BRITISH PUBLIC HOSPITALS ARE POLITICAL FOOTBALLS

A secret meeting has been held by ministers and Labour Party officials to work out ways of closing hospitals without jeopardising key marginal seats, The Times can reveal. Concerns about the political impact of planned hospital closures and other cuts to the NHS, which had a deficit last year of more than 500 million pounds, prompted ministers to organise the closed-door discussion. Details of the meeting, revealed in e-mails passed to The Times, show that it included Hazel Blears, the Labour chairman, political advisers from No 10 and even — at the request of Ms Blears — a Labour Party representative.

Opposition politicians said yesterday it was “deeply inappropriate” that party officials should have had an influence over plans drawn up by civil servants for changes in services on medical grounds. They also expressed concerns that hospitals in Tory constituencies were more vulnerable.

The e-mails show that Patricia Hewitt, the Health Secretary, called for those at the meeting to be provided with “heat maps”, showing marginal Labour seats where closures or reconfigurations of health services could cost votes. She also asked for lists showing hospitals where the European Working Time Directive is likely to hit hardest, making 24-hour rotas hard to sustain. Ministers have always insisted that the directive will not affect hospitals, but the e-mails suggest otherwise. Ms Hewitt may have been seeking to blunt the impact of the loss of 24-hour care by reconfiguring services to conceal it.

David Nicholson, the new NHS Chief Executive, gave warning this week that closures and reconfigurations were imminent. He expected there would be about 60 such changes, affecting every strategic health authority (SHA) and focusing particularly on maternity and accident and emergency services. The leaked e-mails make it plain that such changes have been considered since at least May. The first, from Alison Smith, a Department of Health official, refers to a May 12 submission about “supply-side reconfiguration”. The second, from Ms Hewitt’s private secretary, says that the Health Secretary asked for a political meeting to discuss the submission. She wants the health ministers Lord Warner and Andy Burnham to attend with their advisers, Ms Blears and her two advisers, and John McTernan and Paul Corrigan from No 10. A further e-mail from Ms Hewitt’s diary secretary says that Ms Blears has asked for a party representative to be included. The meeting took place on July 3 at the Department of Health.

Andrew Lansley, the Tory health spokesman, said: “There is a secret political debate going on to try to minimise damage to the Labour Party.” A spokesman for Ms Blears confirmed that the meeting had taken place but said that because it was political there was no record of who was present. “It wouldn’t be unusual for Labour Party press officers to attend meetings with ministers,” he said. “And as Minister without Portfolio, Ms Blears has the responsibility of providing policy advice to the Prime Minister across all departments, so she had a second reason for being there.”

Ministers are worried that the changes planned by Mr Nicholson may have the same effect as the removal of an A&E unit from Kidderminster Hospital in 2001, which led to the Independent candidate Richard Taylor ousting the Labour MP. After Mr Nicholson’s interview appeared, the Department of Health said his remarks did not mean “wholesale closures of hospitals” but rather that the NHS needed to work with local communities to decide how best to organise services.

One of the first strategic health authorities to make a move is the East of England SHA, whose board met yesterday to discuss a review of acute services. There are 19 district general hospitals in the region and reports suggest that as many as nine will be downgraded. Mr Lansley said it was no coincidence that the hospital top of the list for changes, and the only one specifically targeted in the board papers, for yesterday’s meeting, was Hinchingbrooke — “which happens to be in one of the two safest Conservative seats in the country”.

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Good proposal from the Australian Left for partial privatization of public hospital care

Perhaps one day ALL government hospitals wil be seen as a bad idea

Private hospital beds will be bought to slash waiting lists for public hospitals under a new ALP policy designed to shake up the health sector. The federal Opposition also plans to ease pressure on doctors by handing more of their roles to nurses and allied health professionals. Opposition Leader Kim Beazley will reveal his plans today in a speech to the Macquarie Graduate School of Management in Sydney. It will offer the first glimpse into a potential Beazley government's approach to health, starting with a strong repudiation of the Howard Government's long-running accusation that Labor is ideologically opposed to private sector involvement.

Mr Beazley will warn that cost-shifting and duplication are crippling the health system at a time of massive increases in demand for services. He will accuse the Government of squandering reform opportunities and promise to use the next commonwealth-state health agreement, which starts in 2008 and will run for five years, as a springboard for change. "We need to tap into the full potential of the private hospital sector," Mr Beazley says, in a speech obtained by The Australian last night. "Private hospitals are an invaluable national health resource and more needs to be done to integrate them with the public system."

Labor will also shake up medical training by paying private hospitals to provide clinical training for medical students and other specialist trainees. The proposal is designed to meet complaints that the Government has dramatically increased the size of university medical and nursing schools without extracting guarantees that state-run public hospitals would be able to provide hands-on training. "Integration and co-operation will define health care in the future," Mr Beazley will say. "All hospitals are in the health business. They have a vested interest in working together."

Mr Beazley will also promise stronger action to deal with medical workforce shortages by realigning roles of doctors, nurses and allied health professionals, using a Productivity Commission recommendation as his template. Mr Beazley will frame his health policies in an economic context, arguing better health would lift workforce capacity. Labor sources said Mr Beazley's attempt to link social policy with economic policy would set a trend for his bid for victory in next year's election. They said Labor's defeat in the 2004 poll came because voters were convinced by the Government that Labor was not serious about the economy.

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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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