IN SOCIALIZED MEDICINE, TREATMENT IS A PRIVILEGE THAT CAN BE WITHDRAWN, NOT A RIGHT

A pro-life campaigner who sent hospital staff pictures of mutilated and aborted foetuses has been denied hip treatment. Edward Atkinson, 74, was jailed for 28 days and given a five-year antisocial behaviour order for sending offensive photographs to the Queen Elizabeth Hospital in King's Lynn, Norfolk. The pensioner has been taken off a waiting list for an assessment for a hip operation and banned from treatment for anything other than life-threatening conditions.

The move was criticised yesterday by an anti-abortion group backing Atkinson. James Dowson, the national co-ordinator of the UK Life League, said: "It is ridiculous. I think it is completely unfair. They are refusing to treat him. Would they refuse a murderer or a paedophile? "He has paid his taxes, he is entitled to that treatment, who are they to withhold it from him?"

Atkinson, of Hilgay, Norfolk, was jailed at Swaffham Magistrates' Court on Thursday last week after he was convicted of three counts of sending offensive literature or material to staff at the hospital between January and April this year. A hospital spokesman said that the pensioner had been on a waiting list for an assessment for a hip operation when he started sending in pictures of aborted foetuses. The NHS trust wrote to him asking him not to send such material to the hospital as it was distressing staff. When he continued, the trust said he had broken its "Zero Tolerance" policy with regards to staff. Ruth May, chief executive of the Queen Elizabeth Hospital, said: "The trust's view is that we have a duty of care to our staff." [But no duty to people who have paid for care?]

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U.K.: 340 MILLION POUNDS FOR NOTHING

A new contract for hospital consultants cost at least 340 million pounds in its first two years but offered patients few improvements in care, a report has found. The King's Fund, an influential health think-tank, says that rushed implementation, a failure to cost the contract properly and a preoccupation with other problems mean that hospitals, the NHS and patients have failed to get much benefit. The result is that consultants are being paid more money for doing the same work as previously, while hospitals are running deficits caused, in part, by the cost of paying them.

Despite promises by Alan Milburn, then Health Secretary, that the new contract would reduce moonlighting by consultants, private work may actually have increased. Mr Milburn claimed that the contract, the first change in consultants' terms and conditions since 1948, was a "something for something" deal. But the King's Fund concludes that it was closer to something for nothing. Niall Dickson, the chief executive of the charity, said: "Consultants are at the core of the NHS and deserve to be paid well for the work they do. However, the Government promised that this contract would also bring benefits to patients and so far that does not appear to have materialised. This is a limited study and these are early days, but it raises profound questions about the effectiveness of the deal and what now needs to be done to ensure that it delivers greater productivity."

Paul Miller, chairman of the BMA consultants' committee, said that the report was limited, inaccurate and based on a small sample of senior managers in five London trusts. "Blaming the consultant contract for the financial crisis facing the NHS is an easy option," he said. "Many NHS trusts are in debt because they are struggling to shake off years of under-investment. They also face rising drug costs and an ever-increasing number of patients. The blame for the NHS funding crisis lies with an incoherent and inconsistent health policy, riddled with errors and misjudgments."

The consultants' contract, which was finally agreed in 2003, aimed to give management greater control over doctors' activities in return for better pay. The report says that, under the old contract, hospitals and consultants had colluded in a deal that meant consultants worked very long hours. In return for this, managements allowed them to "do their own thing". The consultants worked hard, but wrote their own rules. The new contract aimed to define their work much more precisely, and was based on ten four-hour sessions, called programmed activities, a week. Consultants could do private work only if they offered their NHS hospitals an extra weekly session. In practice this lever proved worthless. There is so much work that the average consultant does more than eleven sessions a week, not the ten envisaged.

The contract cost the NHS 90 million pounds more than expected, in part because nobody in the Department of Health believed what the consultants told them about the hours they worked. Pay increased substantially, with starting salaries rising by 36 per cent since 2001 to 69,298 pounds in 2005. But corresponding improvements in productivity have been lacking, largely because managers have seen the contract as "a box to be ticked" rather than an opportunity for change. "There needs to be more emphasis at both national and local levels on how the contract can be used as a tool to benefit patients," Professor James Buchan, co- author of the report, said.

A spokeswoman for the Department of Health said: "NHS pay reform, including the consultant contract, has been part of a significant success story in the NHS. "There is still some way to go before we realise the full benefits of its implementation, but increasing pay rates is only one small part of the new contract." Alastair Henderson, deputy director of NHS Employers, said: "The focus is now turning to realising the benefits that can be provided for patients."

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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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