Thursday, 28 February 2008

Depressing news

This is how my friend Dr Rant views the recent media reports on antidepressants:

Researchers from Hull University are claiming that antidepressants only work for patients who are severely depressed.

Whilst Dr Rant is perfectly willing to believe that placebo is just as good as antidepressants for mild to moderate depression, I think we do need to point out a glaring problem with this research. It's from Hull. I mean, have you been to Hull? ****, if I lived in Hull I'd be depressed and I don't think antidepressants would help. The 1960s didn't happen in Hull until about 1985.

Here's a suggestion: next time compare the effects on depression of taking placebo against simply moving to somewhere that isn't Hull.

Wednesday, 27 February 2008

Spilling the beans

From The Guardian:

NHS hospitals across England are systematically rigging their waiting lists to make it look as if they are hitting key government targets, the Department of Health acknowledged yesterday.

It said GPs were right to complain that it was becoming harder to make bookings for patients to get hospital treatment.

Many NHS trusts are telling GPs that their lists are full over the next few weeks and refusing to make advance bookings for later in the year. By keeping the queues short, the hospitals hope to hit the government's target for reducing waiting times.

The main health pledge in Labour's 2005 election manifesto was to reduce the maximum wait to 18 weeks from referral by a GP to being wheeled into the operating theatre, with no extra time added for patients needing complex diagnostic tests. An inquiry by Pulse, a newspaper for GPs, found 90% of hospitals were restricting advance bookings. "The practice can mean patients are barred from going to the hospital of their choice, since popular hospitals may have no appointment slots available in the short term," it said.

Ministers told GPs it would be easier to make hospital appointments for patients using an electronic system known as Choose and Book. But the inquiry found hospitals are keeping up to a third of their appointment slots off the electronic register in an attempt to reduce demand. The British Medical Association said: "We have heard of similar reports from doctors across the country. We would be very concerned if trusts were putting targets ahead of patient care.

"It is ironic that when government has put great emphasis on patient choice, their own targets on waiting times are stopping some patients from choosing their preferred hospital for treatment."

The association said it had evidence of trusts refusing referrals from GPs to avoid breaching the 18-week target. "All additional referrals are returned to the GP and not passed to an alternative provider. Such a situation could be repeated, by various providers, and further delay the patient's treatment," the association said. In some cases, hospitals were refusing to treat patients until the GP had dealt with problems such as high blood pressure or excessive weight.

A Department of Health spokesman said: "Hospitals should not be doing this. They are required to accept all referrals if clinically appropriate, and should not be manipulating Choose and Book to help them meet other targets." He added: "It is right for patients that they now have more choice, allowing them to arrange appointments at times and at hospitals that suit them - however this should not be at the detriment of being seen quickly ...

"The department has taken direct action by putting in place a national system to ensure that where patients are told that there are no appointments available on Choose and Book for their chosen hospital, they are still referred on to the provider of their choice."

Tuesday, 26 February 2008

Freedom of Information

The Save Bedford Hospital party has been asking some questions on your behalf under the Freedom of Information Act. We will let you know the outcome : keep checking out this site, because the answers could be interesting (or painful if you are a taxpayer)

Who is telling the truth?

Gordon Brown has promised a "more personalized" NHS

Lord Darzi wants GPs to work in mega-clinics of 20 or more doctors.

Both ideas may have merit, but are they not mutually exclusive?

Saturday, 23 February 2008

Jack's Eye - latest news

I reckon Jack and his wife Gay deserves a pat on the back from us all.

They were up at 0500 getting ready for the Today programme, and BBC Radio Devon, and BBC Spotlight for all of these people Gay made coffee and provided bacon and egg (sadly I had eaten before leaving for their house which proved a mistake).

They "threw me" on the the Today programme when they said that NICE were planning to issue their guidance today - I spent an hour working on a speech to deliver in case we arrive dat Downing Street to the news tat Mr Brown had seen sense.

Jack's treated eye has worsened and he almost tripped over a trailed suitcase in the busy station at Paddington - his cat like reflexes saved the day. He put on a brave face but I could see he was shocked.

We arrived at Downing Street courtesy of The Mail on Sunday (buy a copy please) and were inundated with attention.

The police have a search room and we were welcomed so warmly it felt like they were old friends. They were actually queing up to shake hands with us! I guess the coppers are in the same boat as the docs and we all admire war veterans.

We felt like filmstars with a scrum of photographers fighting to get the best shots of your cheques and Number 10 in the background.

We then swaggered up to the famous door - we were expected - and a photographer shouted out to knock.

At this point I saw it. It was huge. It was Victorian. It was cast iron. It must have weighed five pounds. I could not help myself - I reached up and banged the doorknob so hard the fillings must have been shaken from Gordons teeth (lets hope he has an NHS dentist).

A dazed car park attendant (they must get the uniforms from the same supplier) staggered from inside and asked if I was "The Doctor" Jack replied in the affirmative and said we had something for Gordon.

I was prepared to come in - afterall Gordon knows that it is impossible to get an NHS GP to make a housecall - I even had my gloves (in case he wanted to shake my hand). It was obvious that the doctor was no longer required and we were politely thanked.

We handed over the cheques and the door closed gently behind us. As we walked away I heard a distant low pitched rumble coming from the cabinet room and even Jack's ancient olfactory nerve could detect the powerful smell of flatus.

We turned to the waiting pack of reporters and gave out interviews.

The local BBC and ITV TV news were following us, Radio Devon, and the Mail on Sunday, the Express, The Herald Express, the press association - all out for a soundbite.

A few minutes of fighting talk in Whitehall (Jack was filmed with the cenotauph as a backdrop) and we were in a Taxi.

When we got on the train at Paddington my mobile did not stop ringing until the battery gave out. By this time we had a group of fascinated passengers were politely pretending to read books - the bloke in front of me must have a reading age of 8 because he did not turn a page before Reading.

When the batter packe dup a fellow passenger offered us a charger and another one her phone. We carried on interviewing. The lady with the phone texted her mum who watched the news. "mum says the doctor is going to kick down Browns's door - she says it was brilliant!!!!"...

We will see what comes up on the BBC spotlight (sky 987) and ITV Westcoutry. The crews there thought it would be on national news at 2200.

We know there will be more in the press.

The story is not over though. Now Gordon has got our cheques. And he knows that if he does not send them on to Jack the doctor will be back - which is not the sort of housecall Gordon really wanted.

Open all hours

MPs' working hours

Sir - I recently wrote to my MP about the Government's plans for GPs' extended hours. I was dissatisfied with her response.

I contacted her secretary to make an appointment and was told that her next available surgery appointment was six weeks away. I was even more surprised to learn that she does not offer appointments in the evening or at weekends. I was told she sees constituents between 3pm and 4.30pm on a Friday once a month, take it or leave it.

I had heard that MPs had abandoned evening and weekend parliamentary sittings for more family-friendly hours. However, I was taken aback by how unfriendly their hours are to working constituents. It would appear that the Government does not practise what it preaches.

Dr Steven Nimmo, Plymstock, Devon

Wednesday, 20 February 2008

No wonder

No wonder so much public money is wasted:

A report has revealed that not one single Permanent Secretary (the senior civil servants in charge of Whitehall departments) has a professional finance qualification and so, according to the National Audit Office, government departments lack the financial expertise to manage their multi-billion pound budgets efficiently.

Government spending will reach £678 billion by 2010-11, yet six government departments don't even have a qualified finance director in their senior management team, despite a Treasury requirement to do so.

I wonder what this tells us about how our money is being spent?

On the Rocks

Storm clouds are gathering over a highly technical -- but potentially very important -- aspect of Northern Rock's nationalisation which could throw Alistair Darling's plan seriously off course.

Shortly before midnight in the Commons chamber, it emerged that the legislation to nationalise the stricken bank excluded the offshore company, Granite, which controls £40 billion of the bank's mortgages. Opposition parties say these are some of the bank's most secure assets. This has allowed Vince Cable to say that Northern Rock has been left with "rubbish" assets and he is now threatening to withdraw his support for the bill pending further clarifications from the Treasury.

This could be problematic politically: any alliance between the Lib Dems and Tories in the Lords has the potential to delay the bill and force big amendments. It is also a possible financial problem: Granite, which repackages mortgages into bonds and sells them on, relies on millions of pounds a year from Northern Rock to service them. What happens if Northern Rock is run down and unable to supply this money, however?

Even basic facts are murky. My eagle-eyed colleague Peter Riddell has pointed out seemingly basic contradictions: Yvette Cooper last night in the Commons said Granite is not covered by government guarantees. "It is not being taken into public ownership and it is not, in fact, owned by Northern Rock, so it is not part of the taxpayer's exposure and he has never been so." Yet a Treasury press release from December said the government guarantees were extended to "all obligations of Northern Rock plc to make payments on the repurchase of mortgages under the documentation for the "Granite" securitisation programme." There may be answeres to these questions, but they need to come quickly.

In plain English, this may mean the public is exposed to even greater liability, and could delay the government's timetable

Courtesy of the excellent "Red Box" in the Times

Monday, 18 February 2008

Jack's Eye update

From Martin:

Very exciting day - GMTV interviewed Jack, then we had the Spotlight BBC Team and Westcountryt ITV News, both will be running big stories tonight.

I have checked and the latest info from the NICE website (link below) is that NICE state they don't consider this to be their remit "This is because intravitreal injection for age related macular degeneration is considered standard clinical practice with risks and benefits that are sufficiently well-known. "

If we then quote Patricia Hewitt I think the case is wrappoed up and there is noway out for Brown.

We have been covered on front page of Western Morning News, a whole page in Mail on Sunday and a large article in London Today and Express.

The local paper will be running the story tommorow.

We are having live interview on BBC Spotlight this evening (report tells me I will be against a very unimpressive spokeslady for the PCT).

I was not planning to even send the letters off until morning!

If you watch Sky channel 987 for SW local news this evening you will see the story.

I have promised Jack that I willpersonally make up the first treatment if he does not get it on the NHS and would be very grateful if every one does send teir cheques in.

Well done all.

Sunday, 17 February 2008

Northern Wreck

The future of the NHS depends upon a healthy economy and a competent government.

Now Gordon Brown has decided to start nationalizing the banks. God help us all.

This comment comes from Iain Dale:

Even the most devout Labour spinner cannot disagree that the nationalisation of Northern Rock represents a total humiliation for the government. Alistair Darling's dithering and uncertainty have made even Gordon Brown look like a man of decision. I do not trust the government to run a whelk stall, let alone a bank. And they will be doing it with our - my (!) - money. God knows what hit the taxpayer will take now. And it will get even murkier when the government is sued for mismanaging the whole process, as it surely will be. The whole tri-partite regulatory system, which the Tories warned Gordon Brown would fail when he set it up, has been a disaster. And we're the ones picking up the bill. Plus ca change...

Jack'sEye (update)

This story features in today's Mail on read it first here

Wednesday, 13 February 2008

Jack's Eye

This is a posting from Dr Martin Rankin,a GP in Devon; he is trying to get some media coverage for the story, so do pass it on to any journalists who might be interested:

Below is an open letter that I propose to put in the public domain

Dear Mr Brown,

We need your help to save the vision of an old man.The case of Mr Herbert "Jack" Tagg * a Pit Boy turned WW2 Sergeant Pilot typifies the incompetence of your labour government in managing the NHS."Jack" has developed Wet Macular Degeneration - a condition which will mean he will almost certainly become blind within a couple of years. The good news is that there is a treatment for this. The bad news is that he has to go blind in one eye before the NHS will pay for treatment in the remaining eye. "Jack" is not a wealthy man but his wife has, without any hesitation, decided that they must sell their house to pay for the treatment. You have never met Jack or his lovely wife but I can tell you they are a wonderful couple. He risked his life for us, you are in charge of the NHS, we believe that our patients would prefer you to spend a few thousand pounds on Jack in his hour of need than bailing out an incompetent bank. The doctors who have added their names to this list will all post on a cheque for £5 payable to Mr Gordon Brown. Of course we don't expect you to get Jack his treatment on the NHS - we already know you are not up to the job of running the NHS, we simply would simply ask you to cash our cheques and then forward on the lump sum to Mr Tagg.
Yours sincerely

The Doctors of Great Britain.

*I have Jack's consent to use his name. Please sign your name below and send your cheque for £5 to Mr Gordon Brown (his address is 10 Downing Street, LONDON).
Let's see Brown spin this.

Please send the cheque payable to Mr Gordon Brown to me at Plym River Practice, Plympton, Devon PL7 1AD. I will get a photo and supply it with a photo of myself and Jack and the bundle of cheques next to a post box.

Sunday, 10 February 2008

Pigs at the trough...again

Peers were last night facing demands for an inquiry into their expenses after it emerged that members of the House of Lords with second homes in London were claiming tens of thousands of pounds a year in overnight allowances .

No proof is required to claim the subsistence allowance, worth up to £165.50 a night, which is designed to help peers who live in the country to attend late-night votes and debates in Parliament.

Peers who live full-time in London are not entitled to the perk, but those who have two homes and declare their country residence as their main home can claim, even if it is only used at weekends. They do not have to provide any evidence that their main residence is where they spend most of their time.

The furore over MPs' expenses triggered by Derek Conway, the Tory MP who employed his sons as researchers, has prompted an inquiry into Commons allowances. So far peers have escaped such scrutiny.

Among those who claimed last year was the Labour peer Baroness Billingham, who has a flat in Hampstead and a country house in Suffolk to which she normally returns on Thursday nights. Billingham claimed £26,983 in 2006-07, the last year for which figures are available, and said she had not been asked to provide any proof to support her claim. 'I think a lot of things are based on trust, to be absolutely honest with you,' she said.

Others with property in London who claim the expenses include the Labour peer and former senior trade unionist Lord Brett, who lists his address in Who's Who as a flat in the Dolphin Square complex near Westminster, but declares his main residence as his home in Cumbria. He claimed £27,887 last year.

Tuesday, 5 February 2008


From today's BBC news:

An NHS hospital trust has denied ordering a cut in blood tests as a way to reduce its reported MRSA rates.
The comments, from London's Kingston hospital come after a senior member of staff leaked an email which was circulated to all clinical staff.

The source said that staff were being encouraged to question whether blood samples should be taken.

Kingston Hospitals NHS Trust said the aim was to cut test numbers to those carried out at comparable hospitals.

In a statement, the trust said it currently carried out more blood tests than other hospitals of a similar size, and denied the intention was to reduce the number of MRSA cases being reported.

Sunday, 3 February 2008

Postman's knock

ALAN JOHNSON, the health secretary, has been accused of giving special access to a National Health Service contractor owned by one of the biggest donors to his deputy leadership campaign.

Johnson held a private meeting in his officers with Dr Reg Race of Quality Health, a firm that has been paid millions of pounds to conduct surveys for the NHS. A long-term Labour donor and former MP, Race had earlier given £5,000 to Johnson’s deputy leadership campaign.

Details of the meeting have raised concerns about “cash for access”. They emerged a week after it was disclosed that another of Johnson’s donors had given money to his campaign through his brother-in-law.

Johnson met Race at the Department for Health on November 12, according to questions answered under the Freedom of Information Act. No civil servants were at the meeting and no minutes were kept.

What was said at the meeting has not been made public, but it is known that Race and Johnson discussed Quality Health’s NHS contracts as well as Labour party politics.

Race’s company is one of a select group of “approved contractors” that health trusts must hire to conduct staff and patient surveys. The company, which Race owns with his wife Amanda Moore, has contracts with 320 of the 487 NHS trusts to conduct annual surveys introduced by Labour ministers in 2003.

Race’s £5,000 donation accounted for more than 10% of Johnson’s campaign spending. Nobody gave more to the campaign, in which Johnson came second. Race has also given more than £23,000 to Labour over the past three years.

Johnson’s aides last night denied Race was given preferential treatment and said the donation was given months before Johnson moved to the Department of Health last summer.

However, businesses competing with Quality Health for contracts said they had never had the opportunity to meet a health secretary.

“It is unheard of,” said the chief executive of one such firm. “It just does not happen.”

Saturday, 2 February 2008

The scandal of mixed sex wards

Sir - Lord Darzi's assertion that our hospitals can only separate the sexes by converting or building all hospitals with separate rooms is absurd (report, January 28). Hospitals have had no difficulty in providing separate wards for men, women and children for hundreds of years.

The pressure to mix the sexes in the wards began in the 1970s when politicians mistakenly began to believe that most surgical, and many medical, illnesses could be treated with outpatient or short-stay procedures and so demanded that, in theirview "unnecessary" hospital beds, be closed to reduce costs. At the same time administrators, having been told to achieve a 100 per cent bed occupancy to become more efficient, also enforced the closure of wards. The result was a shortage of beds so that those needing admission were put into any bed available regardless of their sex or wishes.

If hospitals ran with the ideal average bed occupancy of 85 per cent, it would not only be possible to have single-sex wards, but also be able to cope with the periods of heavy demand and have the opportunity to clean and refurbish. All of which would reduce hospital-acquired infection.

Lord Darzi should stop listening to the Treasury and direct his efforts to ensuring that patients are placed in an environment that will aid their recovery not impede it. He should tell his Secretary of State to reopen the multitude of beds that his and previous governments have closed and so give space and time for all the staff of the NHS to do theirjob properly.

Prof Sir Norman Browse, Past President, Royal College of Surgeons, Alderney, Channel Islands

Greedy bastard

The health chief blamed for a hospital superbug outbreak which killed 90 patients has rejected a pay-off of £75,000 and wants twice as much.

The health chief blamed for a hospital superbug outbreak which killed 90 patients has rejected a pay-off of £75,000 and wants twice as much.

Rose Gibb left her job "by mutual consent" as chief executive of Maidstone and Tunbridge Wells NHS Trust in Kent last October after a Healthcare Commission report criticised her handling of the C.difficile infection which hit 1,176 people in three hospitals between 2004 and 2006.

There was anger at the poor hygiene in the trust's hospitals - Maidstone, the Kent and Sussex and Pembury - where the superbug was found to have hastened the deaths of another 180 patients.

Last week it emerged Ms Gibb was to receive a pay-off from the trust of £75,000, despite the efforts of Alan Johnson, the Health Secretary, to block it.

Ms Gibb's representatives have revealed she is not accepting the severance package as she feels she is entitled to twice that figure, and is seeking £150,000.