Department of Health

Reasons to get merry, Part 3

What better reason could there be to top up your glass (and make it a big one), than that the Government and the BMA want to "crackdown on middle class wine drinkers". Some people damage their health by drinking too much, so of course it is necessary for the Government to try to control the drinking habits of all of us. And while we're at it, I hope the Government will be cracking down on the prevalence of STDs amongst certain groups by promoting abstinence for us all.

MTAS - still the fault of the doctors

Patricia Hewitt, interviewed on News 24 on Saturday morning, explained that she should not take responsibility for the MTAS fiasco because the new system had been widely consulted and widely supported prior to deployment. In other words, doctors liked the look of the system, and if they didn't tell her she'd got it wrong, whose fault was that?

The good, the bad, and the not so ugly

JG has been highlighting the MTAS fiasco. Besides the fine illustration it provides of this Government's incompetence and refusal to take responsibility for their mistakes, it also sheds an interesting sidelight on another bad Labour policy. On Thursday's Question Time, Caroline Flint, the Public Health Minister, explained the necessity to scrap the old system in the following words:

"I have heard, for example, from clinicians about how applications used to turn up at hospitals, they'd put them in a pile and literally pull them out at random. So it was all agreed that that system wasn't right."

A bad system is no reason or excuse to introduce something worse. And one of the main criticisms of MTAS is that it made the selection process more, not less random. But equally importantly, does this not describe almost exactly the "lottery" approach to assigning places in schools to students, introduced by egalitarian Labour councils and approved by this Labour government? Why is a random approach wrong for selecting junior doctors but right for selecting students?

But let's be fair and give credit where credit is due if a Minister manages to be sensible (a task made all the more compelling by the fact that Ms Flint is by a long chalk the hottest minister and probably the hottest MP in parliament, and that is not intended to damn with faint praise). Yesterday's Telegraph reports that Ms Flint has taken a robust and rational stance against the call from Alcohol Concern to make it illegal for parents to give their children alcohol. If parents can't teach their children how to drink responsibly, it is hard to know who should have that responsibility. And how would such a law have been enforced? Ms Flint is to be congratulated on resisting blinkered pressure groups, giving short shrift to such a nannyish idea, and choosing masterly inaction over ill-considered action.

Now if she could only teach the rest of her colleagues to apply the same approach, we might have fewer MTAS-style fiascos.

The tax-payers are the biggest losers of all

I haven't mentioned the NHS for a while, but it was always going to come back. So here goes - the National Health Service's £12.4 billion national computer system. It's not a particularly new story, but confirmation of what we all feared has come out yesterday from the Commons public accounts committee. If there was a "Loser of the Year" award for the worst conceived policy or project, the NHS IT system would win hands down.

The sickness tax

Has there been a government better at "charging for old rope" than this current one. As I understand, our taxes go, in large parts, to the funding of all things NHS - including their car parks. However, our money that went to towards building these car parks and maintaining them was only taken from us on the premise that we wouldn't actually use them, it transpires. If we actually want to use these car parks, paid for by us, then the NHS is going to make us pay more. Lots more. What better why to make a quick buck than to charge us twice for the same thing?

How do you lose £2.7bn? Ask the NHS

The NHS has a pensions black hole that has risen by £61bn in just two years. That is incredible! According to the Telegraph the figures include an addition £2.7bn because, and I kid you not, the Government accidentally lost this sum on last year's accounts. You lose the car keys or on a bad day your mobile phone, you do not lose £2.7bn. There is a seriously incompetent accountant working for the government (though I suspect there maybe a whole army of them).

The pharmaceutical price fixing scheme

The Office of Fair Trading is expected to expose the extents to which the NHS will go to waste money. Incredibly, the Department of Health has been cosying up to the big pharmaceutical companies and paying well over the odds for drugs with our money! Why is this not plastered all over the front pages??

The scam basically revolves around the PPRS (pharmaceutical price regulation scheme) that prevents drug companies from making excessive profits from the NHS, by effectively capping them. However, within that profit margin, any new drugs can be charged out at as much as they want. This has been quoted in the Guardian as high as £40k per patient per year for some new drugs. So what does a company do if it’s going to make a load of cash from a new drug? It passes its rights to older drugs to other companies who haven’t reached their cap yet. This is costing us millions each year. Yet another reason why the NHS is in serious need of reform.

£6.2bn, the price of a failed project - but don't tell anyone

The NHS and failed IT projects – it rolls off the tongue like money down a drain. Unfortunately, when the NHS wastes money on dodgy systems it doesn’t just mean an inconvenience for the public and another dent in the public purse (these two outcomes are taken for granted by other government departments these days), it is actually putting patients at serious risk. For some reason, best known to the incompetent technogeeks within the Government, the implementation of a multi-billion-pound computer system linking doctors and hospitals is flawed.

PAC miss the point. Completely.

Have the Public Accounts Committee (PAC) completely missed the point?  They have recently criticised the Dept. of Health’s deal with Dr Foster, who provide the Good Hospital Guide.  They have helpfully (and rightly) pointed out that the contract represents poor value for money due to a less than competitive tendering procedure. 

Paperwork over patient care

It is reported today that Government reforms have led to patients being put at unnecessary risk by an over load of paperwork required by their carers. The British Medical Journal describes hospital wards as having "appalling conditions" and blames nurses for spending more time filling out paperwork that spending time on the wards.

All this negates the effects of a successful operation as many patients are catching hospital acquired infections or developing pressure sores.

Reforming NHS

Today's papers are reporting further mismanagement of the NHS. A leaked document has revealed that the government expects a shortage of nurses and GPs in four years but the NHS will have to reduce the number of hospital doctors to save money. Also, many trusts are cancelling and postponing operations and treatments to reduce the deficit for the financial year.

Government-inflicted pain

Mark and Lezley Gibson and Marcus Davies were convicted on 15 December of distributing cannabis-laced chocolate bars to multiple sclerosis (MS) sufferers. They await sentencing on 26 January.

Lezley is herself a MS-sufferer, who was told at the age of 21 that she would be incontinent and wheel-chair bound within a few years. Conventional treatment (steroid injections) had such unpleasant side-effects that she could not continue. In her search for alternatives, she came across comments on the benefits of cannabis, which she discovered worked for her. She is now 42 and living a quality of life that the medical profession had considered improbable when she was first diagnosed.

Cottage hospitals next for the chop

Following on from the item on birth centres, we now learn that upto eighty cottage hospitals may be facing cuts. As per birthcare, it's not the cuts themselves that are necessarily the problem, but the fact that this is no economic choice, in the sense of matching demand to supply, but a bureaucratic choice. NHS managers have calculated that these facilities are the ones that will be least missed. How do they know? There is no market in healthcare, so there is no way for people to reveal their preferences.

NHS Indirect

Someone in Whitehall decided that the most efficient way of dealing with out-of-hours medical enquiries was to have a centralised phone enquiry system (NHS Direct), rather than doctors on call. This would save money and make doctors' working hours more civilised. Unfortunately, remote diagnosis is not easy, or else the doctors on call would have been handling most of their calls in this way. Not surprisingly, this change has not reduced the number of patients who cannot be diagnosed over the phone. They therefore have to go somewhere. We now discover that where they are going is to the Accident & Emergency (A&E) services of their local hospital (Sunday Telegraph, 1 Oct 2006, News. p.8). There were an extra million visits to A&E in 2005/6 than the previous year. An A&E consultant has estimated that over half of those visiting A&E could have been dealt with by a GP.