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UK DeathCare: NHS Secret Plan to Ration and Deny Healthcare Underway

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« on: July 27, 2010, 10:10:36 am »

Axe falls on NHS services
NHS bosses have drawn up secret plans for sweeping cuts to services,
with restrictions on the most basic treatments for the sick and injured.



The NHS faces extensive cuts  Photo: ALAMY 
 
http://www.telegraph.co.uk/health/7908742/Axe-falls-on-NHS-services.html
By Laura Donnelly, Health Correspondent
Published: 9:19PM BST 24 Jul 2010

Some of the most common operations — including hip replacements and cataract surgery — will be rationed as part of attempts to save billions of pounds, despite government promises that front-line services would be protected.

Patients’ groups have described the measures as “astonishingly brutal”.

An investigation by The Sunday Telegraph has uncovered widespread cuts planned across the NHS, many of which have already been agreed by senior health service officials. They include:

* Restrictions on some of the most basic and common operations, including hip and knee replacements, cataract surgery and orthodontic procedures.

* Plans to cut hundreds of thousands of pounds from budgets for the terminally ill, with dying cancer patients to be told to manage their own symptoms if their condition worsens at evenings or weekends.

* The closure of nursing homes for the elderly.

* A reduction in acute hospital beds, including those for the mentally ill, with targets to discourage GPs from sending patients to hospitals and reduce the number of people using accident and emergency departments.

* Tighter rationing of NHS funding for IVF treatment, and for surgery for obesity.

* Thousands of job losses at NHS hospitals, including 500 staff to go at a trust where cancer patients recently suffered delays in diagnosis and treatment because of staff shortages.

* Cost-cutting programmes in paediatric and maternity services, care of the elderly and services that provide respite breaks to long-term carers.

The Sunday Telegraph found the details of hundreds of cuts buried in obscure appendices to lengthy policy and strategy documents published by trusts. In most cases, local communities appear to be unaware of the plans.

Dr Peter Carter, the head of the Royal College of Nursing, said he was “incredibly worried” about the disclosures.

He urged Andrew Lansley, the Health Secretary, to “get a grip” on the reality of what was going on in the NHS.

The Government has promised to protect the overall budget of the NHS, which will continue to receive above-inflation increases, but said the service must make “efficiency savings” of up to £20 billion by 2014, which would be diverted back to the front line.

Mr Lansley said last month: “This protection for the NHS is protection for patients – to ensure that the sick do not pay for the debt crisis.”

Dr Carter said: “Andrew Lansley keeps saying that the Government will protect the front line from cuts – but the reality appears to be quite the opposite. We are seeing trusts making job cuts even when they have already admitted to being short staffed.

‘‘The statements he makes may be well intentioned – but we would implore him to get a grip on the reality, because these kinds of cuts are incredibly worrying.”

Katherine Murphy, of the Patients Association, said the cuts were “astonishingly brutal” and expressed particular concern at moves to ration operations such as hip and knee operations.

“These are not unusual procedures, this is a really blatant attempt to save money by leaving people in pain,” she said.

“Looking at these kinds of cuts, which trusts have drawn up in such secrecy, it particularly worries me how far they disadvantage the elderly and the vulnerable.

‘‘We cannot return to the days of people waiting in pain for years for a hip operation or having to pay for operations privately.”

She added that it was “incredibly cruel” to draw up savings plans based on denying care to the dying.

On Thursday, the board of Sutton and Merton primary care trust (PCT) in London agreed more than £50 million of savings in two years. The plan included more than £400,000 to be saved by “reducing length of stay” in hospital for the terminally ill.

As well as sending more patients home to die, the paper said the savings would be made by admitting fewer terminally ill cancer patients to hospital because they were struggling to cope with symptoms such as pain. Instead, more patients would be given advice on “self management” of their condition.

Bill Gillespie, the trust’s chief executive, said patients would stay at home, or be discharged from hospital only if that was their choice, and would be given support in their homes.

This week, Hertfordshire PCT plans to discuss attempts to reduce spending by rationing more than 50 common procedures, including hip and knee replacements, cataract surgery and orthodontic treatment.

Doctors across the county have already been told that their patients can have the operations only if they are given “prior approval” by the PCT, with each authorisation made on a “case by case” basis.

Elsewhere, new restrictions have been introduced to limit funding of IVF.

While many infertile couples living in Yorkshire had previously been allowed two cycles of treatment — still short of national guidance to fund three cycles — all the primary care trusts in the county are now restricting treatment to one cycle per couple.

A “turnaround” plan drawn up by Peterborough PCT intends to make almost £100 million of savings by 2013.

Its cuts include closing nursing and residential homes and services for the mentally ill, sending 500 fewer patients to hospital each month, and cutting £17 million from acute and accident and emergency services.

Two weeks ago, Mid Yorkshire Hospitals trust agreed plans to save £55 million in two years, with £20 million coming from about 500 job losses.

Yet, a month before the decision was taken, senior managers at a board meeting described how staff shortages were already causing delays for patients being diagnosed and treated for breast cancer.

Mr Lansley said any trusts that interpreted the Government’s demands for efficiency savings as budget or service cuts were wrong to do so, and were “living in the past”.


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« Reply #1 on: July 27, 2010, 11:32:46 am »


What is the N.I.C.E.? In England today N.I.C.E., the National Institute for Health and Clinical Excellence, is "an independent organization responsible for providing national guidance on promoting good health and preventing and treating ill health" (www.nice.org.uk). This organization was established in 1999 and is part of England's healthcare rationing program to British citizens. Although England provides a "free" healthcare system, government officials are able to rule against citizens that are not worthy of certain kinds of healthcare, if the government so desires.

The N.I.C.E. deems who is worthy of treatment and what kind of treatment is cost-efficient (as is the case of Mr. Hardy, please see "What Price Life?" article below). The N.I.C.E. holds in its hands the power to choose who gets treatment and who doesn't, in essence, who lives and who dies.

Similarly, in a science fiction novel authored by C.S. Lewis in 1944 called That Hideous Strength, Lewis writes of a technocracy that has taken over England through an agency ironically called the N.I.C.E, the National Institute of Co-ordinated Experiments. He writes that "the N.I.C.E. was the first-fruits of that constructive fusion between the state and the laboratory on which so many people base their hopes of a better world" (That Hideous Strength, p. 23). Unknown to many people in the story, the N.I.C.E.'s goal was to take over people's liberties and the entire state through the use of science and research in order to implement a totalitarian government that would rid itself of social and medical problems.

One character remarks in regard to the N.I.C.E., "If Science is really given a free hand it can now take over the human race and re-condition it: make man a really efficient animal"(T.H.S., p. 41). The N.I.C.E.'s sought to weed out the fit men from the unfit. Another character from the book states that, "The powers of science are an instrument. An irresistible instrument as all of us in the N.I.C.E. know...An instrument of judgment and of healing" (T.H.S., p.79).

Lewis wrote of a time that would come when an agency, the N.I.C.E., would gain control and run through any "red tape" constraints (p.102), in order to hold in its hands the power to choose who would live and who should die.

Lewis subtitled his book, “A fairy tale for grown-ups”. Unfortunately it is becoming a true story in England today.


Don't take our word for it. Read the articles below for additional information on England's N.I.C.E.:

As Nice and the UK Go, So does the Globe in Evaluating Drugs

What Price Life?

British Balance Benefit vs. Cost of Latest Drugs

Not So Nice

A Demented Idea: Human Dignity on the Sceptred Isle System

Wheel of Death: Deciding Who will Live or Die

That Hideous Strength, by C.S. Lewis

More information on universal health care in America
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« Reply #2 on: November 28, 2010, 09:11:14 am »

Councils stop elderly from getting help
27 November 2010
, by Emma Simon (The Telegraph)
http://www.telegraph.co.uk/finance/personalfinance/insurance/longtermcare/8161457/Councils-stop-elderly-from-getting-help.html

Excerpt:

Thousands of elderly people are paying nursing home fees that should be covered by the NHS.

Solicitor Daniella Lipszyc of Ultimate Law said she had dealt with a number of cases where those needing nursing care had been wrongly assessed by their local authority and, as a result, had paid thousands of pounds in fees that should have been paid by the Government.

She said: "I first came across this problem when a member of my own family needed care. But this problem appears to be far more widespread and I have since taken on a number of cases in a professional capacity."

This has involved challenging funding decisions made by local authorities as well as pursuing cases with the Health Service Ombudsman and the courts to seek redress for those mis-assessed.
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« Reply #3 on: December 22, 2010, 05:32:26 pm »

Patients denied treatment as NHS makes cutbacks, Telegraph can disclose

Hundreds of thousands of NHS patients are being denied routine procedures as dozens of trusts cut back on surgery, scans and other treatments in order to save money, a Daily Telegraph investigation has found.

http://www.telegraph.co.uk/health/healthnews/8208958/Patients-denied-treatment-as-NHS-makes-cutbacks-Telegraph-can-disclose.html

By Rebecca Smith, Medical Editor Jasmine Malone 11:30PM GMT 17 Dec 2010

Trusts around the country are refusing to pay for operations ranging from hip replacements, to cataract removal and wisdom tooth extraction.

The health service is also tightening restrictions that prevent patients undergoing procedures for lifestyle reasons.

Smokers and obese patients are being denied operations until they change their habits and trusts are delaying surgery and non-emergency treatments, the Telegraph has found in the most comprehensive snapshot of NHS cuts yet.

The cuts - which include the cancelling of MRI scans and x-rays - are taking place in defiance of the Coalition.

Ministers are determined that front line services should be protected and the savings needed can be found from management costs and efficiencies.

But there is growing evidence that NHS managers are sacrificing patient care instead.

Doctors and nurses said the 'grim' results undermine the 'myth' that front line services are being protected and warned they were just the 'tip of the iceberg'.

The situation is predicted to get worse as the NHS struggles to save £20bn over the next four years.

Although ministers have pledged to protect the health service budget and provide a real terms increase, it will not be sufficient to keep pace with growing demand and increasing costs.

In addition from April next year the amount of money hospitals receive for each type of treatment will be cut by 1.5 per cent raising fears that managers will refuse to provide treatments that they make a loss on.

As part of the investigation, The Telegraph had responses from almost one in three primary care trusts.

Cuts were uncovered in 20 out of the 145 primary care trusts in England. Fifteen PCTs have said they are not cutting services and 11 were still undecided.

Fertility treatment is the area most commonly being cut or rationed with some like NHS Surrey stopping all referrals, while others like NHS South West Essex is saying only patients who have had cancer can receive funding.

NHS Portsmouth will not allow patient classed as overweight to have routine hip or knee replacements where as before they only said the obese could be refused and NHS West Kent are forcing smokers to go on quitting courses before they can join waiting lists for operations.

NHS Warwickshire is cutting 'low priority' treatments which include injections for back pain and any orthopaedic surgery must be first cleared by managers.

The NHS in Greater Manchester and Oldham are refusing surgery for mild varicose veins and strict criteria must be met before removal of warts or tonsils will be considered.

In nearby Warrington GPs have been asked to delay all non-urgent operations and treatments for eight weeks.

Katherine Murphy, chief executive, said: "I am really very concerned about trusts cutting back on diagnostics. What is the diagnosis comes too late? You cannot put a cost on someone's life.

"We have had lots of letters and emails from patients about this rationing and a senior clinician has contacted us to say pain management services in their area has been cancelled.

"This is just not the way for a patient centred NHS to operate."

Dr Mark Porter, Chairman of the British Medical Association’s Consultants Committee, said: “Each of these examples undermines the myth that the NHS has been protected from the financial crisis. These are all services that patients value.

"They are by and large not being axed for clinical reasons, but as an inevitable consequence of the massive cost savings that have been imposed on the NHS.

“Despite the continuing claims of real terms increases for the NHS, the reality on the ground is very different. The scale of the financial challenge facing the service is such that this is likely to be the tip of the iceberg.

“While further cuts are inevitable, it is crucial that clinicians are allowed to feed into the process, and put forward ideas for improving efficiency that do not undermine quality or harm patients.”

David Stout, director of the NHS Confederation’s PCT Network, said: “Primary care trusts (PCTs) have the difficult job of putting in place the right health services to meet the needs of their local population while operating within a fixed budget. This inevitably involves deciding priorities.

“Those PCTs facing financial pressures have to put in place measures to reduce access to some services where they have found no alternative ways of reducing expenditure. None of these decisions will be taken lightly and it is important that any decision about funding of services are openly communicated and consulted on with patients, staff and local communities.

“Management costs are a relatively small proportion of overall health service spend and the NHS compares favourably with most health care systems across the world. Nevertheless PCTs are all reducing management costs in line with Government policy. In the short-term however this affects PCTs budgets as a result of redundancy costs.”

Royal College of Nursing Chief Executive & General Secretary, Dr Peter Carter, said savings made should be invested in front line care but there was 'no evidence of this'.

He said:“These grim findings are further evidence that there is a huge gulf between the Government’s promise to protect the front line and what is actually happening on the ground.

"Some trusts are making short term decisions to plug the holes in their budgets and instead of protecting patient care, are cutting jobs and services at an increasingly alarming rate. We have already identified 27,000 posts are earmarked to be cut across the UK.

"Trusts need to take a long term strategic approach to improving care and services rather than shedding jobs by stealth and limiting and closing important services."

A Department of Health spokesman said: "The NHS must cut back on bureaucracy, not on front line care.

"We have been very clear that NHS organisations should not interpret efficiency savings as budget and service cuts. Every penny saved from efficiency savings - including a 45 per cent reduction in management costs – needs to be invested back in to patient care.

"We would expect the NHS to make decisions locally based on the clinical needs of their patients and with regard to the need to make the most efficient use of funding.

"No one should experience undue delay at any stage of their treatment.

"We are making more and more information available to patients so that they can vote with their feet and choose the service that delivers for them."

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« Reply #4 on: December 22, 2010, 05:53:50 pm »

Smokers and fat patients thrown off NHS waiting lists

Smokers and overweight patients in need of major operations could be thrown off hospital waiting lists under "desperate" cost-cutting plans.

http://www.telegraph.co.uk/health/healthnews/8211626/Smokers-and-fat-patients-thrown-off-NHS-waiting-lists.html

By Laura Donnelly, Health Correspondent 9:00PM GMT 18 Dec 2010

Patients' groups described the tactics as an "appalling scam" to enable NHS bosses to claim waiting times are far shorter than they are, simply by denying a place in the queue to many of those referred for surgery.

Under the plans drawn up by NHS bureaucrats in Kent, any smoker referred for "non-urgent" operations – such as hip replacements or cataract surgery – will not be allowed to join the queue until they have either given up smoking, or completed a 12-week course to help them ditch the habit.

Those who are seriously overweight will also be denied a range of operations until they have completed a three-month NHS diet programme.

Although every patient has a legal right to be treated in 18 weeks of being referred for treatment by their GP, the protocols agreed mean different rules could be applied for anyone with a body mass index of more than 30, or those who smoke.

Patients groups said delays getting a place on 12-week "smoking cessation" and "weight loss" programmes could leave many patients waiting even longer than 30 weeks implied by proposals drawn up by NHS West Kent Primary Care Trust (PCT).

Katherine Murphy, from the Patients Association, said: "This is an appalling kind of scam – it is a clear device to manipulate the waiting lists simply to cut their deficit. It smacks of desperation, and it is patients who will suffer."

The plans, seen by The Sunday Telegraph, explicitly say the rules have been introduced to save money by the end of the year.

The document says: "PCTs across the country are making decisions on prioritising treatments in order to match demand to the financial resources available to the economy as a whole and to individual trusts.

"Unfortunately this does not take us far enough: we need to take additional activity to reduce activity in this financial year if we are to be in a position to hand over a balanced budget."

Under the proposals, smokers already on waiting lists will now be taken off until they have either been on the courses or given up smoking.

New referrals will not be allowed on the lists until they have done the same.

All patients with a BMI of 30 or more who are referred for several types of surgery including hip and knee operations will also be cast off the lists until they have been on a three-month diet programme.

Many primary care trusts already try to encourage patients to stop smoking or lose weight before operations, in order to reduce the risks to them.

But patients' groups said the use of tactics to delay even putting patients on the waiting lists was a far more draconian step.

Mrs Murphy said: "This is a clear way to keep these patients off the lists in order to cut costs, while the PCT can officially claim its waiting times have not lengthened."

Simon Clark, director of the smokers' lobby group Forest, accused the PCT of discriminating against smokers and creating a "two-tier" system.

He said: "Of course patients should be told that smoking could have an impact on the success or recovery from an operation, but given that they have paid huge sums in taxation on cigarettes over the years, the question of whether or not they have the surgery should be one for them, not the NHS."

A letter sent out by the PCT tells local GPs: "There is good evidence that stopping smoking prior to surgery reduces length of stay and infection rates, and improves healing time; it is also a time when people are often highly motivated to give up."

Kent doctors accused managers of being dishonest about the real reasons why patients were having their treatment delayed.

Dr Stephen Meech, a GP from Maidstone, said: "Patients are going to be told that they cannot have an operation because they smoke or need to lose weight, when that is not actually true – it is because the health authority can't afford to pay for it."

Dr John Allingham, a GP from Hawkinge, said: "The plan is extremely contentious and it is a way of extending the waiting times.

"If you've got to do a 12-week smoking cessation course before you can have your hernia fixed, or before you've even gone on the waiting list to have your hernia fixed, it immediately makes those waiting lists another 12 weeks longer."

The PCT said it was in talks with local doctors over the proposals. Marion Dinwoodie, its chief executive, said she regretted the need "to take measures in the short term that may have an impact on local people".

She said no one with a compelling clinical need for treatment this year would miss out.

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« Reply #5 on: December 22, 2010, 05:58:16 pm »

Patients denied hip surgery and fertility treatment amid NHS cash crisis

NHS trusts are delaying major operations and refusing to fund fertility treatment amid a spiralling financial crisis.

http://www.telegraph.co.uk/health/healthnews/8181390/Patients-denied-hip-surgery-and-fertility-treatment-amid-NHS-cash-crisis.html

By Laura Donnelly, Health Correspondent 9:45AM GMT 04 Dec 2010

Primary care trusts (PCTs) across the country have just brought in restrictions on dozens of procedures, in an attempt to cut costs or delay paying bills.

Across swathes of the country, patients waiting for the most common types of surgery, including hip and knee replacements, and cataract operations, will now be forced to wait months longer for treatment.

Patients' groups described the decisions as "desperate", warning that thousands of people, especially the elderly, will be left to suffer in pain this winter as their conditions deteriorate.

Katherine Murphy, from the Patients Association, said: "The scale of this is appalling; these decisions will absolutely ruin the quality of life for people. We cannot go back to the days of people waiting months and months for help they desperately need."

NHS trusts are planning to make £20 billion in savings by 2014 so that money can be reallocated to cope with an ageing population, while there is limited increase in overall health funding.

Board papers from across the health service show that many PCTs are already facing an immediate cash crisis, with at least 15 recently taking decisions not to fund basic treatments, or delay procedures so that costs can be pushed into next financial year starting in April.

Most of the decisions were taken at board meetings in the last two months, meaning that their impact will be felt in the weeks and months ahead.

Since September, at least nine PCTs have put an immediate bar on requests for IVF, despite national guidance which says infertile women aged between 23 and 39 should be offered three cycles of the treatment.

The cuts include:

* In Warwickshire, all routine hip, knee and shoulder operations will be delayed until April, along with all referrals of patients with back pain, those needing orthodontics procedures and some cataract patients.

* NHS Eastern and Coastal Kent will extend the average waiting time for "non-urgent operations" – including hip, knee and cataract surgery – by three weeks, to four months.

* Warrington has suspended all IVF treatment until July, while two trusts, South West Essex and West Kent - will delay treatment until April.

* NHS Surrey and NHS Stockport will continue to help existing IVF patients but will fund no new applications for almost a year, while NHS Warwickshire and NHS North Yorkshire and York will fund no new cases until April. NHS Bury has suspended new requests indefinitely.

* Patients in Wiltshire will face an extra five-week wait for routine operations, bringing waiting times to more than four months.

* On Tuesday, Sheffield PCT will discuss plans to delay requests for non-urgent orthopaedic, dermatology and orthodontic treatment until April.

* GPs in Warrington have been asked delay all referrals for non-urgent surgery for two months. The local hospital said it would mean some patients waiting more than four months in total.

Mrs Murphy said that in the past week the Patients Association had been contacted by several elderly people who had been told that their hip operations had been cancelled, with no new date provided, while others were facing long delays to see a specialist at a pain management clinics.

She said: "We are really worried about this, the decisions being made are simply not acceptable. For years, the NHS has wasted money paying managers overinflated salaries.

"Now times are getting tight, and its not the bureaucrats who suffer, but the most vulnerable groups of patients."

The charity expressed concern that the new cuts were "just the start" and that problems would worsen.

Susan Seenan, from patient organisation the Infertility Network, expressed fury about the number of organisations which had decided to cut costs by refusing to help those suffering from fertility problems.

She said: "We feel very angry and really disappointed. Infertility is an illness, people who cannot have children have no choice over the matter, and IVF is a clinically effective treatment.

"They deserve medical treatment the same way anyone suffering from any other illness does."

Other trusts have changed the rules to reduce the number of patients who are allowed surgery, according to the Health Service Journal.

In Surrey, managers are drawing up plans to refuse operations for patients who smoke until they have undergone a "stop smoking" course.

In Portsmouth, severely obese patients will be told they can only have knee and hip operations if they lose weight first. Several PCTs say they will fund no more weight-loss surgery.

Nigel Edwards, head of the NHS Confederation, which represents PCTs and hospitals, said delaying treatments would not help organisations to solve their financial problems, but "simply delay the evil day" when the bills had to be paid.

A spokesman for the Department of Health said: "We have been very clear that NHS organisations should not interpret efficiency savings as budget and service cuts.

"We would expect the NHS to make decisions locally, based on the clinical needs of their patients and with regard to the need to make the most efficient use of funding. No one should experience undue delay at any stage of their treatment."
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