Hopes that hospitals in England could be banned from charging patients for parking are likely to be dashed.
The previous Labour government began a consultation last year on how to implement a pledge by then health secretary Andy Burnham to scrap charges within three years.
But the Tory-Lib Dem coalition indicated this week it was likely to leave the decision in the hands of individual NHS trusts.
Read more at The Independent.
I’m at a loss to understand how the NHS is going to meet rising demand.
Despite all the talk of efficiency and productivity, it’s going to be a tall order - and practically impossible if we want it to stick to its founding principles.
Several recent stories convince me of this. Hard evidence on demand comes in the form of a recent study by the Nuffield Trust which points to a “unsustainable” rise in emergency hospital admissions. There’s been an almost 12% rise in admissions over the last five years, costing the NHS an additional £330 million per year.
The government’s announcement that it’s disbanding NHS Direct, the 24-hour advice line, isn’t going to help. I’m no expert on primary care, but it appeared a useful service that helped take the heat off A&E and GPs.
If you believe the Save NHS Direct Campaign (with it being led by John Prescott, maybe you won’t) then the phone line fields 27,000 calls a day, or 9.5m a year. It’s staffed by 1,400 nurses, provides evidence-based information on its website and scores well on customer satisfaction.
Replacing it with a cheaper service, with fewer health professionals involved, is unlikely to help with demand.
Department of Health figures released this week suggest that GP referrals to secondary care are accelerating once more. Data on outpatient referrals and attendances show the number of GP referrals made from April to June this year increased by 169,000 to 3 million.
Referrals can be clamped down upon temporarily during times of financial crisis, but not when facing inexorable pressure.
It strikes me that there are parallels with global warming (largely because I’ve just ploughed through a weighty tome on the subject to assuage my guilt over reading Stieg Larsson on holiday).
There are loads of things we could do to help with the long-term sustainability of our health system. We should improve our approach to public health, deliver more preventative services, and so on. But, much like reducing our carbon emissions, it’s going to take too long. The NHS is going to be bankrupt long before then.
We have to do something now to deter the ‘time wasters’ from entering the system, and the only way to do this is to put a value on an NHS appointment. We need a simple system of charging for appointments. The usual groups would be exempted from charges and treatment would still be free (I’d even scrap the anomalous prescription charges system).
Jumping back to my rather spurious comparison with global warming, it’s the equivalent of investing in a quick technological fix rather than obsessing about the long game. My personal favourite is to mimic a volcano and pump some sulphur dioxide into the stratosphere to enact some global cooling.
It’s not something you want to do - and there’s always a risk of unintended consequences - but a dramatic approach like this is increasingly necessary, even if it compromises a few principles.
I was at work in my Spanish A&E department on Wednesday during a World Cup football match. The department was empty for several hours and the waiting area totally deserted.
On any other day, having a quiet department is a blessing and it doesn’t happen very often at all, but on Wednesday it bothered me. It is an international thing that A&E departments all over the world become quiet during important sport events and particularly with football. This can only have a reading to it; for many patients A&E is a place of convenience and not a place for real emergencies.
What sort of emergencies are those that stop being such emergencies if there is a good match on? Anything that can wait for the final whistle of a sport involving some men in shorts kicking a ball around is most definitively not urgent. It might be time to redefine what is appropriate for an ED: “All those mental or physical pathologies of recent importance that cannot wait till the end of a football match, even if it is the World Cup”
I guess it is obvious that I am not fond of football but really it’s the footballers I dislike and even more nowadays. The economic crisis has hit Spain so hard that some professionals, like us doctors, are having our salaries decreased by a minimum of 5%. In the meantime, the ball-kickers are protected by a law which keeps them as low tax payers and, even worse, if they win the World Cup they get a massive bonus.
Isn’t winning the World Cup or even just being in the national team enough reward? Shouldn’t I get an extra payment every time I treat a fracture, reduce a dislocation or diagnose an acute abdomen? Should these guys being rewarded for doing their job well? Outrageous.
There is a lot of talk about getting the patients to pay part of their treatment in Spain at the moment. The government has denied it categorically which of course is always the best indicator that they are about to promote it (yes, I am a cynic). I am all for a free national health system but surely there should be some sort of penalty for those patients who make inappropriate use of key services like A&E.
And that gives me another idea just as I write: our international footballers should be financially penalised when they lose a match, too. The carrot is clearly not working for us so maybe the stick will.
I tend only to read The Sun newspaper at my local Chinese takeaway waiting for the arrival of what I hope to be a chicken curry and boiled rice. I say ‘hope’ because I am never quite sure about the chicken, but it has done me no harm up to now.
The newspaper not only adorns the waiting room of the takeaway but thanks to the most amazing publicity is now itself on the front page of just about every newspaper in the country - and also lies torn to shreds on the Labour Party Conference floor.
I hate the political conference season, and particularly the sound-bites that promise so much but on examination tell us little about ‘the future that is to come’ or the ‘new initiatives’ that are to be introduced. How can initiatives be anything other than new I keep asking myself - until that is one examines the small print a bit more carefully.
The ending of car parking charges for in-patients may sound attractive (although why the deserving outpatient should be discriminated against defeats me). But this government policy initiative will not be binding on foundation trusts. In a couple of years or so the government plans are that all NHS trusts will be foundation anyway so the poor patient may not see much benefit.
A National Care Service has surely to be welcomed - but where the money is to come from, how it will work, who will benefit and by how much, remains as much a mystery as the ‘chicken’ in my curry.
But there is one thing on which I entirely agree with the Prime Minister and it is that newspapers should not promulgate propaganda. I just wish the same mantra applied to politicians. If what happens in Blackpool, Brighton or Bournemouth is not propaganda then I don’t know what is.
So let’s have a new pact between politicians and the national media. Politicians stop the propaganda - media stop publishing it; and only then will it matter not what I read in the takeaway or use to wrap my fish and chips.
Health secretary Andy Burnham told Labour’s party conference in Brighton that he wanted to introduce parking permits instead of charges to allow friends and relatives of patients to visit for free.
He said the last thing people visiting hospital wanted to worry about was keeping the car parking ticket up to date.
“For families of the sickest patients, the costs can really rack up. It’s not right if some people don’t get visitors every day because families can’t afford the parking fees.”
He said the change could not be brought about overnight.
But to cheers and applause from delegates, he added: “Over the next three years, as we can afford it, I want to phase out car parking charges for in-patients, giving each a permit for the length of their stay, which family and friends can use.”
Read more at The Telegraph.
The use of premium phone rates for people contacting the NHS in England is to be banned, the government has said.
It comes after 3,000 people responded to a public consultation about the use of 084 numbers in the NHS, and 90% said calls should be charged at local rates.
The 084 numbers will not be banned but calls to hospitals or GP surgeries must cost no more than a standard call. Doctors’ leaders welcomed the change, saying patients should not be penalised because they are ill.
However, the ban would not apply to the cost of making phone calls from hospital beds, an NHS spokesperson said.
Read more at BBC Health.
Some hospitals are making profits of more than a million pounds a year from patients, visitors and staff using their car parks.
A new report reveals the profit margins made from car park fees at 23 of England’s busiest trusts, over three years.
The trusts were asked how much they spend on running parking facilities, what they charge for four-hour parking and how much they make from patients, visitors and staff using their car parks.
In 2008/09, profit margins ranged from just 3% (£31,385) at Gloucestershire Hospitals to 534% (£1,070,476) at Norfolk & Norwich University Hospital.
Four-hour fees also differed, with the cheapest and most expensive trusts actually making a loss: from £1.10 at Newcastle-upon-Tyne Hospitals (£253,981 - a 9% loss) to £5 at Hull & East Yorkshire Hospitals (£335,643 - a 26% loss) for the same period.
Trusts aren’t supposed to run parking at a loss - to stop it being subsidised by money intended for healthcare. Charging also aims to encourage public transport use and to keep out non-hospital users, the report by Which? magazine claimed.
A spokesperson from Norfolk & Norwich said that it hadn’t increased charges in the past five years and that revenue goes into improving patient care. Others explained that income funded the upkeep and security of car parks, with any remainder supporting patient care.
Claire Lilley, Which? health policy adviser, said: “The NHS principle is that healthcare is funded through taxation not by patients paying for ancillary services. Our research shows high charges don’t always result in high profits but, where they do, these charges should be reduced.”
Car park balance sheet of 23 trusts 2008/2009: profit/loss
Leeds Teaching Hospitals -25%
Hull and East Yorkshire Hospitals -12%
Newcastle upon Tyne Hospitals -9%
University Hospitals of Leicester -9%
Pennine Acute Hospitals -8%
Lancashire Teaching Hospitals -1%
Gloucestershire Hospitals 3%
North Bristol 12%
Derby Hospitals 16%
Sandwell & West Birmingham Hospitals 26%
Nottingham University Hospitals 63%
Sheffield Teaching Hospitals 106%
Mid Yorkshire Hospitals 112%
East Kent Hospitals 175%
Southampton University Hospitals 342%
Norfolk & Norwich University Hospital 534%
Oxford Radcliffe Hospitals Not available
United Lincolnshire Hospitals Not available
Portsmouth Hospitals Not available
University Hospital of North Staffordshire Not available
United Bristol Hospitals Not available
East Lancashire Hospitals Not available
South Tees Not available
