Awake Sedation for Brain Surgery May Shorten Hospital Stay

Published works/trials of interest
Post Reply
User avatar
Registered User
Posts: 18130
Joined: Mon Mar 10, 2008 4:03 pm
Location: Australia

Post by kenobewan » Thu Jul 21, 2011 5:24 am

Hospital combines diverse services for cancer patients

The Swedish Cancer Institute at Swedish/Issaquah is a one-stop shop for all things cancer related.

Patients will find doctors, surgeons, radiation, chemotherapy and magnetic oncology, not to mention naturopathic medicine, stores, social workers, clinical research and a resource library.

The institute is partnering with the American Cancer Society and providing a part-time navigator who can connect patients and families with support groups and other resources. The Be Well and Perfect Fit stores will sell prosthetics, wigs and other items a cancer patient might need.

Though the Swedish Cancer Institute has operated in the Seattle area for almost 80 years, the Swedish/Issaquah location opened July 14 and doctors are now seeing patients.

With three radiation oncologists, three medical oncologists and a nurse practitioner working there full time, the institute is able to treat all types of cancer. Some specialists will be onsite part time, at least for now, helping patients treat disease with state-of-the-art equipment, including linear accelerator radiation therapy, an instrument that shoots hundreds of tiny lasers at a focused point, destroying a malignancy but not the surrounding cells.

Some specialists include physicians for breast, lung, colon and rectal cancers, naturopathic medical doctors and genetic counselors.

Doctor says focus should be on lung cancer screening

One specialist, Ralph Aye, a thoracic surgeon at the institute, cares for patients experiencing cancer in their lungs, chest cavities, esophagus or stomachs.

These days, screening for lung cancer is a hot topic for thoracic surgeons. Aye is one of the doctors at Swedish participating in a clinical study called the International Early Lung Cancer Action Project, or I-ELCAP.

It’s about time lung cancer got more attention, Aye said. It kills 160,000 people per year, claiming more lives than breast, colon and prostate cancer combined, according to the I-ELCAP website. And, it’s significantly less funded in terms of research and support, Aye said.

The statistics are not encouraging. Today, 85 percent of people diagnosed with lung cancer in the United State will die within five years, according to the website.

“If you have 100 people diagnosed, five years from now only 15 will be alive,” Aye said.

In conjunction with the study, doctors such as Aye screen at-risk patients yearly for lung cancer using a CT scan.

CT scans are more sensitive than X-rays when it comes to detecting lung cancer, and the screening exposes patients to less radiation than a normal CT scan, he said.

The study is already showing positive results. Instead of 85 percent of people dying within five years, 85 percent of patients involved in the study are surviving.

Aye encouraged at-risk adults to get involved with the study, which targets people ages 40-75 and have a 20-pack year history, meaning they smoked a pack of cigarettes a day for 20 years, or they smoked two packs a day for 10 years.

The CT scan does cost $300 and insurance does not cover it unless an abnormality is found, but Aye said he hopes insurance policies, and lung cancer screening policies, will change soon.

“I think we’ll see an increase in pressure to start screening for lung cancer instead of just breast and colon,” he said.

Naturopath enhances treatments

Other specialists, including naturopathic doctor Dan Labriola and his partners at Northwest Natural Health Specialty Care Clinic, will take up residence at the institute at least one day a week.

The naturopaths will work hand in hand with medical physicians, helping patients return to health and manage their diseases.

There are three main ways naturopaths help cancer patients, Labriola said.

First, they try “to get and keep the patient as strong and healthy as possible in every way,” he said.

For example, if chemotherapy patients are experiencing bloating, stomach upset or fatigue, naturopaths can find natural ways to help them feel better, such as suggesting a change in diet or supplements.

Second, naturopaths make sure patients are not doing anything to interfere with their cancer treatment.

“Anything that can act in your body can also interact,” Labriola said.

He co-authored a scientific paper in 1999 about how antioxidant supplements can interfere with certain chemotherapies and most radiation therapy. Also, folic acid can interfere with some chemotherapies, making them stronger or weaker.

“We actually have to modify the way patients take supplements,” Labriola said.

Third, naturopaths can recommend additional herbs and supplements to patients. While those recommendations are not a substitute for cancer treatment, they are another resource for the patient.

“We work seamlessly with the conventional medical staff out there,” Labriola said. ... -patients/

User avatar
Registered User
Posts: 18130
Joined: Mon Mar 10, 2008 4:03 pm
Location: Australia

Post by kenobewan » Fri Jul 22, 2011 7:29 am

Going into hospital far riskier than flying: WHO

(Reuters) - Millions of people die each year from medical errors and infections linked to health care and going into hospital is far riskier than flying, the World Health Organization said on Thursday.

"If you were admitted to hospital tomorrow in any country... your chances of being subjected to an error in your care would be something like 1 in 10. Your chances of dying due to an error in health care would be 1 in 300," Liam Donaldson, the WHO's newly appointed envoy for patient safety, told a news briefing.

This compared with a risk of dying in an air crash of about 1 in 10 million passengers, according to Donaldson, formerly England's chief medical officer.

"It shows that health care generally worldwide still has a long way to go," he said.

Hundreds of millions of people suffer infections linked to health care each year. Patients should ask questions and be part of decision-making in hospitals, which must use basic hygiene standards and WHO's checklist to ensure safe surgical procedures were followed.

More than 50 percent of acquired infections can be prevented if health care workers clean their hands with soap and water or an alcohol-based handrub before treating patients.

Of every 100 hospitalized patients at any given time, 7 in developed and 10 in developing countries will acquire at least one health care-associated infection, according to the United Nations agency.

"The longer patients stay in an ICU (intensive care unit), the more at risk they become of acquiring an infection," it said. Medical devices such as urinary catheters and ventilators are associated with high infection rates.


Each year in the United States, 1.7 million infections are acquired in hospital, leading to 100,000 deaths, a far higher rate than in Europe where 4.5 million infections cause 37,000 deaths, according to WHO.

"Health care is a high-risk business, inevitably, because people are sick and modern health care is delivered in a fast-moving, high-pressured environment involving a lot of complex technology and a lot of people," Donaldson said.

A heart operation can involve a team of up to 60 people, about the same number needed to run a jumbo jet, he said.

"Infection is a big problem, injuries after falls in hospitals is a big problem and then there are problems that are on a smaller scale but result in preventable deaths. Medication errors are common," he said.

Risk is even higher in developing countries, with about 15 percent of patients acquiring infections, said Dr. Benedetta Allegranzi of the WHO's "Clean Care is Safer Care" program.

"The risk is really higher in high-risk areas of the hospitals, in particular ICUs or neonatal units in developing countries."

About 100,000 hospitals worldwide now use the WHO's surgical safety checklist, which the agency said has been shown to reduce surgery complications by 33 percent and deaths by 50 percent.

If the checklist is effectively used worldwide, an estimated 500,000 deaths could be prevented each year, it says.

"Frankly, if I was having an operation tomorrow I wouldn't go into a hospital that wasn't using the checklist because I wouldn't regard it as safe," said Donaldson. ... 5R20110721

User avatar
Registered User
Posts: 18130
Joined: Mon Mar 10, 2008 4:03 pm
Location: Australia

Post by kenobewan » Sat Jul 23, 2011 6:55 am

When the cure is worse than the illness

Each year more people die from infections they catch in hospital than are killed on Australia's roads. Thousands more languish in hospital, sometimes for weeks under intensive care, their lives painfully disrupted because of entirely preventable infections with bugs such as staphylococcus aureus, or golden staph.

A Sydney executive, David Donkin, is one such casualty. He went into the elite Sydney Adventist Hospital for a shoulder reconstruction last November.

What should have been a routine operation requiring one or two nights in hospital followed by physiotherapy turned into three months of desperation and agony, three further operations and 19 nights in hospital to rid the repaired joint of a deep-seated golden staph infection.

It left Donkin with severely limited use of his right arm and a fierce ambition to fight the cover-up culture he says blankets the issue of hospital-acquired infection. Donkin wants to change the ''see no evil, hear no evil, say no evil'' campaign so successfully orchestrated by some members of the medical profession regarding infection-control failures.

''My single, sole and absolute ambition is to reduce the incidence of the extreme pain, suffering and financial loss I have endured happening at all, and specifically within the … private medical service sector,'' he says.

While Donkin targets the private sector, the problem of hospital-acquired infection is thought to be more prevalent in public hospitals.

Just how individual hospitals perform in preventing the infection of their patients remains undisclosed to all but a few hospital and government insiders.

The Rudd government pledged four years ago to expose such information to the scrutiny of taxpayers and patients but the move has remained mired by resistance from state governments, hospitals and bureaucratic obstacles to fixing a nationally agreed approach.

It has been estimated by an expert committee that there are about 6500 cases a year of lethal golden staph bloodstream infections, about 20 per cent of which are linked to the death of infected patients within six months.

Those cases are apart from the many thousands of other usually milder golden staph cases, such as Donkin's, where the bug does not get into the bloodstream but can still cause severe illness.

The tragedy of these figures is that in a significant number of cases, according to infectious diseases experts, the deaths could have been avoided if hospital staff cleaned their hands between patient contact.

And national surveys show that despite a two-year national campaign, Australian hospital doctors meet World Health Organisation hand hygiene standards only 50 per cent of the time.

An infectious disease physician and author, Professor Frank Bowden, has written that it should only take one high-profile case of an affected patient successfully suing a hospital ''for the climate on hygiene to change''.

Donkin has found that despite the cost and agony he suffered, getting meaningful redress is elusive.

His post-operative saga went bad when a swelling appeared at the site of the surgery. A month after the operation his GP referred him back to the surgeon. Neither hospital nor surgeons involved have questioned that the infection was acquired in hospital, Donkin says. However the original surgeon says in response to a NSW Health Care Complaints Commission inquiry that Donkin's ''deep'' infection was only the third such case out of 918 similar operations he had performed over the previous five years.

Donkin saw another surgeon second time around because Bokor was away, and underwent the first of two unsuccessful operations under full anaesthesia to ''wash out'' the golden staph. It was only after a third wash out operation and three months of heavy medication that Donkin apparently got cleared of the bug.

The self-employed personnel consultant from Five Dock has launched his own exhaustive inquisition of the hospital, doctors, NSW Health Care Complaints Commission, NSW Health Department and even the Commonwealth's Chief Medical Officer.

He has documented in detail his observations of the failure by some staff to clean their hands in 33 per cent to 50 per cent of occasions and to follow other hygiene practices before and after attending to him.

He also took photographs of his surgical dressings showing seepage of red-yellow fluid, despite a surgeon's direction that the dressings be changed when one-third of the dressing surface became discoloured. ''Frequently the dressing was not replaced until it was extremely full and/or leaking. On five occasions I found my shoulder, arm, chest, pillows and sheets were partially covered in this fluid.''

It may well be that from the hospital's point of view Donkin was a particularly exacting patient. He has noted numerous other deficiencies, including being offered the wrong pills, being pressured to vacate his room after the initial operation when still seeing spots before his eyes.

His traditional Christmas with his wife and family of six children and eight grandchildren was ruined. His shoulder function is much reduced and he endures pain using his home computer.

He believes the Health Care Complaints Commission and NSW Health failed to investigate thoroughly why and how the infection occurred. The commission said it consulted with the Medical Council of NSW which ''did not identify any issues of public health and safety''.

NSW Health, however, in its response to him said that the hospital had confirmed that some deficiencies have been identified in relation to infection control and medication management practices and had implemented changes to improve and audit hygiene practices.

These matters would be followed up at the next inspection of the hospital, the department informed Donkin.

The final eye-opener for Donkin has been his failure to find a reputable lawyer prepared to take his case on. The legal obstacles include the inherent difficulty of pinning down how the infection began and who was responsible.

He has paid about $5000 out of his own pocket and more than $25,000 from his health fund. But he says it is not the money he is after; he would give away any court award. Donkin has been amazed at the number of similar cases he has heard about since his own experience, and at the lack of redress or even recognition of the suffering it causes. ... 1hsp3.html

User avatar
Registered User
Posts: 18130
Joined: Mon Mar 10, 2008 4:03 pm
Location: Australia

Post by kenobewan » Mon Jul 25, 2011 7:28 am

Here, safety is major casualty

There were no fire exits or ramps to move patients in an emergency. The staff were not trained to handle a fire. The Government Kilpauk Hospital, where a fire claimed three lives on Saturday, has allegedly not fully implemented safety norms suggested by the fire department over a year ago. Tamil Nadu Fire and Rescue Services (TNFRS) sources say this is the third such accident in the past one year on the premises.

After the incident, angry relatives and visitors claimed the maintenance, particularly of the electrical equipment, at the hospital was poor.

TNFRS officials said two past fire mishaps had occurred due to an air conditioner. "On February 19, 2010 there was a fire in a room near the children's ward followed by one in the cardiology department on March 28, 2010. After this we submitted a fire safety audit to the hospital," said a senior officer.

He said it was mandatory for Multi-Storied Buildings (MSB) like hospitals to have passive fire safety systems. "There should be ramps for taking out patients who are sick and immobile. Proper fire exit gates and the width of the door leading to the blocks in hospitals should be wide to help in evacuation," said the officer.

Officers also noted that nurses and doctors were not adequately trained to handle a fire. On Saturday, they said, fire fighters struggled to enter the IMCU. "There was no one to guide them. In the smoke-filled room, they did not know where the equipment was. The patients ' hands were strapped to the bed as they were given drips and it was difficult to move them out," said the officer. "We don't know why they did not have fire extinguishers in the block," he added.

Tamil Nadu Electrical Inspectorate (TNEI) officials said it was important to maintain electrical equipment from time to time. "Air conditioners can catch fire even if there is a small wiring problem. This can be identified during maintenance. We will conduct an enquiry soon," said an official.

TNFRS director Bhola Nath said his department had submitted a fire safety audit report to the hospital in March 2010. "It is the hospital's responsibility to implement safety measures. We can't force them to have them in place," he said. ... 342926.cms

User avatar
Registered User
Posts: 18130
Joined: Mon Mar 10, 2008 4:03 pm
Location: Australia

Post by kenobewan » Tue Jul 26, 2011 7:08 am

Sydney private hospital nurses to strike

Nurses at private hospitals across Sydney will strike for 24 hours from Tuesday morning over a pay dispute.

The industrial action will affect Macquarie Hospital Services, as nurses protest at Martin Place in Sydney's city centre from 8am (AEST) before demonstrating at the group's other hospitals.

NSW Nurses Association general secretary Brett Holmes said nurses at the operator's five hospitals were fed up with having their pay rates curtailed by the company's owner, Dr Tom Wenkart.

Advertisement: Story continues below "It is not really how things should be done and it is one of the main reasons we now have this historic private hospital nurses strike in NSW," he said in a statement.

The strike will affect the Minchinbury Community Hospital in Mount Druitt, President Private Hospital in Kirrawee, Delmar Private Hospital in Dee Why, Manly Waters Private Hospital in Manly and Eastern Suburbs Private Hospital in Randwick.

The union argues that nurses at these hospitals are paid 10 to 12 per cent less than nurses at most other public and private hospitals.

Fair Work Australia gave the nursing union permission to take industrial action. ... 1hxgp.html

User avatar
Registered User
Posts: 18130
Joined: Mon Mar 10, 2008 4:03 pm
Location: Australia

Post by kenobewan » Wed Jul 27, 2011 7:21 am

Study: Medicare drug coverage keeping seniors out of hospitals, nursing homes

CHICAGO — A new study suggests that Medicare’s 5-year-old prescription drug plan is keeping seniors out of hospitals and nursing homes, saving the federal program an estimated $12 billion a year in those costs.

The savings only offset a portion of the $55 billion a year the government spends on Medicare Part D, as the drug plan is known. But the study’s authors say it means seniors are staying healthier and enjoying a better quality of life.

“This is what people always hope for: If people get drug coverage, they won’t need hospitalization,” said Marsha Gold of the nonpartisan Mathematica Policy Research, who wasn’t involved in the new study. “If it holds up, that’s great news.”

The Harvard analysis, appearing in Wednesday’s Journal of the American Medical Association, found Medicare saved an average of about $1,200 a year for each senior citizen who had inadequate drug coverage before Medicare Part D. Most of the savings came from hospital and nursing home costs.

That translates to an annual savings of $12 billion, experts said.

With subsidized drug coverage, seniors can afford drugs that prevent trips to the emergency room by lowering cholesterol and blood pressure and controlling diabetes, said lead author Dr. Michael McWilliams of Harvard Medical School.

Other savings come from doctors no longer admitting patients to hospitals just so Medicare would pay for drug treatments — like injectable clot-busting drugs for deep vein thrombosis — that can be given more cheaply in a doctor’s office, McWilliams said.

“Spending on one type of service can reduce spending on another type of service,” McWilliams said. “By expanding Medicare to include drug benefits, clearly we’re spending more, but we’re getting a lot of value out of that spending.”

The findings suggest that lawmakers, while grappling with reducing the federal deficit, should consider all of Medicare’s moving parts and how they affect each other, experts said.

“It’s critical to think about the entire program. They can’t just be thinking about how to pay hospitals differently,” said Julie Donohue, a health policy researcher at the University of Pittsburgh, who wasn’t involved in the new study. “They have to think about the whole delivery system and the whole Medicare system.”

It’s tough for researchers to pinpoint the effect of a policy change because they usually can’t randomly assign people to participate in a program or not. Medicare Part D is voluntary. Enrollees pay premiums that cover about 25 percent of the cost. There were 23 million Part D beneficiaries last year.

For the new study, researchers analyzed nondrug Medicare spending for about 6,000 seniors from 2004 through 2007.

The Medicare drug benefit started in January 2006. Before then, about 2,500 of the seniors in the study reported having generous drug coverage, which many bought as supplemental insurance. About 3,500 reported having limited or no drug coverage.

By comparing spending trends before and after 2006, the researchers were able to calculate any nondrug savings.

Previous studies show Medicare Part D increased use of antibiotics and drugs for diabetes, high blood pressure, depression and other chronic conditions.

The nation’s 1-year-old health care law is gradually closing the Medicare drug coverage gap, the “doughnut hole,” which also should keep seniors out of hospitals, McWilliams said.

But another view on the doughnut hole came from Joseph Antos, a health policy expert at the conservative-leaning American Enterprise Institute. Antos said the doughnut hole “turned out to be a very good idea” because it encourages seniors to use cheaper generics instead of more expensive brand-name drugs.

“It’s disastrous policy to whittle away at the doughnut hole,” Antos said. “If we see generic usage drop, that means the program is going to cost more.” ... story.html

User avatar
Registered User
Posts: 18130
Joined: Mon Mar 10, 2008 4:03 pm
Location: Australia

Post by kenobewan » Thu Jul 28, 2011 6:54 am

Local hospital squeezed by state budget cuts

Staff reductions, a wage freeze and eliminating services are all on the table for Cheshire Medical Center/Dartmouth-Hitchcock Keene.

The hospital is bracing itself for a $6 million hit in what its officials are calling a tax on hospitals.

According to figures provided by the Keene medical center, about $6 million of reimbursements will be lost there — the equivalent of about 4 percent of the hospital’s total budget.

That means hospital officials, for starters, will likely have to eliminate 15 to 20 positions, most of which they hope to accomplish by leaving vacant jobs unfilled, said John G. Schlegelmilch, chief medical officer for the hospital.

Hospital officials also plan to implement a freeze on pay raises, and are considering eliminating services often accessed by Medicaid patients, such as mental health care and even certain pediatric services, Schlegelmilch said.

“With the cuts the mental health community has suffered, if we have less services (available), more of them (patients) end up in the emergency room or outpatient services,” he said.

And because Cheshire Medical, a nonprofit hospital that turns no one away, is the only hospital in Keene, officials worry about the potential impact on the health of the community if they’re forced to eliminate services.

“We’re extremely vulnerable to this because of the number of Medicaid patients we have, and the number of people we provide services for who can’t afford them,” said James A. Putnam, chairman of the hospital’s board of trustees.

Cheshire Medical Center spends about $10 million annually to care for Medicaid patients, and is reimbursed $5.5 million by the federal government while absorbing the rest of the cost. The elimination of $6 million in state Medicaid reimbursements more than wipes out that federal money, said Arthur W. Nichols, the hospital’s chief administrative officer.

But hospital officials aren’t taking the cuts lying down. Cheshire Medical Center/Dartmouth-Hitchcock Keene joined nine other New Hampshire hospitals in a lawsuit against the state on Monday alleging the Legislature violated its legal obligation to reimburse them for Medicaid costs.

The hospitals are seeking injunctive relief for the budgeted cuts in Medicaid reimbursements.

The state’s hospitals estimate they will be taxed $250 million over the next two years, only this time the largest facilities will not be reimbursed. The state budget cuts $115 million — $230 million when counting matching federal money — from a fund used to make Medicaid payments.

“In order to not impose a new tax, (the Legislature) reneged on this deal,” he said. “We’ve already paid our share in caring for Medicaid patients.

“They haven’t lived up to the arrangement. Why pick on hospitals? It really feels like we had the rug pulled out from under us, and it feels arbitrary,” Schlegelmilch said.

New Hampshire lawmakers released a statement Tuesday, decrying the lawsuit.

“Every group received cuts in order to deliver a budget that balanced honestly, and the hospitals are one of many groups that will see less money,” House Speaker William O’Brien said.

And while it’s true that many groups besides hospitals will see less money over the next two years, Schlegelmilch believes the decision was more about politics than logic.

“Why would you choose the nonprofit sector to put a tax on? (Because) politically, it’s more expedient (than taxing the public),” he said.

After several years of operating in the black, hospital officials say they expect to be in the red when they put their budget together in October.

Sandie Phipps, senior director of development and communications at Cheshire Medical Center, said the Legislature failed to consider the scope of the hospital’s charity care when deciding to make the cuts.

“Between the Medicaid and Medicare (patient coverage) gaps, and add in some uncollected debt (for patients who can’t afford to pay for their care), we’re at $11.8 million for 2010 (in total charity care),” she said. “With benefits to the community on top of that, it’s really significant.

“We do so much,” Phipps said. “Community education, Vision 2020, Cheshire Smiles, which treats children who otherwise wouldn’t have access to dental care ... when we have a positive operating margin, that money gets reinvested back into the community.” ... dbd23.html

User avatar
Registered User
Posts: 18130
Joined: Mon Mar 10, 2008 4:03 pm
Location: Australia

Post by kenobewan » Fri Jul 29, 2011 7:22 am

NHS delays operations 'in hope that patients die or go private'

Health service trusts are “imposing pain and inconvenience” by making patients wait longer than necessary, in some cases as long as four months, the study found.

Executives believe the delays mean some people will remove themselves from lists “either by dying or by paying for their own treatment” claims the report, by an independent watchdog that advises the NHS.

The Co-operation and Competition Panel says the tactic is one of a number used by managers that “excessively constrain” patients’ rights to choose where to be operated upon, and damage hospitals’ ability to compete for planned surgery.

It claims unfair practices are “endemic” in some areas of England and pose a “serious risk” to the Government’s drive to open up the health service to competition.

But managers, who are already rationing surgery for cataracts, hips, knees and tonsils, say they must restrict treatment as the NHS is under orders to make £20 billion of efficiency savings by 2015.

Lord Carter of Coles, chairman of the panel, said: “Commissioners have a difficult job in the current financial climate, but patients’ rights are often being restricted without a valid and visible reason.”

Katherine Murphy, chief executive of the Patients Association, said: “It is outrageous that some primary care trusts are imposing minimum waiting times. The suggestion that it could save money because patients will remove themselves from the list by going private or dying is a callous and cynical manipulation of people’s lives and should not be tolerated.”

Since 2006, NHS patients who need routine elective care have had the right to choose between at least four hospitals including privately-run units. But there have been claims that trusts, the local bodies that pay for treatment, restrict choice and favour some hospitals to balance their books. The panel investigated whether the allegations were true.

It found “many examples of PCTs excessively constraining patients’ ability to choose, and providers’ ability to offer routine elective care services”.

Managers restricted GPs’ ability to refer patients to some hospitals by imposing “caps” on the number a provider would be paid to treat and by imposing minimum waiting times, its report said.

Under government targets, patients should be treated within 18 weeks of referral by a GP. But even when surgeons could see them far sooner, the study found that some trusts made hospitals wait as long as 15 weeks before operating. The tactic forced private hospitals, which were more likely to be able to treat patients quickly, to operate as slowly as overcrowded NHS units in an “unfortunate levelling down”.

Some managers insisted that longer waiting times would lead to overall savings as “experience suggests that if patients wait longer then some will remove themselves from the list”. Interpreting this statement, the panel noted: “We understand that patients will 'remove themselves from the waiting list’ either by dying or by paying for their own treatment at private sector providers.”

It said that minimum waiting times should only be used as a “last resort” and told trusts to publish their policies on the home page of their websites.

The panel also found that trusts tended to give elective business to their local NHS hospital, rather than allowing choice, in order to ensure its other services such as casualty departments remained financially viable.

The findings come as the NHS is under pressure from increasing demand and tighter budgets. Waiting times have lengthened since last year’s general election and more trusts are increasing the number of procedures of “low clinical value” they turn down or insisting that patients’ conditions worsen before they are seen.

Labour yesterday unearthed Treasury figures that show health spending totalled £101.985 billion in 2010-11, down from £102.751 billion in the last year of Labour, despite David Cameron’s pledge that “the money going into the NHS will actually increase in real terms”. The Tories pointed out that the fall represented the last part of the previous government’s five-year spending plan.

Ministers welcomed the competition panel’s study. Paul Burstow, the care services minister, said: “This report illustrates exactly why we need to modernise the NHS and increase choice for patients.

“Trusts will want to take a hard look at practices in light of this report and ensure they are always in the best interest of patients and the taxpayer.”

Under the Health and Social Care Bill, which has been watered down in the face of opposition from the medical profession and Liberal Democrats, power to buy treatment will be handed from trusts to new bodies led by GPs.

The new Clinical Commissioning Groups are intended to be more accountable to patients, while the number of sectors where choice and competition apply is being extended. David Stout, director of the NHS Confederation’s primary care trust network, said: “Today’s report rightly acknowledges that each situation will be different and the extent that any benefits outweigh the loss of choice should be considered on a case-by-case basis.”

He added: “Commissioners will still be left to decide the right course of action when faced with trade-offs between patient choice and value for money. The suggestion that many current trust decisions are not justifiable on these grounds is largely unsubstantiated by the detail in the report as the CCP has not investigated specific cases in detail.” ... ivate.html

User avatar
Registered User
Posts: 18130
Joined: Mon Mar 10, 2008 4:03 pm
Location: Australia

Post by kenobewan » Sat Jul 30, 2011 7:11 am

Hospital to fire the senses

SICK children will find themselves in a different world when they are transported through a temporary corridor from the old to the new Royal Children's Hospital on November 30.

The first impression for most visitors will be walking into the hospital's light-filled ''main street'', the starting point for a tour of the new $1 billion building yesterday.

Colourful mobiles hang from the fifth-storey ceiling, a coral reef aquarium awaits some fish to call it home, and a towering animal sculpture is due to be installed in coming weeks.

The street leads off to various parts of the hospital including the emergency department (also accessed from an ambulance bay), inpatient wards, and areas for outpatient appointments.

To make it easy for families to navigate, each floor has a theme - from earth on level one through to tree tops on three and sky on five. And each ward has a name too, from the butterflies in newborn intensive care, to the kookaburras in the cancer ward.

The building offers views of Royal Park around many corners, and from most rooms. There are courtyards throughout to provide an escape for families and some fun distractions for children, including 15 interactive science displays and a zoo enclosure in the outpatients area for which meerkats are currently being bred.

The new hospital has not been without its critics, with some dubbing it ''The Royal Children's Hotel'' for devoting space to single bedrooms they say could be better used on more clinical services to meet growing demand.

The change from an open-plan intensive care unit to single cubicles has caused particular concern, with several doctors worried it could impede surveillance of patients and cause delays in treatment of sudden events, such as cardiac arrests.

Hospital chief executive Christine Kilpatrick yesterday said there was ''a growing buzz'' about the new building as staff were given details of training ahead of the move, and its detailed logistics.

The patients will move on a single day - November 30 - including critically ill children on ventilators who will need to be carefully managed.

''Because we are right next door we won't need ambulances, but a temporary corridor is being built - which you'll hear more about,'' Professor Kilpatrick said.

The emergency department will change over at an appointed hour so ''we don't run two hospitals for a second longer than we have to'', she said.

Health Minister David Davis said he expected Victorians to ''warmly embrace'' the new hospital. ''Everywhere you look is another surprise, another point of detail that you can see will make the hospital work better for children and their families,'' he said.

The existing hospital will be demolished and a hotel built on the site, some of which will be returned to parkland, as part of a public-private partnership arrangement. ... 1i4f4.html

User avatar
Registered User
Posts: 18130
Joined: Mon Mar 10, 2008 4:03 pm
Location: Australia

Post by kenobewan » Sun Jul 31, 2011 7:01 am

Serco wins £850m Australian hospital contract

On Saturday, the London-listed company said it has secured a $1.3bn (£850m) 10-year contract to run non-clinical support services at the new Fiona Stanley Hospital in Perth, Western Australia.

The hospital will open in 2014. It will provide a full range of acute medical and surgical services including emergency care, a major trauma centre, comprehensive cancer services, a mental health unit, a burns service, maternity and pediatric care, as well as medical research and education facilities. Eventually the Australian hospital will employ 3,000 people and operate 783 beds.

Serco will be responsible for 30 different services at Fiona Stanley Hospital, such as procurement for the fit-out of the hospital, management and maintenance of hospital assets including medical equipment, and recruitment all clinical staff.

Christopher Hyman, chief executive of Serco Group, said: “We are delighted that the Western Australian Department of Health has chosen Serco as their partner to provide these vital services at their new and innovative Fiona Stanley Hospital.”

He added: “Serco has a proven global track record of providing quality non-clinical services at major hospitals that care for millions of people. We look forward to supporting our customer in providing the best possible care and a world-class experience for patients.”

The Fiona Stanley Hospital contract win comes after Serco said on Friday that it had won a five-year contract with the Queensland Department of Corrective Services to manage and operate the new 300-bed high-security South Queensland Correctional Centre. That prison contract is valued at around A$100m over five years, with an option to extend to 10 years. ... tract.html

User avatar
Registered User
Posts: 18130
Joined: Mon Mar 10, 2008 4:03 pm
Location: Australia

Post by kenobewan » Mon Aug 01, 2011 7:22 am

Unions threaten to cripple hospitals

UNIONS warned of strikes for WA after the State Government signed a $4.3 billion contract to privatise non-clinical services at Fiona Stanley Hospital.

United Voice state secretary Dave Kelly said industrial action at WA hospitals was possible after a deal was signed to hand over 28 services at WA's new $2 billion hospital to Serco Australia.

Meanwhile, deputy Opposition leader Roger Cook vowed a future Labor Government would try to scrap the 20-year agreement with Serco.

Mr Kelly said both patients and workers at Fiona Stanley would be worse off, claiming Serco would be focused on profits instead of patients and hygiene standards.

He said an independent British investigation into Serco's Wishaw General Hospital in the UK revealed six out of eight wards failed to meet hygiene standards claims Serco Australia chief executive David Campbell yesterday said were "taken completely out of context".

Mr Kelly, whose union character "Sam the Superbug" gatecrashed Health Minister Kim Hames' press conference at Parliament House yesterday afternoon, said: "At $4 billion, this contract is six times more expensive than the (new Perth) stadium and yet the consultation with the public has been much, much less.

"I don't think the people of Western Australia will think the privatisation of our hospitals will be good for patients.

"This won't just stop at Fiona Stanley. Our members will continue their campaign. That may include some actions in hospitals."

Serco runs detention centres in Australia and operates services in transport, defence, justice and migration in WA.

At Fiona Stanley, the company will handle fleet management, waste disposal, reception, pest control, linen, grounds maintenance and cleaning.

Under the agreement:

* Doctors, nurses and allied health professionals at Fiona Stanley will still be employed by the WA Health Department.

* The contract between Serco and the State Government contains performance targets that must be met. Serco will have to report on performance on a monthly basis.

* The contract can be terminated if Serco does not meet targets set by WA Health.

* Serco will be responsible for employing and managing 4000 staff at Fiona Stanley.

Dr Hames said the deal would save WA taxpayers $500 million and deliver the most technologically advanced public hospital in Australia.

"The hospital will still be a public hospital. It will be run by government in a sense that all medical, nursing and allied health staff will be public employees. But the support services will be managed by Serco," Dr Hames said.

"We have looked at the sort of services they provide in hospitals in the UK and I have to say we are very impressed by the standard of service that they offer."

But Mr Cook said Serco did not run any hospitals in Australia, making Fiona Stanley its guinea pig.

"Running a hospital is a lot more complex than running a detention centre," he said. "They are cutting their teeth on what is supposed to be our premiere flagship Australia. We will do everything possible to reverse those contracts and bring those services back into public hands."

The hospital is due to open in mid-2014. ... 6105009165

User avatar
Registered User
Posts: 18130
Joined: Mon Mar 10, 2008 4:03 pm
Location: Australia

Post by kenobewan » Tue Aug 02, 2011 6:44 am

Woman to sue after sponge left in her body

A WOMAN claims a grapefruit-size sponge lay inside her abdomen for more than 15 years after a North Shore surgeon failed to remove it during an operation on her bowel.

Helen Caroline Anne O'Hagan said the surgical pack was left inside her abdominal cavity by Dr Samuel Sakker during a partial colectomy he performed in August 1992.

The NSW District Court has been told that over time the sponge ''became encapsulated in dense fibrous adhesions within a sac of fluid'' and was only discovered in October 2007 when an X-ray detected the embedded radiopaque thread.

Advertisement: Story continues below The sponge was removed by another surgeon the same day but it was another three years before he told Mrs O'Hagan that it could only have been put there during the operation performed by Dr Sakker at the Poplars Private Hospital, in Epping.

District Court Judge Leonard Levy has awarded Mrs O'Hagan the right to sue Dr Sakker for alleged negligence or breach of contract despite her claim falling outside the statute of limitations.

He accepted that Mrs O'Hagan, who has been hospitalised 23 times since 1970, was so preoccupied by her various health issues when the surgical pack was eventually discovered that she didn't seek an explanation as to how and when it got into her abdomen.

Furthermore, the surgeon who removed the sponge spent a significant portion of the next three years outside NSW and did not tell Mrs O'Hagan that he suspected the 1992 operation until she saw him for a consultation in May last year. Her solicitor filed a statement of claim four months later.

Dr Sakker, who retired in June 2007, had sought to have the case thrown out, arguing that it was improbable that she didn't make the connection sooner.

He said he had no recollection of treating Mrs O'Hagan and a search of his archives had failed to locate any medical records. However, he said he never departed from the practice of signing off the instrument count at the end of an operation after a count was made vocally by the scout nurse.

Mrs O'Hagan's husband, John, gave evidence that Dr Sakker advised him on the day of the surgery that the operation to remove about a half a metre of her bowel went well.

Mrs O'Hagan continued to experience cramping, fevers and loss of bowel control but didn't relate the problems to the procedure, assuming it was part of her long-standing underlying abdominal and pelvic issues.

The case returns to the Sydney District Court this week. ... 1i6fv.html

User avatar
Registered User
Posts: 18130
Joined: Mon Mar 10, 2008 4:03 pm
Location: Australia

Post by kenobewan » Wed Aug 03, 2011 7:21 am

Hospital funding to end blame games

JULIA Gillard calls her new hospitals funding the most fundamental public health change since Medicare.

This is despite claims the agreement as been watered down to get it through parliament.

But the Opposition says the Prime Minister caved in to get the states onboard.

Trumpeting a new era of financial transparency via a MyHospitals website and the concept of an independently set "efficient price" for all public hospital procedures, Ms Gillard said the agreement locked in the Commonwealth funding share for the first time, ending the "blame game", ensuring value for money, and forcing under-performing hospitals to lift their game.

"This is signed. This is done and it's agreed to by all states and territories," she said.

But acting Opposition leader Julie Bishop said it represented little real change and was the third time Labor had announced a "historic agreement".

"After promising sweeping national reform, the Prime Minister has capitulated to the states and handed them a blank cheque," Ms Bishop said.

The deal winds back several of previous prime minister Kevin Rudd's objectives including his ambitious 60 per cent "dominant funder" promise, which Ms Gillard candidly admitted yesterday had been doomed to failure because states "were never going to agree" to hand over their GST revenue".

Other aspects of the Rudd agenda softened include a "guarantee" that 95 per cent of elective surgery patients be treated within a clinically recommended time or be transferred to a private bed at the public hospital's expense.

Ms Gillard advised that this may have led to "perverse" incentives for hospitals and this has been replaced with a 100 per cent "target" instead.

Under the agreement, the Commonwealth will meet 50 per cent of the growth in health funding from 2017-18 - up from an interim 45c in every new dollar for the three years leading up to then. That amounts to $19.8 billion in new Commonwealth funds for hospitals to 2020 escalating to $175 billion by the end of the following decade.

Premier Mike Rann, who was the first of the premiers to sign up, said it provided both greater certainty and more money for the state.

"In dollar terms that means an extra $1.15 billion for South Australia between 2014-15 and 2019-20," he said in a statement.

"This is a huge improvement on the position we are in now." ... 6106994109

User avatar
Registered User
Posts: 18130
Joined: Mon Mar 10, 2008 4:03 pm
Location: Australia

Post by kenobewan » Thu Aug 04, 2011 7:15 am

Maroondah Hospital gets $12 million

Prime Minister Julia Gillard says Victorian hospitals will have more money and beds at their disposal from next year under new national health reforms.

Victoria will receive an extra $4.1 billion by 2020.

Ms Gillard says only two thirds of people are seen within four hours at Victorian emergency departments, but that will increase this to 72 per cent by next year.

She says under the deal, one of Melbourne's busiest hospitals, the Maroondah Hospital, will get $12 million and 20 new beds.

Construction will start next year.

"People will see extra services being able to be provided from this hospital," she said.

"Here in this hospital and right around the state, people will see less waiting time in the emergency department and for elective surgery." ... ls/2823114

User avatar
Registered User
Posts: 18130
Joined: Mon Mar 10, 2008 4:03 pm
Location: Australia

Post by kenobewan » Fri Aug 05, 2011 7:16 am

Other hospitals outsourced data

At least three more hospitals have indicated today they have used the services of a company implicated in a data breach involving the records of patients of Tallaght hospital in Dublin.

Tallaght hospital admitted yesterday there had been “unauthorised access and disclosure” of material sent to the Philippines for transcription by the company Uscribe.

Mercy University Hospital in Cork confirmed today it had been using an online transcription company for the past six years. Galway University Hospital outsourced transcription to Uscribe for a six-month period several years ago.

While the Mercy University Hospital did not confirm it had also used the same company as that used by Tallaght, it is understood that Uscribe is the firm involved.

A spokesman for the Cork hospital said it had “no evidence whatsoever that any of its patient data has been misused, destroyed or disclosed improperly”.

He added: “The hospital has been assured that the company’s security system is intact and that there is no evidence of any systems failure."

The Galway hospital said in a statement it did not outsource administration work and that nor did the Mid Western Regional Hospital, Limerick.

It confirmed that in 2004, GUH undertook a "short six-month pilot project with Uscribe, involving the typing of encrypted material with no patient identifiers".

Peamount Hospital in Dublin confirmed to RTÉ News it had used the service since 2005. It said it continued to use it and that it had encountered no problems.

The Tallaght records were outsourced to the private firm Uscribe, which has offices in Dublin but which sent the records to its business in the Philippines for transcription. The records concerned are letters to GPs, and hospital referrals.

The Data Protection Commissioner’s office met the company Uscribe today to discuss the breach.

Mr O’Connell has admitted in a letter to consultants that the scope of the breach is “much larger” than Tallaght hospital.

The Dublin hospital’s arrangement with Uscribe has been terminated, and the hospital is now using another provider.

While the Health Service Executive has indicated it does not outsource such transcription services, it is understood that some consultants have entered private arrangements for such services.

The data in question comprises records of patient consultations with doctors and not full medical records. It appears, however, that at least in some cases information identifying patients was compromised.

Tallaght hospital confirmed it had asked the Garda to assist in determining how the sensitive patient data fell into “inappropriate hands”.

It has opened an information helpline for patients who may be concerned about the issue. The phone line is available on 1800 283059 from 9am to 5pm.

Some 173 calls were received by 4.30pm, the hospital said.

There is no bar on a hospital using a third party to process such data, but very stringent due-diligence procedures and contracts must be put in place to satisfy data protection requirements. ... ing24.html

Post Reply