Monday, January 05, 2009

Outrage over British organs ‘sold to foreigners’

Note that the NHS was set up to abolish privileged health access for the rich. Reality is a little different

THE organs of 50 British National Health Service donors have been given to foreign patients who have paid about £75,000 each for private transplant operations in the past two years, freedom of information documents show. The liver transplants took place at NHS hospitals, despite severe shortages that mean many British patients die while waiting for an organ that could save their lives.

The documents disclose that 40 patients from Greece and Cyprus received liver transplants in the UK paid for by their governments. Donated livers were also given to people from non-European Union countries including Libya, the United Arab Emirates, China and Israel. The surgeons who carry out the transplants receive a share of the operation fee — believed to be about 20,000 pounds — as all the work is done privately in NHS hospitals.

It comes as a record 8,000 Britons are on NHS lists waiting for transplant organs. About 260 British patients are waiting for a liver. Last week leading transplant surgeons and patient groups called for an end to the practice. Professor Peter Friend, president of the British Transplantation Society, said it was unethical to give organs to people from abroad while British patients were dying. “While there is a surfeit of UK residents awaiting transplant it is correct that these patients should have priority,” he said. “Were the situation such that there were organs that were not required, it would be appropriate to make them available to other nationals. “We do not have a European organ donation system; it is a UK system and I therefore feel that . . . the system is there essentially for the benefit of residents in the UK.”

Jane Dodd, whose nine-year-old daughter Rebecca died while waiting for a liver transplant, said she was shocked and upset to hear that organs from British donors have been given to overseas patients. Dodd, a part-time bank clerk from Wirral, who also has a 19-year-old son, Matthew, whose life was saved by a liver transplant, said: “I do feel that organs donated in this country should go to people from this country unless there isn’t a suitable recipient. “If you are signing a donor card in this country you expect someone from this country to get the organ.”

The Healthcare Commission, a watchdog body, conducted brief inquiries last summer after being alerted to the practice at King’s College Hospital NHS Foundation Trust in London, but decided it was not breaking any rules. It referred the matter to the Department of Health. The documents show that another hospital, the Royal Free Hampstead NHS Trust in London, has also carried out four liver transplants on foreign patients in the past year, the most recent being in November. Despite the criticism, King’s College hospital said last week that it would be “business as usual” and surgeons would continue to give British organs to overseas patients in private operations. The hospital gave livers from British donors to 19 overseas patients last year.

A spokesman for King’s College hospital said: “We are continuing to treat citizens of the European Union as they have the same entitlement to treatment under the NHS as UK patients under European law." Under European law , patients from member states have a right to seek treatment in other European countries. Britain is not obliged to treat these patients, however, and the decision is left to individual hospital trusts.

If the trusts do decide to perform transplants on patients from elsewhere in Europe, they must give them equal access to British organs as those who live in the UK. When an organ becomes available, a recipient is selected according to the severity of his or her condition and the blood group. Some leading transplant hospitals refuse to carry out such operations. Dr Mervyn Davies, a consultant hepatologist at St James’s University hospital in Leeds, which does not carry out private transplants on overseas patients, said: “There is a shortage of donors and we cannot cater for the whole of the EU. “It is tragic for these patients but the system that we have cannot cope with the UK demand as it is. Extending that to the whole of the EU and beyond we consider is inappropriate.”

EU rules say patients from outside the bloc should be offered an organ only if it is not considered of a high enough standard or suitable for a patient in the UK. Transplant surgeons argue, however, that if livers can save the lives of patients from Israel, Libya and the United Arab Emirates, they must be of a sufficiently high standard to treat a British patient. The Department of Health has admitted there are concerns about the issue and is understood to be in talks with the European commission seeking clarification.


NHS wasting 2.1 billion pounds a year in procurement inefficiencies

The NHS is wasting 2.1 billion a year through poor procurement procedures, a report says. The study uncovered huge inefficiencies, with procedures for buying goods and services little changed since the 1950s. It found no common item codes or descriptions used by the NHS or its suppliers, while in some trusts orders are placed without any tendering process, often without an agreed contract price. The method of buying goods and services varied hugely from trust to trust and different departments within the same trust used numerous systems. Vast quantities of paper-based invoices were being generated, requiring huge numbers of permanent employees in accounts departments to match invoices to orders.

The report, published today by the think tank Policy Exchange, also found that dozens of health service projects and innovations are abandoned before they have any impact on care. Of the 2.7 billion spent on the creation of ideas within the NHS, only a small proportion, 153 million, is actually spent on spreading the innovations down to patient level. By spending nearly 16 times more on invention rather than diffusion, millions of pounds is being wasted in generating ideas that are never implemented.

The report, All Change Please, which interviewed 80 senior healthcare professionals, also highlights the slow uptake of new technologies, devices and drugs in the NHS which contribute to standards of care in UK hospitals falling behind that of comparable countries. Premature deaths from causes that are preventable with prompt and effective healthcare are higher in the UK than in Germany, Canada, Australia and France. It condemned the UK's poor access to CT and MRI scanners and below average uptake of new drugs for treatment of cancers including breast, colorectal and lung cancers.

An "alphabet soup" of organisations created by the Government to assist hospital trusts lacked a clear strategy for spreading ideas, it said. Henry Featherstone, head of health and social care at Policy Exchange said: "Procurement practices in some parts of the NHS haven't moved on substantially in the last 60 years. By adopting best practices, as used by other healthcare organisations, the NHS could save up to 2.1 billion each year. "There are also many innovative technologies that are not being taken up uniformly across the NHS. Focusing more funds towards the spread of proven innovations would both improve patient care and reduce costs."

The report recommended the setting up of a central procurement body would have the task of developing common standards for all trusts and performance related bonuses in clinicians' contracts. Managerial incentives should be linked to improving outcomes as well as financial performance.


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