Tuesday, March 17, 2009

Hospital waiting lists will soar due to European laws, British surgeons warn

Patients face a significant increase in waiting times for operations as 'insane' European rules mean doctors' hours are cut so much medics will not be able to cope, surgeons have warned.

The key pledge of Labour's NHS reform has been to reduce waiting lists and now the majority of patients are treated within the target of 18 weeks from seeing their GP. However this will be reversed as junior doctors will be limited to working a 48-hour week, from their current 56 hours, it is claimed. The extension of the European Working Time Directive will effectively result in the loss of thousands of doctor shifts, John Black, President of the Royal College of Surgeons said. And the Government fears there will be a lack of locum doctors available to step in and help fill the gaps, following changes in doctors' recruitment.

It means patients will have to wait months for routine operations as surgeons prioritise emergencies rather than scheduled cases. The Royal College of Surgeons wants trainee surgeons on a 65-hour working week in order to produce safe, properly trained doctors and cover the workload required by hospitals.

Mr Black said: "If the 48 hour limit is enforced, surgeons will have to make a hard choice between caring for emergency cases and dealing with elective cases as there will not be the time available to do both. Surgeons will put patient safety first and focus on looking after emergency patients. "All the progress on reducing waiting lists will go out of the window. Forty eight hours for surgeons is currently insane if we want maintain surgery in the NHS."

Doctors have calculated an average hospital trust outside London will lose the equivalent of three trainee surgeons and other specialities such as paediatrics, trauma, and intensive care are likely to be similarly affected. Smaller surgical units may have to shut or be merged in order to comply with the Directive, Shadow Health Secretary Andrew Lansley warned.

It is understood the Department of Health is considering increasing the length of time it takes to qualify as a consultant surgeon from seven years to eight or nine so doctors can gain enough experience and also comply with the limited working week.

Vanessa Bourne of the Patients Association said: "How can this be happening in a supposedly patient-centred service? Access to high quality safe care is the paramount requisite for patient and clinician alike and this muddle needs sorting out before patients are put at risk."

The new regulations come into force on August 1 at the same time hospital trusts are trying to cope with organising the new intake of junior doctors. The shake-up of doctors' training, which caused a fiasco in 2007, means more trainees are in longer-term posts so there are now fewer candidates looking for locum posts and temporary jobs.

Remedy UK, the junior doctors pressure group, has calculated that switching all juniors from a 56 hour to a 48 hour working week is the equivalent of losing one working day per doctor per week, or up to 70,000 doctor days per week across the UK. Dr Matt Jameson Evans, co-founder of Remedy UK, said: "In many key specialties the system is already massively overstretched. "Just imagine the impact of a blanket reduction in doctors' hours by one full day a week. A creaking system will collapse. And yet most doctors want the freedom to choose to opt-out of 48 hours. "We're begging for some common sense - an official endorsement by Government of the individual opt-out for trainee doctors would go a long way."

Mr Lansley said: "NHS staff have been absolutely clear that if the 48 hour working week is imposed on them it will leave many junior doctors with insufficient experience from their training. It will also threaten the care that patients receive because there will not be the same continuity of care and because smaller surgical teams will have to be shut down."

Dr Andy Thornley, chairman of the British Medical Association's Junior Doctor Committee warned that the doctors' training will lose out because there will be an 'all hands on deck' culture to delivering patient care. He said: "Doctors will work hard to ensure that patient services are maintained, but the potential for disruption exists. The NHS will not be sustainable if we do not equip our junior doctors with the necessary training to be the consultants of tomorrow."

The Department of Health wants to delay the introduction of a 48-hour week for some specialities and is expecting an answer from the European Commission by the end of May. However this would only mean some doctors could remain on 56 hours until 2012 and will not solve the problem in the long-run, experts have said.

A spokesman for the Department of Health said: "Most UK doctors in training already comply with the Working Time Directive, and the overwhelming majority will do so by 1st August this year. However, we have notified the European Commission that we intend to operate a derogation for a small number of services involved in delivering urgent and emergency patient care."

The Working Time Directive is already in force in most areas of business, limiting the working week to 48 hours and setting minimum rest periods. Individual workers can choose to opt-out although some professions such as the Armed Forces are not covered.


The British Nanny State pulls back, for once

Gordon Brown has rejected a proposal by his top medical adviser for a minimum price of alcohol to tackle binge drinking. The Prime Minister acted after newspapers published details of Sir Liam Donaldson, the Chief Medical Officer's, plan, which could result in every can of beer costing at least 1 pound and a bottle of wine a minimum of 4 pounds. The Department of Health gave the idea a fair wind initially, saying that nothing was ruled out and pointing out that Sir Liam had been one of the earliest proponents of a ban on smoking in public places.

Mr Brown made plain that the idea, which would fix prices at no less than 50p per unit of alcohol, was a non-starter. "I do not think this is where we are going," said a source close to the Prime Minister. "The majority of sensible drinkers should not have to pay the price for the irresponsible and excessive drinking by a small minority."

That line was repeated by James Purnell, the Work and Pensions Secretary. "We want to focus on the irresponsible minority rather than I think punishing everyone equally. Clearly we will look at Liam Donaldson's proposals; he's a very eminent person in his field," he told BBC One's The Politics Show. "But we are very clear we don't want to punish the majority for the sins of the minority. I think certainly at a time of economic difficulty that looks like it would be the effect."

Department of Health sources said that it would have come to the same conclusion as Mr Brown but would have preferred to see Sir Liam's ideas debated. "There is no split on the policy," an insider said, "but the truth is, this policy was made this morning in Downing Street. That is their right. They are in charge." Other Whitehall sources denied that the department's approach suggested a split with No 10. "The Health Department has to be diplomatic about this and dealing with Sir Liam. It's easier for No 10 to knock it."

The Conservatives were equally unenthusiastic about raising prices. Andrew Lansley, Shadow Health Secretary, said: "There is clearly a need for action. But it is very important to recognise that we need to deal with people's attitudes and not just the supply and price of alcohol."

He said that Conservative proposals, which include measures to tackle loss-leader promotions and higher taxes on high-alcohol drinks aimed at young people, would address this without penalising the majority of moderate drinkers. "This would seem to be a much better route to go down than distorting the whole drinks market, which in any case may not be legal."

The Liberal Democrat culture, media and sport spokesman Don Foster backed Sir Liam's call. "The Liberal Democrats have long argued that the ridiculously cheap below-cost price of alcohol in some of our supermarkets and off-licences is a key contributor to the problem of binge drinking," he said. "There is clear research showing that putting an end to pocket money-priced alcohol will influence drinking behaviour. While more work needs to be done on the details, we welcome Sir Liam's intervention and hope that the Government will act." Sir Liam's proposal would mean most bottles of wine could not be sold for less than 4.50.

A Department of Health spokeswoman said that the Government had not ruled out taking action on cheap alcohol. She said: "It's clearly linked to people drinking more and the subsequent harm to their health. It would be wrong to make sweeping changes without consideration of all the options suggested by our research published in December. "We need to do more work on this to make sure any action we take is appropriate, fair and effective. Any decisions we make will take into account their wider economic impact during this difficult time and it would not be right to penalise the overwhelming majority of responsible drinkers."

More here

Britain's very strange "green" car plan

It's "green" to encourage the automobile industry? Quite a turnabout!

I've had my 42in television for a good few years. I fancy replacing it with a new 55in model but the 4,800 pounds price has put me off. Thanks to Peter Mandelson, however, I've realised that I've been worrying over nothing. I'm going to knock on someone's door and ask them to give me 2,000 towards it. In return, I'll smash my old one up. Lord Mandelson, you see, is about to set up precisely such a scheme, not for plasma TVs but for cars. If you fancy a new car, take your existing one to a car recycling plant and you'll get a œ2,000 voucher towards it.

Isn't life grand! Bored with your Nissan Micra? Upgrade to an MG and someone else will pay. That someone else, of course, is you and me, through our taxes. At a time when public spending is running away with itself, tax rises are inescapable and most of us are counting every penny, the Government is planning to force those of us still in work and paying taxes to subsidise other people's luxury spending. Genius.

The rationale, of course, is that it will protect jobs in an industry where demand has collapsed. As Roy Kishor, described in Saturday's Times as a "car industry restructuring expert", put it: "Scrappage is an absolute no-brainer. It addresses the two most fundamental issues facing the car industry today - the first is that it creates demand, getting inventory moving and helping the car companies get back to manufacturing. The second is that it deals with emissions."

Translated from car-industry- lobby-speak that means: "We wanted to find a way to persuade the Government to take your money and hand it over to car companies that can't sell their cars. And because we came up with some environmentally friendly spiel - newer cars cause fewer carbon emissions - they bought it."

But why just the car industry? There are all sorts of companies struggling at the moment to make ends meet. Cars have no greater right to taxpayer support than coffee shops or book publishers. They all create jobs. They all manufacture something. And they are all facing collapsing demand. Forget the nanny state; this is old- fashioned 1970s-style government investment in failing industry, dressed up in 21st-century, market-friendly, cuddly green disguise. British Leyland, you are reborn.

Rather than being forced to hand over an even greater proportion of our income to the Government to spend as it sees fit, can't we be left to decide for ourselves how, and on what, to boost demand?


Another BBC joke that fell flat

We read:
"The bizarre exchange took place during a newspaper review which was broadcast at the end of the ten o'clock bulletin on the BBC News 24 channel. Chris Eakin, a BBC presenter, was commenting on a story about a chimpanzee at the Furuvik Zoo in Sweden who collected stones to throw at visitors.

Eakin then asked viewers: "Can you see any likeness?" before handing back to veteran newsreader George Alagiah. The respected presenter of the BBC's News at Six initially looked a little surprised before attempting to laugh off the comment. Alagiah, 53, who was born in Sri Lanka, changed the topic quickly and continued with the rest of the programme...

However, in the wake of the Carol Thatcher race row, and the comments made by Jonathan Ross and Russell Brand to the actor Andrew Sachs on a Radio 2 broadcast, the corporation has been quick to issue an apology.


Interesting that regular BBC empoyees are quickly forgiven for slurs and abuse uttered on TV but outsiders like Carol Thatcher cannot be forgiven even for things said in private

Scottish independence referendum: "Scottish Liberal Democrat leader Tavish Scott has demanded the Scottish Government ditches its planned independence referendum. Mr Scott told the SNP to drop the `independence panto' and focus on tackling the recession. At the Scottish Lib Dem conference, he branded the SNP government's planned Referendum Bill a waste of cash."

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