Today’s NHS news features the interesting case of a huge US health care provider UnitedHealth selling its business undertaking of Camden GP practices to The Practice Plc. The public clearly have absolutely no influence over such private business transactions which will increase under increasing privatisation.
Cameron says Socialists have no sense of humour. A doctor claims he was misrepresented by Cameron and accuses Cameron of playing football.
- Conservative election poster 2010
A few recent news articles concerning the UK’s Conservative and Liberal-Democrat coalition government – the ConDem’s – brutal attack on the National Health Service.
A NURSING union has hit out at what it claims are proposed cuts to frontline services at Two Teesside hospital trusts.
The Royal College of Nursing (RCN) aims to highlight how health reforms could result in cuts to jobs and frontline services.
Its website Frontline First outlined how South Tees NHS Foundation Trust, which manages James Cook University Hospital in Middlesbrough and The Friarage in Northallerton, “cut” 14 cardiology beds and a 30-bed surgical ward containing specialities including ear nose and throat, and ophthalmology.
The RCN also stated the trust had to save £20m over four years. However, the trust said the process of removing cardiology beds was completed last year with no redundancies, although some nursing staff were redeployed to other wards.
Article > MPs ask: post-NHS reform, who will be accountable for health spending?
MPs have told the government that even though its NHS reforms are still at an early stage, they need certainty about who to hold accountable for health spending once they are complete.
“It is vital that the Department [of Health] creates robust accountability structures so that Parliament and the public can property follow the taxpayers’ pound and hold those responsible to account,” Margaret Hodge, chair of the Commons Committee of Public Accounts said yesterday, as the panel published its latest Landscape Review of the NHS. “Key questions have yet to be addressed,” added the Labour MP for Barking.
In particular, she said, the Committee is concerned that the Department has yet to develop a high-quality risk management protocol for either the commissioning or providing bodies. Health officials have told the MPs that certain health trusts and GP practices still have some way to go to achieving Foundation Trust status or becoming commissioning consortia, and the panel stresses that the Department must have effective systems in place to deal with failure so that, whatever happens, the interests of both patients and taxpayers are protected.
PATIENTS registered at three Camden GP practices sold by an American health giant to a rival company last week were not told about the changes.
UnitedHealth, who had boasted of how well they had run the surgeries since a controversial takeover in 2008, said it was not up to them to inform thousands of unknowing patients of the transaction.
A UnitedHealth spokeswoman said: “It’s not one for us. This is a simple transfer of ownership and patients will be seeing the same doctors and nurses.”
But the sale to The Practice Plc was exactly the kind of move that NHS campaigners warned of when they protested against UnitedHealth’s initial introduction to the borough three years ago.
They warned that patients would lose a say in how their surgeries were run and would be unable to scrutinise performance.
The UnitedHealth UK surgery sell-off was introduced to Thursday’s Town Hall health scrutiny committee meeting agenda “as a matter of urgency” following a story in the New Journal last week.
Labour councillor Adam Harrison told the meeting: “I must express an interest as I am a patient at the Brunswick [Medical Centre].”
When asked if he was informed of the change before it was agreed, Cllr Harrison replied: “No, I certainly was not.”
Chairman of the committee, Liberal Democrat councillor John Bryant, said: “We are in a no man’s land.”
The panel has asked for clarification from NHS bosses on how contracts are managed and transferred apparently behind closed doors.
The Prime Minister was accused of sexism by Labour after his Commons put-down to Angela Eagle at Prime Minister’s Questions.
Mimicking a catchphrase used by Michael Winner, the film director, on a television insurance advertisement, he repeatedly told her to “calm down, dear”, prompting calls for him to apologise.
But yesterday he brushed off the row and made light of the remarks.
He said: “I don’t know what it is about some people on the Left. It seems that when they put the socialism in, they take the sense of humour out.
An ex-Labour MP who David Cameron claimed supported his health reforms has accused the prime minister of using the NHS as a “political football”.
Dr Howard Stoate said his views about GPs powers were “taken out of context”.
He was at the centre of a political row on Wednesday after Mr Cameron told Labour MP Angela Eagle “to calm down dear” at Prime Minister’s Questions.
He made the comment after Ms Eagle sought to correct remarks he made about Dr Stoate in the Commons.
Previous | Index
Calm down, David Cameron – and get your facts right at PMQs
The prime minister distorted my views. He should stop using the health service as a political football
David Cameron’s comments to MP Angela Eagle to “calm down, dear” caused a furore during prime minister’s questions on Wednesday (Cameron accused of sexism over ‘calm down dear’ Commons taunt, 28 April). But along with many others I was more concerned about inaccuracies in the point he was trying to make at the time.
He quoted a comment I made in a Guardian Response column (GPs do not fear the chance to reshape services, they welcome it, 12 January) in which I said many GPs were enthusiastic about the chance to help shape services for patients. I was referring to GPs in my own borough of Bexley, south London, and qualified this by saying GPs in the borough had a head start, building on their experience of commissioning over the last four years.
Taken out of context, and interspersed with condescending comments to backbench MPs, Cameron’s quote is entirely misleading. As you report, “Eagle picked him up when he started to claim that a former Labour MP who supports the health reforms, Dr Howard Stoate, had been defeated at the election by the Tories.” I was not defeated by a Conservative candidate – I did not in fact stand.
David Cameron was evasive and engaged in distraction at Prime Minister’s Questions yesterday. I’ve started seriously wondering wether he’s intellect-challenged.
- Conservative election poster 2010
A few recent news articles concerning the UK’s Conservative and Liberal-Democrat coalition government – the ConDem’s – brutal attack on the National Health Service.
On 5 May over 9,500 council seats will be contested across England, as well as elections to the Scottish Parliament and the Welsh and Northern Ireland Assemblies and the AV referendum.
Millions of people will see these elections as an opportunity to express their hatred for the axe-wielding Tories and Lib Dems. However, while there is no mass party through which working class people can effectively fight the cuts, Labour is likely to benefit from this desire to punish the government. But this will not be done with great enthusiasm – Labour’s slogan of “cuts too far too fast” is not a rallying call and their record of implementing brutal cuts in local government means huge suffering.
But as the working class in Britain begins to flex its muscles, the need for an independent political voice is increasingly urgent.
HUNDREDS of hospital beds are to be cut at the region’s main hospitals as health officials battle to save millions of pounds.
Hull And East Yorkshire Hospitals NHS Trust, which runs Hull Royal Infirmary and Castle Hill Hospital in Cottingham, has 1,514 beds on more than 50 wards.
The move will cut 300 beds by closing two wards per year for the next five years and comes as the trust has to make £95 million in efficiency savings by 2015.
It could also see the trust scaling back its estate, knocking down empty wards and cutting back on costs.
Trust chief executive Phil Morley said reducing the number of acute beds by 300 will save £10 million.
He warned the move was a reflection of the challenges and pressures facing the NHS nationally, not just in East Yorkshire.
The Chamber is well used to extraordinary displays of boorishness during prime minister’s questions but even hardened MPs were taken aback by David Cameron’s performance on Wednesday, when (to recap, in case you have somehow missed a moment that within minutes was swamping the Twittersphere and within an hour had spawned nearly 400 news stories) he was challenged by Angela Eagle, shadow chief secretary to the treasury.
It was not a particularly earth-shattering challenge – he had said former Labour MP Howard Stoate (whom he was enlisting in his increasingly ragged defence of Andrew Lansley’s NHS reforms) had been defeated by a Tory at the last election; she was pointing out, in the vociferous way required when a roomful of supposed adults is shouting at each other like sleep-deprived six-year-olds, that Stoate had in fact retired, rather than been defeated, in order to return to his job as a GP. “Calm down, dear,” said Cameron, failing only to pat her gently on the head as he said it. “Calm down. Calm down and listen to the doctor.”
In terms of levels of offensiveness, where to start? The imputation that Eagle, being a woman, was just being hysterical, over-emotional? The further imputation that nothing she said was therefore worth listening to? The belittling “dear”? The arrogant superiority? The paternal order to listen not just to him, but to “the doctor”, these men who know best? Frankly, he only failed to pat her gently on the head.
“Calm down,” he said yet again, in case anyone had missed it. They most definitely hadn’t: even the Daily Telegraph, which could not resist an en passant dig at the “frighteningly feminist” Eagle, noted that: “The wind whistled around the Commons chamber in the seconds after he said it.” There was some laughter: George Osborne, unsurprisingly, guffawed, but Nick Clegg, sitting to the prime minister’s right, went completely, unsmilingly still, as though by doing so he could somehow will himself invisible, or at least somewhere else.
CONSERVATIVE leader David Cameron yesterday used Prime Minister’s Questions to launch repeated attacks on Labour’s plans for the NHS in Wales.
Mr Cameron waded into one of the most contentious issues in the Assembly election when he claimed that a Labour-led Government would leave patients worse off than those in England.
He launched the assault on the party led in the Assembly by Carwyn Jones during a question session which threatened to descend into farce when he appeared to tell a female Labour MP to “calm down, dear”.
The heated exchanges came after Labour Cardiff West MP Kevin Brennan asked if Conservative Health Secretary Andrew Lansley was safe in his job.
His plans for sweeping NHS reform in England are now subject to a “pause” and have been emphatically rejected in a no confidence vote by the Royal College of Nursing.
Advertising standards authorities have launched an investigation into the Department of Health’s promotion of the NHS reforms during their ‘listening exercise’, after they received a number of complaints about a patient leaflet on the health bill.
The pamphlet ‘Working together for a stronger NHS’ was published earlier this month to explain the rationale behind the Government’s NHS reforms, but after a number of complaints – including from one from John McTernan, former political secretary to Tony Blair – the Advertising Standards Authority have launched an investigation.
The leaflet suggests that the NHS perform better if it has more competition between providers of healthcare, including private companies.
The Department of Health says the leaflet is based on ‘a wide range of reputable sources’, but Mr McTernan claims that the information presented in the leaflet is misleading.
The National Audit Office (NAO) has criticised central government for pushing local state sector bodies, including NHS trusts, into using the private finance initiative (PFI) rather than other methods of finance.
In a new report, the central government watchdog concurs with parliament’s Public Accounts Committee, which in January noted that some organisations chose the PFI route due to a lack of other options.
It said the committee had seen “no clear evidence to conclude whether PFI has been demonstrably better or worse value for money for housing and hospitals than other procurement options,” adding: “In many cases local authorities and NHS trusts chose the PFI route because the departments offered no realistic funding alternative. This led to the committee’s recommendation that departments should prepare and publish whole-programme evaluations.”
The NAO adds that under national accounting rules, privately financed projects will often still be off the government’s balance sheet, which it says may act as an incentive to use PFI.
The report says that lessons from the experience of using PFI schemes can be applied to other types of procurement and help government achieve major cost savings, but it warns that Whitehall must do more to act as an “intelligent customer”.
A report by the Public Accounts Committee has generated a lot of news. The report raises concerns that there is no healthcare provision in the case of (financial) failure, that ‘reforms’ risk demanded ‘savings’ (cuts) and that they risk patient care. The British Medical Association (BMA) comments on the report.
- Conservative election poster 2010
A few recent news articles concerning the UK’s Conservative and Liberal-Democrat coalition government – the ConDem’s – brutal attack on the National Health Service.
GPs may demand more money before they agree to participate in the Government’s health reforms, ministers have been warned.
Under plans to alter the way the NHS is run, family doctors, many of whom are already earning over £100,000 a year, will be required to form “consortiums” to commission care for their patients.
But ministers have yet to reach agreement with the doctors’ union, the British Medical Association, on making the necessary changes to GPs’ contracts to allow the reforms to go ahead. NHS employers have warned this could cost the Government millions of pounds more in unbudgeted costs.
The last time the government renegotiated the GP contract in 2004, it cost £1.76 billion more than was predicted in its first three years while GP productivity fell. “The last time the government negotiated with the GPs it was quite a horrendous exercise,” said David Stout, deputy chief executive of the NHS Confederation.
“What you have to remember is the GPs are very good at negotiation and the Government’s problem is this: the legislation says that all GPs have to be in these new GP consortiums – but it is not in their contracts. Either the Government chooses to impose this on them or they have to renegotiate and that could be very tricky.”
MPs are demanding that the government urgently put in place plans to ensure vital health services continue if a hospital or other provider goes bust under its NHS reforms.
In a report published on Wednesday, the public accounts committee says the proposals for the NHS do not include details of what will happen if providers fail in the new market model of healthcare provision.
Members of the committee dismissed claims by the most senior civil servant in the Department of Health, Una O’Brien, that the government was “not planning for failure”, and condemned the lack of contingency planning, suggesting that the proposals now pose an intolerable risk to value for money and quality of services.
Richard Bacon, the Conservative MP for South Norfolk, said: “In any organisation as large and complex as the NHS, things can and do go wrong, and the Department of Health has yet to establish a robust framework for dealing with failure in the system. The department must not only understand the danger of either a provider or a commissioner going ‘belly up’, but also toughen up its contingency plans, drawing upon strong, effective and clear chains of governance and accountability throughout the new NHS model.”
In a report published on today, the Committee of Public Accounts has warned that the reorganisation of the NHS in England could “make the challenge of achieving savings for reinvestment even tougher.”
Commenting on the report, Dr Hamish Meldrum, Chairman of Council at the BMA, said:
“Having already been set the massive challenge of cutting costs by £20 billion, the NHS in England is now facing the most fundamental reorganisation in its history. The Public Accounts Committee is right to highlight the risks posed by such a massive restructuring at a time of financial crisis.
“However, it is not just the timing, but also the direction of travel of these reforms that will cause problems. We share the concerns of the PAC that the consequences of increasing competition in the NHS have not been fully addressed. ‘Market failures’ in healthcare have far more serious consequences than in other industries – and may have little connection with quality of care, or even patient demand.”
The planned shake-up of the NHS in England that will put GPs in charge of buying in services could risk patient care, warns a group of influential MPs.
The Public Accounts Committee says pushing through the changes while seeking £20bn in efficiency savings may damage front-line services.
The concerns follow those of others, including Deputy Prime Minister Nick Clegg’s close adviser Norman Lamb.
A council is to investigate a provisional decision by the NHS to leave east Berkshire without mental health in-patient services.
It would mean patients from Slough and Maidenhead having to travel up to 20 miles for beds at Reading’s purpose-built Prospect Park Hospital.
Three ideas were consulted on but the NHS trust said a plan to build a new facility in Slough was too expensive.
Slough council has set up a working group to look into the decision.
Berkshire Healthcare NHS Foundation Trust, which is trying to save £12m over the next three years, said it was working on a plan to put aside £100,000 a year for travel costs.
Kill Lansley’s Bill
OUR HEALTH SERVICE NOT FOR SALE
Tuesday 17 May
5.30pm Assemble UCH Gower St
6pm March to Whitehall
Andrew Lansley’s Health and Social Care Bill threatens to break up our health service and hand it to private healthcare companies.
The Bill would open up the entire health service to the private sector and as private companies calculate how much profit is to be made, 50000 NHS jobs are being cut and front line services are under threat.
The government has now been forced to retreat in the face of a huge groundswell of nationwide opposition. Cameron and Clegg had to intervene to “pause, listen, reflect and improve” the plans, but it is clear they only plan minor cosmetic changes.
We have to seize this opportunity to step up public opposition to demand the Bill is dropped and to force the government to really listen. Our NHS is precious and these plans will destroy it. We appeal to everyone to join us on 17 May and to speak out against these threats in what ever way they can.
27/11/13 Having received a takedown notice from the Independent newspaper for a different posting, I have reviewed this article which links to an article at the Independent’s website in order to attempt to ensure conformance with copyright laws.
I consider this posting to comply with copyright laws since
a. Only a small portion of the original article has been quoted satisfying the fair use criteria, and / or
b. This posting satisfies the requirements of a derivative work.
Please be assured that this blog is a non-commercial blog (weblog) which does not feature advertising and has not ever produced any income.
NHS news: This posting covers yesterday’s news. I’ll do a further NHS news review for today.
Three Labour MPs – Grahame Morris, Diane Abbott and Michael Meacher – object to the bill to destroy the NHS, Conservative pro-‘reforms’ Dr. Jonathan Munday warns “I am now getting seriously worried that the political pressure on Lansley is such that the government may abort GP commissioning entirely…” and cuts.
- Conservative election poster 2010
Radical plans to shake up the NHS have been put on hold for what has been spun as a natural break and an opportunity to “pause, listen, reflect and improve” the Health and Social Care Bill.
This cynical step by the coalition’s leaders is a strategy destined to fail.
The prospect of Andrew Lansley’s flagship policy receiving royal assent must now be constrained by the fact that minor tweaks will not change the thrust and direction of travel charted by the Bill.
Lansley’s plans are not simply another reorganisation but a root-and-branch upheaval, which over time will lay the foundations for private health care to compete against in-house NHS provision throughout the entire health service.
Much has been made of the need to make new GP-led commissioning consortiums more inclusive and accountable.
As the Bill currently stands, primary care trusts will be replaced by statutory private bodies with GPs acting as figureheads.
These bodies will be able to conduct their affairs behind closed doors.
Freedom of information requests will not apply to them and there will be no legislative safeguards against conflicts of interests between commissioning and providing NHS services.
Grahame Morris is Labour MP for Easington and a member of the health select committee.
An influential group of MPs fuelled the row over the coalition’s NHS shake-up today by warning that ministers have “no control” over many of the costs.
Pushing through the changes at the same time as seeking £20 billion in “efficiency savings” by 2014/15 could also put patient care at risk, the Commons public accounts committee warned.
It raised the concerns in a report into the unpopular changes, which are opposed by unions and the public and threaten to drive a wedge between the coalition partners.
One of Deputy Prime Minister Nick Clegg’s closest advisers, Norman Lamb, has hinted he could quit unless implementation of the package – which would put GPs in charge of commissioning services – is slowed down.
Committee chairwoman Margaret Hodge said: “Whilst the reforms could complement the imperative of achieving £20bn efficiency gains, the reorganisation might also distract those responsible for making the savings while safeguarding standards of patient care.
“Furthermore, if the Department of Health estimate of the one-off costs associated with reorganisation turns out to have been too low, it will make the challenge of achieving savings for reinvestment even tougher.”
The health secretary has faced criticisms from Labour MPs over his pledge to “pause and listen” to concerns over planned reforms the NHS, ahead of next week’s local elections.
Shadow health minister Diane Abbott asked how the public are expected to take the discussions and the listening exercise on the Health and Social Care Bill “seriously”.
Speaking during departmental questions in the Commons, Andrew Lansley said the government is united in its commitment to strengthen the NHS.
Abbott told MPs the pause was merely “a device” to get the coalition through the May elections, with the health secretary determined to “get away with as little substantive change” as possible.
Oldham West and Royton MP Michael Meacher has written to health secretary Andrew Lansley to oppose what he describes as lunatic changes to the NHS which he believes are unconstitutional.
He said that abolishing local Primary Care Trusts (PCTs) — which run community health services — will have “significant detrimental consequences on patient care”.
And he believes that it puts the whole provision of health care at risk.
The change is part of the move giving GPs rather than PCTs the power to commission community health services.
As part of the transition, a temporary Greater Manchester PCT serving around three million people will be in place by June.
In his letter, Mr Meacher writes: “These arrangements have been made with no consultation at any level and, for the first time in NHS history, there will be no decision-making at local level.
NHS campaigners across London are in a buoyant mood as they prepare for a major demonstration in May against the government’s health service “reforms”.
Prime minister David Cameron and his health secretary Andrew Lansley are still reeling from a stream of attacks on their health bill.
And last week around 40 activists met to plan the next phase of their assault.
“It was a brilliant meeting. Full of life and lots of people committed to making the protest a success,” said Jordan, an occupational therapist and Unison union rep at Hackney’s Homerton hospital.
“Trade unionists from my part of east London agreed to distribute 10,000 postcards for the demo that my union branch is sponsoring. By this weekend we’d already given out 2,000 of them.
A doctor who runs a sparsely-supported campaign in support of the government’s health “reforms” has been revealed as a leading Tory—and the head of a body that expects to profit from the changes.
Dr Jonathan Munday, the former Conservative mayor of Kensington and Chelsea, is leading an operation to rescue Andrew Lansley’s health bill.
He also runs a GP commissioning consortia, Victoria, found in the new NHS “cluster” of north west London.
In a leaked email, he told the heads of GP consortia that the political climate against reforms is “getting worse by the day”.
“I am now getting seriously worried that the political pressure on Lansley is such that the government may abort GP commissioning entirely or, almost worse, may so water it down and constrain it so that GP consortia will have the worst of all worlds—a lot of effort, political responsibility for any cuts but no ability to wrest initiatives or make needed reforms,” he moaned.
A MERSEYSIDE hospital will close a 28-bed ward as part of a £30m cuts plan.
Ward 7b, at Southport and Formby District General Hospital, will shut before the end of May.
Southport and Ormskirk Hospital NHS Trust said the move would save £1m, with health bosses insisting that patient care would not be compromised.
The trust must save £8.5m this year and £30m over a four-year period. It has already announced plans to cut 125 jobs.
NHS services will face huge cuts as health chiefs admit they have to save an unprecedented £77.6 million over the coming financial year.
Measures are being drawn up to scale back yet more services and change the way patients are treated – effectively meaning fewer people will be referred to hospital.
Millions will be sliced off budgets for elderly care, end of life services, hospital referrals and medication, raising fears healthcare in south Essex will be cut to the bone.
The health trust which serves Basildon and Thurrock, has now merged with its counterpart in Southend and Castle Point to make savings.
Together they saved £52million in order to end the 2010/11 financial year in the black – but this was as a result of a swathe of cuts to services being made. Now more are looming.
Despite having a combined budget of £1.2billion for the coming financial year, health bosses say their costs are rising at an alarming rate.
They must save a total of £117million over the next four years, with £77.6million having to be saved in this financial year –- 2011/2012.
There’s been very little NHS news over the bank holiday weekend. Today’s NHS news is about cuts, the denial of services and drugs and an article by the Morning Star about how the listening exercise is a sham.
- Conservative election poster 2010
Health bosses in Berkshire have said it is “very disappointing” to hear many cancer patients in the area are paying for much needed medication which they could get for free.
Figures released from a National Cancer Patient Experience Survey show around 37 per cent of people surveyed who are receiving treatment for cancer with the Royal Berkshire NHS Foundation Trust have not been told they are eligible for free prescriptions.
Since April 2009, cancer patients have been eligible for exemption certificates for medication relating to their illness, its treatment and the effects of the treatment.
However, according to the survey, conducted by the Department of Health last year, many cancer patients are still not aware of the free cancer treatment available to them, and are said to be cutting back on essential items such as food or heating to cover the cost.
But the boy’s father, Max, has now learned the request has been unsuccessful and has vowed to lodge an appeal. Without the drug, he says his son will suffer permanent mental and physical disabilities.
NHS trusts across the area are looking to save a staggering £150m-plus this year, The News can reveal.
The trust which runs Portsmouth hospitals has already this week announced plans to axe up to 99 jobs in a bid to save £30.5m. But now NHS Hampshire – which funds healthcare across the county – has declared it needs to shave £105m off its budget.
NHS Portsmouth – which pays for city healthcare – has to save £15.2m, while the area’s ambulance service needs to save £6m.
The reason for the massive savings is down to reduced government spending. Also the health service as a whole was last year told it needed to make efficiency savings of £20bn by 2014.
Don’t believe the headlines about a pause or a so-called “listening exercise.” Cameron and Lansley are forging ahead with their plans to break up the NHS into a competitive market, and to slice off a growing share of the NHS budget for private providers.
The pause in the process is designed to give Lib Dems long enough to see their party massacred in the local elections and scare them into agreeing to support Lansley’s Health Bill for fear that they trigger the collapse of the coalition.
To front up the so-called “listening” exercise, an NHS Future Forum has been set up. It is stuffed with high-profile supporters of Lansley’s plans. All five of the GPs on the panel are among the minority of GPs who signed up for Lansley’s suggested commissioning consortiums. The whole forum is under the chairmanship of Professor Steve Field, who controversially supported Lansley’s white paper back in July and has since been replaced as president of the Royal College of GPs by Dr Clare Gerada, who has criticised much of the Lansley plan.
The forum on “choice and competition” will be led by Sir Stephen Bubb, a one-time Labour councillor and now at the head the Association of Chief Executives of Voluntary Organisations.
Bubb is a vigorous advocate of competition and greater private-sector involvement in delivering healthcare. He led a challenge to Labour’s attempts to designate the NHS as preferred provider of community health services.
Other doctors, trust bosses, primary care trust and strategic health authority bosses and senior council officers among the 40 hand-picked appointees on the forum are likely to be influenced by their career aspirations. They are unlikely to listen to any articulate critics of the Lansley plan.
The whole process has been set up to waste a month, to give the impression of responding to public opinion – and then to press through the key elements of the plan with little if any actual change.
There is no indication that the principal objections raised at the Lib Dem conference a few weeks ago have been taken on board by the Tories, not least because the suggestion that the private sector can somehow be prevented from “cherry-picking” the most profitable services from the NHS is pure fantasy.
A WOMAN will this week spend £16,500 undergoing surgery on three brain tumours which the NHS refused to fund.
Lynn Payne, 62, of Radcliffe-on-Trent, was diagnosed with the tumours in February after she lost feeling to her right leg.
Following the diagnosis she applied for funding to have the tumours treated with radioactive gamma rays.
But the East Midlands Specialised Commissioning Group turned down her request as did her primary care trust, NHS Notts County, forcing her to pay £16,500 to have the surgery done privately.
That’s enough of these Conservative and Liberal-Democrat cuts. We’ll go for Cuban standards of National Health Service in UK.
I got my copy yesterday so I have yet to complete it. The book identifies intense lobbying by commercial interests resulting in the privatisation of ancilliary NHS services under Thatcher, covert privatisation of the NHS under Blair’s New Labour administration and Andrew Lansley’s overt privatisation under the current Conservative and Liberal-Democrat coalition government. It draws a picture of the private sector unable to compete with the NHS in terms of cost or quality and the private sector being given excessive, hugely favourable terms. Patricia Hewitt, Alan Milburn and John Reid are identified as covert privateers ‘marketers’ under the Blair administration.
By late 2008 the crisis was at it’s height. Lehmann Brothers was history, Northern Rock had been nationalized along with Lloyds and the Royal Bank of Scotland, and the government’s debt was on course to reach 70 per cent of national income, up from around 40 per cent for most of the decade. In this situation it was obvious that public spending was going to suffer. How would this affect the NHS?
According to the Department of Health, the management consultants McKinsley (where Dr Dash was by now a partner in the company’s London office) were instructed in February 2009 ‘to provide advice on how commissioners might achieve world class NHS productivity to inform the second year of the world class commissioning assurance system and future commissioner development. The advice from McKinsley … was provided in March 2009.’ But the advice McKinsley gave actually tells a different story.
We don’t know what assumptions they were told to make but it looks as if they were told or at least encouraged to assume that NHS spending would remain constant for the next five years, and asked how productivity could be increased to cope with the rise in demand over that time. Their conclusion was that in order to find enough savings to meet the rising cost of providing health care over those years the NHS might have to shed ten per cent of it’s staff. When the press got hold of the report in September 2009 there was a furious reaction from the NHS workforce.
Health ministers then said that the report had been rejected, and even then it had been commissioned without their authority.
In October 2010 the coalition government announced that it would continue to raise NHS spending in real terms (based on the general consumer price index) over the next four years – the figure actually claimed was an annual rise of 0.1 per cent. As a result most people outside the NHS assumed that the cuts would now stop. But the reality was different. For one thing, the NHS was told to transfer £2.1 billion to local authorities over the next five years as part of a drive to move patients out of hospitals and into more ‘cost-effective’ social or community care. So the NHS budget was actually being cut. And the NHS’s costs (for drugs, equipment, electricity, etc) would go on rising faster than the general cost of living, so that even if its budget stayed more or less constant it would soon be too small to cover all the bills.
On top of this, people’s healthcare needs (or ‘patient demand’, as today’s policy-makers call patients’ needs) would also go on rising as people got older, or more obese, or more depressed – and as more of them became unemployed. The economic crisis was thus also a healthcare crisis, in which drastic measures could be presented as being unavoidable, measures of ‘last-resort’ – even if they implied the end of a high-quality health service equally available to all.
Which was pretty much what the new Secretary of State for Health, Andrew Lansley, decided to do, with proposals for yet another NHS reorganization – a reorganization not only un-mentioned in the election campaign, but one that flatly contradicted David Cameron’s pledge not to undertake any more ‘top-down reorganizations’ in the NHS. Everyone noticed, of course: but the coalition’s argument that the financial crisis meant that all previous bets were off proved effective – even if at first most people couldn’t quite see what Lansley was driving at. All comentators agreed in calling his proposals the most important changes in the NHS since it was set up – but what exactly did the changes mean? And were they really so different from what had been covertly planned for ten years or more under New Labour?
By the time of the 2010 election a fairly clear picture of what the future NHS market would be like had emerged amoung health policy insiders. Influenced by a decade of exposure to US policy advice, and especially by the link with Kaiser Permanente, they envisaged an NHS that was already much closer to being a kitemark attached to a wide variety of provider organizations and systems than people outside the policy-making circle realized.
They imagined a radically reduced NHS hospital sector, with the surviving NHS foundation trusts focused intently on financial success. They envisaged the bulk of outpatient care being transferred out of hospitals into local, cheaper settings, which would be privately built and owned (as so many NHS hospitals already were, through PFI), or jointly owned with ‘entrepreneurial’ clinicians. They envisaged a growing number of the remaining NHS hospitals being run by private companies. They imagined specialist clinicians becoming increasingly self-employed, rather than working on a salary for a single foundation trust, and selling their services to a mix of public and private organizations.
They expected a growing proportion of patients with chronic illnesses to have fixed budgets for their care, and they accepted that top-ups, for which insurance companies would provide insurance plans, would become a normal form of co-payment, as they already were for some life-prolonging cancer drugs. They expected PCTs to be using private healthcare corporations to help them commission services in a more sophisticated way, or doing it for them, and so driving foundation trusts to become more focused on economy and driving more work to private providers. Fundamentally, they anticipated a replication of many of the structures and values of US managed care.
No one who was familiar with this imagined future could have been surprised by the contents of Lansley’s White Paper of July 2010, or the Health and Social Care Bill of January 2011. The only people likely to be surprised were the public, with whom the marketizers had chosen not to share their vision.
NHS news: Cuts and huge increases in waiting times under the UK Con-Dem – Conservative and Liberal-Democrat – coalition government. There appears to be a growing acceptance that the changes are intended to destroy the NHS.
There’s an interesting article by Hospital Dr that suggests that contrary to claims to the opposite, the Con-Dem coalition has been very effective in communicating it’s ‘message’ of NHS ‘reform’ – concentrating on the core soundbite that GPs will have a huge proportion of NHS budget to do commissioning while other far more important details are obscured.
The Guardian has some very useful articles providing background information.
Hospital waiting times are at a three year high and the percentage of patients waiting longer than four hours in accident and emergency rose sharply at the end of 2010, reports Victoria Macdonald.
The King’s Fund reports says: “Over the next few years the NHS faces two unprecedented challenges: coping with the tightest funding settlement for decades and implementing top-to-bottom reforms of the system.”
The panel of finance directors reported that they had “limited” confidence in meeting theirproductivity targets over the following years. Many of the panel also reported the difficulty they were having in trying to “manage increased demand for care with reduced capacity and the need to continue to meet targets and maintain quality while keeping within reduced budgets”.
When asked how they would meet their productivity target, the majority mentioned reducing beds or services.
After warnings of the coming of a “perfect storm”, health expert Professor Colin Leys speak to Channel 4 News about the future of the NHS in a climate of cuts and reform.
Professor Leys pointed out that because NHS funding is no longer pooled, there is a “very uneven spread” of resources: “Some foundation trusts in surplus and others with huge debt.” He compared the current situation with shops closing on the high street: “Cutting,” he said, “is due to breaking the NHS into various parts – the story of the last 11 years… The point of converting it into a market is that each provider is independent, but now they have put the break on, there are problems.”
So, does the NHS have a future? “I don’t think any government will abolish funding for health treatment. The question is how much health funding is available in a uniform and complete way.
“The universality of the NHS whereby everyone will have access, rich or poor. That is bound to go.
“The redistributive and egalitarian system will go; since the consortia will have the power to decide what is appropriate, and will be acting within budget constraints, they will be forced to make decisions, and there will be pressure to go for cheaper providers.”
Professor Leys said the idea, presented by finance directors in The King’s Fund report, that productivity could be maintained alongside cuts, was problematic and argued that since health care is “inter-personal”, its effectiveness is lessened if there is a reduction in “the ratio of skill to patients”.
“Services do not need to close; that always has been and remains a political decision,” writes health expert Professor Allyson Pollock for Channel 4 News.
The UK government is proceeding with its plans to abolish the NHS and is implementing its new system in advance of the highly controversial Health and Social Care Bill becoming law. This is profoundly undemocratic and combined with demands for £20bn worth of efficiency savings represents a looming catastrophe for public health care.
The efficiency targets are without precedent, according to the House of Commons health select committee. No country in the world has acheived a real terms decrease of £20bn in its health budget in just five years. Nevertheless, the government is allowing chief executives and finance director to press on with a policy of service, ward and hospital closure.
It is also continuing a policy of hollowing out the NHS as the Government allows CEOs to use the excuse of deficits to offload services on to the private sector and risks of not being treated onto patients. Hinchingbrooke Foundation Trust Hospital has been contracted out to Circle, private patient bed numbers increased in Maidstone, Kent, and US health care company, United, allowed to run primary care trust commissioning along with other companies.
NHS finance directors predict ward closures, job cuts and other reductions as they struggle to make ends meet and prepare for the reorganisation of England’s health system, according to the King’s Fund thinktank.
With some hospital waiting times the worst for three years, A&E departments overstretched, and surgeons warning that patients are being denied key treatments, the first in a series of planned quarterly monitoring reports highlights “significant concern” among some of those responsible for contributing to £20bn of “efficiency savings” in the NHS over four years and for ensuring that new bodies taking over services in the next three years do not start with deficits. Most say they are unlikely to meet productivity targets this year.
The challenging picture painted by the report, from a respected independent analyst of the health service, comes during the government’s two-month “pause ” in trying to push through its controversial legislation. It has promised to listen and make “substantive” changes to its plans, although NHS staff have been told by the chief executive, David Nicholson, to “maintain momentum on the ground”.
The government’s proposed health reforms have proven so controversial that the health minister has announced a two-month ‘pause’ in the health bill to review concerns. According to NHS Future Forum, the body set up to lead the so-called ‘listening exercise’, there are four key themes to the reforms that they will be reviewing. We have tried to decode them for you below
Rowenna Davis explains the jargon used in the debate over the coalition’s controversial plans for the NHS
PM rejects claim government is moving too fast with plans to ‘reform and modernise’ NHS but accepts elements of original plan will have to change
David Cameron has said “changes need to be made” to the health and social care bill in recognition of the need to get more “full-throated support” for reforms from NHS staff.
The prime minister denied the government had moved too fast with its plans to “reform and modernise” the NHS in the face of an ageing population and more expensive drugs and treatment, but accepted that elements of the original plan would have to change.
Speaking as he prepared to conduct another NHS “listening exercise” alongside the health secretary, Andrew Lansley, Cameron said key planks of the reforms – such as giving hospitals greater independence, a payment by result system and GPs having a greater role in commissioning services – must go ahead.
But he insisted on the BBC Radio 4 Today programme that “substantive and serious changes” would be examined.
Critics who claim the government’s NHS marketisation reforms lack democratic legitimacy have invariably provoked a robust, if partial, response from the beleaguered health secretary, Andrew Lansley.
He maintains town halls are being offered unprecedented powers to integrate health and social care commissioning through statutory health and wellbeing boards – thus giving councillors, potentially, a stronger role in the oversight of the NHS. Or not, as the case may be.
Councils have few friends in the Department for Communities and Local Government, but even the (Liberal Democrat) care services minister, Paul Burstow, managed to praise authorities last week for having an in-depth understanding of the public health needs of their populations.
But Burstow and Lansley have not made clear how health and wellbeing boards are expected to align with stand-alone GP commissioning consortia, which lack accountability and are said to cover, in “pathfinder” form, nearly 90% of patients in England through 220 groups of GP practices.
The boards give a vaguely “localist” gloss to the health and social care bill, which is “paused” for a two-month rethink, as Cameron privately blames the messenger (Lansley) rather than the message. However, leading Lib Dems clearly see moves over wider NHS “democratisation” as the key concession to be dragged from the PM. But not, it seems, much else.
Waiting times for NHS treatment are spiralling out of control as finance directors seek ways to make £20 billion in budget cuts by 2015.
Health charity The King’s Fund published shocking figures today showing that NHS waiting times are at their highest in three years, with nearly 15 per cent of hospital inpatients waiting more than 18 weeks for treatment in February.
The figures have been steadily increasing ever since the coalition government relaxed the 18-week waiting target for hospital treatement almost as soon as it came to power in June last year, the charity warned.
King’s Fund chief economist professor John Appleby said: “With hospital waiting times rising, the NHS faces a considerable challenge in maintaining performance as the financial squeeze begins to bite.
“The trouble is it’s hard to see what the mechanisms are to keep that target low.
“I think the issue is how far they will continue to rise and at what point does the public start to notice.”
He warned that the problem was escalating as hospitals now only have “a vague commitment” to meet targets.
Well, it’s goodbye to any illusion that the NHS is either safe in Tory hands or that the coalition’s efforts to “reform” the service would be accomplished without affecting front-line services.
Health charity The King’s Fund disposed of those twin delusions very effectively indeed yesterday, without any political spin or even party-political angle.
It reported that NHS waiting times are at their highest level for three years, with nearly 15 per cent of hospital inpatients waiting more than 18 weeks for treatment in February this year.
In addition, waiting times in accident and emergency departments also rose steadily with the proportion of patients waiting more than four hours climbing through the roof.
Andrew Lansley has apologised. Not for being the architect of a Bill that has met with near-universal concern in the healthcare world, but because what he is “setting out to do, hasn’t communicated itself”.
The irony is that, in some senses, the government has been very clever in its communications, keeping the elements of the Health Bill it wants to talk about centre stage. Almost every newspaper article that discusses the Bill includes the neat phrase, “the plans, which would hand the £80 billion NHS budget over to GPs”, as if the changes were only about who controls the purse strings.
The fact that the Health and Social Care Bill is, in the public ’s mind at least, assumed to be purely about GP commissioning works very much to the government‘s advantage. It’s hard to argue against the principle of devolving power to doctors, whom patients know and trust. The BMA, as you’d expect, has always been very keen on the idea of doctors having a genuine say in the shaping of services (though it has a number of significant concerns about how the current plans would work in practice).
But the reality is that doctors could have been empowered without any legislation at all, and without the £2-3 billion cost of the top-down reorganisation. The Bill as it is currently written is actually more about fundamentally altering the character of NHS service provision than it is about putting in place a new process of commissioning.