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Welfare Reform on the Web (July 2001): National Health Service - Reform - General

BONE OF CONTENTION

M. Harley

Health Service Journal, vol.111, May 17th 2001, p.22-25

The number of orthopaedic consultants has increased by 78% since 1984, but average waiting time for elective treatment has hardly changed. Orthopaedics is one of the greatest problem areas for waiting lists, although workloads have fallen by about a fifth in the past five years. An extra 85,000 patients will have to be admitted over the next five years if the government is to eliminate waits of more than six months. Consultants oppose the expansion of staff grades, so specialist centres may have to be established to deal with the backlog.

BRIDGING THE GAP

L. Eaton

Health Service Journal, vol.111, Apr. 26th 2001, p.16-17

Large scale moves from NHS dentistry into private practice, coupled with dentists' general reluctance to work in deprived areas, are leaving large swathes of the population without access to dental care. Outlines government initiatives to tackle these problems.

CONSULTANT WAITING LISTS "HAVE RISEN BY TWO-THIRDS"

M. Woolf

Independent, May 11th 2001, p.6

Analysis of outpatient figures by the Liberal Democrats has shown that waiting lists to see a hospital consultant have gone up by two-thirds under the Labour government.

DOCTORS DISMISS NHS PLAN AS ELECTION GIMMICK

N. Hawkes

Times, Apr. 19th 2001, p.4 + 1

An Internet survey of 900 doctors has shown that 70% are disillusioned with the NHS Plan, which has raised expectations without providing the resources to fulfil them. There was, however, strong support for a public debate on health care funding, with a majority favouring more private sector involvement and the introduction of co-payments.

DON'T TAKE IT LYING DOWN

R. Jones

Health Service Journal, vol.111, Apr. 26th 2001, p.28-31

Argues that there is no standard optimum occupancy rate for hospital beds. Bed occupancy rates must be considered in relation to the number of beds in the hospital. A large hospital operating the same occupancy rate as a small one will generally have to turn away fewer patients. The bed requirements of each trust therefore need to be analysed in greater detail.

ELECTION COUNTDOWN

P. Healy

Community Practitioner, vol.74, 2001, p.177-178

Considers the major parties' stance on a range of health issues in the run-up to the general election. Covers the hospital sector, nurses' pay and conditions, their clinical role in primary care, and NHS response to minority needs.

FAREWELL FLORENCE

Anon

Health Which? Apr. 2001, p.27-30

Demarcation lines between nurses and doctors are being blurred as nurses assume responsibility for diagnosis and prescribing. However, the expansion of the responsibilities of nurses means that fundamental patient care will be left to healthcare assistants. There is concern that these staff are not subject to professional regulation.

HEALTHY PROSPECTS

P. Pallot

Daily Telegraph, May 8th 2001, p.26-27

Reports a rise in the number of NHS patients treated in the private sector, following the government's concordat between state and private medicine signed in October 2000.

IMPLEMENTING THE NHS PLAN: PREMISES

Health Service Journal, vol.111, Apr. 26th 2001, Supplement. 12p

Surveys progress on plans to:

  • fund improvements to primary care facilities through a public-private partnership;
  • build ambulatory care centres for elective diagnosis and treatment;
  • improve hospital cleanliness, signage, parking etc. through the work of Patient Environment Action Teams (PEATs);
  • provide more affordable private rented accommodation for health care workers.

IN FAVOUR OF MOTHERHOOD

Y. Cooper

Guardian, Apr 30th 2001, p.15

Discusses how maternity services across the country vary and the improvements that are needed. Alan Milburn, the Health Secretary has set out a major modernisation programme for maternity services. Investment in facilities and recruitment, improvements to screening and the beginning of a major scheme of national standards in maternity and health care have been proposed. Modern maternity services need modern facilities. As new investment and improvements take place they need to make sure that choices of parents are being supported.

INDEPENDENCE WAY

C. Laurent

Health Service Journal, vol.111, Apr. 19th 2001, p.22-24

Government has defined intermediate care services as those which:

  • are targeted at people who would otherwise face long hospital stays or inappropriate admissions to hospital or residential care;
  • are provided on the basis of a comprehensive assessment;
  • are time-limited.
For the new services to succeed, they must be integrated with existing acute hospital and community care services and promote multi-disciplinary working.

INFLUX OF FOREIGN NURSES HELPS NHS

J. Carvel

Guardian, May 4th 2001, p.10

Figures released by the UK Central Council for Nursing show a 71.1% increase in overseas-trained nurses applying to get on the UK register since April 2000. Most of the 29,119 overseas trained applicants of 2000/01 are now on adaptation courses preparing them to work in UK hospitals.

IS THERE A DOCTOR IN THE HOUSE? YES, BUT NOT FOR MUCH LONGER....

R. Baker

Independent. Wednesday Review, May 2nd 2001, p.5

Attributes current demoralisation of doctors to: increasing workload and paperwork; staff shortages; ever-increasing risk of litigation; and imposition of targets.

LABOUR'S NHS POWER SHIFT

P. Wintour

Guardian, Apr. 25th 2001, p.1

Reports a speech by the Health Secretary promising a massive cut back in NHS bureaucracy and a switch of resources to frontline staff. Promises that by 2004:

  • the number of health authorities in England will be reduced from 90 to 30;
  • the 10 regional offices will be abolished;
  • primary care trusts will be responsible for 75% of the NHS budget;
  • NHS Executive regional outposts will be abolished.

(See also Times, Apr. 26th 2001, p.9; Daily Telegraph, Apr. 26th 2001, p.6; Financial Times, Apr. 26th 2001, p.6; Independent, Apr. 26th 2001, p.2; Health Service Journal, vol.111, May 3rd 2001, p.12-13).

LAST DITCH DEAL SAVES NHS BILL

J. Carvel

Guardian, May 11th 2001, p.6

The government has abandoned controversial plans to abolish Community Health Councils in the hope of getting the rest of the Health and Social Care Bill through Parliament before the general election.

(See also Independent, May 11th 2001, p.8; Health Service Journal, vol.111, May 17th 2001, p.4-5).

MASTERCHEFS FATTEN UP HOSPITAL MENUS

D. Charter

Times, May 9th 2001, p.6

Announces the launch of a new NHS cookbook compiled by six leading chefs. The cookbook will be sent to all hospital caterers and at least one of the new recipes must be on all hospital menus every day by August and two by December. There is also a new 24-hour snack box of chocolates, crisps and fruit for patients who miss meals.

(See also Guardian, May 9th 2001, p.10; Independent, May 9th 2001, p.5; Health Service Journal, vol.111, May 17th 2001, p.14-15).

MILBURN OFFERS CASH TO LURE BACK DISGRUNTLED MIDWIVES

D. Charter

Times, May 3rd 2001, p.4

The Health Secretary has promised that an extra 2,000 midwives will be recruited by 2005 in England, with 500 in place by the end of 2002. Former midwives will be encouraged to return by a £1500 retraining grant and help with childcare worth up to £150 per week. All 250 NHS maternity units in England will receive a share of £100m to refurbish facilities.

(See also Independent, May 3rd 2001, p.6).

MINISTERS TRY TO HEAD OFF NHS MUTINY

D. Charter

Times, Apr. 23rd 2001, p.1 + 2

Reports that the medical profession is in full revolt against the government. GPs are planning an unofficial strike on May 1st in protest against rising workloads. Research shows that almost 70% of hospital consultants plan to retire early, due to concern about their heavy workload. Nearly 66% of respondents to another survey were prepared to work strictly to their contracts to reduce their hours.

NATIONAL SURVEY OF USE OF HOSPITAL BEDS BY ADOLESCENTS AGED 12 TO 19 IN THE UNITED KINGDOM

R.M. Viner

British Medical Journal, vol.322, Apr. 21st 2001, p.957-958

The report comments that the use of hospital beds increases rather than decreases through adolescence. The findings covered 12-19 year olds between 1997 and 1998 from 37 health authorities and boards in England, Wales and Scotland.

(See also Daily Telegraph, Apr 20th 2001, p.14).

NEW LABOUR, OLD GRIPES

T. Shifrin

Health Service Journal, vol.111, May 3rd 2001, p.14-15

Results of a survey of NHS managers reveal poor morale, ever-increasing workloads and a keen desire for more resources and less central direction. However, support for the aims of the NHS Plan remain high, and Labour's health policies are widely preferred to those of the opposition parties.

NHS PERFORMANCE INDICATORS: A CONSULTATION

Department of Health

London: 2001

Proposes the development of three different forms of performance indicators. A relatively small set of headline indicators accompanied by independent commentary would be published annually. More detailed information would be disseminated internally within the NHS as a benchmarking exercise. A wider set of indicators for which data is not currently collected could be developed in time. Clinical areas covered by National Service Frameworks will be measured, as will areas such as access, workforce, efficiency, health inequalities, public health and patient satisfaction.

OVERWORK IS BLAMED FOR LOWERING NHS MORALE

C. Hall

Daily Telegraph, Apr. 30th 2001, p.7

Staff survey data from 118 NHS trusts analysed by the Liberal Democrats show that rising workloads and staff shortages have left the majority of employees demoralised and strained. Results showed that 48% of respondents considered communications in their trust to be poor, 45% thought staff could not cope with the level of work and 44% thought there were too few staff.

PATIENT AND PUBLIC INVOLVEMENT IN THE NHS: WHAT IS NEEDED AT NATIONAL LEVEL?

C. Hogg and L. Graham

London: The Patients Forum, 2001

Proposes that the planned new national patients body should advise on recruitment, support and training for patients and public representatives on NHS bodies, and set standards for the new patients' councils. Argues that the body should be a membership organisation, with members drawn from patients' councils and the voluntary sector. Recommends that the body should be accountable to a Commons Select Committee, members and the public.

PEERS DEFEAT GOVERNMENT ON HEALTH COUNCILS

G. Hurst

Times, Apr. 25th 2001, p.10

The House of Lords has passed an amendment to the Health and Social Care Bill to retain the main independent whistle blowing functions of Community Health Councils and reassign them to new regional Patients' Councils.

(See also Independent, Apr. 25th 2001, p.8; Guardian, Apr. 25th 2001, p.11; Daily Telegraph, Apr. 25th 2001, p.11).

PULP FICTION?

A. McGauran

Health Service Journal, vol.111, May 3rd 2001, p.16-17

Reports NHS managers' complaints about excessive central government direction and control, evidenced by an endless stream of directives and detailed circulars and demands for information at short notice.

SCOTCH GUARD

J. Trueland

Health Service Journal, vol.111, May 10th 2001, p.12-13

Reports that the Health Technology Board for Scotland is to examine all NICE judgements about treatments and decide whether they can be applied as they stand in Scotland or if they need modification.

SLOW MOTION

P. Stephenson

Health Service Journal, vol.111, May 10th 2001, p.12-13

The slow pace of change in the NHS in Scotland is causing frustration. There is much confusion about how the 15 unified health boards, which come into being on October 1st 2001, will operate. The prospect of further radical change has been raised, involving realigning services to focus on multi-agency programmes for specific target groups, such as children and older people.

A TURN FOR THE BETTER

P. Coyne and A. Beadsmoore

Health Service Journal, vol.111, Apr. 19th 2001, p.29

Describes a nurse rotation programme run by two West London mental health trusts which has boosted recruitment.

THE UK DENTAL SERVICE: A MAKE WORK PROJECT?

A. Sheinam

Consumer Policy Review, vol.11, Mar/Apr. 2001, pp.53-59

Discusses the idea that Britain has too many dentists and that patients have their teeth checked more often than is necessary. Suggests that two key changes alone could save up £240m and reduce "dentists' chairside time by one fifth". Dental patients are currently recalled for a checkup every 6 months. This could be extended to 18 months and in the case of healthy adults as long as 3 years. 13 million adults have their teeth scaled and polished each year, another costly and ineffective practice that could be dropped. Dental health has seen marked improvements as a result of flouride toothpaste, better oral hygiene and baby feeding practices.

(See also Independent, Apr. 5th 2001, p.5).

WINNING WAYS

P. Dunman

Health Service Journal, vol.111, May 10th 2001, p.20-23

All hospital trusts in England should have a patient advocacy service in place by 2002. The author has been a patient advocate for many years and gives advice on how such a service should be run. Patient advocates need considerable professional experience and personal skills. They should report to someone at Board level, and the seniority of the post should be reflected in the salary.

WORKFORCE PRODUCTIVITY AND INCENTIVE STRUCTURES IN THE UK NATIONAL HEALTH SERVICE

K. Bloor and A. Maynard

Journal of Health Services Research and Policy, vol.6, 2001, p.105-113

Paper explores issues concerning the measurement of workforce productivity in the NHS, exploring the potential for analysis of labour productivity using routinely collected activity data, describing labour productivity trends over time, using limited indicators, in both hospital and primary care sectors, and assessing the need for improved data collection. Finally, potential relationships between incentives and productivity are discussed, remuneration systems are described and the potential for reforming medical contracts is explored.