NEWS
Retiring heart czar reit- erates reforms criticism
Sir Roger Boyle, who retired as national director for heart disease at the end of July, marked the oc- casion with a further attack on Health Secretary Andrew Lansley and the NHS reforms.
In a newspaper interview, he said private companies would wreck the NHS, saying their allegiances will always be to shareholders rather than patients, adding: “If the market was going to work, the Americans would have cracked it.”
He praised Lansley’s “encyclo- paedic knowledge” of the NHS acquired in his seven years as his party’s leader on health – but said that policy needs to be made through engaging with the NHS rather than through a small group of advisers.
The Department of Health has announced a £1m funding boost to support the development of Health & Wellbeing Boards, which are proving very popular with local authorities.
Nearly every one of the 152 top-tier councils (county councils, unitary authorities, and London boroughs) has volunteered to become an early implementer of the boards, as they seek to have a greater role in inte- grating the NHS with social care and public health, have more say over commissioning and push for ‘place- based’ health spending.
Health Secretary Andrew Lansley has promised that the boards – con- troversial with some clinicians – will have a critical role in bringing about
more joined-up health and care ser- vices, representing patients, and overseeing commissioning deci- sions.
The boards will be part of local au- thorities’ own structures, and them- selves subject to usual council scru- tiny and oversight procedures.
Councils themselves will therefore choose how many elected council- lors will sit on the boards.
Councils are hopeful that their new role can help tackle some of the deeper issues that determine health outcomes – especially housing, transport, and deprivation.
Lansley said: “Local authorities have an in-depth understanding of
the public health and care needs of their populations, but too often they haven’t had the right systems in place to work with the local NHS to get the best health and wellbeing for their people.
“The reality is the NHS must mod- ernise in order to keep up with the increasing demand on services, an ageing population and rising costs of new drugs and treatments.
“That is why we are making £1 mil- lion available to support the devel- opment of Health and Wellbeing Boards as part of Local Authorities.
“I want to ensure they are able to effectively support communities in getting access to the services that they need.”
The NHS Co-operation and Com- petition Panel has said that PCTs are deliberately delaying opera- tions to save money as they wait for patients to go private instead or to ‘remove themselves from the waiting list’ for another reason – perhaps by dying.
Trusts are “imposing pain and in- convenience” by making patients wait longer than clinically neces- sary for accounting reasons, the Panel’s report said, due to the need to stay within budgets within given financial years. The report says that these practices are “en- demic” in parts of England.
without a valid and visible reason.”
There are also reports of Trusts im- posing minimum waiting times as commissioners struggle to make £20bn of efficiency savings by 2015. Surgery for cataracts, knees and hips are already routinely be- ing rationed and restricted.
Difficult job
Lord Carter of Coles, chairman of the panel, said: “Commission- ers have a difficult job in the cur- rent financial climate, but patients’ rights are often being restricted
6 | national health executive Jul/Aug 11
Katherine Murphy, chief executive of the Patients Association, said: “It is outrageous that some PCTs are imposing minimum waiting times. The suggestion that it could save money because patients will remove themselves from the list by going private or dying is a cal- lous and cynical manipulation of people’s lives and should not be tolerated.”
The report says that commission- ers are restricting GPs’ ability to
refer patients to some hospitals by imposing caps on the number a provider would be paid to treat.
Levelling down
The tactic of imposing minimum waiting times – as much as 15 weeks in some cases – forces pri- vate hospitals especially to work slowly in an “unfortunate levelling down”, the panel said.
Paul Burstow, the care services minister, said: “This report illus- trates exactly why we need to
modernise the NHS and increase choice for patients.
“Trusts will want to take a hard look at practices in light of this report and ensure they are always in the best interest of patients and the taxpayer.”
Trade-offs
David Stout, director of the NHS Confederation’s PCT network, said: “Today’s report rightly ac- knowledges that each situation will be different and the extent that any benefits outweigh the loss of choice should be considered on a case-by-case basis. Commission- ers will still be left to decide the right course of action when faced with trade-offs between patient choice and value for money.
“The suggestion that many current trust decisions are not justifiable on these grounds is largely un- substantiated by the detail in the report as the CCP has not investi- gated specific cases in detail.”
He rejected suggestions that pa- tients are dying because of delays in routine surgery.
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