Why do private hospitals want to hide their patient safety records? | openDemocracy

Why do private hospitals want to hide their patient safety records?

Colin Leys 21 August 2014

In opposition George Osborne criticised the ‘endemic culture of secrecy in some private hospitals’. But after 4 years in government, the secrecy persists, even as the NHS itself is opened up to ever more scrutiny.

In February 1999 Mrs Laura Touche, the wife of an American lawyer in London, died of a brain haemorrhage after giving birth to twins by caesarean section at the private Portland Hospital in London, the favoured choice for maternity care of the Royal Family and many celebrities. It emerged that unlike NHS hospitals, the Portland had no protocol requiring patients’ vital signs to be checked at frequent specified intervals following a delivery. Although complaining of a headache Mrs Touche was not checked for two and a half hours, by which time it was too late.

In the UK maternal deaths directly due to pregnancy are extremely rare – around five in 100,000 live births. A coroner’s jury found that neglect had contributed to Laura Touche’s death. Her husband Peter Touche said the facts disclosed at the inquesthad convinced him that his wife’s death was ‘completely avoidable’. He added: ‘This all took place in a private hospital at the end of the 20th century. I understand that the Government is now contracting out NHS operations to the private sector. The NHS is opening up and publishing statistics. So should the private sector. The irony is that often, as in Laura’s case, a patient is transferred to an NHS bed and so the death is registered at the NHS hospital.’

And it is not just deaths that are a cause of concern. Serious incidents short of death can be devastating too. For example over the past year no fewer than three patients at one private hospital in Southend had the wrong joints replaced – ‘never events’, in NHS parlance.

The key lesson from all such cases was actually drawn in 2002 by George Osborne, then a backbench MP. Referring to the Touche tragedy he moved a private members’ Bill ‘to require private hospitals to publish independently audited information on clinical performance and on complaints from patients on the same basis as that required of NHS hospitals.’ He pointed out that:

Unless the hospital volunteers the information, it is impossible to know how many deaths occur within 30 days of surgery or how many emergency readmissions take place, yet information of that kind is now freely available in the NHS. Although private hospitals now need to have a proper complaints procedure, there seems to be no requirement for them to publish complaints in the same detail. Other prospective patients therefore cannot judge the hospital’s record for themselves.

But as a new report by the Centre for Health and the Public Interest points out, this information is still not available. Sir Robert Francis reporting on Mid Staffs, Sir Bruce Keogh reporting on 14 NHS trusts, the American Don Berwick reporting on the safety of NHS patients in general, and more recently Jeremy Hunt, all stress the importance of openness. But what George Osborne called ‘an endemic culture of secrecy in many private hospitals’ persists. There were 1.6 million admissions to private hospitals for surgery last year, including some 420,000 funded by the NHS; yet none of the patients involved had any means of knowing whether the hospital they were going to had a better or worse than average patient safety record, or how it compared with their local NHS hospital.

Suppose you need a hip replacement. The NHS Choices website shows all the hospitals in your area, including private hospitals, which as an NHS patient you now have the right to choose. Since Jeremy Hunt’s recent patient safety drive, for every NHS hospital you can now see, besides a users’ rating, the number of hip replacement operations it does, the average length of stay in hospital, whether the mortality rate and the rate of unplanned readmissions are above or below average, plus the hospital’s rating for infection control, whether its staffing level is safe, how far its own staff recommend it, whether patients are assessed for blood clots, and whether it reports safety incidents honestly. But for private hospitals only a users’ rating, the number of operations they do, and (for some) the average length of stay, are given. The rest remains secret.

This makes informed choice impossible, even for private patients. There is a separate Private Hospital Information Network website. But it compares private hospitals only with each other, and for most indicators does not provide the data on which the comparisons are based.

And having informed choice is only one reason for transparency. Even more crucial is that only full information allows risks to patients to be identified, trends to be analysed and lessons to be learned so that mistakes are not repeated. Yet the Care Quality Commission acknowledges that it has comparatively little information on private hospitals.

Given that the taxpayer is now the second largest source of funding for the private hospital sector and that this has, according to the Competition and Markets Authority, sheltered private hospitals from the economic downturn, there is no good reason why they should not be subject to the same reporting requirements on patient safety as NHS hospitals.

via Why do private hospitals want to hide their patient safety records? | openDemocracy.

Doctors at St Austell’s biggest GP surgery terminate NHS contract due to “financial difficulties” | Cornish Guardian

Doctors at St Austell’s biggest GP surgery terminate NHS contract due to “financial difficulties”

By Cornish Guardian | Posted: August 13, 2014


THOUSANDS of patients have been left shocked after doctors at St Austell’s largest GP practice terminated their contract with the NHS due to “financial difficulties.”

Partners at Polkyth Surgery, on Carlyon Road, informed NHS England of their decision last week.

Doctors Angus Senior and Manisha Cooper said in a statement on the surgery’s website that the practice would remain open while a new contractor was found.

“We would like to reassure our patients that we are fully open as normal for all services,” they said. “We can confirm we will be ending our contract for GP services. We will remain open while NHS England put in alternative arrangements.”

The statement continued: “We apologise if this is unsettling. It is with great regret that we have decided to relinquish our contract, having made many friends and supported the community for so many years.”

NHS England said it was working with the practice “to make sure patients are not affected”.

A spokesperson told the Cornish Guardian: “The practice has told us it has financial difficulties and therefore cannot continue with its contract.


“Discussions are already under way with another provider with the aim of securing continuity of care and making the transition as smooth as possible.

“Patients can continue to make and take up appointments as usual during this time.”

St Austell and Newquay MP Stephen Gilbert said he was gravely concerned by news of the surgery’s plight.

“As the local MP, I have visited Polkyth Surgery on a number of occasions and I know what a valuable contribution the doctors and nurses have made to the local community,” he said.

“The news that the GPs will hand back their contract will be deeply worrying for patients. It is vital that our National Health Service providers are able to operate viably and I will be raising the specifics of this case with ministers after the summer recess.”

He added: “Ultimately, I am pleased that managers are working to put alternative arrangements in place to provide continuity of service for patients; and I have offered my support and assistance for this process if needed.”

Jenny Curtis, vice-chairman of the Polkyth Patient Participation Group (PPG), said she had no idea the situation at the surgery had become so dire.

“It’s been as much of a shock to us as anyone else,” she said. “We heard about it in the news.

“I would hate to see Dr Senior or Dr Cooper leave for any reason. They’re both caring GPs. I don’t know what their situations are, but it would be a terrible shame if they did.”

Polkyth Surgery serves almost 11,000 patients, but has struggled to cope with long-term staff absences and the pressures of recent government healthcare reforms.

In 2012, the abolition of Primary Care Trusts (PCTs) forced GPs to take control of their own finances and made them responsible for planning, and buying local services for their patients – effectively turning doctor’s surgeries into businesses.

NHS England refused to speculate about who would take over the practice, but under the Health and Social Care Act 2012 the contract will be put out to tender to the private sector. “It could well be a private company that takes over, it wouldn’t surprise me” said Mrs Curtis. “These days doctors’ surgeries are forced to chase profit.

“GPs never used to be involved in the business side of things, so it’s no surprise some practices are struggling.

“The amount of pressure on GPs at the moment is incredible,” she said. “It’s appalling, but it won’t end at Polkyth. I think this is going to

via Doctors at St Austell’s biggest GP surgery terminate NHS contract due to “financial difficulties” | Cornish Guardian.

Mental Health Patients Shipped Out-of-County

44 Cornish mental patients have been shipped out-of-county following the closing of  one of the two psychiatric facilities in Cornwall. Longreach House, built under the Private Finance Initiative, has been closed since May when it failed a safety inspection. The building is 12 years old. It is not expected to re-open until November. Meanwhile, people requiring in-patient treatment are sent miles from their homes and far from the friends and family who might be able to support them.

It would be unacceptable for cancer or cardiac patients to be treated in this manner. Likewise, mental health services in Cornwall should be funded and provided in parity with medical/surgical services.

The locations of these patients are unknown, but it is likely they are in private psychiatric facilities.


Keep Our NHS Public

March from Jarrow to Parliament Square

London, 16 August – 6 September

Probably you have heard of this fantastic initiative, started by a group of mothers in Darlington (also known as the Darlo Mums). It is to recreate the historic Jarrow March of the great Depression – this time in order to save the NHS from the damage being done to it by the current government through privatisation and cuts. It is a fantastic expression of collective solidarity and support for the institution which cares for us when we most need it.


Help on the route

The organisers are doing a fantastic job but can always use a helping hand. The route is pretty much North-South between Jarrow in the North East and London, so you may live too far away to offer practical help, but if you are closer to the route there are all sorts of ways that you can help.

Please go to the website 999callfornhs.org.uk for the links to follow the route in detail. Each of the 23 towns where the march stops overnight has its own contact person (linked on the website) and they should be your point of contact if you are offering help, whether it is food, shelter, first aid, stewarding, local publicity or anything else. This is a fantastic campaigning opportunity and news will reach millions of people. Do your best to connect and get the message across that we need to Keep Our NHS Public.

Arriving in London

The last stage of the March is from Edmonton (on the northern outskirts of London) to Parliament Square in Westminster, a distance of 11 miles. The March leaves Edmonton Fore Street at 10:00am and is expected outside Parliament at 4:00pm. You are welcome to march from Edmonton if you want to, but the organisers are encouraging people to join the March at the Unite Building at 128 Theobalds Road, London WC1X 8TN, near Holborn Underground station. The big KONP balloon will be carried from there. The March will move off from there at about 2:30pm and should reach Parliament Square at about 4:00pm.

The reason for asking most people to join at that point is that from then on there will be road closures and stewards. Before that the March will be on the pavement.

In Parliament Square, there will be a rally with speakers and performers to celebrate this great achievement.

Support the marchers

Do your best to support them by turning out to walk with them when you can, attending one of the many rallies that are due to take place at the overnight stops (see details by clicking the relevant button on 999callfornhs.org.uk), make a lot of noise in local and national broadcast media, and leaflet so that as many members of the public as possible get to know about this brave attempt to remind us all how important it is to keep the NHS public.

via Keep Our NHS Public.

KONP News Updates

Keep Our NHS public News Updates

 23 July 2014

Commissioning system belatedly balances £97bn budget. NHS England has belatedly managed to set plans to balance its £97bn budget for 2014-15. The budget has been balanced in part because clinical commissioning groups are expected to perform worse than was budgeted for against income linked performance targets, HSJ has learned. HSJ reported two weeks ago that plans submitted in late June by CCGs and NHS England’s own commissioners showed an aggregate overspend of £137m against the commissioning system’s £97.3bn spending limit for this financial year. NHS England cannot afford for CCGs to reduce their overall surplus this year because it has allocated the entire £400m surplus that commissioners are permitted to “draw down” in 2014-15 to offset a potential £800m overspend in its own specialised commissioning budget. However, HSJ understands that plans are now agreed that would see both the CCG sector and NHS England’s specialised commissioners break even against their overall spending limits. HSJ
NHS finances ‘stretched to limit’. NHS finances have been ‘stretched to the limit’, influential think tank The King’s Fund has warned. The King’s Fund said that there are “huge pressures” on the health service’s purse strings after a quarter of finance directors at hospital trusts in England said they expect to overspend their budgets this year. Its latest report on NHS financial woes found “a distinct lack of optimism about the general state of the finances” with 85 per cent of the 73 finance directors polled saying they were fairly or very pessimistic about money for the next year. The King’s Fund said that “cracks are beginning to appear” in performance as a result of the growing financial pressures. A number of waiting time targets have been missed and the number of people on waiting lists for treatment in hospital is now at its highest level for six years.
Poll shows support for raising taxes to sustain NHS. Voters remain wedded to Britain’s taxpayer-funded model of healthcare even as NHS leaders question its sustainability, according to a Guardian/ICM poll. Analysis by NHS England and outside experts points to a large funding gap that could reach £30bn by the end of the decade, and last month 71 leading lights of the health service wrote to the Guardian to warn politicians that failure to level with the public about the black hole before polling day would jeopardise the service’s future. Asked how they would tackle the future funding of medicine, voters are resolved by a margin of more than two to one that “raising taxes for everybody, to put more money in” is the right way to go. Tax-funded increases in expenditure are preferred by 48% of respondents, while 21% are in favour of charges, such as paying to see the doctor, and 19% would cut the range of available treatments. On the face of it, these results offer some support for the suggestion – debated in Labour circles – of going into the election pledging a ring-fenced national insurance rise to cover NHS spending.

Altenhof, Blick in die Dorfkrankenstation



Survey reveals managers’ concerns about integrating health and care:   Moves to integrate health and social care are regarded by many to be the turnkey solution to take the pressure off our healthcare system. The drive towards closer integration of services does makes sense. The case has been made rather convincingly by the leaders in our healthcare system. However, making integrated care a reality will fall to our health and social care managers. In our latest survey of Institute of Healthcare Management (IHM) members, more than half said they didn’t believe that integrated care would take the pressure off the NHS. Doubts were raised about whether the Better Care Fund will be used for its intended purpose, to help reduce occupancy in costly acute services and improve care pathways. Health and wellbeing boards in England have to approve proposals on how the funds are used locally, but managers working for acute providers, particularly foundation trusts, are concerned about their lack of involvement as proposals are developed, and are wary that the funds would not be used to achieve the significant step changes needed. Another anxiety centred around the heavy workloads created by the need to set up new infrastructures for collaborations and integration between the health and care sectors. Managers pointed out that staffing and financial resources were already stretched to breaking point. Many IHM members also signalled their anxiety about whether everybody involved in the integrated care agenda was being fully consulted and, given the significant changes that were already underway in the NHS, whether the timescales envisaged for its implementation were realistic. Guardian

Concordia Health pull out of contract for The Broadway Practice: The Broadway Practice faces an uncertain future after Concordia Health pulled out of the contract to run the GP surgery. The 5,500 patients received letters today dated July 16, informing them that the surgery could be taken on by another provider in April or closed leaving people to join other practices. Concordia Health Limited is contracted by NHS England to provide the care but they asked if their contract could be brought to an end. NHS England has accepted their request and their contract to provide services at The Broadway Practice will end on 31 March 2015. The NHS is now seeking people’s views on whether they should identify an alternative provider or ask patients to register with another GP. The announcement comes after all of the permanent GPs left the practice in June 2012 just seven months into Concordia’s takeover. This exodus led to angry protests from patients about the new management. Thanet Gazette


On TTIP and the NHS, they are trying to bamboozle us: The TTIP trade treaty talks re-open in Brussels this week. We should not be reassured by the convenient ‘leak’ of a private letter between key TTIP advocates claiming the treaty poses no threat to the NHS. The NHS has become a key battleground for the Transatlantic Trade and Investment Partnership (TTIP), the controversial treaty currently being negotiated in secret between the European Commission and the US government. Now that more and more people are becoming aware of the threat that TTIP poses to public services, the European Commission and its friends have found a new and inventive way of trying to bamboozle people into accepting it. On the eve of the sixth round of talks, which begin in Brussels this week, a ‘private’ letter from the EU’s chief negotiator, Ignacio Garcia Bercero, to John Healey MP was conveniently leaked to the Guardian and Financial Times. The letter attempts to downplay the fact that public health services are included in TTIP, suggesting that there is no need to fear for the NHS as a result. The first thing to note is that there is nothing new in the letter, nor any change in the EU’s position. The European Commission has used exactly the same arguments to defend the inclusion of health, education and other public services in all previous trade agreements, as those of us who have been engaged in these debates for the past 20 years know all too well. Yet trade experts point out that public services are still highly vulnerable when they are included in negotiations, particularly when private operators have been granted access to public sector contracts, as is the case with the NHS.

Pricing authorities to tighten grip on specialist service payments.
Monitor and NHS England today floated plans to tighten their grip on the pricing of specialist services while mounting a push for local commissioners to move away from national NHS prices. Early proposals for the 2015-16 NHS payment system – published this afternoon – signal the two bodies’ intention to extract greater “value” from hospital services that have no national price and to accelerate “the pace of convergence towards only remunerating efficient costs for specialised services”. They propose to do this either by providing commissioners with new guidance on existing contracting options or by introducing new rules for local price setting in the 2015-16 national tariff.. HSJ

The We Are Primary Care report, jointly developed by Pharmacy Voice, NHS Alliance, the Optical Confederation and the National Community Hearing Association, warned that the future of the NHS was ‘precarious’ if the current medical model was maintained. The report calls for increased investment into community primary care services such as pharmacy and optometry – boosting these services could ease GP workloads and improve patient care, it says. The report calls for all non-emergency treatment, including care for long-term conditions and minor ailments, to be taken out of hospitals and into primary care.But the report said the public’s lack of understanding about primary care, coupled with a ‘dramatic imbalance in funding’ between primary and secondary care, was acting as a ‘significant barrier’ to this move.Members of the public generally have little understanding of what is meant by ‘primary care’ and are ‘confused’ about who can provide it, the report says.