&E and cancelled operations are still the grim reality for many patients in the NHS, a BBC documentary has found.
What do you we want from the NHS? :
BBC Doctor Colin Thomas asks what we can reasonably expect from the NHS.
NHS 'shunned private cancer patient' :
An NHS hospital turned away a patient with suspected breast cancer because she had been referred from a private clinic.
- More than a dozen cases in hospitals, GP surgeries, and in
one case, a pharmacy, were highlighted in the report.
- A case in which poor staffing over a weekend may have contributed to the death of a patient following surgery
- A case in which a patient died after a pharmacist dispensed the wrong drug
- A case in which staff failed to spot the infection which could have contributed to the death of a premature baby
NHS told to use PR spin during crisis :
A BBC investigation claims Health Minister Jane Hutt has urged health bosses to divert attention
from winter crises - with "good news" stories.
Call for end to 'NHS secret society' :
Health Secretary Alan Milburn promises a reform of the health service to give patients
better protection during their treatment.
Cancer patient's 'NHS death sentence' :
A woman whose husband's cancer operations were delayed for four months says he has been handed a death sentence.
NHS 'fails to respect patients' :
Sir Donald Irvine, President of the GMC, calls for radical changes in the culture of the NHS.
Hospitals 'failing' hygiene tests :
One in three NHS hospitals are still failing hygiene tests in spite of government attempts to
improve conditions, a report says.
NHS 'shake-up' set after baby inquiry :
An inquiry into the deaths of 29 babies at the Bristol Royal Infirmary could result in big changes in NHS culture.
Mixed reports for hospitals :
The first "healthcheck" inspections at NHS hospitals find they are generally doing well.
'Winter could break NHS' :
Lung specialists warn that an epidemic of chest problems this winter could swamp the fragile NHS.
Bullying 'ruining NHS workers' lives' :
Many NHS workers feel their lives are being ruined because of bullying at work, according to a survey.
Blair: 'NHS faces tough winter' :
Prime Minister Tony Blair admits the NHS will find it tough to cope this winter but says the
service is better prepared than ever before.
NHS crisis 'here already' :
A top health worker warns that the NHS is already suffering from serious problems even
before the expected surge in demand this winter.
Record nurse numbers flee country :
Record numbers of nurses are leaving both the NHS and the country - threatening to
derail the government's recruitment drive.
Elderly 'failed by NHS complaints system' :
Older patients face endless obstacles if they try to complain about the care they receive, according to Age Concern.
NHS inspectorate shows its teeth :
The first investigations by the new NHS inspectorate has proved that the fledgling organisation pulls no punches.
Grossman to spice up hospital food :
BBC Masterchef host Loyd Grossman will lead some of Britain's best chefs in an initiative to
improve the standard of NHS food
Cash handout for London nurses :
Nurses facing high living costs in London and the south of England will get a significant salary boost.
Most NHS nurses 'consider quitting' :
Eight out of 10 nurses have considered leaving their NHS jobs because of either low morale
and poor pay, according to a survey.
NHS complaints increase :
The number of complaints about treatment received from the National Health Service in Scotland rises.
£100m dentistry plan criticised :
The government announces a £100m package aimed at ensuring everyone has access to an NHS dentist by 2001.
Regional lottery in NHS waiting times :
Patients in England wait an average of seven months for hospital treatment, with worse
delays in many parts of the country.
NHS failing heart attack patients :
Thousands of people die unnecessarily from minor heart attacks because NHS hospitals fail to provide adequate care, say doctors.
- Thousands of people die unnecessarily from minor heart attacks because NHS hospitals fail to provide adequate care, a study has found.
Research carried out by doctors found that patients who are admitted to hospital with serious heart pain are just as likely to die as those who have major heart attacks.
They discovered that many hospitals were discharging patients without carrying out all of the recommended treatments.
They found that 15,000 patients die or have a major heart attack six months after being in hospital.
More than 120,000 people are admitted to hospital in the UK each year with serious heart problems."
- "According to the study, almost all of the patients should have been given an angiogram to assess the condition of the heart.
However, just one in four patients were given this treatment.
Patients with angina problems are also recommended to be given aspirin or heparin, a blood-thinning drug.
But, according to the study, almost a third of patients did not receive heparin while in hospital.
It also found that six months after been discharged nearly a quarter of patients were no longer taking aspirin.
Just one in eight of those patients with unstable angina were given an angioplasty, a treatment that
helps to clear blocked arteries."
Hospital warns of 'Third World' NHS :
Hospital managers in Northern Ireland warn that the NHS risks becoming a Third World healthcare system.
NHS equipment 'dangerously old' :
More than a third of vital NHS machines are dangerously old and in need of replacement, says a former government scientist.
Madonna snubs 'Victorian' NHS :
Pop star Madonna says she plans to give birth in the US because she does not trust the NHS, as she announces she is having a boy.
NHS trusts 'putting budgets first' :
NHS trusts in Scotland are accused of using £160m earmarked for new equipment to reduce budget deficits.
Flu: An NHS nightmare :
Winter can bring severe respiratory infections, and lead to patients flooding A&E departments.
BBC News Online examines the potential for crisis.
- "It is supposed to reduce demand on the NHS by encouraging patients to
take care of themselves and by stopping people from going to their GP or local
A&E department for treatment when they don't need it."
- "However, the service has been widely criticised because calls can
take as long as 15 minutes, advice varies and there is a suspicion that
nurses are sending patients to GPs and A&E departments anyway. "
NHS helpline 'risking lives' :
The NHS's telephone helpline may be placing patients in danger by giving sub-standard advice, say researchers.
Inquiry sought into NHS 'ageism' :
Pressure mounts for an inquiry after an NHS study finds younger patients are more likely
to get treatment than the elderly.
NHS to tackle 'causes of ill health' :
Extra screening programmes and free fruit are part of plans to improve people's health.
Six months: A realistic wait? :
The government wants to make sure no-one waits more than six months for hospital treatment - is this feasible?
Tackling smoking 'could save millions' :
The NHS could save huge sums of money by persuading people to give up smoking, according to a report.
NHS managers 'to blame for problems' :
Problems in the NHS are down to poor management and not a lack of funding, according to a major report.
Analysis of NHS performance :
The BBC's health correspondent Daniel Sandford investigates huge variations in levels of care in different parts of England revealed in NHS Performance Indicators.
Helpline 'has not eased' NHS pressure :
The introduction of NHS Direct - a medical advice phoneline - has not lessened the pressure on hospitals and GPs, say researchers.
NHS postcode lottery revealed :
NHS performance figures show massive differences between England's best and worst health authorities, but critics say they are misleading.
'Don't spin NHS reform' :
The BMA tells ministers that its plan for reform of the NHS must put substance above spin.
Gibraltarians attack 'filthy' NHS hospital :
A London hospital is accused of poor hygiene standards by Gibraltarians sent there for treatment.
Rise in NHS complaints :
More people are complaining about GPs and hospitals, according to the Health Service Ombudsman.
NHS 'failing disabled patients' :
NHS services helping patients who have suffered strokes or had limbs amputated are "inadequate",
according to leading doctors.
Virgin to advise NHS :
The government has asked Sir Richard Branson's Virgin Group to advise the National Health
Service how to treat patients better.
Labour launches Tory website attack :
Labour says its secret website recording of Tory comments on the NHS proves the party would privatise.
NHS 'failing' diabetics :
Diabetes sufferers are at risk because of sub-standard care from the NHS, a watchdog warns.
Third World plan to save NHS :
Flying patients abroad for cut-price operations could save the UK National Health Service "from collapse", an MP suggests.
Bosses face NHS 'hit squad' :
The government uses new powers to investigate a health care trust after abuse of elderly patients was uncovered.
Thousands shun the NHS :
The number of people opting to pay for private operations out of their own savings has jumped significantly.
NHS spending claims 'misleading' :
Health minister Alan Milburn is accused of misleading the public over funding of the NHS.
Blair promises end to 'NHS lottery' :
Prime Minister Tony Blair outlines a five-point plan to cut casualty waiting lists as part
of an ongoing plans to reform the NHS.
Forgery inquiry into NHS death :
Two hospital staff are suspended following the death of a patient.
NHS bugs 'kill 5,000 a year' :
Up to 5,000 people die each year from infections picked up in hospitals in England,
according to the national spending watchdog.
'At least you don't work in the NHS' :
The French Employment Minister tells striking doctors and nurses things are worse across the English Channel.
Winston back on NHS offensive :
Lord Winston renews his attack on the National Health Service in a House of Lords debate.
Call for probe into NHS 'lab danger' :
The Conservatives have called for a full investigation into allegations that NHS
patients are being put at risk by a laboratory staffing crisis
Winston calls for NHS spending pledge :
Lord Winston has stepped back into the fray over NHS funding - challenging Tony Blair to
give a firm commitment on massive spending increases.
Staffing crisis exposed in NHS labs :
A new report says the medical service in Britain which helps doctors make accurate diagnoses is being put at risk because of underfunding and understaffing.
Papers keep focus on NHS :
There is no let-up in the barrage of criticism facing the government over the state of the NHS.
Father's death prompts GP's call for overhaul :
Her father's death after a three-hour hospital transfer prompts a GP to call for a debate on the future of the NHS.
NHS faces £2.8bn negligence bill :
Outstanding medical negligence claims against the NHS could cost the cash-strapped
service up to £2.8bn, a Commons report warns.
Government accused of NHS complacency :
The Conservatives have accused the government of leaving voters feeling angry,
frightened and betrayed by their management of the NHS.
Why an NHS nurse is hard to find :
Professional bodies have talked of a recruitment and retention crisis in NHS nurses for
years, but what are the reasons behind it?
NHS remedies dominate papers:
The government's discomfort over criticism of the state of the National Health Service
remains the main topic in the UK's Sunday newspapers.
Test-tube Lord slates Blair's NHS :
The British government has been strongly criticised over its record on the National Health
Service -- this time from one of its own supporters, who is among the country's most prominent doctors.
Flu pushes NHS to breaking point :
The death of a pensioner who waited five hours for a hospital bed highlights the crisis facing
the NHS following a flu outbreak.
NHS euthanasia claims ludicrous' :
A senior consultant's claim that elderly patients are being left to starve to death in NHS
hospitals has been dismissed by Health Secretary Alan Miburn as "ludicrous".
Thousands of OAPs charged 'illegally' :
Up to 42,500 elderly people could be being charged illegally for their nursing home costs,
according to a report by the Royal College of Nurses.
Winter plea for NHS :
The public is being asked by the Government not to put the NHS under unnecessary strain during the winter.
NHS quality reforms :
Major reforms which came into force in April 1999 focus on quality and standards in the NHS.
NHS still losing nurses :
The lack of family-friendly policies is forcing nurses to give up their jobs just as the
government is spending millions to increase numbers, a survey suggests.
NHS complaints 'fail the elderly' :
The NHS complaints system is too slow to help old people who are suffering neglect or poor treatment, says new research.
Family challenge NHS over artificial limbs :
Limbless patients often have to go private to get the latest prosthetic arms and legs -
but one family is challenging the system as they fight for the best for their nine year old daughter.
Hospital ships for sinking NHS :
Two military hospital ships could be loaned to the NHS to cope with bed shortages.
'Unsustainable NHS will trigger private boom' :
Thousands will turn to the private healthcare system over the next decade as state systems
such as the NHS break down, says a report.
'Friday, 27 September, 2002, 09:20 GMT 10:20 UK
NHS facing midwife crisis
- A shortage of midwives in the NHS is reaching crisis point, according to the Royal College of Midwives.
Its officials say the government has failed to meet a key target to recruit extra staff.
The college has also warned that plans to boost midwife numbers by 50% by 2009 will fail unless action is taken to make posts more attractive.
Hundreds of midwives are leaving their jobs each year and vacancy rates are at record rates, according to the college.
The shortages mean few women have the sole attention of a midwife if they give birth on the NHS.
Midwives themselves warn that the shortages may be putting patients at risk.
The government has pledged to recruit 2,000 extra midwives by 2004 and a total of 10,000 over the next seven years.
As part of that programme of expansion, ministers aimed to encourage 500 additional staff to take up posts in the NHS by September.
However, figures obtained by the BBC show that it has failed - the overall number of midwives has actually fallen since the target was set.
Vacancy rates have increased everywhere apart from London, where empty posts were already at critical levels.
The royal college says the shortage is putting extra pressure on existing staff, many of whom are now also considering quitting.
Jon Skewes, director of employment relations at the RCM, said: "The government was making progress towards the 500 figure but our latest information shows in the last six months they've been slipping back and there are now 45 fewer midwives.
"It is clear from our own staffing survey that vacancy rates are increasing everywhere and not just in London and the south-east," he told BBC News Online.
The college has called for extra money for midwives.
"Midwives clearly have to be valued much better than they are. The most that quite qualified midwives can learn in the NHS is about £25,000," said Mr Skewes.
"We want to see the government investing in a new pay system for the NHS which is more than three years in negotiation and it is about time it delivered for midwives."
- Tuesday, 24 September, 2002, 10:51 GMT 11:51 UK - GP shortage 'critical'
- MRSA Scandal -
Each year, 100,000 people catch an infection in hospital. Of these, 5,000 die - more than are killed on the roads. It's one of the worst rates in the world. So is there a cure?
By Jeremy Laurance and Colin Brown -
07 December 2004
- Every year 5,000 patients in hospitals in Britain die from an infection acquired after they were admitted.
Up to 100,000 more - almost one in 10 in-patients - endure extended illness, pain and suffering caused by bugs they contract in the place where they came for a cure.
The number of deaths exceeds that from road accidents, and that from drugs and HIV/Aids combined. Our rate of infection is among the highest in the world, above that of Australia, Denmark, Norway, the Netherlands and Spain. It costs the NHS more than £1bn a year.
Today, the Government will launch its latest crackdown on poor hygiene to cut the rate of hospital infections, of which the worst is MRSA (methicillin-resistant Staphylococcus aureus). Lord Warner, a health minister, will launch a guide for hospitals, setting out how every part of the institutional environment should be cleaned. Hospitals are to be ranked in a league table on food standards and cleanliness.
The Tories accused the Government last night of window-dressing and claimed this was the 22nd initiative on hospital infections announced to cut the death toll since the Government came to power. Michael Howard, the Conservative leader, has made action on MRSA one of the Tories' 10 priorities for the general election. In an article today in The Independent, he describes how his mother-in-law died of the disease.
The Tory health spokesman, Andrew Lansley, said: "It is a national scandal. Over the last seven years, deaths from MRSA have doubled. It has been clear for years that the actions required included closing wards and giving patients the right to refuse hospitals or wards where there is infection. Nurses should have the power to stop admissions to wards."
For people like Jacqui Munro, the measures are too late. Days after returning home from hospital in Lanarkshire with her first child, born by Caesarean on 21 June, she was rushed back after a black rash appeared around the wound. She spent 11 weeks battling against infection with MRSA and other bugs, but she died in September.
The best way of saving people such as Mrs Munro is with hygiene - yet simple procedures are still not being practised. One in three people naturally has staphylococcus infections on their skin, which is not a problem in fit, healthy people. But since the early 1990s, there has been a sharp growth in staphylococcus infections resistant to methicillin and other antibiotics. Today, 40 per cent of Staphylococcus aureus bloodstream infections are caused by MRSA.
When these organisms get into the blood of people who are sick or elderly through a wound or a needle inserted in a vein they become seriously ill because their immune system is already weakened. They are hard to treat because the organism is resistant to antibiotics. Yet the infections could be sharply reduced - this is the key point - by ordinary measures such as washing hands. To improve hospital hygiene the Government's chief medical officer ordered every NHS trust to appoint a director of infection control last year with responsibility for cutting deaths and illness caused by superbugs. Sir Liam Donaldson ordered the move after acknowledging that five years of advice and guidelines had failed to work.
"The message is, there will be no more Mr Nice Guy in the fight against hospital-acquired infections," he said. "We are going to get much tougher and more aggressive."
However, six months later in July this year an investigation by the National Audit Office found rates of infection were still rising. Official figures published by the Department of Health showed overall infections caused by MRSA increased from 7,384 in 2002-03 to 7,647 in 2003-04 - a rise of 3.6 per cent.
The highest rates were seen in some of the country's most prestigious hospitals. Guy's and St Thomas' NHS Trust in London had the highest MRSA rate at 0.45 cases per 1,000 bed days, followed by Addenbrooke's in Cambridge, with a rate of 0.38.
The NAO blamed chronic failures by the NHS to deal with the problem and said that, four years after its first report, many of its original recommendations had still not been implemented.
"The war against hospital- acquired infection must be pursued on many different fronts, including a more robust approach to antibiotic prescribing and hospital hygiene, instituting a system of mandatory surveillance and persuading all NHS staff to take responsibility for effective infection control," said Sir John Bourn, comptroller and auditor general of the NAO.
Many of the infections occurred because sick patients were more vulnerable to infection, the NAO said, but it estimated that 15 per cent of cases were preventable by better practices. That is equivalent to 750 deaths a year which could be prevented if more stringent regulations were in place.
MRSA is caused by overuse of antibiotics, especially by the agriculture industry, where they are added routinely to animal feed as growth promoters. Bacteria resistant to the drugs grow and multiply, by a natural process of evolution, and the more widely the drugs are used the greater the opportunities for resistance to develop.
- 'No one came in to clean it. Three weeks later the blood was still lying on the floor' -
By Terri Judd - 07 December 2004
- For any pensioner, the prospect of surgery in hospital is worrying, but for Bob McReight it is terrifying.
The 75-year-old had to have a leg amputated after contracting MRSA at the old Royal Infirmary in Edinburgh. Four years later, his wife Margaret, now aged 68, was in the same hospital and she also caught the disease. She still has problems walking.
Mr McReight now has problems with his elbows. He says the prospect of returning to hospital, albeit another one this time, is shattering for both him and his wife.
"I am dead scared to go in. But I won't go if they won't let me come home. I am not staying in after the operation. If they are not going to do that, I am not going. I don't trust those people," said the retired lorry driver yesterday.
Mr McReight went into the old infirmary, since closed, in 1998 to have an aneurysm treated. "It was pretty rough. My wife had to come and clean the sink it was so filthy," he said.
On the day he returned home, he began to develop pains in his groin and immediately returned to hospital. "They discovered MRSA. They never really explained anything. They just put me on a load of drugs and drips. I lost a lot of weight - went from 11 stone to seven stone," he added.
After weeks he was finally discharged again but the problem persisted and he went back to consult a surgeon on a painful toe. "He told me: 'I'm afraid that toe is going to kill you. Come in on Thursday and I will have the leg off Friday.' I was absolutely shocked," he said.
Mr McReight learnt to walk again with a prosthetic leg and the couple were rebuilding their lives in 2002 when his wife fell in the garden and broke her leg in several places.
While she was being treated in the old infirmary she learnt she too had contracted methicillin-resistant Staphylococcus aureus. "I was taking my wife out for a wee walk. One of the nurses stopped her and just told her there and then. It broke her heart," said Mr McReight.
"She spent six weeks in hospital and two months at home on antibiotics. She will never walk properly again. Her legs are stiff."
Mrs McReight added: "Two years down the line I'm still walking with a stick. I kept asking them when the pain would go and they just said it was a very bad fracture. They didn't say anything about MRSA."
The former telephonist has a keen memory of the appalling conditions she endured. Three weeks into her treatment, her leg bled across the floor. "No one came into the ward to clean it. Three weeks later, when I was discharged, the blood was still lying on the floor by the side of my bed."
Now they are contemplating the prospect of Mr McReight going into another hospital. Mrs McReight said: "I am very worried about him going back into hospital because I have witnessed both times what happens there."
The couple say they have never received an apology. Instead, one ward sister accused them of bringing the disease into the hospital.
Mr McReight said: "I felt like choking her.
Thursday, 19 September, 2002, 04:55 GMT 05:55 UK -
Why NHS dentists are so hard to find
- "And the Audit Commission warns the piecework system, under which dentists are paid per item of treatment provided, means there is a "perverse incentive" for unnecessary or cosmetic work.
For example, scaling and polishing teeth is a common procedure which accounts for 11% of NHS family dentist spending. "
- "The Audit Commission has said the check-up system, which requires people to come in every six months, also needs to be reformed.
Experts say because dental health has improved, in most cases a check-up every two to three years for adults and one to two years for children, is enough to pick up dental health problems. "
Friday, 6 September, 2002, 10:05 GMT 11:05 UK -
Trainee nurses snubbing NHS
- "Thousands of nursing students decide every year against working as nurses as soon as they finish their training, a study reveals.
Researchers at The King's Fund believe as many as one in three newly-qualified nurses fails to register to practise.
They have also found that some of the biggest hospitals in the country are continuing to have major difficulties keeping nurses.
The problem is particularly acute in London where some major hospitals lose more than one third of their nursing staff each year. "
- GP 'used crystal pendant to treat sick child' - By Arifa Akbar - 14 January 2003
- A GP interested in alternative medicine tried to treat a baby's gastroenteritis by swinging a crystal pendant over her stomach, the General Medical Council was told yesterday.
Dr Michelle Langdon also told the mother of 11-month-old Kira Jinkinson her home was built on "geopathic stress lines", which could cause ME, cancer and cot death.
Dr Langdon, 43, a partner at Brunswick Medical Centre, London, was appearing before a disciplinary hearing charged with serious professional misconduct by refusing to prescribe patients with orthodox drugs. She denies her treat-ment of three patients fell below the standard of care expected of a registered doctor.
The hearing was told that while Dr Langdon practised conventional medicine, she was known to have an "evangelical zeal" for alternative and natural cures.
Opening the case for the GMC, Jeremy Donne said: "This case is not about the merits or otherwise of complementary medicine but about the enthusiasm of Dr Langdon for it, which compromised the interests of her patients."
Bethan Jinkinson, a BBC journalist, took Kira to the GP in October 2000 after the baby suffered severe vomiting. She was allegedly sent away without a diagnosis and returned when the condition worsened. Mr Donne said: "She [Dr Langdon] started to talk about the geopathic stress lines."
The GP allegedly tried to arrange for a spiritual doctor to lay down copper pipes in the home to "disrupt the flow" and prevent deadly illnesses.
Dr Langdon, who has practised for 24 years, used her dowsing chain to treat the toddler, who was later diagnosed with gastroenteritis at University College Hospital, London, the hearing was told.
In June, the GP allegedly refused to prescribe antibiotics to a patient who was later diagnosed with a stomach infection. The hearing continues.
- Kidney patients dying in dialysis care shortage - By Jeremy Laurance Health Editor - 14 January 2003
- Britain is in the grip of an epidemic of kidney failure and people are dying because hospitals do not have enough dialysis machines to keep them alive.
About 100,000 people have kidney disease but only 34,000 receive dialysis – regular treatment on a kidney machine – or have had a transplant, the National Kidney Research Fund (NKRF) says.
When the kidneys fail, patients must receive dialysis or a transplant within three months or they will die.
A survey of the 71 kidney units providing dialysis on the NHS in the UK found some were being forced to turn away patients because they could not cope with the demand.
The NKRF survey found 12 units turned away patients in 2001. Seven said they turned away between two and 20 patients each during the year. Others reported having to take emergency measures to accommodate patients by setting up temporary dialysis stations or treating them overnight.
The report says: "Some providers acknowledged that the final options for such patients are conservative management and/or death." John Bradley, director of the renal unit at Addenbrooke's Hospital, Cambridge, said: "There is concern that patients are dying because they can't get dialysis. If you talk to the units they say they don't know what happens to the patients they turn away."
Kidney failure is a growing problem in Britain, fuelled by the rise in diabetes caused by increasing obesity. The total number of sufferers is projected to double over the next decade. It is four times more common in Asians and Afro-Caribbeans. Treatment involves being connected to a kidney machine, three times a week, for dialysis that cleanses the blood of impurities. Some patients survive for decades having dialysis but it costs £30,000 a year.
- Dialysis shortage exposes failings of NHS - Hard-pressed kidney units admit turning away patients and offering inadequate treatment - By Jeremy Laurance Health Editor - 14 January 2003
- Kidney disease claims the lives of 7,000 people in Britain every year, many of whom die prematurely because they cannot get the treatment available in the rest of Europe and the United States.
Once the kidneys fail, a patient must start on a kidney machine within three months or they will die. The shortage of kidney machines exposes the failings of the health service with grim finality.
A survey of the 71 renal units providing dialysis in the UK by the National Kidney Research Fund (NKRF) and Sheffield University revealed there were 19,307 adults receiving dialysis, a rate of 328 patients per million population.
In the five European countries of Germany, France, Spain, Italy and the Netherlands the average dialysis rate is 537 per million population, 63 per cent higher than in Britain. In America, 267,327 adults were receiving dialysis in 2000, a rate of 1,000 per million, three times the British rate.
The discrepancy means that patients with kidney failure in Britain are not being diagnosed or are unable to find a kidney unit to accept them.
That has now been confirmed by the renal units, which have admitted turning away patients in the NKRF survey. If the doctors responsible for those patients cannot find a unit to take them, then the only option is for the doctors to keep them comfortable in hospital until they die.
Callers to the helpline for patients and their families run by the National Federation of Kidney Patient Associations reveal a similar picture. In one case, staff spent eight days trying to secure a critically ill patient a space on a kidney machine in one renal unit and only succeeded after "a lot of hard work and harassment of clinical staff," according to an internal report.
Tim Statham, chief executive of the federation, said: "Our helpline receives calls from people who say their relatives are not being offered kidney treatment. In addition, there are many thousands who do not know they have kidney problems. GPs don't even recognise it – they might see one or two cases in a lifetime."
Most renal units try to accommodate extra patients by reducing dialysis sessions to two a week instead of the normal three, offering the treatment out of hours or using inpatient facilities to care for outpatients.
At Addenbrooke's Hospital, Cambridge, where more than 300 patients are receiving dialysis, no patients are turned away. John Bradley, director of renal services, said: "We would tend to take everybody but we probably compromise their care because we have some on dialysis twice a week. The evidence suggests that if you don't provide adequate dialysis the patient has a higher risk of dying and their well-being is less good."
He added: "It is estimated that one quarter of units in the UK do not provide optimum care to all patients because of the pressure on services."
A kidney machine takes over the function of the kidneys, which are vital life-sustaining organs. Their main job is to cleanse the blood of toxins and transform the waste into urine. When a kidney is not working properly, harmful waste and salts build up in the body, causing high blood pressure and the symptoms of kidney failure, such as tiredness. The first sign of the disease is traces of blood or protein in the urine.
The simplest way to protect the kidneys is to drink plenty of water and avoid becoming overweight. The National Kidney Research Fund recommends that people drink two litres (three and a half pints) of water a day.
Although the kidneys can function on less than one litre a day this produces concentrated urine and leads to the build-up of harmful toxins. Together the kidneys filter about 200 litres of fluid every 24 hours.
The NKRF survey says that although services have expanded in recent years, most units are already operating at maximum capacity and will be unable to cope with any increase in patients.
"There is cause for considerable concern that the existing limited facilities will be insufficient to provide patients with optimal care in the future without some form of expansion of the service," it says.
Long wait for treatment - 'drugs were cheaper'
Doreen Allingham was a lively 60-year-old who ran a B&B from her home in Winchester, Hampshire, and doted on her five grandchildren. But in the past five years declining health forced her to give up the business and spend more time confined at home.
She had high blood pressure but the drugs prescribed by her GP made her feel worse. "She always wanted to get on with life but she felt sick, she couldn't climb the stairs and she wasn't eating well," said her son, Roger Savill, 41. Mrs Allingham was referred to a kidney specialist who prescribed more drugs and plotted her progress on a computer, but her condition deteriorated further. "She was feeling so poorly but his attitude was either take the tablets or don't take them and die."
Mr Savill asked the specialist if dialysis would improve his mother's condition. "I pressed him. I spent 55 minutes with my mother in his office and I said there must be something else that could be done. He said no – dialysis would make no difference."
Last November, Mrs Allingham was admitted to hospital as an emergency after contracting a kidney infection and put on dialysis. The transformation in her condition was immediate.
Mr Savill said: "She is much better. A whole cloud has lifted from her. Every day she is improving. What I want to know is, 'Why wasn't she given dialysis sooner? Was it because it was cheaper to treat her with drugs?'
"I got the feeling they didn't want to put her on dialysis because that was the last resort. She didn't need dialysis, not yet. But I think it was because of financial concerns, not what was best for the patient. She feels better every day now. In six months I would say she is going to be fighting fit."