Tag Archives: hospitals

English hospitals say hit by suspected national cyber attack

FILE PHOTO: A National Health Service (NHS) sign is seen in the grounds of St Thomas' Hospital, in front of the Houses of Parliament in London June 7, 2011. REUTERS/Toby Melville/File Photo

By Costas Pitas and Alistair Smout

LONDON (Reuters) – Hospitals across England were being forced to divert emergency cases on Friday after suffering a suspected national cyber attack.

Among them was the Barts Health group which manages major central London hospitals including The Royal London and St Bartholomew’s.

“We are experiencing a major IT disruption and there are delays at all of our hospitals,” it said.

“We have activated our major incident plan to make sure we can maintain the safety and welfare of patients. Ambulances are being diverted to neighboring hospitals.”

Patients requiring emergency treatment across England were diverted away from the hospitals affected and the public was advised to only seek medical care for acute medical conditions.

Reuters was unable to independently verify whether the hospitals were the subject of a concerted cyber attack ahead of the June 8 election.

Britain’s National Crime Agency said it was aware of the reports of a cyber attack but made no further comment.

The National Health Service (NHS) said it was responding to the incidents.

“We are aware of a cyber security incident and we are working on a response,” said a spokesman for NHS Digital, a division of the NHS which handles information technology issues.

There was no immediate comment from the Health Ministry.

Earlier on Friday, Spain’s government warned that a large number of companies had been attacked by cyber criminals who infected computers with malicious software known as “ransomware” that locks up computers and demands ransoms to restore access.

(Additional reporting by Kate Holton, Andy Bruce, Michael Holden and David Milliken; Writing by Guy Faulconbridge; editing by Stephen Addison)

Insight: Ballooning bills – More U.S. hospitals pushing patients to pay before care

FILE PHOTO: An emergency sign points to the entrance to Scripps Memorial Hospital in La Jolla, California, U.S. March 23, 2017. REUTERS/Mike Blake/File Photo

By Jilian Mincer

(Reuters) – Last year, the Henry County Health Center in Iowa started providing patients with a cost estimate along with pre-surgery medical advice.

The 25-bed rural hospital in the southwest corner of the state implemented the protocol because of mounting unpaid bills from insured patients, a group that had previously not raised red flags.

Henry County is one of hundreds of U.S. hospitals trying to cope with an unexpected consequence of the Affordable Care Act of 2010, known as Obamacare: millions more Americans have health insurance, but it requires them to spend thousands of dollars before their insurer kicks in a dime.

Since U.S. hospitals do not want to end up footing the bill, they are now experimenting with pre-payment strategies for patients, with a growing number requiring payment before scheduled care and offering no interest loans, according to interviews with more than two dozen hospitals, doctors, patients, lenders and healthcare experts.

“Most patients are appreciative that we’re telling them up front,” said David Muhs, chief financial officer for the Henry County hospital, which provides a discount for early payment. The discussion leads some patients to skip care, others to delay it or use a no interest loans available through the hospital, he said.

The ACA extended insurance to 20 million Americans, which initially helped hospitals begin to shrink debt from uninsured patients who could not pay their medical bills. But more and more, people in Obamacare plans or in employer-based health plans are choosing insurance that features low monthly payments. The trade-off is high out of pocket costs when they need care. (For a graphic, click http://tmsnrt.rs/2oCzePS)

If President Donald Trump dismantles Obamacare as promised, these plans won’t disappear. Republicans also believe high-deductible plans curb spending, and Americans faced with medical costs that rise faster than inflation and wages will look for premiums they can afford.

The trend is expected to accelerate this year because unpaid bills are creating massive bad debt for even the most prestigious medical centers. U.S. hospitals had nearly $36 billion in uncompensated care costs in 2015, according to the industry’s largest trade group, a figure that is largely made up of unpaid patient bills.

The largest publicly-traded hospital chain, HCA Holdings Inc, reported in the fourth quarter of 2016 that its ratio of bad debt to gross revenues of more than $11 billion was 7.5 percent.

One of the first to test this new payment strategy was Novant Health, headquartered in North Carolina with 14 medical centers and hundreds of outpatient and physician facilities. It saw patient debt increase when more local employers started adopting high deductible plans, including one that made its executives pay $10,000 in out-of-pocket expenses.

“To remain financially stable, we had to do something,” said April York, senior director of patient finance at Novant, whose patient default rate dropped to 12 percent from 32 percent after it started offering no interest loans through ClearBalance.

“Patients needed longer to pay. They needed a variety of options,” she said.

IMPACT ON PATIENTS

These prepayment strategies are being rolled out by hospitals across the country because the financial equation has changed so much for patients – even the insured ones.

Almost half of Americans – 45 percent – polled by the Kaiser Family Foundation said they would have difficulty paying an unexpected $500 medical bill. The average deductible this year for the least expensive of the widely used Obamacare health plans is $6,000 for an individual – an 18 percent spike since 2014 – and more than double that for a family, according to government data.

Jessica Curtis, a senior advisor at Community Catalyst, a consumer advocacy group in Boston, said the impact on patients stretches beyond personal finance.

“They delay procedures, they don’t follow advice on prescription drugs, and when they see care, they usually are for more expensive procedures because they’ve waited,” she said

Brian Sanderson, managing principal of Crowe Horwath’s healthcare services group, said communicating with patients and providing longer repayment options is a good strategy since hospital margins have shrunk, thanks to growing unpaid medical bills from consumers.

“A well informed patient is more likely to meet their obligations,” he said. “It’s just good patient relations and it helps to minimize bad debt.”

Hospitals are doing what they can to retain patients while helping them pay medical bills that could run thousands of dollars. Many are expanding charity eligibility, and hiring companies like ClearBalance, AccessOne and Commerce Bank to provide loans to patients no matter what their credit. Most carry no interest rate for the patient, and could be extended far longer than the few months that hospitals once required before sending a bill to collections.

“People are more likely to pay a bank than a hospital,” said Mark Huebner, director of Health Services Financing at Commerce Bank, which offers its line of credit at more than 200 hospitals.

“People are aware that banks will come after them. Banks do collect on debt, and hospitals generally have been more relaxed,” he said.

Wake Forest Baptist Medical Center in North Carolina had seen its bad debt creep up in recent years as more patients saw out of pocket expenses soar, with some deductibles reaching $15,000.

“We’ve seen that many patients are unaware of the increases in their deductibles,” said CFO Chad Eckes. Wake Forest now asks for payment before non-emergency services are provided but also offers zero interest, longer repayment options.

“It’s a challenging position,” he said. “It’s a discussion no one wants to be in, and none of us enjoy.”

(Editing by Caroline Humer and Edward Tobin)

Like a nuclear bomb; cholera and destruction after hurricane in Haiti

Relatives and patients treated for cholera after Hurricane Matthew in the Hospital of Port-a-Piment, Haiti,

By Gabriel Stargardter

PORT-A-PIMENT, Haiti (Reuters) – Patients arrived every 10 or 15 minutes, brought on motorcycles by relatives with vomit-covered shoulders and hoisted up the stairs into southwest Haiti’s Port-a-Piment hospital, where they could rest their weak, cholera-sapped limbs.

Less than a week since Hurricane Matthew slammed into Haiti, killing at least 1,000 people according to a tally of numbers from local officials, devastated corners of the country are facing a public health crisis as cholera gallops through rural communities lacking clean water, food and shelter.

Reuters visited the Port-a-Piment hospital early on Sunday morning, the first day southwestern Haiti’s main coastal road had become semi-navigable by car.

At that time, there were 39 cases of cholera, according to Missole Antoine, the hospital’s medical director. By the early afternoon, there were nearly 60, and four people had died of the waterborne illness.

“That number is going to rise,” said Antoine, as she rushed between patients laid out on the hospital floor.

Although there were 13 cases of cholera before Matthew hit, Antoine said the cases had risen drastically since the hurricane cut off the desperately poor region.

The hospital lacks an ambulance, or even a car, and Antoine said many new patients were coming from miles away, carried by family members on camp beds.

Inside the hospital, grim-faced parents cradled young children whose eyes had sunk back and were unable to prop up their own heads.

“I believe in the doctors, and also in God,” said 37-year-old Roosevelt Dume, holding the head of his son, Roodly, as he tried to remain upbeat.

RUBBLE

Out on the streets, the scene was also shocking. For miles on end, almost all the houses were reduced to little more than rubble and twisted metal. Colorful clothes were littered among the chaos.

The region’s banana crop was destroyed with vast fields of plantain flattened into a leafy mush. With neither government or foreign aid arriving quickly, people relied on felled coconuts for food and water.

The stench of death, be it human or animal, was everywhere.

In the village of Labei, near Port-a-Piment, locals said the river had washed down cadavers from villages upstream. With nobody coming to move the corpses, residents used planks of driftwood to push them down the river and into the sea.

Down by the shore, the corpse of one man lay blistering in the sun. A few hundred meters to his left in a roadside gully, three dead goats stewed in the toxic slime.

“It seems to me like a nuclear bomb went off,” said Paul Edouarzin, a United Nations Environmental Program employee based near Port-a-Piment.

“In terms of destruction – environmental and agricultural – I can tell you 2016 is worse than 2010,” he added, referring to the devastating 2010 earthquake from which Haiti has yet to recover.

Damaged houses are seen after Hurricane Matthew passes in Jeremie, Haiti,

Damaged houses are seen after Hurricane Matthew passes in Jeremie, Haiti, October 9, 2016. REUTERS/Carlos Garcia Rawlins

Diarrhea-stricken residents in the village of Chevalier were well aware of the nearby cholera outbreak, but had little option except to drink the brackish water from the local well that they believed was already contaminated by dead livestock.

“We have been abandoned by a government that never thinks of us,” said Marie-Ange Henry, as she surveyed her smashed home.

She said Chevalier had yet to receive any aid and many, like her, were coming down with fever. Cholera, she feared, was on its way.

Pierre Moise Mongerard, a pastor, was banking on divine assistance to rescue his roofless church in the village of Torbeck. In his Sunday best – a sports coat, chinos and brown leather shoes – he joined a small choir in songs that echoed out into the surrounding rice fields.

“We hope that God gives us the possibility to rebuild the Church and help the victims here in this area,” he said, before the music seized him, and he slowly joined in the chant, closing his eyes and turning his palms up toward the sky.

(Editing by Frank Jack Daniel and Kieran Murray)

HELP FOR HAITI

New Famine Fears Loom in Yemen

A nurse checks a boy at a hospital intensive care unit in Sanaa, Yemen

By Jonathan Saul, Noah Browning and Mohammed Ghobari

LONDON/DUBAI (Reuters) – Intensive care wards in Yemen’s hospitals are filled with emaciated children hooked up to monitors and drips – victims of food shortages that could get even worse due to a reorganization of the central bank that is worrying importers.

With food ships finding it hard to get into Yemen’s ports due to a virtual blockade by the Saudi-led coalition that has backed the government during an 18-month civil war, over half the country’s 28 million people already do not have enough to eat, according to the United Nations.

Yemen’s exiled president, Abd Rabbuh Mansur Hadi, last month ordered the central bank’s headquarters to be moved from the capital Sanaa, controlled by Houthi rebels in the north, to the southern port of Aden, which is held by the government. He also appointed a new governor, a member of his government who has said the bank has no money.

Trade sources involved in importing food to the Arab peninsula’s poorest country say this decision will leave them financially exposed and make it harder to bring in supplies.

Diplomats and aid officials believe the crisis surrounding the central bank could adversely affect ordinary Yemenis.

“The politicization of the central bank and attempts by the parties in the conflict to use it as a tool to hurt one another … threaten to push the poorest over the edge,” said Richard Stanforth, humanitarian policy adviser with Oxfam.

“Everything is stacked against the people on the brink of starvation in Yemen.”

The effects of food shortages can already be seen. At the children’s emergency unit at the Thawra hospital in the port of Hodaida, tiny patients with skin sagging over their bones writhe in beds. Hallways and waiting rooms are crowded with parents seeking help for their hungry and dying children.

Salem Abdullah Musabih, 6, lies on a bed at a malnutrition intensive care unit at a hospital in the Red Sea port city of Hodaida, Yemen

Salem Abdullah Musabih, 6, lies on a bed at a malnutrition intensive care unit at a hospital in the Red Sea port city of Hodaida, Yemen September 11, 2016. REUTERS/Abduljabbar Zeyad

 

Salem Issa, 6, rests his stick-thin limbs on a hospital bed as his mother watches over him. “I have a sick child, I used to feed him biscuits, but he’s sick, he won’t eat,” she said.

A nurse said the ward began taking in around 10 to 20 cases in April, but now struggles with 120 patients per month.

The World Food Programme says half Yemen’s children under five are stunted, meaning they are too short for their age because of chronic malnutrition.

IMPORTERS STRUGGLING

In July, Reuters reported that importers were already struggling to buy food from abroad because $260 million worth of their funds were frozen in Yemeni banks, while Western banks had cut credit lines.

Since then, importers have guaranteed much of the risk of financing shipments themselves.

The decision to move the central bank, seen as the last impartial bastion of the country’s financial system which has helped keep the economy afloat in wartime, is viewed as a major blow for suppliers who are mistrustful of the decision and expect even more chaos ahead. Foreign exchange is already scarce and the sources do not have confidence in the new governor.

All of this will lead to further food disruptions and more hardship for Yemenis already facing impending famine, according to the trade sources.

“We have begun to cancel our forward contracts – it’s just impossible to trade when there is no financial system in place. There is no coverage from the central bank where we can trust them or know them,” said one source.

“This leaves anyone bringing in cargoes completely exposed,” added the source, who declined to be identified due to the worsening security situation and fear of reprisals.

Shipping data showed at least nine vessels carrying supplies such as wheat and sugar were on the way to the Yemeni ports of Hodaida and Salif, but the source said there were worries for forward shipments for late October and November.

A second trade source also active in Yemen confirmed the growing difficulties.

“Western banks are not willing to process payments and the whole system is freezing up. It is an ever growing struggle to do anything commercial,” the second source said.

“Obtaining foreign exchange has to be done through currency smuggling. Yemen is like a country of smugglers now  – this is unacceptable.”

A woman holds her child at the door of her hut in al-Tuhaita district of the Red Sea province of Hodaida, Yemen

A woman holds her child at the door of her hut in al-Tuhaita district of the Red Sea province of Hodaida, Yemen September 26, 2016. REUTERS/Abduljabbar Zeyad

 

DWINDLING RESERVES

The old central bank in the capital Sanaa used Yemen’s dwindling foreign exchange reserves to guarantee shipments into a country which imports 90 percent of its food.

But Hadi disliked the bank paying salaries to his foes in the army and the Iran-aligned Houthi movement opposed to his internationally recognized government.

Struggling to advance on the battlefield and keen to undermine the Houthis, Hadi dismissed the bank’s governor, Mohamed Bin Humam, named Finance Minister Monasser Al Quaiti in his place and decreed the bank be moved to Aden.

It was a sudden decision that aroused suspicion among traders.

“The governor Humam enjoyed the confidence of all parties since he was clearly independent and working in the best interests of Yemen. To now appoint a minister of finance of the government is a retrograde step and none of the traders have any confidence in him or in the bank in Aden,” the first trade source said.

The new governor of the central bank did not immediately respond to a Reuters request for comment.

Quaiti told the Saudi-owned Asharq al-Awsat newspaper on Thursday he had inherited a bank with no money, but he pledged to keep it independent.

Ibrahim Mahmoud, of Yemen’s Social Development Fund, said only an improvement in the country’s financial system and an emergency aid effort could stop the spread of hunger.

“If there is no direct and immediate intervention on behalf of the international community and state organizations, we could be threatened by famine and a humanitarian catastrophe.”

Even though moving the central bank seemed to be aimed at hurting the Houthis, Yemeni economic officials and diplomats say the group has its own financial resources.

Losing out on $100 million in salaries to its fighters as suggested by the new bank governor may hurt the Houthis, but the bank’s closure in Sanaa is likely to hurt ordinary people already suffering from a collapse in the economy due to the war.

“It risks leaving the salaries of more than a million Yemenis unpaid. There may be a long-term effect on the Houthis, but the immediate effect will be on normal people trying to put food on the table,” Yemeni economic analyst Amal Nasser said.

 

(Additional reporting by Michael Hogan in Hamburg, Stephanie Nebehay in Geneva; Editing by Giles Elgood)