DELIBERATE DELAYS IN BRITAIN'S NHS

Hospitals have been told to delay operations to reduce debts faced by primary care trusts, according to reports. The trusts involved are said to be trying to postpone paying for operations until the new financial year begins in April.

But the Government has washed its hands of the practice, saying it was an "operational issue for the local NHS". It comes just two days after Health Secretary Patricia Hewitt admitted the health service could be facing a deficit of œ620 million.

A letter leaked to the Times reveals hospitals within Harrow Primary Care Trust, which is reportedly facing an œ8-12 million deficit, have been told to delay surgery. The document, written by Dr Ken Walton, chairman of the trust's professional executive committee, tells GPs it has "reluctantly" asked hospitals to "do the minimum required to meet national targets". It says: "This means that patients sent for outpatient appointments will only be seen at 10-13 weeks (national target 13 weeks) and elective surgery will be delayed until the sixth month (national target six months)."

In a statement, the trust defended its policy. It said: "Harrow PCT is taking action to control its expenditure that will not affect the quality of care given to its patients. "All patients in Harrow will be seen within national targets." Similar practices are also reported to be taking place to save money at trusts elsewhere in the country.

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PERKS FOR SCOTTISH HOSPITAL BUREAUCRATS WHILE HOSPITALS CUT HEALTH SERVICES

An island NHS board with debts of o1.5 million has been criticised for shutting hospital wards while continuing to pay senior managers 50,000 pounds to cover their travel expenses. The Western Isles NHS Health Board, which runs some of Britain's most remote hospitals, is also paying locum consultants 11,000 popunds a week for working in Stornoway, on the isle of Lewis, because of difficulties attracting full-time staff. At a public meeting this week, islanders joined local councillors and health workers to express anger that while the Hebrides will be forced to take swingeing hospital cuts, including weekend ward closures and the loss of on-site theatre night nurses, no expense is being spared to cover the travel costs of managers who do not live on the islands.

Dick Manson, the health board's chief executive, who is presiding over o1.3 million cuts, returns from Stornoway to his home in Glasgow almost every weekend at taxpayers' expense. He is one of five senior managers at Western Isles NHS Health Board who live on the mainland and whose travel expenses and accommodation costs during the week are met from the public purse to the tune of 10,000 pounds each, the board admitted yesterday. One manager recently had the curtains changed at her rented accommodation in Stornoway, at NHS expense, because they did not meet in the middle, the board confirmed.

Yesterday Angus McCormack, vice-convenor of Western Isles Council, said: "This is a scandal. They have no commitment to the Outer Hebrides and its people. They are trying to cover a huge financial gap which has arisen through mismanagement, through an increase in administration staff, five of whom live on the mainland and fly back and forth each week. We think that is a huge waste of public resources."

A public meeting was called this week by Mr McCormack and Unison, the health workers' union whose members claim they have not been properly consulted over the "unworkable" health service changes proposed for the Hebrides. One of the health board plans, outlined at a second public meeting in Stornoway last night, is to close one ward at Western Isles Hospital, in Stornoway, on Lewis, and a second ward at weekends, which would save 500,000 pounds. There will no longer be a night nurse on duty on site to cover the operating theatre in the event of an emergency.

Councillors and health workers are demanding an external review of the financial arrangments and governance of the Western Isles NHS Health Board by the Audit Commission Scotland. "Following the huge amount of public disquiet, we want the board to look again at what they are doing, to take a step back and respond to the demands of local people," Councillor McCormack said. Yesterday a health board spokesman denied there had been a lack of consultation over the service changes, which are part of a recovery plan which aims to put the board back in the black within three years. He claimed there had been health forums held over the past 18 months which were open to the public. He said that patients would not suffer from ward closures because 30 per cent of the bed spaces were unoccupied; a claim disputed by the unions, who said yesterday that, earlier this week, only four beds in the hospital were free

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For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?

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