Pressure building over NHS plans

AppId is over the quota
AppId is over the quota
24 January 2012 Last updated at 10:23 GMT By Nick Triggle Health correspondent, BBC News The health bill is working its way through Parliament Pressure is building on ministers over the NHS reforms in England after a critical report by MPs has added to the mounting concerns.

The health select committee report said the overhaul was hindering the ability of the NHS to make the savings it needs to safeguard its future.

It comes ahead of a meeting this week of medical leaders about the plans.

Health Secretary Andrew Lansley has again defended the reforms, saying they were "essential" for improving the NHS.

The report by MPs, which was leaked over the weekend, did not specifically look at the changes.

Instead, it was focused on how the health service was doing in meeting its savings target.

While the health budget is being protected, it has still been told to save £20bn by 2015 through improving productivity to keep pace with the rising demands linked to the ageing population and lifestyle factors, such as obesity.

'Disruption and distraction'

The MPs said there were strong concerns about the ability of the NHS to make the savings - the equivalent of 4% a year.

It said there had been too much emphasis so far on short-term cuts and "salami-slicing", instead of rethinking the way care is delivered.

And it argued there needed to be more integration with social care to stop people needing hospital treatment, which tends to be more expensive.

But it warned that in some ways the opposite was happening as councils were increasingly restricting access to services.

On the reforms, it concluded they were "complicating" the savings process because they were acting as a "disruption and distraction".

The committee is chaired by Conservative former health secretary Stephen Dorrell, who said every comment about the NHS tended at the moment to be framed by the debate about the bill.

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There is a growing sense that the critics of the NHS reforms are scenting blood.

Last year's pause had taken the sting out of the attacks and the bill was well on its way through Parliament when 2011 came to a close.

But there is now a feeling among those who have been expressing concerns about the changes that the momentum is again gathering behind them.

The decision last week by the midwives and nurses to move to "outright opposition" attracted attention - as has this report by MPs.

Ministers accused the unions of being motivated by the row over pensions.

But later this week a host of health bodies are meeting to discuss the reforms.

The majority of them are professional bodies that are focused on standards. So if they come out with a strong rejection of the plans it will get even more difficult for ministers.

Attention will then turn to the Lib Dems and whether their MPs will block the bill when it returns to the Commons.

There are no signs of that happening at the moment, but serious questions will start to be asked.

He said the need to achieve efficiency savings in the NHS was paramount, and that the bill must come second.

"The priority is to deliver more efficient care, in order to meet demands placed upon the system - and the implementation of the bill has to fit in around that," he said.

The findings have prompted critics to renew their attacks.

Last week the Royal College of Midwives and Royal College of Nursing said the bill underpinning the changes should be scrapped - joining the British Medical Association in moving to outright opposition.

Rachael Maskell, of the Unite union, said the report should be the "final nail in the coffin" for the bill.

And BMA chairman Dr Hamish Meldrum said the plans will prove harmful to patients.

"The health select committee say it's distracting - we would say it's completely unnecessary and somewhat dangerous.

"As the Health Select Committee say, it's taking everybody's mind off the real issues, which is trying to run an efficient health service, trying to make changes to the health service for the benefit of patients, and, at the same time, trying to identify savings."

Peter Carter, general secretary of the Royal College of Nursing, said the plans will pose a threat to patient safety and the future of the NHS itself.

"We completely concur that money has to be saved. We've never disputed that, it's the way they're going about it."

'Uncertainty'

Concerns were also expressed outside of the union movement.

Professor John Appleby, chief economist of the King's Fund think tank, said: "The report should serve as a wake-up call for ministers and the NHS about the magnitude of the task ahead."

And Mike Farrar, of the NHS Confederation, which represents NHS managers, agreed.

He said there was a lot of "uncertainty" in the NHS at the moment that was dangerous.

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The legislation's not completed its passage, the Lords are making many significant and constructive suggestions, and we will take those on-board, but the principles of the bill are widely supported”

End Quote Andrew Lansley Health Secretary "The NHS faces a once-in-a-generation financial challenge that is still to be explained properly to the public," he added.

Attention will now turn to the meeting on Thursday when the Academy of Medical Royal Colleges, an umbrella group of 20 organisations, and unions will discuss what to do about the plans.

The bill is still working its way through Parliament and at the weekend Deputy Prime Minister Nick Clegg said the planned reforms must go ahead, despite the fresh criticism from MPs.

A number of major structural changes have already taken place within the health service and senior staff have started to be recruited to head up the new organisations.

Enough GPs have also come forward to set up the new management groups to cover 97% of the country.

Mr Lansley said the government's plans for modernisation were "essential if we are to put the NHS on a sustainable footing for the future".

He told the BBC: "We have to deliver more care in the right place at the right time. That means more care in the community.

"There's been support for the principles of what we're doing, including from many of the leading professional organisations.

"The legislation's not completed its passage, the Lords are making many significant and constructive suggestions, and we will take those on-board, but the principles of the bill are widely supported."

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HEALTH MANAGEMENT. Study casts a wider net for risky blood pressure in children

NEW YORK (Reuters Health) - could more children than previously assumed his risk of dangerously high blood pressure, with more than a quarter with blood vessels, which look like the much older, according to a new study.
Since there is a theoretical possibility that some of these children, a stroke or a heart attack, which might suffer down road, say the researchers, that the results mean that all children should their blood pressure measured.
"I believe it is important that everyone for high blood pressure, is shown," said Dr. Karen Redwine Arkansas Childrens Hospital in little rock, which the results in the journal of Pediatrics are displayed.
"The overall rate for the development of high blood pressure, if you are a teenager is still very low," added to them, in an interview with Reuters Health. "But it is a subset of people, the development of high blood pressure somewhere between two and five times, that is, and many of those are children, now normally would apply."
These children have slightly increased blood pressure and diagnosed with so-called "Prehypertension." The label is disputed, however, because no disease to describe it - it is a risk factor for the development of later high blood pressure, which itself is a risk factor for heart disease.
An expert, who said not part of the new study he worried it could be used, to push drugs without evidence, that they do something good children.
"What me a little worried is that they are talking about the pharmacologic therapy,", said Dr. Curt D. Furberg, expert on heart disease prevention and drug safety at Wake Forest Baptist Medical Center in Winston-Salem, North Carolina.
"If I me the author list, it is one of the Bristol-Myers Squibb," he added. "Pharmaceutical companies want to increase their market." "In this area sense not taking into account the healthy young children for pharmacological therapy."
The national heart, lung and Blood Institute in 2004 defined Prehypertension in children as a top blood pressure number between 120 and 139 or a lower number between 80 and 89. high blood pressure starts at 140 over 90.
If changes of lifestyle such as cutting down on salt and exercise sufficient to control high blood pressure in children, NHLBI advises drugs to try.
In adults the ups hypertension of the risk of stroke and heart attack a few percent. However, for children, the NHLBI recognizes that the long-term effects unknown are with high blood pressure for children, as are the side effects of drug treatment.
"In my mind, there are many more pressing issues in medicine as a screening for hypertension among young people, where we don't even know if treatment is useful," Furberg, Professor of public health, told Reuters Health.
The new study is an attempt, estimate how often children with Prehypertension further to develop full-blown high blood pressure or hypertension.
Development of data from a large test study - sponsored by pharmaceutical companies-at Texas schools, found Redwine and colleagues, that 11 of 1,006 students developed high blood pressure during the study.
This corresponds to a rate of 1 in 200 young people each year. Although the rate for children with Prehypertension appeared similar, a broader definition tripled created by Redwine and her colleagues nearly the rate.
After only a blood pressure higher than normal group a child in the "at risk" would set the new definition.
Until now, Redwine, explains to doctors think that a high blood pressure measurement only a Zufall--could be because the child nervously or somewhat ill was used.
Now, said she, "when it is raised only once, then you must observe and monitor it."
Currently, not the NHLBI recommend drug therapy for children with Prehypertension. But the new report suggests the investigating of the use of drugs in the "endangered."
According to the Texas screening study could that be, more than 26 percent of U.S. teenagers with the new definition-including healthy children who are not overweight.
Furberg and other critics is Prehypertension--not to mention the extended definition in the new students-a concept that comes with over slide diagnosis, over treatment and wasteful expenditure.
He said "That's what the industry is trying to do, to get people to drugs,". "they insist that for adults, and now they seem to children, which is tedious."
Redwine neutralized, although their co-authors at Bristol-Myers Squibb is busy, not drug use in children with Prehypertension are in favour of her report.
"It is not the point to say that they have to be," said Reuters Health.
The US preventive services task force, a State-sponsored group of Experts recommends screening adults for high blood pressure. It is currently the guidelines 2003 updated for children and young people, who pointed out that the evidence is not sufficient to weigh the harm and the benefits of screening children.

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