New NHS proposals

Today the Conservatives set out our proposals for greater accountability and autonomy in the NHS.

The proposals aim to:

- ensure that money put into the NHS goes into improving the NHS for everyone and is not wasted on red tape and pen pushing

- end the top down target culture and take Ministers out of day-to-day decision making in the NHS

- give patients more information and choice

- end pointless reorganisations in the NHS.

Hospital Acquired Infections data show that we must keep hospital beds

This week disappointing figures have come out for Hospital Acquired Infections. The most infamous, MRSA, has slightly improved but overall figures for hospital acquired infections have got slightly worse.

This demonstrates that one thing which frequently happens when hospitals are rebuilt or reconfigured - that the NHS persuades itself that it can manage with fewer beds - must be resisted.

There are good reasons for changing the pattern of treatment to reflect changing needs and techniques, and in the long term these may not require as many hospital beds, but it is fatally easy to make overoptimistic estimates of the extent to which equal or better service can be provided with fewer beds.

If a hospital is over-full, it means difficulty finding beds for patients, which can mean they are moved around between wards, and that harrassed and over-worked staff may not have time to fully clean beds between each patient - which means more people actually catch an illness while in hospital.

The target for bed occupancy which is generally regarded as good clinical practice is that not more than 80% of the beds in a hospital should be occupied at any one time.

Until bed occupancy rates are consistently below 80%, any proposal to reduce the number of hospital beds in Cumbria, whether in community hospitals like Millom and Keswick, or at District General Hospitals like the West Cumberland, must be resisted.

New figures expose queues for NHS operations

New Government figures have for the first time exposed the actual waiting times patients face across the North West and other NHS regions for hospital operations. They make very depressing reading. Much more progress is needed if we are to ensure that patients do not face long waits in accessing NHS care.

The official figures show that just under 50,000 patients in the North West began hospital treatment in March 2007. Details of how long more than 16,000 of them were waiting are given as “Not known”. Of 32,909 patients for whom the time between referral and treatment is available, 17,461 – or 53% - began their hospital treatment within 18 weeks. For different types of operation the proportion of patients in the North West whose treatment started within 18 weeks varied between 88% for Thoracic medicine and 24% for Neurology.

National figures also show that in March 2007, 25,750 of those starting treatment – 12.4% of the total admitted in that month - had been waiting more than a year between referral and the start of their treatment. That includes 3,480 patients in the North West. If the figures released this week for admissions in March are representative of waiting times for all hospital admissions, this suggests that in a full year nearly half a million people, including just under 75,000 in the North West Region, would be kept waiting for over a year.

Ministers in Whitehall claim that they have reduced waiting times for hospital patients, but they did not even collect actual waiting times until they had been in power for over ten years.

These figures prove that many of the things government ministers have been telling us about the NHS are just not true. Tony Blair and Gordon Brown has claimed that no-one waits more than six months for an operation. Hearing this must have been very annoying for the 25,650 people in March alone who were admitted to hospital after waiting more than a year. Is it any wonder that people are losing faith in politics when their intelligence is insulted by this kind of spin and propaganda?

It is simply not good enough that only 53% of patients in the North West are seen within 18 weeks, and worse, in March 3,480 people in this region alone had to wait for over a year. But let’s make this absolutely clear, the way to improve this performance is to divert resources from bureaucracy to front-line patient care. We will not improve performance by shutting hospitals.
Britain must learn lessons from the health services on the other side of the channel - in Europe, waiting lists like this are unheard of.

Labour have had ten years, and spent vast amounts of money bringing NHS funding up to the European average, but all this money has not delivered anything like the improvement in outcomes required to take us up to continental standards of health care.

NHS staff work hard every day to deliver improvements in patient care, but they are held back by a top-down, target-driven culture imposed on the NHS by Gordon Brown’s Treasury. We need to set doctors and nurses free to make decisions about patients based on their need, rather than a central target.

NHS Funding: the economics of Bedlam

It is daft that the government penalises local hospitals both when theyunderspend and when they overspend.

If you want to give hospital trusts an incentive to use money wisely,allowing them to keep at least some of any underspend and re-invest it inlocal health care would make far more sense.

I make this comment because NHS North West confirmed this week that it has underspent on its predicted 2006/07 budget by £161 million. It is expected that this money will be clawed back by the treasury.

NHS trusts are in a catch 22 situation: overspend and they get fined, underspend and the money gets clawed back. Hence they have little incentive to save money.

To provide good healthcare in Cumbria the government needs to do more than making money available and then clawing it back. Our local health service also needs the right environment in which we can recruit and keep doctors, nurses and other key staff.

This means we have to improve morale among health staff and take, not duck, the decisions which demonstrate that our local hospitals have a future. I hope the recent decision to postpone the "Great debate" on Cumbria's NHS to later in the year is the last time a decision on the future of the West Cumberland and our other local hospitals is put off. We need to demonstrate that plans are in place to provide a positive future for all our local hospitals.

A tax on being sick

Last week a member of my family spent some time in Luton and Dunstable hospital.

I have nothing but praise for the individual nurses and doctors who looked after him. But there were certain aspects of the organisation of the hospital which were maddening. One of these was car parking arrangements at the hospital.

I thought the parking charges at West Cumberland Hospital were bad enough, but by comparison with the Luton and Dunstable, parking at the hospital in Whitehaven is easy.

The minimum time slot you can buy at the car park in the front of L&D hospital is something like four or five hours, and it costs £2.50.

On my first visit last week I was at least able to get a space. On my second visit, despite these high charges there were no spaces in either of the hospital's two car parks. Most of the streets near the hospital have parking reserved for residents - I can see why the council has done this but it makes it very difficult for people who are visiting the sick.

I ended up spending nearly half an hour driving around the hospital before I found a street on the other side of the main road between Luton and Dunstable where I could park.

Parking charges at these levels amount to a tax on sickness. In some ways it is even worse than that, these charges represent a tax on caring about the sick, as it is usually people visiting patients who end up paying the charge. I can see why hospital trusts feel they have to levy some charge for parking, but NHS hospital trusts and councils ought to consider carefully how much it is reasonable to ask people visiting hospitals to pay.

"Great Debate" postponed

I am sorry to learn that the "Great Debate" into the future of hospitals in Cumbria, which had been due to start this month, has been put back to later in the year.

I would rather have an intelligent and properly framed debate later this year than yet another botched consultation now.

However, we cannot indefinately keep putting off decisions about the future of our hospitals. The longer we delay taking decisions the worse the morale of key staff will become, the more good people we will lose, and the harder it will be to ensure that the level and quality of health services which the local community in West Cumbria needs remains sustainable.