NHS to punish conservatives



Community hospitals that lie in Conservative or Liberal Democrat constituencies will bear the brunt of the Government's closure programme, re-igniting accusations of political interference in the NHS. The Times has learnt that seven times as many community hospitals have closed or are under threat in constituencies held by opposition MPs. There are 62 closed or at-risk hospitals in Conservative constituencies and 8 in Liberal Democrats seats, with 11 in Labour areas. This has prompted opposition MPs to accuse the Government of "playing politics" and undermining the hospital closure programme.

The revelation comes a month after The Times disclosed that ministers and Labour Party officials held meetings to work out ways of closing hospitals without jeopardising key marginal seats. Leaked e-mails showed 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. The Department of Health has consistently denied that political considerations reflect policy-making.

But research carried out by the Community Hospitals Association reveals that of the ten community hospitals that have already closed this year five fall in Conservative-held seats while four are in Liberal Democrat areas. The Department for Health said that it was committed to community hospitals, which are often found in more rural areas. Ms Hewitt recently promised a 750 million pound cash injection to community health services declaring: "Community hospitals have for too long been viewed as the poor relation of larger hospitals. This stops today."

Lord Warner, the Health Minister, has said that the Government is committed to spending 100 million on building or refurbishing at least 50 community hospitals which provide diagnostics, day surgery and outpatient facilities closer to where people live and work. However, a spokesman for the department said that some community hospitals could not cope with the challenge of the modern NHS and would close. The spokesman insisted that ministers had no ability to chose directly which hospitals closed and which stayed open. A statement from the department in February said that "hit squads" of inspectors would be dispatched to meet the heads of strategic health authorities, and reject any plans for community hospital closures from primary care trusts if they could not show that they had considered all other options, including other companies taking over the hospitals.

However, opposition MPs are suspicious of the move. Andrew Lansley, the Conservative health spokesman, said: "Last month we discovered that ministers are more concerned with saving the political skins of Labour MPs than they are with pursuing the long-term interests of the health service." Steve Webb, the Liberal Democrat health spokesman, said: "There are too many times for coincidence that the process is favouring Labour seats and Labour MPs. That undermines the whole process. If you go through consultations with a sneaking suspicion that the Labour seat is going to get the hospital anyway, it destroys your faith in these consultations. "Nobody would argue that a particular set of buildings should be set in stone for ever. Health needs change, population change, so buildings and services should change. The key is that the decision should be clinically based; what delivers the best care."

Sources close to Ms Hewitt said: "The reality is that a lot of these hospitals are not particularly strong on state-of-the-art healthcare. "We want the best healthcare, which is not the same as wanting to maintain the same buildings."

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Australia: Victoria's public hospitals are in deep doo doo also



Emergency ambulances are waiting up to three hours to unload patients because of overcrowded hospitals. The Herald Sun has been told patients' lives are at risk as the system struggles to cope. Some hospitals are accused of putting money before patients by refusing to send ambulances on. A Herald Sun Insight investigation has found:

HOSPITALS are going on ambulance bypass or partial diversion at near-record levels.

SOME are forcing ambulances to wait rather than miss financial bonuses by going on bypass.

A CASE when eight ambulances were queued outside an emergency department.

PARAMEDICS are no longer warned when hospitals shut their doors to emergency ambulances.

NEW mobile computers to record patient details are delaying patient delivery.

The Herald Sun revealed in May that the lives of hundreds of critically ill and injured patients were being put at risk by long delays in ambulance black spots. A Department of Human Services source this week told Insight some hospitals were ignoring a system designed to ensure ambulances bypassed overcrowded emergency departments. "They get penalised if they go on bypass so they don't, which in turn affects ambulance services quite badly," the DHS source said. "They can wait two to three hours at some hospitals before a patient is taken off the stretcher."

A Langwarrin ambulance crew was sent to relieve a Rosebud crew left waiting at Frankston Hospital for two hours last Wednesday night. The source said ambulances had been forced to wait three hours on several occasions at Frankston last month. "It's not just a Frankston problem. It's widespread," the source said. On one day in June, eight ambulances were banked up outside Dandenong Hospital waiting for patients to be assessed. Three were eventually treated at the hospital, but beds couldn't be found for the other five.

Leaked documents reveal city hospitals refused all but the most critical cases while on bypass on 65 occasions totalling 130 hours in May. These don't include diversions under the Hospital Early Warning System, introduced in 2002 to cut bypasses. In May, hospitals used HEWS 287 times, 80 more than in May last year. That puts total bypasses and diversions in 2005-06 as high as 4200. City hospitals went on bypass 2021 times in 1999-2000. The Government stopped releasing bypass numbers four years ago and does not publish HEWS figures.

Operational changes introduced last month mean paramedics are no longer told by dispatchers when a hospital goes on bypass or HEWS diversion. They are notified only when they enter a hospital name into an onboard data terminal when loading a patient. Ambulance employees union boss Steve McGhie accused the Government of keeping paramedics in the dark on bypasses ahead of the election. "It's a way of avoiding access to any data regarding hospital bypass by ourselves and ambulance employees," he said.

Paramedics said it took 20-40 minutes longer to enter cases on new handheld computers. "You actually take your mind off what you're doing with the patient at times to type things in," one said.

Opposition health spokeswoman Helen Shardey blamed Government pressure to reduce elective surgery waiting lists. "For the Government to tell us that everything is working well is clearly a distortion of the truth and these horrific stories are evidence of that," she said. Health Minister Bronwyn Pike rejected suggestions hospitals would endanger patients for financial reasons. "But our emergency departments are busy places and if they get an influx of people at the same time then the system has to deal with it," her spokesman said. He said the ambulance bypass rate of 1.3 per cent was a third of what it was in 1999.

MAS emergency operations manager Andre Coia said computerised bypass alerts were part of a new tracking system. He said average "at hospital times" had risen four minutes to 29 because of it, but changes were being made to speed up the process and cut times. The leaked figures show Royal Melbourne Hospital was worst hit, going on bypass for 50 hours and HEWS for 52 hours in May.

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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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