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£7 an hour, receives an extra £1 an hour for a night shift and £2 an hour for weekends.

"The NHS encourages you to have these NVQs, all this training, improve your knowledge, and then they [private care companies] come along and it all comes to nothing.

Care UK expects to make a profit "of under 6%" by the end of the three-year contract

£700,000 operating profit in the six months between September last year and March this year,

In 1993 the private sector provided 5% of the state-funded services given to people in their homes, known as domiciliary care. By 2012 this had risen to 89% – largely driven by the local authorities' need for cheaper ways to deliver services and the private sector's assurance that they could provide the answer. More than £2.7bn is spent by the state on this type of care every year. Private providers have targeted wages as a way to slice out profits, de-skilling the sector in the process.

1.4 million care workers in England are unregulated by any professional body and less than 50% have completed a basic NVQ2 level qualification, with 30% apparently not even completing basic induction trainin

Today 8% of care homes are supplied by private equity-owned firms – and the number is growing. The same is true of 10% of services run for those with learning disabilities

William Laing

report on private equity in July 2012

"It makes pots of money.

Those profits – which are made before debt payments and overheads – don't appear on the bottom line of the health firms' company accounts, and because of that corporation tax isn't paid on them.

Some of that was in payments on loans issued in Guernsey, meaning tax could not be charged. Its sister company, Silver Sea, responsible for funding the construction of Care UK care homes, is domiciled in the tax haven of Luxembourg

Bridgepoint

.voterDiv .ob_bctrl{display:none;} .ob_pdesc IMG{border:none;} .AR_1 .ob_what{direction:ltr;text-align:right;clear:both;padding:5px 10px 0px;} .AR_1 .ob_what a{color:#999;font-size:10px;font-family:arial;text-decoration: none;} .AR_1 .ob_what.ob-hover:hover a{text-decoration: underline;} .AR_1 .ob_clear{clear:both;} .AR_1 .ob_amelia, .AR_1 .ob_logo, .AR_1 .ob_text_logo {display:inline-block;vertical-align:text-bottom;padding:0px 5px;box-sizing:content-box;-moz-box-sizing:content-box;-webkit-box-sizing:content-box;} .AR_1 .ob_amelia{background:url('http://widgets.outbrain.com/images/widgetIcons/ob_logo_16x16.png') no-repeat center top;width:16px;height:16px;margin-bottom:-2px;} .AR_1 .ob_logo{background:url('http://widgets.outbrain.com/images/widgetIcons/ob_logo_67x12.png') no-repeat center top;width:67px;height:12px;} .AR_1 .ob_text_logo{background:url('http://widgets.outbrain.com/images/widgetIcons/ob_text_logo_66x23.png') no-repeat center top;width:66px;height:23px;} .AR_1:hover .ob_amelia, .AR_1:hover .ob_logo, .AR_1:hover .ob_text_logo{background-position:center bottom;} .AR_1 .ob_org_header { border-top: 10px solid #D61D00; display: block; font-family: georgia,serif; font-size: 14px; font-weight: bold; padding-bottom: 10px; padding-top: 5px; } More from the guardian Rogeting: why 'sinister buttocks' are creeping into students' essays 08 Aug 2014 Theatre's decision to ban Jewish film festival is 'thin end of wedge' 09 Aug 2014 Sir Paul Nurse: 'I looked at my birth certificate. That was not my mother's name' 09 Aug 2014 Adventures in contraception: eight women discuss their choices 10 Aug 2014 Child prison deaths 08 Aug 2014 [?] .voterDiv .ob_bctrl{display:none;} .ob_pdesc IMG{border:none;} .AR_2 .ob_what{direction:ltr;text-align:right;clear:both;padding:5px 10px 0px;} .AR_2 .ob_what a{color:#999;font-size:10px;font-family:arial;text-decoration: none;} .AR_2 .ob_what.ob-hover:hover a{text-decoration: underline;} .AR_2 .ob_clear{clear:both;} .AR_2 .ob_amelia, .AR_2 .ob_logo, .AR_2 .ob_text_logo {display:inline-block;vertical-align:text-bottom;padding:0px 5px;box-sizing:content-box;-moz-box-sizing:content-box;-webkit-box-sizing:content-box;} .AR_2 .ob_amelia{background:url('http://widgets.outbrain.com/images/widgetIcons/ob_logo_16x16.png') no-repeat center top;width:16px;height:16px;margin-bottom:-2px;} .AR_2 .ob_logo{background:url('http://widgets.outbrain.com/images/widgetIcons/ob_logo_67x12.png') no-repeat center top;width:67px;height:12px;} .AR_2 .ob_text_logo{background:url('http://widgets.outbrain.com/images/widgetIcons/ob_text_logo_66x23.png') no-repeat center top;width:66px;height:23px;} .AR_2:hover .ob_amelia, .AR_2:hover .ob_logo, .AR_2:hover .ob_text_logo{background-position:center bottom;} .AR_2 .ob_org_header { border-top: 10px solid #D61D00; display: block; font-family: georgia,serif; font-size: 14px; font-weight: bold; padding-bottom: 10px; padding-top: 5px; } /* updated via mysql on 2014-04-08 */ .AR_2 .ob_what { display: block; } /* added via mysql on 2014-06-20 */ .OUTBRAIN:hover .ob_what a { text-decoration: underline; } .ob_box_cont.AR_2 { padding-bottom: 5px; } /* end mysql add */ /* added via mysql on 2014-07-14 */ .AR_2 .ob_org_header span { color: #999; font-family: arial; font-size: 11px; font-weight: normal; display: block; } /* end 2014-07-14 */ More from around the webPromoted content by Outbrain http://paid.outbrain.com/network/redir?p=0iZOm4XuGW6R5uuT6ZFciNevzJlIfmxs0SRwpiMrH7gWrMXoPie4vIA9PlhaEW%2BXNi57pCgl9j8yOE3HuJT75pwCLNj4n18v3EKQDEV0YFQjOBxc46mOs

he national safety improvement programme, launched in 2008, included a focus on infection prevention, targeted screening of vulnerable elderly patients, and extra checks on administration of high risk drugs.2Although the study was not a randomised controlled trial and so proved no causal relation, the researchers argued that the reductions found in numbers of preventable adverse events in elderly and surgical patients fitted well with progress made in the use of checklists for these groups as part of the national patient safety programme. Though the figures are encouraging, concerns remain that nearly 1000 patients still die every year.

The Netherlands is the best country in Europe to live for health care, a new report has found. The 2014 Euro Health Consumer Index (ECHI) ranked 37 countries according to several factors. These were patient rights and information disclosure; accessibility and waiting times for treatment; outcomes; the range of services offered; illness prevention and access to pharmaceuticals.

The 2012 government of Ontario-commissioned Drummond report projected that the cost of the province's health-care system, which already devours almost half of provincial spending, will rise to 80 per cent over the next two decades. The report states, "We challenge the government to open the door more widely for private sector involvement, not only to improve efficiencies, but also to capitalize on the huge economic potential in building a vibrant health care sector in Ontario".

The role of government is mainly funding and regulatory. The lesson here is that, as in virtually all other sectors, governments that try to be the deliverer and the regulator fail to do either well. That systems featuring competing private sector providers would prove superior to a bureaucratic government monopoly should come as no surprise. But that monopoly is also financially unsustainable. Ontario is the poster boy for this stark reality.

Recent Fraser Institute reports on the German and Dutch health-care systems found that just five per cent suffered elective surgery wait times longer than four months, compared with 25 per cent in Canada. Those assessments also pinpoint the key reasons for this superior performance. Germany provides universal access to high quality, timely health care through statutory social health insurance, along with an option to buy supplemental insurance. Since Germany's government monopoly health-care system was replaced in 1991, the proportion of care delivered by private hospitals and clinics has risen to 70 per cent. The result has been higher quality care and shorter wait times at a lower cost. Private hospitals and clinics also play a dominant role in the Netherlands. The Dutch system offers universal coverage while allowing the public to select providers competing on the basis of quality and timelines of care.

So what is that "economic potential"? A 2013 report commissioned by the Royal College of Physicians and Surgeons found that one out of six new medical specialists can't find work, while many others accept roles far below their qualifications. Even long-established specialists are only working part time because of severe shortages of operating room access. Allowing these highly qualified professionals to fill those empty hours treating paying patients in private facilities would not only reduce public system waiting lists and costs, but also foster the establishment of Canada as a "go-to" country for fee-paying international patients. This represents a huge opportunity to enhance the sustainability of our public health-care system, while creating a thriving private health care industry.

One would think such a compelling picture would have funding-stressed governments eager for change. But with the exception of Quebec, provinces have tried to stamp out the fragile green shoots of private patient care. The fate of private health care will soon rest with the Justices on the Supreme Court of British Columbia.

After the British Columbia Medical Services Commission ordered him to stop collecting fees at his Vancouver private clinics, Dr. Brian Day launched a lawsuit on behalf of four of his patients claiming a constitutional right to access timely private care. These patients had faced long waiting times that would have proven permanently debilitating or even fatal.

It's astounding that Day and his patients should be forced to fight an expensive court case aimed at winning Canadians the same freedom of choice that exists in every other country. Governments across Canada had better hope he wins, or they will see their citizens trapped in a downward spiral of ever-longer waiting lists and ravaged social programs. Gwyn Morgan is a retired Canadian business leader who has been a director of five global corporations. (troymedia.com)

the price tag — an estimated $1.2 trillion over the next 35 years

backed up by a 27-page study

The final speaker was Michael Decter

The challenge is not insurmountable, he assured the audience. Germany has done it. Several other nations — Japan, Korea, the Netherlands and Luxembourg — are following the same path. But it will require a mix of public and private funding.

What all three speakers agreed on was that it is critical to get Canadians thinking and talking about this issue. The existing elder care system is breaking under the strain — the waiting list for a spot in a nursing home is approximately 20,000 in Ontario alone — and the baby boom hasn’t even hit its heavy-need years. Home care is severely underfunded. And hospitals, the most expensive option, can’t accommodate an influx of frail, elderly patients.

In the 1980s, Bayer sold Factor VIII concentrate, a blood-clotting medicine acquired from Cutter Laboratories in 1978. Though Factor VIII carried a high risk of transmitting AIDS and Bayer knew, Bayer continued to sell the drug in Asia and Latin America while selling a new, safer product in the West.

takeover would dilute Bayer’s core drug business currently flush with sales of its blood-thinner Xarelto and Eylea, a drug to treat blindness.

Coalition Against Bayer Dangers

Bayer, a history of unsafe drugs

Monsanto’s first entry into Big Pharma.

Blood clotting drug spread AIDS

all three proposed mergers face antitrust reviews by agencies in the U.S., Europe and China,

In Hong Kong and Taiwan alone, more than 100 hemophiliacs got H.I.V. and “many have since died,” reported the New York Times. 

Statin Baycol recalled

In 2001, Bayer withdrew its lucrative new statin drug Baycol because more than 50 people had died and more than six million patients were at risk from the deadly side effects of rapidly dissolving of muscle tissue.

Yaz birth control pill causes deaths

Xarelto, shady approval of a dangerous drug

underreported bright side: Industries that are doing well generally spin off; industries that are performing poorly generally merge and consolidate.

Millions Against Monsanto movement,

Not a chance, On October 14-16, merged or not with Bayer, the OCA and the global grassroots will expose Monsanto’s crimes against humanity and the environment at the Monsanto Tribunal, a citizens’ tribunal which will take place in The Hague, Netherlands.

“Dutch healthcare uses the fewest antibiotics in the world,” is the bold and justifiable claim of the Dutch Health Council, the government’s independent scientific advisers. The country has had low use for decades.1 Yet in veterinary medicine the Netherlands, the world’s second largest exporter of agri-food products (after the United States), was, until a few years ago, among the highest users. This mismatch sparked action that saw the country cut antibiotic use in farm animals by nearly 60% from 2007 to 2015.2 3

152 residents

A compact, self-contained model village on a four-acre site on the outskirts of town, half of it is open space: wide boulevards, cosy side-streets, squares, sheltered courtyards, well-tended gardens with ponds, reeds and a profusion of wild flowers. The rest is neat, two-storey, brick-built houses, as well as a cafe, restaurant, theatre, minimarket and hairdressing salon.

low, brick-built complex, completed in early 2010

encourages residents to keep up the day-to-day tasks they have always done: gardening, shopping, peeling potatoes, shelling the peas, doing the washing, folding the laundry, going to the hairdresser, popping to the cafe

250-odd full- and part-time staff

six or seven to a house, plus one or two carers, in 23 different homes. Residents have their own spacious bedroom, but share the kitchen, lounge and dining room.

25 clubs, from folksong to baking, literature to bingo, painting to cycling

suffering from severe or extreme dementia

seven different "lifestyle categories"

Nor is the cost per resident of this radically different approach to dementia care much higher than most regular care homes in Britain: ¤5,000 a month, paid directly to Hogewey by the Dutch public health insurance scheme

a house in ambachtelijke style, for people who were once in trades and crafts: farmers, plumbers, carpenters

Huiselijke is for homemakers: neat, spotlessly clean, walls hung with wooden display cabinets for dozens of brass and porcelain ornaments

No doors – apart from the main entrance, with its hotel-like reception area – are locked in Hogewey; there are no cars or buses to worry about (just the occasional, sometimes rather erratically-ridden, bicycle) and residents are free to wander where they choose and visit whom they please. There's always someone to lead them home if needed.

Other houses are designated christelijke, for the more religious residents; culturele, for those who enjoy art, music, theatre (and, says Van Zuthem, "getting up late in the morning"); and indische, for residents from the former colony of Indonesia (rattan furniture, Indonesian stick puppets on the walls, heating two degrees higher in winter, and authentic cuisine).

urban, for residents who once led a somewhat livelier lifestyle

By the time Hogewey was finished, it had cost ¤19.3m (£15.1m). The Dutch state funded ¤17.8m, and the rest came from sponsors and local fundraising.

anyone can come and eat in the restaurant, local artists hold displays of their work in the gallery, schools use the theatre, businesses hire assorted rooms for client presentations

One is gooise, or Dutch upper class

Some residents also pay a means-tested sum to their insurer. There is a very long waiting list.

You don't see people lying in their beds here. They're up and about, doing things. They're fitter. And they take less medication.

we've shown that even if it is cheaper to build the kind of care home neither you or I would ever want to live in, the kind of place where we've looked after people with dementia for the past 30 years or more, we perhaps shouldn't be doing that any more."

allow people to buy health insurance from a choice of up to 180 private insurers

Though there is a shortage of empirical evidence in any of the countries on what works, evidence suggests that such a system encourages patients and doctors to better manage their health, curbing the likelihood people will end up in an emergency ward or pricey acute-care hospital bed, the report said.

Canadians appeared to experience higher rates of some hospital errors or adverse events, including trauma during delivery of babies

Canada has higher rates of foreign bodies being left in incisions after surgeries but that may be because Canada does a better job collecting adverse events data than some other countries

wait times to receive care were highest in Canada in an 11-country survey cited in the OECD report

While survival rates for breast cancer and colorectal cancer are among the highest in the OECD, the country has a relatively high rate of cancer compared to other countries, the CIHI report says.

As well, the country's self-reported obesity rate is the second-highest in the G7 countries.

lower smoking rates in Canada today may mean fewer lung cancer cases in the future — but some of this progress could be offset by higher obesity rates

The OECD report says Canada spent 11.4 per cent of its gross domestic product on health in 2009, more than the OECD average of 9.6 per cent. The United States spent the most, at 17.4 per cent of GDP, with the Netherlands, France and Germany spending slightly more than Canada.

Health spending per person in Canada was also higher than the OECD average. Canada spent $4,363 (U.S.) per person on health care in 2009; the OECD average was $3,233 (U.S.).

If nothing is done to transform the health care system, with the aging of the population this proportion will rise to 3.2 per cent by the year 2050.

This growth could be significantly reduced to 2.3 per cent if a sizable investment (e.g. 0.4 per cent of GDP or $5 billion) is made in home care now.

In the short term, a substantial return on investment (ROI) would be generated by keeping women in the work force and creating home care jobs in the public, private and social economy sectors. In the medium term, a further ROI would likely result from decreasing the use of hospital beds by patients waiting for nursing home beds and reducing the need for nursing homes.

home care should become a right and not a privilege as it is now

To achieve this, a public long-term care insurance plan should be created

to cover the necessary services from public (“in kind”), private, social economy or voluntary organizations

We should not opt for “cash-for-care” allowances as in some European countries since this type of benefit has undesirable effects: the creation of a “gray market” with untrained and underpaid workers, risk of financial abuse, poor quality services, and keeping women in traditional roles.

To finance this universal publicly funded insurance plan, a specific fund should be created to which the current budget for long-term care would be transferred to ensure a clear separation of this budget from the rest of the health care budget.

This growth could be significantly reduced to 2.3 per cent if a sizable investment (e.g., 0.4 per cent of GDP or $5 billion) is made in home care now.

We need to change the philosophy of home care: It should become a right and not a privilege as it is now.

a public long-term care insurance plan should be created

to cover the necessary services from public (“in kind”), private, social economy or voluntary organizations

We should not opt for “cash-for-care” allowances as in some European countries since this type of benefit has undesirable effects: the creation of a “grey market” with untrained and underpaid workers, risk of financial abuse, poor quality services, and keeping women in traditional roles.

To finance this universal publicly funded insurance plan, a specific fund should be created to which the current budget for long-term care would be transferred to ensure a clear separation of this money from the rest of the health care funding.

It is time for a Continuing Care Act in Canada that would prioritize integrated care and home care, and include the creation of a public long-term care insurance plan

Réjean Hébert is a geriatrician and professor at the Research Centre on Aging of the Université de Sherbrooke.

The white paper draws lessons from seven comparator countries (U.K., Australia, Germany, U.S., France, Switzerland and the Netherlands), which formed the foundation for the Centre’s key recommendations for Canada’s health care system. The Centre’s recommendations include the following: Create financial incentives using insurance programs or personal health budgets that empower consumer decision making to drive competition and innovation among health system stakeholders. Make the case for innovation adoption by empirically measuring and capturing the impact of innovation on health system sustainability and patient outcomes. Transform Canada’s health system from a dominant acute care focus to a community-based system focused on chronic illness management and prevention. Create accountability systems whereby health providers, and physicians in particular, assume 24/7 responsibility for managing health and wellness in communities.

arm citizens with the tools and resources to manage their own health and welfare in partnership with health providers

the Department of Health in the United Kingdom (UK)1 has found that bed occupancy rates exceeding 85% in acute hospitals are associated with problems dealing with both emergency and elective admissions. That county has instituted a target bed occupancy of 82% as one of its hospitals' quality measures.

Borg3 also found a significant correlation between bed occupancy and MRSA infection rates.

The association between nosocomal infection and bed occupancy rate was also highlighted in another UK Department of Health report5 . That report revealed that hospitals with occupancy rates of more than 90% had a 10.3% greater incidence of MRSA infection than those with occupancies below 85%. Furthermore, the UK House of Commons Committee of Public Accounts has "repeatedly noted that high levels of bed occupancy are not consistent with good control of infections" 6 .

This model suggests that there is a discernable risk of a hospital failing to provide sufficient beds, and thereby safe efficient care, when average bed occupancies exceed 85%.

considering the nature of hospital system, "spare (bed) capacity is essential if an emergency admissions service is to operate efficiently and at a level of risk acceptable to patients".

Orendi6 has recently compared the circumstances in the UK with those in the Netherlands where the average hospital bed occupancy rate was 64%, as opposed to 84% in the UK (2005), with the same number of beds per head of population.

The lesser pressure on hospital beds may in part have been the result of the special level of care provided to nursing home patients

Canadian data also show that hospital bed availability has a significant influence on ED length of stay for admitted patients10 (access block) and thus a delay in patients reaching an appropriate inpatient bed. This was most marked when "hospital occupancy exceeded a threshold of 90%", as also found by Sprivulis et al11.

analysis of emergency presentations to an Australian hospital has shown that access block may increase a patient's overall hospital length of stay12

increased in-hospital mortality11,13

increase in the mortality of patients presenting to EDs in Western Australia11 independent age, season, diagnosis or urgency.

there appears to be sufficient evidence to support the contention that bed occupancy rates provide a useful measure of a hospital's ability to provide high quality patient care and that 85% is a reasonable target.

That's long-term care in Denmark, Margaret MacAdam says. The University of Toronto professor focuses on health policy and how it relates to gerontology, visiting institutions across Canada and around the world to look at who is doing it best.