Town halls offered healthcare bonus

Town halls will be rewarded for cutting tooth decay in children and boosting breastfeeding under plans to be unveiled.

Health Secretary Andrew Lansley is expected to announce plans that would see councils allocated more than £2 billion to look after public health, a responsibility that has not lain with local authorities since the 1970s.

Under the system, councils will be judged against a range of measures including reducing the number of falls in older people and increasing breastfeeding rates, as well as factors such as truancy, air pollution, domestic violence and homelessness.

Data will be collected on more than 60 factors that influence health, and a "Health Premium" incentive scheme would see the most successful councils given extra funds.

Councils will be left to decide which practical steps they take to achieve the improvements laid out by the Government.

Andrew Lansley is expected to announce
a 'Health Premium' incentive scheme

Mr Lansley is to set out the new Public Health Outcomes Framework in a speech at the Faculty of Public Health.

According to the Daily Telegraph, he says that 2000 to 2010 was a decade in which public health was seen as "something to be sidelined".

He will reportedly say: "Obesity rates from 2000 to 2010 rose from 21.2% to 26.1% so now over a quarter of adults are obese. Sexually transmitted infections, after the steep declines in the 80s to 90s, doubled in the subsequent decade. And health inequalities persist, with gaps in life expectancy of over a decade between people born in the richest areas and people born in the poorest."

The public health budget is to be ring-fenced so it cannot be used to shore up day-to-day spending, he is expected to say. Next year £5.2 billion will be spent on public health, with the Government increasing the budget in real terms each year after that.

The announcement comes as the Commons Health Committee is this week expected to claim the Government's controversial NHS reforms are obstructing efforts to make the service more efficient.

Lansley defends health Bill plans

Health Secretary Andrew Lansley has defended the Government's controversial health Bill after the main medical unions became the latest bodies to declare all-out opposition to the reforms.

The Royal College of Nursing (RCN) and the Royal College of Midwives (RCM) have called for the Bill to be scrapped. It follows a move by the British Medical Association (BMA) in December to also fully oppose the Health and Social Care Bill, currently going through Parliament.

The RCN, the biggest nursing union, said "serious concerns" have not been addressed during the parliamentary process, listening exercise or political engagement and the Bill will not deliver on the principles originally set out.

Recent announcements such as the rise in the cap on private patients being treated in NHS hospitals to almost half (49%) "make the Bill in its entirety a serious threat to the NHS", it said.

But Mr Lansley backed the reforms, saying the opposition to the Bill was more about issues of pay and pensions. He said the legislation was "essential in order to give nurses and doctors clinical leadership".

The leading medical unions have declared their
opposition to the proposed NHS reforms

"I'm afraid the only thing that has happened in the last few weeks that has led to this situation with the Royal College of Nursing is that the two sides of the Royal College of Nursing have shifted," Mr Lansley said.

"There used to be a professional association that was working with us on professional issues and will carry on doing that, but now the trade union aspect of the Royal College of Nursing has come to the fore, they want to have a go at the Government - I completely understand it - but they want to have a go about things like pay and pensions.

"The Bill actually enables the NHS to deliver efficiency savings and improve performance - not least because actually the Bill is part of the process of cutting administration in the NHS. It takes about £1.5 billion a year out of NHS administration costs because it reduces that superstructure of bureaucracy in the NHS - over the course of this Parliament it will deliver over £4 billion savings itself.

"Through the NHS Future Forum we have been out there, making sure, and doing it ourselves time and again, that we're taking staff with us in terms of understanding these issues. And the RCN and the RCM are very clear that they support the principles of the Bill. What they are actually unhappy about is pay, pensions and jobs. I complete understand that.

"But if there were no Bill the same issues would have to be addressed. We inherited a deficit, we are having to manage the NHS within limited increases, but actually next year the NHS budget is going to go up by 2.8%."

©Press Association

NHS WAITING LIST PENALTIES DELAYED

A Government plan to tackle hidden NHS waiting lists has been delayed - just two months after being announced by Health Secretary Andrew Lansley.

Mr Lansley said in November that hospitals would face a clampdown from this year on the number of people languishing on waiting lists for treatment.

But according to the Department of Health, although hospitals are expected to make progress towards that goal, penalties will not now be introduced until 2013/14.

Mr Lansley delays plans to tackle NHS waiting lists

Under NHS rules, patients should be treated within 18 weeks of being referred by their GP but when that deadline is breached, there is often no incentive for hospitals to see them.

To tackle this, NHS managers were told in November they had to reduce the number of long waiters from this year - and by about 50,000 by April.

Mr Lansley said at the time: "Because of Labour's perverse approach, the NHS actually had an incentive not to treat patients.

"The new approach we will take from next year will clamp down on this practice."

However, according to the Department of Health, penalties will now only be introduced "once progress has been made on validating the backlog data and the NHS has had time to adjust to working to the new standard."

Data suggests there are around 250,000 people waiting longer than 18 weeks to be treated and thousands have waited for more than a year.

The new delay, uncovered by the Health Service Journal (HSJ), was condemned by patient groups.

Patients Association chief executive Katherine Murphy said: "The Department of Health said they would tackle the issue yet instead of taking action they have just stuck to the same targets which have not helped these forgotten patients.

Katherine Murphy: NHS targets create "perverse disincentives"

"These targets have produced perverse disincentives meaning that once a patient has waited for longer than 18 weeks, there is no push to make sure they receive treatment as soon as possible after that."

A spokeswoman for the Department of Health said: "We want to reduce the number of patients on hidden waiting lists to help ensure everyone gets access to the treatment they need.

"Work on this has already started and we expect organisations to reduce their backlog and long waits whilst this is ongoing.

"Penalties will be introduced for 2013/14 once progress has been made on validating the backlog data and the NHS has had time to adjust to working to the new standard."

HSJ columnist and waiting list consultant Rob Findlay said delaying the measure "fundamentally undermines the government's stated intention to reduce the number of patients 'forgotten' on English waiting lists."

According to the HSJ, the 2012-13 operating framework and second quarter report, both released late last year by the Department of Health, planned to introduce a new target to cut the list of long waiters.

But the NHS standard contracts for 2012-13, released on December 23, leave the old system in place.

Shadow health secretary Andy Burnham said: "We are losing count of the Government's broken promises on health, but this seems to be the quickest on record.

"Only six weeks after making this promise the Health Secretary has further undermined the already fragile confidence in his ability to run the NHS.

"One of his first acts in office was to relax Labour's waiting time standards.

"We warned him that patients would pay the price and this is exactly what has happened.

"Sadly, things will get even worse for NHS patients if he succeeds in amending his health Bill to allow NHS hospitals to devote up to 50% of their beds and theatre time to private patients.

"This free-market NHS reorganisation opens the door to an explosion of private work in the NHS, meaning longer waits for NHS patients.

"It takes us straight back to the bad old days of the Tory NHS, when the only choice patients had was to wait longer or pay to go private."


PA 2012