Babak Belurs

Kamis, 06 Juli 2023

HS2: Government unclear on Euston station goal, report finds - BBC

Computer-generated image of what Euston HS2 station would look like

By Yasmin Rufo

BBC News

The government still does not know what it is trying to achieve with the High Speed 2 (HS2) station at Euston, a parliamentary committee report states.

The Public Accounts Committee (PAC) said this was despite the Department for Transport (DfT) spending over eight years planning and designing it.

In March it was announced that station work had been paused for two years.

The DfT said it remained "committed to delivering HS2 in the most cost-effective way".

The PAC report called on the DfT to use the current pause in construction on the project to establish the design and expectations for the station against what it is willing to spend.

It called the original £2.6bn budget "completely unrealistic", with estimates now suggesting the cost to build the station to be about £4.8bn.

It also said the department must provide greater transparency in its six-monthly updates to Parliament.

Previous updates on cost pressures at Euston did not disclose the risks that construction costs could be significantly higher than expected, the committee said.

Other conclusions and recommendations from the PAC report included:

The department does not yet know the costs and impacts of pausing construction
The department and HM Treasury have not reached a clear understanding about how they would manage high levels of inflation on the HS2 programme
The department's reports to Parliament on the HS2 Programme did not reflect the significant level of uncertainty in its estimated cost of Euston station
The department has not yet learned lessons from managing major rail programmes

Dame Meg Hillier MP, chair of the committee, said the Euston project was "floundering".

She said the scheme had caused "major disruption to the local community" and pausing it was "not cost free", even though it had been done to save money.

"The government must now be clear what it is trying to achieve with this new station, and how it will benefit the public," she added.

Responding to the report, a DfT spokesperson said: "Earlier this year we made the decision to rephrase the construction of Euston to help balance the nation's books and work on an affordable design for the station.

"The National Audit Office recently acknowledged this will provide time to put the station design on a more stable footing and we continue to work at pace to ensure the transformational benefits of HS2 are delivered to passengers by better connecting our biggest cities, supporting thousands of jobs and helping grow the economy.

"We note the recommendations made in the committee's report and will respond to them in due course."

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Rabu, 05 Juli 2023

NHS 75: Warning Wales' health service is not fit for future - BBC

By Jenny Rees

BBC Wales health correspondent

Wales' NHS is not fit for the future in its current form, the health minister is expected to say.

Speaking at a conference later to mark 75 years of the NHS, Eluned Morgan will warn that increased demand on services means tough choices lie ahead.

She is expected to say the health service will need reform if it is to be preserved for future generations.

Groups representing NHS staff have long complained of worker shortages at all levels in the health service.

A projected rise in cancer and diabetes, among other conditions, means the health service will need to treat even more patients in future.

The number of people diagnosed with cancer is expected to rise from 20,000 a year to 25,000 a year in the next 20 years.

Type 2 diabetes is also projected to rise rapidly, reaching 17% of the population by 2035.

Advancement in treatment and care, coupled with people living longer, means there are more complex cases to treat.

During her speech it is understood the minister will also announce an independent review into the management of the NHS.

She will also repeat her calls for people to help by looking after their own health and wellbeing.

Retention is also a serious concern, with about 5,000 vacant posts across Wales.

The health service has faced a series of strikes by workers in a dispute over pay and conditions.

Earlier this week, Prime Minister Rishi Sunak set out a 15-year plan to recruit and train 300,000 more doctors and nurses in England.

It is thought the independent group being set up by the Welsh government will focus on NHS governance and accountability and whether it can meet future needs.

Meanwhile, it has emerged that the first regional diagnostics hub, serving about half the population, will include surgery space in the future, to bring down lengthy waiting lists.

While plans are still in their infancy for the new centre in south Wales, one NHS boss said he hopes some services will start by the end of this financial year.

Paul Mears, chief executive of Cwm Taf Morgannwg University Health Board

Paul Mears, head of Cwm Taf Morgannwg health board, where the diagnostic hub will be located, said patients would accept travelling further for care if it meant being seen more quickly in the future.

The new hub based in Llantrisant will cover the Cwm Taf Morgannwg, Cardiff and Vale, and Aneurin Bevan health boards in south east Wales.

While it was initially billed as a diagnostics and treatment hub, Mr Mears said the aspiration is for that to include surgery, further down the line.

Opposition parties have long called for the establishment of surgical hubs, which are separated from the demands of emergency patients, to help tackle the post-pandemic backlog.

Waits for orthopaedic operations and other surgeries are among the most stubborn in Wales, with more than 30,000 people waiting longer than two years for treatment.

But Mr Mears said health boards with extra capacity have already been working with neighbours to reduce their waiting lists, where possible.

"What we're looking at is how we can work together to think about the collective resources available to us and we've got some really great examples already happening in ophthalmology," he said.

"We have been offering opportunities for our patients to go down to Cardiff to have their procedure to try and make sure that we get as many people through as quickly as possible."

The regional hub will be based in an existing set of buildings near the Royal Glamorgan Hospital and will provide CT and MRI scans as well as ultrasounds in the first instance.

Mr Mears hopes mobile services could be on site by spring 2024, but acknowledged it would be some time before the site is fully kitted out and operational.

"Also we'll be looking to provide treatment there - so theatre capacity to provide day surgery facilities for all sorts of surgical procedures. Potentially some orthopaedic capacity and other surgical specialties," he added.

"Often we have to cancel elective operating lists because we've got huge pressures on the beds from the emergency patients.

"A facility such as the one in Llantrisant will mean that we will have dedicated space that can't be 'crashed' by the emergency demand coming through the front door.

"It will give surgeons, anaesthetists, nurses, and others the ability to keep going with the work regardless of how many people are coming through on the emergency side."

'World leader'

"It will either get filled by the Labour Party with their green industrial policy, or it will get filled by the climate delayers and detractors who then dominate the front pages of the Telegraph and the Mail.

"If you're not willing to show leadership, someone else will."

A government spokesperson responded: "We can be proud of the UK's record as a world leader on net zero. We are going far beyond other countries and delivering tangible progress whilst bringing down energy bills with hundreds of pounds coming off bills.

"With a new department dedicated to delivering net zero and energy security, we are driving economic growth, creating jobs, bringing down energy bills, and reducing our dependence on imported fossil fuels.

"The UK is also cutting emissions faster than any other G7 country and attracting billions of investment into renewables, which now account for 40% of our electricity."

Mr Skidmore is one of the Conservative party's keenest advocates for pursuing net-zero policies - plans that ensure the UK is not adding to the total amount of greenhouse gases in the atmosphere.

Last year, he was commissioned by then-Prime Minister Liz Truss to review the government's delivery of net zero to ensure it was "pro-growth and pro-business".

Mr Skidmore, who is standing down as an MP at the next general election, told the Institute for Government event that having voted against the government on fracking In October, he had been "fully prepared to be sacked" from his climate role.

However, the following day Ms Truss resigned, "and I was left in post," he said.

Addressing the same conference, Labour's shadow energy secretary Ed Miliband said climate change was a "great threat" but also provided a "great opportunity".

He argued that changing the UK's sources of energy would ensure the country was not "at the mercies of the Putins of this world". The UK has been trying to decrease its reliance on Russian oil and gas since the invasion of Ukraine last year.

Last month, Labour watered down its pledge to invest £28bn a year in green industries. The party says it will ramp up investment over time, if it wins the next general election.

Mr Miliband said his party was still committing to a "significant sum".

Selasa, 04 Juli 2023

No money for birthday gifts as the NHS turns 75 - BBC

BBC producer Claire McAllister with partner John after the birth of baby Christopher

By Lisa Summers

Scotland Health Correspondent

BBC Scotland's office in Edinburgh has had a lot to thank the NHS for in recent weeks.

My colleague, political editor Glenn Campbell, has been missing in action recently - spending a week in hospital after a serious pothole incident on his bike.

It involved paramedics, A&E and a trauma team, but thankfully he is on the mend.

At about the same time our health producer Claire McAllister found herself in high dependency at the end of a rather complex pregnancy.

Again staff were amazing and delivered an adorable bundle of premature joy - and mother and baby are doing fine.

It got me thinking, what would those experiences have been like 75 years ago when the NHS was born?

And I wonder what a future NHS will look like, for a baby born in 2023.

Clearly the health service is still doing an incredible job in increasingly difficult circumstances.

But Covid and its aftermath have really tested a system which has been struggling for many years - and the warnings from the experts about the future are bleak.

The two biggest challenges are how to pay the soaring bills, and how to find enough people with the right skills to meet demand?

Big bills to pay

Earlier this year, BBC Scotland commissioned a poll to find out your views on the health service. Most people who responded said they expected the NHS to remain free at the point of need in 10 years' time and believed that the highest earners should be the ones to pay for it.

In Scotland this year's health and social care budget is £19bn. That is far more than is spent on education, the justice system and transport combined - but it is still not enough.

Already, taxpayers earning over £43,662 pay an extra penny in the pound, with the money going directly to the NHS, raising £129m in Scotland.

But to put that into context, the cost of this year's pay increase awarded to nurses, paramedics and other healthcare workers is more than £500m.

Huge advances in medicine and technology in the past 75 years mean many people can be cured of disease or live comfortably with quite complex medical conditions.

The patients who gave up waiting on the NHS

That's a cause for celebration but at the same time, health board budgets can't always stretch to offering the most expensive drugs or investing in new buildings or equipment.

Demand on the NHS is now much greater than when the service was being built.

In spite of some world-leading public health policies, Scotland remains a profoundly unhealthy nation.

A third of adults are now obese, and a quarter drink at harmful or hazardous levels.

About a fifth of the population lives in poverty.

More and more of these people will need help with complex combinations of illnesses, including heart disease or cancer, in the coming years.

Recruitment riddle

Workforce is the second fundamental issue that the NHS in Scotland faces.

The pensionable population of Scotland is expected to rise by 35% by 2043, yet over the same time period the working age population is expected to decrease by 3% and the number of children to decrease by 22%.

There are already significant NHS vacancy rates and a critical shortage of social carers.

I was shown a presentation slide the other day that suggested three in every 20 primary school children in Scotland will have to choose a career in the NHS, just to keep up with the current demand.

Attracting NHS workers from overseas is one option - but at the same time many homegrown clinicians are looking abroad for more rewarding opportunities as the health service struggles to retain existing staff.

Meanwhile, thousands of people are languishing on record waiting lists, wondering whether the NHS is really providing the safety net they were promised, from the cradle to the grave.

Free in future?

It is extremely difficult to see how policy makers can maintain the type of service we've become used to.

And while most people in our BBC poll wanted the NHS to remain free at the point of use, 43% said they would be likely to pay for private treatment if they faced long waits.

In the past year almost 10% had already done so.

But First Minister Humza Yousaf has been clear that he does not want a two-tier health service and that it must remain true to its fundamental principles.

These are issues the whole of the UK faces but many of the professional bodies and unions have been critical of the Scottish government for promising more than is realistically achievable.

And the spending watchdog said the government needs to be honest with the public about what its priorities are, and what the NHS can afford.

So there are plenty of difficult and potentially unpopular decisions to be made.

Do you raise taxes, cut other public spending, or even charge people for elements of care?

If not, the reality is cutting back on some of the services the NHS provides.

It is a big birthday for the NHS but celebrations are likely to be muted - while the hard work goes on.