A monthly overview of news and developments within the health sector in Northern Ireland.
Issue 9 December 2010 www.asitisconsulting.com
Welcome to the ninth edition of Health Matters Spending Cuts Hugh Mills Chief Executive of Independent Health and Care Providers (IHCP) Diary Focus
Consultation Details and dates
Health on the Hill
Last week’s decision by the Executive to ringfence the Health portion of the Department of Health, Social Services and Public Safety’s Budget must have been a great relief for Minister Michael McGimpsey. The Minister has spent the last number of weeks grappling to secure support for the protection of his budget, while at the same time defending accusations that the Department continues to spend too much on overseas junkets and wages.
Gillian Creevy, Northern Ireland Cancer Fund for Children
Northern Ireland’s premium public relations and public affairs agency
We also provide our monthly round-up of Health in the News, and all the political happenings in Health on the Hill.
News Review “The e-zine is excellent!”
Aside from the Budget, domiciliary care and a Commissioner for Older People have dominated the debate at Stormont. We speak to Hugh Mills, Chief Executive of the Independent Health and Care Providers, about the role the sector could play in solving the longer term problems. With an aging population and a limited health budget could as much as £50 million really be saved by delivering more services through independent providers?
A Harvard Medical School review has found that taking vitamin E increases the risk of suffering a rare form of stroke, haemorrhagic stroke, by 22% compared to those not taking the vitamin. However, the same review found that Vitamin E reduced the risk of having the most common type of stroke – ischaemic – by 10%.
In other news, scientists at the Institute of Cancer Research say exercising as a young girl can help prevent the later onset of breast cancer. The findings were made in a study determining factors that contribute to girls starting periods early, which is linked to later breast cancer. The study found lack of exercise, low birthweight, not being breastfed, mothers smoking during pregnancy, weight, height and ethnicity all had an effect on when a girl reached puberty and her chances of developing breast cancer.
Scientists have found that women who regularly take painkillers during their pregnancy are more likely to give birth to sons who will suffer from low sperm counts and reproductive problems.
HEALTH MATTERS – December 2010
News Review (continued) quadrupled over the past decade, largely due to sufferers living longer now. The statistics also showed the number of infections resulting from heterosexual contact are New research has shown that increasing. high blood pressure can be treated with a simple surgical procedure A study published in the which cuts the risks associated with International Journal of Clinical the condition such as stroke or heart Practice has established a link attack. between weekly exercise and a reduction in the chance of A team of experts at Cardiff developing major diseases, University believe they may have including colon cancer, stroke, found a way to prevent Dyskinesia, heart disease and osteoporosis. a side-effect of common Parkinson’s New research suggests that binge treatment drug levodopa, which drinking increases the risk of heart Recent data indicates that the causes involuntary movements in disease more so than drinking rate of smokers quitting has slowed the patient which are different to steadily over the course of a week. during the recession. the usual tremors associated with The findings came following a Parkinson’s disease. comparison study between male drinking habits in Belfast and Researchers at the University France, which showed although of Ulster, Coleraine are about to the same amount of alcohol was undertake a study to determine consumed, 9% of Belfast men were if there are dietary solutions to binge drinking compared to just Systemic Lupus Erythematosus 0.5% of French men, who drank less (SLE, or Lupus), an autoimmune but more regularly. disease that primarily affects women who are at childbearing age. For the first time, scientists can The WHO have released statistics show that the common cold virus showing that over 600,000 people can be combatted by the body’s die each year from passive smoke. immune defences after the virus The figures, based on data from has entered the inner sanctum of a 2004, indicate that 1% of all worldhuman cell. wide deaths are due to passive smoking, and children are the New figures show that men in the most heavily exposed group with UK mostly die from stroke or heart around 165,000 children dying disease, wheras cancer is the biggest from second-hand smoke. killer for women. The figures also According to the Rainbow show that Scotland has the highest Professor Peter Bundred told Project, men in Northern Ireland incidence in all of these in the UK. delegates at a Queen’s University are still put off being tested for HIV Belfast Conference “Taking Action on because of the stigma attached to Asitis Consulting can provide Childhood Obesity” that childhood the disease. The news comes as an in-depth weekly monitoring obesity could be prevented with the Public Health Agency released service for clients. Phone or email good nutrition during the pregnancy statistics showing the number of for further details and breastfeeding stages. people living with HIV in Ulster has A team of researchers at McMaster University, Canada are have found that ordinary skin cells can effectively be changed into adult blood. The team aims for patients to be treated with blood made from their own skin in just two years time.
A recent report from Barnardo’s has found that more than one in ten teenagers live with an alcohol or drug-abusing parent.
HEALTH MATTERS – December 2010
Specialist Neurology Beds On Monday 29th November, George Robinson MLA of the DUP brought a motion before the Assembly on Specialist Neurology Beds, calling on the Minister to ensure that reduction in the number of beds in the Royal Victoria Hospital, from 23 to 15, be reversed. The facilities in the RVH, although operated by the Belfast Trust, provide neurological services for the whole of Northern Ireland. In response to the motion, the Minister said that ‘with the steps to improve current services, there should be no need to reinstate beds at this time’, but that ‘if there is pressure on beds and more are needed, I will ensure that additional capacity is provided’. He noted that the last Budget had taken £100 million out of the Health budget, and that “there are no easy answers to this issue, other than to be prepared to stand up for your Health Service”. Health Committee Chair Jim Wells MLA concluded the debate by calling on the Minister to “… go back to the drawing board and totally review that decision”. Commissioner for Older people When the final stage of the Commissioner for Older People Bill was carried in the Assembly on the 7th December, Junior Minister Gerry Kelly MLA described it as ‘a good day for older people’ and ‘a momentous day for the Assembly’. The Bill, which should receive Royal Assent by midJanuary, will see the establishment of an Office of Commissioner, which will have a wide range of powers to advocate for and represent elderly people. These will include the power to conduct a formal investigation into a complaint, with High Court powers to call for persons papers and evidence, as well as the power of entry and inspection. The Commissioner will also be in a position to produce research to help shape policy and services. Recruitment for the position will begin once Royal Assent is received.
Health on the Hill
“Clinical Excellence Awards” During the debate on Domiciliary care, Sinn Féin’s Martina Anderson clashed with the Minister for Health on the issue of bonuses. In response to the Minister’s assertion that his entire budget must be protected, Ms Anderson asked if this included £57 million of bonuses paid to consultants and overseas junkets. The Minister responded that the Health Service does not pay bonuses, but rather there is a national clinical excellence award scheme, which costs £12 million. According to Ms Anderson, “If it walks like a duck and talks like a duck, it is a duck, but the Minister calls it a clinical excellence award. The people who received it received in the region of £75,000, £60,000 or £48,000 over and above their salaries”. Domiciliary Care The assembly passed a motion calling on the Minister of Health to ensure there is adequate investment in domiciliary care to meet the current and future needs of an aging population. Sinn Féin’s Martina Anderson proposed the motion, noting that she had been inundated with constituents whose domiciliary care packages are being reduced or taken away. A number of MLAs noted that in some cases, hospital beds were being taken up because adequate domiciliary care was unavailable. The motion was passed by oral vote. Health and Social Care Services for Vulnerable people Tommy Gallagher MLA of the SDLP brought a motion before the Assembly expressing concern at the reduction in essential health and social care services for vulnerable people and calling on the Minister to tackle wastage within his Department and its agencies. The motion
further called on the Minister to review senior salaries, spending on travel and accommodation for senior management and procurement practices. Mr. Gallagher said that the SDLP was not prepared to support the ringfencing of the health budget until wastage in the system is reigned in. A number of MLAs criticised the salaries of top earners in the Trusts and the high level of bureaucracy which exists. In response, Minister McGimpsey said that his department was the only one to have completed a Review of Public Administration, and are reducing administrative staff by 1,700 and saving £53 million per anum. New member of the Health Committee Pól Callaghan of the SDLP has replaced Mary Bradley on the Health Committee. Pól was recently co-opted to the Assembly take the seat vacated by Mark Durkan MP in the Foyle constituency. Aged 33, Pól is now the SDLP’s youngest MLA. He has worked as an assistant to Mark Durkan for the past three years, and has previously worked in the Northern Ireland Equality Commission and Health Service. Consultation on the Obesity Framework A new consultation has been launched on the Obesity Prevention Framework for Northern Ireland, 2011-2021. This Framework aims to “empower the population of Northern Ireland to make healthy choices, and reduce the level of harm related to overweight and obesity, by creating an environment that supports and promotes a physically active lifestyle and a healthy diet”. The consultation opened on 2nd November 2010 and will remain open until 28th January 2011.
“The e-zine looks really good” Bill Halliday, MindWise
HEALTH MATTERS – December 2010
As the era of radical spending cuts begin, we speak to Hugh Mills, Chief Executive of Independent Health and Care Providers (IHCP), about how he believes the independent health sector could ease the burden of devastating cuts in the health budget, by creating £50 million per annum in savings. In recent years Trusts have been reducing their long stay beds across all programmes of care. All nursing home care is now provided by the independent sector. It’s a service the independent sector has developed successfully and Hugh sees no reason why this can’t happen on a broader scale. It is a strategy he believes could be used to help protect other frontline health services. “If politicians want to protect community care services on the ground, they should be looking to the independent sector to provide it because they will provide more services than the statutory services for the same amount of money. It’s quite straight-forward. And these services are quality assured, being regulated by the Regulation and Quality Improvement Authority (RQIA).” In the case of care provided in people’s own home, frontline services are increasingly restricted to basic personal care, eradicating previous support available for practical needs such as shopping or laundry. The independent sector, he argues, offer a good quality of service at better value for money, offerring a saving to the Trusts which should be reinvested into extending services. He continues “If the current levels of domicillary care were maintained and moved from the statutory sector to the independent sector, the savings would be in and around £40 million per annum.” The amount saved in relation to residential care would be £10 million. The figures can’t be ignored given that community care provision is such an essential frontline service. If budgets are cut there will be less funding available and this will impact upon people’s care. It’s a situation that applies to all care whether provided by the statutory or independent sector. The combination of reduced funding and the ageing demographics is a problem Hugh cites as the biggest challenge facing society, likening the magnitude of the challenge to that of climate change. Whilst these issues are serious and
reductions are inevitable, Hugh believes the independent sector is “very well prepared” to deal with an increased responsibility in providing services: “They’ve always been quicker off the mark in responding to situations; I think that’s an inevitability of a sector which has that flexibility and can respond to needs and changes.”
“In terms of residential care, Trusts have already acknowledged that their services are more costly and they’re winding them down because their accomodation, in a number of cases, isn’t meeting current standards. The independent sector is ahead of the game in terms of setting those standards... The reality is they are competeing for business and have to provide what families and residents actually want”. Although the independent sector offers cost effective care, Hugh stresses that quality is not compromised. Politicians, he argues, need to forget their preconceived perception that “public is good, private is bad”. Services are assessed by the RQIA and offer quality assured, regulated services. He points to a recent survey conducted by the RQIA, assessing both statutory and independent domiciliary care providers, which found the independent sector was providing better quality. Yet still the independent sector is viewed with suspicion, with suggestions that it makes profits from the vulnerable. Hugh is keen to point out, market pressures mean there is
no room for a business to abuse its position as a care provider: “If a care home is not delivering quality, it will very soon get a bad reputation.” The business restraints of an independent care home means it must be well run, otherwise it would go out of business; in contrast, statutory sector equivalents are not subject to the same pressures. As a business, they must be able to provide quality services which are well regulated, value for money and offer high standards. So why hasn’t the government been doing more with regards to allowing the independent sector to help? Hugh believes this is down to political pressures to protect public sector jobs. However, giving the climate change-style challenge facing society and the potential £50 million that could be saved, he suggests that we all need to remember the real need is to protect older and vulnerable people and the services they receive. And whatsmore if these savings here invested in services in the independent sector there would be more jobs and they would assist development of Northern Ireland’s Enterprise Economy. Hugh is certain that the independent sector has the capacity to take on the role of care for the elderly, disabled and vulnerable. But, as he points out, it will depend on politicians changing their perceptions of the independent sector. “Many individuals and their families r e s p o n d positively to the limited care they receive and we must endeavour to maximise this provision by using all the available resources m o r e effectively”.
HEALTH MATTERS – December 2010
Skin cancer prevention strategy – closes 24th December
Consultation on the development of a new strategy focusing on the importance early detection and prevention.
Display of Tobacco Products – closes 24th December
Consultation on draft tobacco control regulations removing displays of tobacco products at point of sale and banning sales of tobacco products from vending machines.
Obesity Framework – closes 28th January
A new consultation has been launched on the Obesity Prevention Framework for Northern Ireland, 2011-2021. This Framework aims to “empower the population of Northern Ireland to make healthy choices, and reduce the level of harm related to overweight and obesity, by creating an environment that supports and promotes a physically active lifestyle and a healthy diet”.
Details of all consultations can be found here: http://www.dhsspsni.gov.uk/index/consultations/current_consultations.htm
“Had a quick look at the Health Matters publication - It’s short and snappy and pulls together quite a diverse range of issues. It’s easy to read with a user friendly layout.” Breedagh Hughes, Royal College of Midwives
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Issue 9 of Health Matters, A monthly overview of news and developments within the health sector in Northern Ireland, produced by ASITIS Cons...