HSJ Live 25.04.2013: Lords vote to defeat competition rules fails

5.22pm: We’ve published an exclusive by Sarah Calkin on NHS Direct U-turning on cost cutting plans, following its 111 debacle.

5.21pm: The Royal College of GPs has responded to Jeremy Hunt’s out of hours speech. Dr Clare Gerada, Chair of the RCGP said: “Once again, GPs are being used as a scapegoat and it is not acceptable.

“It is not true that the rise in demand on A&E services is due to a reduction in out of hours provision by GPs - and there is no evidence to prove that the increase is due to the GP contractual changes in 2004. We acknowledge that there has been a gradual rise in the numbers of patients attending A&E since 2004, but the numbers are calculated differently to a decade ago and now take into account attendance at Walk in Centres and Minor Injury Units.

“There are numerous reasons why our colleagues working in A&E departments are under pressure. As well as a serious shortage of A&E consultants, the lack of co-ordination between health, community and social care -  particularly in the care of frail elderly patients - leads to a myriad of problems including unnecessary admissions, breaches in the four-hour target and delays in ambulance turnaround.

“We must stop assuming that the health service starts and ends with hospitals.  Nor should we assume that increased demand equates to bad outcomes. Over the last decade, a number of initiatives have been put in place to  improve access to timely and appropriate care.”

4.00pm A copy of Jeremy Hunt’s speech to Age UK is now attached. As well as discussion of emergency demand Hunt also champions integration and calls for clinical commissioning group’s to address long standing issues with the discharge of frail elderly people

He said: “I have also asked NHS England to look at the system-wide operational incentives that need to change to make this happen.

“But in the meantime I will play my role by promoting better integration between the health and social care systems and addressing the national barriers that need to be removed.”

3.55pm The BMA has asked for an urgent meeting with the government followi

I have also asked NHS England to look at the system-wide operational incentives that need to change to make this happen.

But in the meantime I will play my role by promoting better integration between the health and social care systems and addressing the national barriers that need to be removed.

ng health secretary Jeremy Hunt’s comments on out of hours care.

Dr Laurence Buckman, chair of the GP committee, said: “The BMA has made it clear for many years that the provision of out-of-hours care in England needs to be improved, particularly in how it is resourced and co-ordinated, but it is wrong to blame the GP contract for problems with the system. The Government’s analysis of the problem is extremely inaccurate.

“Out-of-hours care has historically been badly underfunded even before the introduction of the GP contract in 2004. Despite rising patient demand, funding has remained static in the last few years. The bungled introduction of NHS 111, which was intended to alleviate pressure on the system, has just made matters worse.”

1.38pm Health public affairs manager Patrick Leahy tweets a link to an FT blog on prime minister’s questions yesterday:” PMQs: Miliband is relying on an NHS crisis | Westminster blog | http://t.co/7QtX6LKhJI http://t.co/AZWascQyG1

1.36pm The Department of Health has confirmed the review of out of hours care referred to in the Daily Telegraph story this morning is in fact the review of urgent and emergency care being led by Bruce Keogh. A spokesman said NHS England had been asked to look at out of hours care as part of that.

11.53am Chair of the Royal College of GPs Clare Gerada has hit back at claims changes to GP contracts are to blame for the pressure on A&E departments. Teeteing as @clarercgp she wrote: Rise in AE related to lack of access to social care - NOT GPs & new OOH contract.

The tweet was accompanied by a link to an article in the BMJ which supported her argument: http://bmjopen.bmj.com/content/3/1/e002007.long …

11.14am Troubled Basildon and Thurrock University Hospitals has been licensed by Monitor, but with “wide ranging conditions” HSJ’s reporter for the East of England James Illman reports.

10.55am The Chartered Society of Physiotherapy has responded to the failed vote to anul the section 75 regulations on competition.

In a statement chief executive Phil Gray said: “The Government’s claim that effective services will be protected from competition is undermined by recent history. We have already seen excellent services opened up to the market for no good reason with the expansion of any qualified provider for community health services such as physiotherapy.

“This has led to restrictions on treatment for patients and confusion for commissioners. “These new regulations seem certain to do the same for all other NHS services in an open market.

“Further fragmentation of services, when cuts and reorganisation are already wreaking havoc, cannot be in the best interests of patients or the health service at large.”

10.25am The Guardian features a front page story about the £20m vaccination campaign to halt the measles outbreak. The newspaper reports fiugures from Public Health ENgland which say there have been 587 confirmed cases in England in the first three months of this year, three times more than the same period last year.

10.14am In the Daily Telegraph’s opinion pages columnist Allison Pearson leaps to the defence of nurses, who she says have been unfairly blamed for Mid Staffordshire Foundation Trust scandal, and turns on NHS managers.

“This pampered breed skulk in their offices with luxuriant pot plants,” she writes, “while nurses are dispensing complex medication, answering phone calls from vexed relatives, bleeping doctors who are too busy to reply, and trying to prevent a confused patient climbing out of bed – all of which means they can’t answer the call bell rung by another patient who needs a bedpan.”

She also coins a new nick-name for NHS chief executive Sir David Nicholson: “He Who Cannot Be Sacked”. It’s probably more accurate than the Daily Mail’s similarly capital letter heavy moniker for Sir David The Man with No Shame.

10.00am The Daily Telegraph is trailling a speech due to be made by health secretary Jeremy Hunt later today in which he blames the “disatrous” changes to GP contracts, which allowed more than 90 per cent to opt out of providing out of hours services, for the pressure on accident and emergency departments. He will say this growing pressure is the “biggest operational challenge” facing the NHS.

9.27am: Health secretary Jeremy Hunt has criticised Labour’s bid to move primary care out of hours services outside of GPs’ general contracts. He apparently wants to see a move towards a different system of 24-hour primary care, and reports say there is a review on going. It is likely to be part of NHS England’s plans to extend 24/7 services and improve general practice.

9.19am: Last night’s Lords vote on whether to annull the government’s controversial competition rules was voted down. Labour’s attempt lost by 254 to 146 in a vote after 10pm. The breakdown of votes is available - coalition peers were united in opposing the “fatal motion”, which would have meant a second redrafting of the section 75 rules. You can read some of the points made in tweets by @HSJEditor, @HSJnews and @davewwest.

8.05am: Good morning, Hepatitis C virus is a growing public health problem in the UK. Infected people have three times the mortality rate of the general population and account for about a third of all cases of premature deaths from liver disease.

In London alone, 52,000 people are thought to have the virus. The majority of cases develop chronic infection.

In our commissioning channel today, Abigail Knight reveals how “one stop shop” local treatment of hepatitis C can help to tackle a long-overlooked health problem.