Patients' groups expressed horror at the "sick experiment" in which NHS managers have agreed to pay £38 for every casualty that ambulance staff "keep out of Accident and Emergency" (A&E) departments after a 999 call has been made.
The tactic is part of an attempt to manage increasing demand for emergency care amid failings in the GP out-of-hours system.
Documents seen by The Sunday Telegraph disclose that staff at Britain's largest ambulance service have been encouraged to maximise the organisation's income, by securing payments for diverting patients to telephone helplines.
The bonuses are among dozens of schemes being tried out by ambulance trusts across the country as they attempt to improve their emergency response times and help A&E departments meet controversial targets to treat all patients within four hours of arrival.
Another plan uncovered would see thousands of 999 calls currently classed as urgent downgraded so that callers receive telephone advice instead of an ambulance response.
The changes were due to be introduced across the country this week, but the Government committee governing ambulances has delayed its decision amid safety concerns.
Last week, an investigation was launched at the ambulance trust piloting the scheme following the death on Thursday of a man whose case was referred for telephone advice when an ambulance should have been immediately dispatched.
Sunday, 28 March 2010
Sunday, 7 March 2010
Coming to a hospital near you
The catastrophe of Stafford Hospital, where hundreds of patients needlessly died, was an entirely predictable result of this governments target driven obsessions.
Much of what happened at Stafford happened, and continues to happen, elsewhere, perhaps in diluted form (think, perhaps of Stoke mandeville and Maidstone).
It was headline news for 24 hours, but how have we allowed it to slip away. When are senior members of the SHA,, of the Department of Health and health ministers going to be held to account?
Much of what happened at Stafford happened, and continues to happen, elsewhere, perhaps in diluted form (think, perhaps of Stoke mandeville and Maidstone).
It was headline news for 24 hours, but how have we allowed it to slip away. When are senior members of the SHA,, of the Department of Health and health ministers going to be held to account?
Monday, 1 March 2010
You have been warned
"Transforming" & "Vertical Integration".
As in "Transforming" Community Services.
Every PCT in the land has been ordered by the DoH to complete the purchaser-provider split within the next 8 months, by divesting itself of all its community services. These must either be set up as independently-contracting cooperatives ("Social enterprises"), or handed over in their entirety to an alternative contractor.
Such organisations will inevitably be too small to be financially viable, so the preferred solution, & inevitable doom, is for "Vertical Integration" - in plain English, a hostile takeover by the local Acute Trusts.
The Trusts, of course, have perverse incentives NOT to provide community service, but to get everyting transferred to in-patient care, especially as non-elective emergencies to get the massively increased PBR tariffs.
So, in translation, "Transforming" means utterly destroying.
As a means of providing care, or saving money, it is barking mad.
But as a means of fattening up the acute trusts for eventual privatising, it is a brilliant way to give them abusable & highly desirable monopolies.
And in the meantime, as a side-effect, the eligibility of the employees of the divested services for the NHS pension is already being questioned with a view to being cancelled - potentially setting a dangerous precedent for existing GPs & future employees of privatised trusts.
So be advised, this is not going to go away, with or without a change of geovernment. It is civil service policy & not open to democratic debate.
As in "Transforming" Community Services.
Every PCT in the land has been ordered by the DoH to complete the purchaser-provider split within the next 8 months, by divesting itself of all its community services. These must either be set up as independently-contracting cooperatives ("Social enterprises"), or handed over in their entirety to an alternative contractor.
Such organisations will inevitably be too small to be financially viable, so the preferred solution, & inevitable doom, is for "Vertical Integration" - in plain English, a hostile takeover by the local Acute Trusts.
The Trusts, of course, have perverse incentives NOT to provide community service, but to get everyting transferred to in-patient care, especially as non-elective emergencies to get the massively increased PBR tariffs.
So, in translation, "Transforming" means utterly destroying.
As a means of providing care, or saving money, it is barking mad.
But as a means of fattening up the acute trusts for eventual privatising, it is a brilliant way to give them abusable & highly desirable monopolies.
And in the meantime, as a side-effect, the eligibility of the employees of the divested services for the NHS pension is already being questioned with a view to being cancelled - potentially setting a dangerous precedent for existing GPs & future employees of privatised trusts.
So be advised, this is not going to go away, with or without a change of geovernment. It is civil service policy & not open to democratic debate.
Wednesday, 24 February 2010
Gordon Brown a bully?
Amusing comment on Channel 4 News. The staff at No 10 said Brown had a ferocious temper but none said they would describe it as bullying. One said he didn’t have the empathy to bully!
Tuesday, 23 February 2010
Meanwhile at Stafford Hospital
The NHS Trust running Stafford Hospital spent £628,000 boosting its image in a 3 year period when it was embroiled in a scandal over dismal standards of care.
Over the same period that Stafford Hospital is accused of causing between 400 and 1,200 avoidable deaths the parent Trust spent tens of thousands of pounds on a PR agency….advertisments and ‘marketing management costs’.”
Stafford Express and Star, Feb 23rd
Over the same period that Stafford Hospital is accused of causing between 400 and 1,200 avoidable deaths the parent Trust spent tens of thousands of pounds on a PR agency….advertisments and ‘marketing management costs’.”
Stafford Express and Star, Feb 23rd
and in London...
Dr Anwara Ali, a Labour councillor in Tower Hamlets and the face of the NHS's East End campaign on breast cancer (see below), has switched to the Tories.
Dr Ali, who is the borough's lead Cabinet member on health, told the Evening Standard today:
“I have been a lifelong Labour supporter, but I believe the country cannot afford five more years of Gordon Brown.
“As a GP working on the frontline in the largest practice in the East End, I have become increasingly disillusioned with Labour’s failure to reform the NHS. The past decade has seen this government waste millions of pounds on bureaucracy in hospitals.”
“Gordon Brown’s obsession with top down targets and a tick box culture has ruined the moral and goodwill of the national health staff. Ill health and early death in the East End is a direct result of Labour’s failure to bring real reform to the NHS.”
Dr Ali, who is the borough's lead Cabinet member on health, told the Evening Standard today:
“I have been a lifelong Labour supporter, but I believe the country cannot afford five more years of Gordon Brown.
“As a GP working on the frontline in the largest practice in the East End, I have become increasingly disillusioned with Labour’s failure to reform the NHS. The past decade has seen this government waste millions of pounds on bureaucracy in hospitals.”
“Gordon Brown’s obsession with top down targets and a tick box culture has ruined the moral and goodwill of the national health staff. Ill health and early death in the East End is a direct result of Labour’s failure to bring real reform to the NHS.”
Wednesday, 17 February 2010
The hazards of alternative medicine
A practitioner of Chinese medicine has pleaded guilty to selling a banned substance to a woman who went on to develop kidney failure and cancer.
Ying "Susan" Wu, 48, of Holland-on-Sea in Essex, has been on trial at the Old Bailey for selling pills containing aristolochic acid to a civil servant.
The judge said he accepted Ms Wu had not meant to harm, and that the case highlighted the need for regulation.
Ms Wu has now been given a conditional discharge.
Patricia Booth, 58, took the pills, bought at Chelmsford's Chinese Herbal Medical Centre, for over five years. She was in her mid-40s when she first sought help from the centre in 1997 for stubborn patches of spots on her face.
The Old Bailey heard the products had been advertised as "safe and natural".
But they contained a substance - aristolochic acid - which when she was first sold them, should only have been given under prescription, and which was later banned.
Traditionally this would be used maybe once or twice by a doctor who would know about its toxicity, but sometimes it might get into a formulation which is then used by somebody who doesn't have this wealth of experience
Professor Monique Simmonds
The court heard Mrs Booth became ill months after she stopped taking the pills. She was diagnosed with kidney failure, and later with cancer of the urinary tract - both allegedly caused by the pills.
The grandmother, who used to manage a government office of up to 60 people, currently goes to hospital three times each week for dialysis.
She had told the court that she had been advised to take about 30 tiny brown tablets three times each day, returning to the shop every two weeks to buy up to three bottles at a time. She became friendly with Ms Wu, who was employed at the shop as a "Chinese doctor" until it closed in 2003.
Ms Wu, who had initially denied the charges, pleaded guilty to selling prescription only medicines without authorisation and to selling a banned substance.
Ying "Susan" Wu, 48, of Holland-on-Sea in Essex, has been on trial at the Old Bailey for selling pills containing aristolochic acid to a civil servant.
The judge said he accepted Ms Wu had not meant to harm, and that the case highlighted the need for regulation.
Ms Wu has now been given a conditional discharge.
Patricia Booth, 58, took the pills, bought at Chelmsford's Chinese Herbal Medical Centre, for over five years. She was in her mid-40s when she first sought help from the centre in 1997 for stubborn patches of spots on her face.
The Old Bailey heard the products had been advertised as "safe and natural".
But they contained a substance - aristolochic acid - which when she was first sold them, should only have been given under prescription, and which was later banned.
Traditionally this would be used maybe once or twice by a doctor who would know about its toxicity, but sometimes it might get into a formulation which is then used by somebody who doesn't have this wealth of experience
Professor Monique Simmonds
The court heard Mrs Booth became ill months after she stopped taking the pills. She was diagnosed with kidney failure, and later with cancer of the urinary tract - both allegedly caused by the pills.
The grandmother, who used to manage a government office of up to 60 people, currently goes to hospital three times each week for dialysis.
She had told the court that she had been advised to take about 30 tiny brown tablets three times each day, returning to the shop every two weeks to buy up to three bottles at a time. She became friendly with Ms Wu, who was employed at the shop as a "Chinese doctor" until it closed in 2003.
Ms Wu, who had initially denied the charges, pleaded guilty to selling prescription only medicines without authorisation and to selling a banned substance.
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