Tuesday, November 11, 2008

Branson on MRSA

Letter sent to the Torygraph today in response to:

http://www.telegraph.co.uk/news/newstopics/politics/health/3405467/Branson-the-fears-behind-my-war-on-MRSA.html

Sir,

Branson's claim that the air industry is safer than the NHS could be construed as a deliberate attempt to advertise his new health care enterprises. His claim that the NHS is too dangerous compared to the private sector ignores that fact the most private providers do not admit unwell or infectious patients. Private hospitals mostly provide routine operations on patients in moderately good health and who have been screened first. These patients are also admitted for a relatively short time.

Branson also seems to forget the damage that the air industry does. While direct deaths from accidents are rare, the impact of air travel on the climate is large and growing. In the near future, the deaths from the climate crisis will far outweigh those from hospital infections.

The NHS can and must do better to reduce the level of infections but Branson should not use his elderly father to drum fear into people and cash into his pocket.

Stuart Jeffery
Health Spokesperson for the Green Party

Sunday, November 9, 2008

BigHealth Privateers

The letter below is from Wendy Savage, Chair of Keep Our NHS Public. As I have stated, we should refuse treatments to people who want to pay for ineffective top-up treatments, but the discussions are clouded by the NHS's refusal to pay for effective care, which is in turn muddied by the enormous profits of the drug and private health care industry.

Post Script: There should be a NOT inserted above between the words we and should... sorry!

Branson was in the press yesterday slating the NHS as dirty and incompetant. Apparently he couldn't find an NHS hospital with no incidences of MRSA or CDiff. He has now persuded his father to have his hip done privately. Given that Branson has set up his own health care business, is this a deliberate attempt to drum up business using his father for publicity?

CDiff and MRSA are prevalent on medical wards that admit emergency patients and patients with infections. There are virtually no private hospitals seeing this class of patient, they can also pre-screen patients and admit them for short periods - no wonder they have low HCAIs compared to the NHS. Obviously we all want the NHS to do better, but Branson's comparisons with an airline is bizarre.

The letter from Wendy:
Mark Lawson (A poisonous prescription, December 7) rightly identifies the threat to the basic principles of the NHS that allowing those who can afford it to pay for extra drug treatment poses. However we dispute that "the NHS could not have afforded this" (ie expenditure on expensive life-prolonging drugs). From the figures given in Professor Richards' review, Improving Access to Medicines for NHS Patients, we calculate that the cost of providing unapproved drugs would be £120m a year, which is a tiny proportion of the £110bn NHS budget.
The NHS has not overspent this year and foundation trusts are sitting on surpluses of £400m. The international evidence is that the introduction of top-up fees increases inequality and that the poor suffer most - surely not what Gordon Brown with his "war on poverty" wishes to happen. The review is out for consultation until January 27, but does not give the option of paying for these drugs. We will be mounting a campaign to fight this proposal.
Wendy Savage
Chair, Keep Our NHS Public

Cancer drug consultation flawed

Keep Our NHS Public are an excellent group. Below is a press release which adds to the recent news about top-ups. The two tier service that is emerging is fundamentally against the founding principles of the NHS. We shouldn't ban people from having NHS treatment because they try additional drugs, but neither should we stop effective drugs from being available on the NHS. The NHS should be able to clearly demonstrate that any treatment that is not available is not effective and is a waste of time and money. Sadly this is not the case at present.

Press release from KONP:

There is no reason why the best drugs cannot be available to all NHS patients, the Keep Our NHS Public campaign has said, but the Government has wrongly excluded this option from the current consultation over cancer drugs.
Following the report by Professor Richards, the Government’s clinical director for cancer, Keep Our NHS Public said the consultation was flawed as the consultation document accepts that private drugs are acceptable alongside NHS care but does not ask the fundamental question of whether this is appropriate.
In his report Prof Richards states that ‘I believe that the option of NHS top-ups should be rejected,’ yet his recommendations accept this in practice, despite the fact that the number of patients requiring such treatment is small and the cost negligible in the context of the NHS budget.
Professor Wendy Savage, chair of Keep Our NHS Public, said:
This undermines the key principle of the NHS – that a patients’ wealth should have no bearing on the quality of the care available to them. It introduces a two tier system and already the private insurance business is welcoming the profits they can make.”
“There is no justification for a situation where desperate families have to use life savings to afford effective drugs denied them by the health service. But the option of providing all necessary care on the NHS is not mentioned in the consultation document. No figures are given for the cost of equitable NHS provision, which on the basis of the available evidence is likely to be less than 0.001% of the annual NHS budget.”
“The Government’s policy, while appearing compassionate on the surface, is in fact deeply disturbing. We call on all concerned citizens and organisations to respond to the consultation on these lines and involve their MPs to fight this dangerous move that threatens the very basis of the NHS.”

Green spaces improve health

Fascinating piece of research published last week in the Lancet on the connection between green spaces and health. It's all pretty obvious stuff really, the closer you live to the natural world the healthier you will be. A bit of a no-brainer really, but the research gives us a useful reminder about how we should design our living spaces.

Plant more trees should now be on the lips of every public health professional!

Tuesday, November 4, 2008

Top-up payments

The issue of top-ups is a tough one. The key problem is that this decision could open the door to the government making decisions more on price than effectiveness, which goes contrary to the NHS principles. It could easily mark the end of free health care at point of need. That said, how can the NHS refuse treatment to someone who wants to add expensive treatments that would not be particularly effective?

The NHS now needs to be far more careful that it provides the most effective care and not dumb down the level of interventions on the basis that people can top-up. They should ensure that no-one has to top up care, but with the proponents of high cost interventions hard selling their services, the public are unlikely to get good information to base decisions on.

Meanwhile the right wing health capitalists intent on making huge piles of cash are laughing all the way to the Leeds...
Interesting press release from the NHS Support Federation below:

NHS Support Federation News release Immediate:

4 November 2008 NHS top-ups a victory for the individual, but what about the rest?

Reacting to the plan to allow patients to top-up their NHS treatment with private care the NHS Support Federation said

“This is a victory for individual patients just trying to get themselves the treatment they want, often in tragic circumstances. But the obvious question is what about the patients with similar illnesses that can’t afford to go private.”

“The NHS was born out of the need to give everyone equal access to healthcare. Safeguards to protect these principles are essential. How far can we go without this defining principle of the NHS becoming meaningless in reality.”

“NICE will come under pressure to reassure the public that NHS patients are not being denied access to effective treatments. And if treatments are held back because of their cost it should only be after the public have had their say.”

“We need NICE to continue to help ensure NHS treatments are safe and effective. Their role in establishing affordability is less well understood by the public. The NHS itself needs to be more accountable. We cannot off load this responsibility.”

Paul Evans, director NHS Support Federation