Nhs

Conservatives ramp up the pressure on Andy Burnham

One of the striking things about politics at the moment is how the Tories are behaving like an opposition, campaigning against Labour with even more intensity than they managed in 2009. The Tories intend to use the Keogh report, out tomorrow, to — in the words of one Number 10 insider — give Labour ‘both barrels’ over the NHS. As one Tory minister puts it, ‘Labour’s argument about Mid-Staffs is that it is one isolated, bad case. Keogh disproves that.’ As part of this, the Tories are going after Andy Burnham. The Tory leadership is convinced that Ed Miliband will move Burnham in the reshuffle, there’s a reason why people

Jeremy Hunt turns on Labour over union policy influence

One of David Cameron’s better lines at Prime Minister’s Questions was that the trade unions ‘buy the candidates, they buy the policies and they buy the leader’. In his final response to Ed Miliband, he said: ‘What is Labour’s policy on Royal Mail? It is determined by the Communication Workers Union. What is its policy on health? It is determined by Unison. What is its policy on party funding? It is determined by Unite.’ To underline that point, Jeremy Hunt has sent a letter to Andy Burnham this afternoon asking for ‘clarification about union influence over Labour health policy’. The letter, which you can read in full here, says Burnham

Letters: Sir Peter Lampl replies to Charles Moore, and the memories of a wasteful GP

Medical waste Sir: Susan Hill’s article (‘Patient, heal thyself’, 29 June) dealt only with the unnecessary visits to GPs for minor ailments. In Wales we have an extra incentive to waste GPs’ time — all prescriptions are free. There are many people who are prepared to make a GP appointment just to get routine medicines for free, and GPs are powerless to resist. Tim Johnson Aberystwyth, Ceredigion   Sir: Susan Hill’s article revived pleasant memories of my stint as a locum general practitioner in the early 1970s in Goring-by-Sea. As the registered patient number of the solo practice was the maximum allowable by the NHS at the time, I was

How the Spectator blew the whistle on the International Health Service

At Prime Minister’s Questions today, backbencher Philip Lee ambushed David Cameron on the subject of health tourism. He asked: ‘As a doctor who once had to listen incredulously to a patient explain, via a translator, that she only discovered she was nine months’ pregnant on arrival at terminal 3 at Heathrow, I was pleased to hear the statement from the Secretary of State for Health today on health tourism. Does the Prime Minister agree that although the savings are modest, the principle matters? The health service should be national, not international.’ The Prime Minister replied: ‘My hon. Friend makes a very important point. This is a national health service, not

NHS GPs should charge for appointments. Here’s why

The Chairman of the Royal College of GPs recently said that ‘general practice has radically altered over the last five years, with ballooning workloads and more and more patient consultations having to be crammed into an ever-expanding working day.’ The blame for this tends to be put on a growing and ageing population or an ever-increasing range of ailments. It might also be put on the last Labour government for changing the way in which GPs work, by rewarding them for preventing, not just treating, illness. Whatever the cause, the solutions are more numerous and often ineffective. NHS Direct is for the most part staffed by poorly trained non-medics who

Doctors pass motion of no confidence in Jeremy Hunt. Good.

The health service that employs you is under more scrutiny than ever before, with shocking cases of bad care, ‘never events’ and serious lapses crawling out of the woodwork. The regulator that was supposed to keep an eye on all of this is under attack, not just for missing it, but also for apparently deciding not to publish what details it did know, and then deciding to withhold key names implicated in a ‘cover-up’. So what, in its eternal wisdom, does the trade union representing you do? The British Medical Association, which has always managed a veneer of respectability over and above many other public sector unions, today passed a

Isabel Hardman

Tories must tread carefully in NHS battle

It is clear now that we have reached a tipping point where it is no longer enough to repeat ‘I love the NHS’ or swear allegiance to Danny Boyle’s Olympic caricature of the health service. So what now? Labour and the Tories are scrapping over who still really, truly loves the health service: the latest round of revelations about the Care Quality Commission have allowed the Conservatives to ask questions about the culture and attitudes of both the health service and of the Labour government that led it. Labour, meanwhile, points out that Andrew Lansley is also alleged to have leaned on a whistleblower, something the former Health Secretary denied

CQC row marks new level in ‘party of the NHS’ battle

That former Care Quality Commission chief executive Cynthia Bower resigned so quickly from her current job after being named as one of the three executives involved in a discussion about covering up the Commission’s failings simply underlines what an appalling mess this case has been from start to finish. The names were withheld ostensibly because of data protection, but when they appeared, it was clear that this was about another sort of protection. Perhaps this will be the tipping point against unaccountable NHS managers and inspectors staying safe whatever their failings. Jeremy Hunt certainly seemed to think that it could be, tweeting: ‘Pleased to receive CQC letter naming the individuals involved. Clear sign

There’s more to fixing the NHS than chasing A&E waiting times

NHS workers used to enjoy hearty backslaps for their ‘jolly hard work’ to bring down accident & emergency waiting times. Such praise was delivered by the Labour government’s chief nursing officer at a conference I covered back in 2003. Back then, talk was of shrinking queues rather than impending ‘A&E crisis’. Nurses should congratulate themselves, she beamed, for helping speed patients through casualty in fewer than four hours. This apparent success was just the beginning, if this graph, circulated in a campaign e-mail by Labour’s shadow health secretary recently, is to be believed: ‘This is what three years of David Cameron running the NHS looks like: a crisis in A&E,’

The backbench hunt for Sir David Nicholson’s scalp continues

Today’s hearing of the Public Accounts Committee is going to be real box office stuff. Sir David Nicholson is giving evidence, supposedly on the NHS IT programme, but he’ll find himself confronted by Tory committee member Steve Barclay, who, armed with freedom of information evidence of 52 gagging orders in the NHS, will demand that the health service boss step down immediately. This is what Nicholson told the Health Select Committee when he gave evidence on 5 March (full transcript here): Barbara Keeley: What do you think, as chief executive of the NHS, of a loophole like that existing-where £500,000 of taxpayers’ money could be used to gag somebody who

We have an A&E crisis: Jeremy Hunt should suspend all hospital downgrades until it’s over

Health Secretary Jeremy Hunt is correct to say that there was a ‘dramatic fall in confidence’ in alternatives to Accident & Emergency units. He says that this has built up steadily since GP contract changes in 2004. He is right of course, and who can blame him for making the obvious political point that Labour government negotiations have helped fuel this present mess? They may have caused it, but he is in power to help solve it. As a group of NHS Trusts has warned that casualty departments could collapse within six months as a result if ‘huge pressure’, any long term strategy will frankly not alleviate today’s problems. Patients

Why is the NHS spending public money on inferior treatment, and why don’t patients know about it?

The NHS reform debate remains fixated with money. Budgets, we are led to believe, are directly related to the quality of treatment a patient receives. But in too many areas the same spending in comparable areas is producing widely differing results. Most patients remain in the dark, thinking that if a treatment is available locally, then a national service will deliver similar outcomes. Yet the NHS’ own data shows this is untrue. Take mental health. Both North Tyneside and Gateshead have similar health characteristics. They spend similar sums per head on a course of treatment -£214 in North Tyneside and £215 in Gateshead – both above the national average of

Isabel Hardman

The political battle over A&E will get nastier before the problem is solved

Today’s row about Accident and Emergency has little to do with the issue itself, and far more about one party trying to prove a point about the other. Those rows are the most vitriolic, the most hard-fought, and to the outside world, the most pointless. The King’s Fund today finds waiting times are at their worst level for nine years. What’s going wrong? Each side has its own theories. But what’s significant is that each side is trying to use this row to steal that coveted ‘party of the NHS’ title. This was abundantly clear from Andy Burnham’s response to the report, written in what appears to be a spitting

Julie Bailey: Enemy of the People

They’re running Julie Bailey out of town. The poison pen letters, foul-mouthed phone calls, slashed tyres, shit through the letterbox, boycott of her cafe and attacks on her mother’s grave have become too much. Stafford’s upstanding citizens, or a good number of them, want her gone. So she is leaving her home and business, and looking for a better place. ‘People come up to me in the street and just start bawling,’ she told me. ‘I can’t go out by myself. I always need someone with me’” Bailey had been the public face of the campaign to highlight the conditions inside Stafford Hospital. She showed that nurses left food and

Sir David Nicholson to go: but will it change the culture at the top of the NHS?

Health Service Journal has a great scoop this afternoon that NHS boss Sir David Nicholson will retire in March 2014. The man who was in charge of the Mid-Staffordshire NHS Trust when the serious failings in care took place had long been considered a busted flush, but his departure seems to be set for a great deal later than those pushing for it had hoped. I’ve spoken to Conservative MP Charlotte Leslie, who has long been after Nicholson’s scalp. She says: ‘I don’t think it’s soon enough and he should go immediately. If you want to oversee a massive culture change from the bullying and stifling of whistleblowers, then you

Isabel Hardman

Jeremy Hunt attacks Labour for A&E crisis

Andy Burnham summoned Jeremy Hunt to the Commons this afternoon for a shouty hour about who loves the NHS more. The Health Secretary’s answer to Labour’s urgent question on the government’s plans for changes to the GP contract and the crisis in Accident and Emergency departments was largely a direct attack on decisions the opposition took when it was in government. He decried Labour’s ‘disastrous changes to the GP contract’ which had led to a significant rise in the number of patients visiting A&E, and ‘the disastrous failure of Labour’s IT contract’. He also told Burnham that his government had failed to address the disconnect between social care and the

Susan Hill’s diary: The joy of fountain pens, the frustration of GP appointments

I bet you remember your first fountain pen. Mine was a Conway Stewart with marbled barrel, I had it for starting Big School and I used to polish it. That trusty pen lasted until A-levels finally broke its back and after that I slipped down the primrose ballpoint path to slovenly writing. I never used a typewriter — too noisy, so I hand-wrote my books until the almost-silent laptop seduced me down another slithery slope. But I still hand-write when I need to take my time — books can be divided, like Americans, into fast ones and slow ones. Recently, a friend told me he had gone back to a

It’s time to admit it: the NHS is unable to look after our elderly

I decided to become a hospital visitor last year, after being a patient and finding myself in something more like a factory than an old-fashioned ward. A terror of infection in 2011 (there were 2,053 deaths involving Clostridium difficile) has ended the cosy world of side tables covered in flowers and cards. Concerns about data protection have put paid to WRVS ladies pushing trolleys, and vicars walking around offering solace. There aren’t even many nurses about, and even if there were, you wouldn’t want to bother them for tea and a chat. It’s OK if you have family or friends nearby, but if you don’t, being a patient in today’s

The question Labour won’t even consider on the NHS

Labour’s new independent commission on health and social care aims to draw up plans on bringing together health services and social care so that the NHS can be financially sustainable. Launching the plans today, Ed Miliband said that ‘we must make every pound we spend go further at a time when our NHS faces the risk of being overwhelmed by a crisis in funding because of care needs by the end of this decade’. But there is one big question that Sir John Oldham, who will chair the year-long review, won’t be asking about the long-term financial viability of the health service. It’s a question that some Labourites are well-attuned

Isabel Hardman

Nurses cannot dismiss calls for reform out of hand

It’s not unusual for a trade union representing its members to resist change, and today the Royal College of Nursing is sticking well and truly to form. Not only has Peter Carter, its chief executive, called the government’s plan to put nurses through a year of work as healthcare assistants ‘stupid’, he has also penned an op-ed for the Guardian in which he appears resistant to the suggestion that the profession needs to consider wholesale reform following the Francis Report. Carter writes: ‘For the million or so people working in the NHS, a number of things come with the job: a boom-and-bust budget, growing demand and a high level of