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Also In Global Health News: Children With HIV/AIDS; Leishmaniasis Treatment; ITNs In Tanzania; U.S. Malaria Fight; PEPFAR Safe Injection Funds
IRIN Examines Hardships Facing Parents, Guardians Of Children Living With HIV/AIDS
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Opinion Pieces Discuss Whether Current Efforts To Fix Health Costs Will Produce Sufficient Savings
David Brooks, New York Times: Health care costs have become "the crucial issue of [President Obama"s] whole presidency," Times columnist Brooks writes. According to Brooks, Obama"s original plan was to fund his priorities, including education and energy, with debt that would be paid off with future savings resulting from health care reform. Brooks writes that Obama"s aides have been discussing "game-changers" -- such as health information technology, wellness programs, preventive medicine, comparative effective measures and altering reimbursement policies -- that would result in cost reductions. However, Brooks writes that most experts do not think such efforts would "produce much in the way of cost savings over the next 10 years" and that "nobody is sure" the efforts would "ever produce significant savings." Brooks writes that because "there are deep structural forces, both in Medicare and the private insurance market" that make it "nearly impossible to put together a majority coalition for a bill" challenging those structures, reform efforts this year likely will produce a "medium-size bill that expands coverage to some groups but does relatively little to control costs." Brooks concludes, "Without serious health cost cuts," Obama"s agenda "will hasten fiscal suicide" (Brooks, New York Times, 5/15).
News of the day
House Seeks To Pay For Reform With New Tax On Wealthy
House Democrats are expected to begin marking up a health reform bill this week that members of the Ways and Means committee said "would cost less than $1 trillion over 10 years, [and would be] paid for chiefly by a combination of spending reductions in the health care system and a surtax on wealthy taxpayers," CQ Politics reports. "The surtax would be levied beginning in 2011. ò€¦ [T]here would be three income brackets - $350,000, $500,000 and $1 million for couples filing jointly, and $280,000, $400,000 and $800,000 for individuals - with a different rate at each level: "One, two, three [percent] - something like that,"" the committee"s chairman, Charles Rangel, D-N.Y., said (Wayne, 7/13).
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Good Governance Guidance Published For Primary Care Trust Provider Committees, UK

The Appointments Commission and the Department of Health have published guidance to help Primary Care Trusts (PCTs) with their governance arrangements for Provider Committees. Provider Committees are a committee of a PCT Board, overseeing the operations of a PCT"s provider arm. The guidance published today, "Governance Arrangements to Support PCT Provider Committees", sets out core principles that should underpin the committee"s membership and make-up. Provider Committees need to be able to focus on quality, taking into account patient safety, patient experience and effective outcomes. This guidance will help to ensure that these committees are able to independently monitor, identify and mitigate risks to patients. The guidance also offers options for recruiting the independent members and outlines their roles and responsibilities. All NHS organisations need to be underpinned by robust governance arrangements that deliver independent challenge, scrutiny and accountability. This is particularly important for community services as they transform their patterns of service and organisational structures. The Department of Health is also giving more freedom to the NHS, to allow timescales to be set locally for when a PCT must choose an organisational structure under which to operate. Moving to locally-set timescales will enable the NHS to focus on driving-up quality and productivity in community services. Minister of State for Health, Mike O"Brien, said: "This guidance will support Primary Care Trusts in ensuring their local governance arrangements are fully in place and that PCT Provider Committees are well-equipped to provide both excellent management and clinical leadership and independent scrutiny and challenge." Andrea Sutcliffe, Chief Executive of the Appointments Commission, said: "We have sought to address the concerns raised by PCTs that they needed clear guidance that was sufficiently flexible to respond to local circumstances. This guidance will help to ensure that recruitment of independent members to Provider Committees is supported by a process that is fair, rigorous, transparent and that is able to stand up to public scrutiny." Jonathan Montgomery, Chair of Hampshire PCT, said: ""I welcome the publication of today"s guidance, which contains principled and practical advice on how to ensure robust governance arrangements are in place for PCT provided services. It promotes consistency of practice and conformity with the high standards governance that patients and the public expect of NHS organisations, while recognising that the precise form of arrangements depends on local circumstances. "It also contains important advice on the recruitment of independent members to Provider Committees, to provide the challenge and scrutiny necessary to give assurance that provider services are strategically led and that risks are effectively managed." The guidance is available to download from the Appointments Commission"s website http://www.appointments.org.uk/providergovernance. A Frequently Asked Questions section to update PCTs on key issues and developments is also available on this site. Department of Health, UK


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