A few recent news articles about the UK’s Conservative and Liberal-Democrat (Conservative) coalition government – the ConDem’s – brutal attack on the National Health Service.
The BMJ, HSJ and Nursing Times have published the same editorial comment on the Health and Social Care Bill. The editorial is critical of Andrew Lansley and the ConDems for the poor progress of the bill and the resulting “unholy mess”. The editors claim that further NHS reforms will be needed to clear up that “unholy mess”.
As the editors of the BMJ, HSJ and Nursing Times, we have divergent views on the NHS reforms and its beleaguered Health and Social Care Bill. But on one thing we are agreed: the resulting upheaval has been unnecessary, poorly conceived, badly communicated and a dangerous distraction at a time when the NHS is required to make unprecedented savings. Worse, it has destabilised and damaged one of this country’s greatest achievements: a system that embodies social justice and has delivered widespread patient satisfaction, public support, and value for money. We must make sure that nothing like this ever happens again.
Health interest groups differ in their stance on whether to oppose the bill outright or to work with the government to try to improve it. But there can be no doubting the deep distress and lack of confidence in the plans among those who must deliver the service.
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The reforms did not have to result in this unholy mess. The coalition agreement released in the honeymoon period immediately after the election focused on clinical leadership and patient and public empowerment. It was generally well received by those whose daggers are drawn against the reforms.
But through a combination of poor political judgement and reluctance to engage with criticism, a set of (mostly) reasonable objectives morphed into an old fashioned top-down reorganisation. This was the very thing the agreement had pledged to avoid. It also resulted in a bloated piece of legislation, whose goals could have largely been achieved by other, more effective, means.
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Unions representing hundreds of thousands of healthcare professionals and workers from across the NHS are to step up the pressure on peers with a central London rally as the Health and Social Care Bill enters its final crucial parliamentary stages.
On Wednesday 7 March – under the banner of the All Together for the NHS campaign – nurses, midwives, doctors, physiotherapists, managers, paramedics, radiographers, cleaners, porters and other employees from across the health service will join with patients to fill Central Hall Westminster for a 6pm ‘Save our NHS’ rally.
The Bill is hugely unpopular with NHS employees and patients, who have major concerns over the effect the draft legislation will have on healthcare by pushing through competition and markets on to the NHS, and allowing the private sector to take over delivering NHS services.
The All Together for the NHS campaign has called the rally over concerns that an NHS with a future based on competition will fragment the health service, worsen the care available to patients, and mean continued uncertainty for NHS employees, with the quality of training and their terms and conditions likely to suffer.
The pressure on the Secretary of State, Andrew Lansley, has been growing in recent weeks with more professional bodies joining the calls to amend significantly or withdraw the Bill completely. The March rally is intended to add to that pressure by demonstrating the broad coalition of opposition to Bill.Unions representing hundreds of thousands of healthcare professionals and workers from across the NHS are to step up the pressure on peers with a central London rally as the Health and Social Care Bill enters its final crucial parliamentary stages.
On Wednesday 7 March – under the banner of the All Together for the NHS campaign – nurses, midwives, doctors, physiotherapists, managers, paramedics, radiographers, cleaners, porters and other employees from across the health service will join with patients to fill Central Hall Westminster for a 6pm ‘Save our NHS’ rally.
The Bill is hugely unpopular with NHS employees and patients, who have major concerns over the effect the draft legislation will have on healthcare by pushing through competition and markets on to the NHS, and allowing the private sector to take over delivering NHS services.
The All Together for the NHS campaign has called the rally over concerns that an NHS with a future based on competition will fragment the health service, worsen the care available to patients, and mean continued uncertainty for NHS employees, with the quality of training and their terms and conditions likely to suffer.
The pressure on the Secretary of State, Andrew Lansley, has been growing in recent weeks with more professional bodies joining the calls to amend significantly or withdraw the Bill completely. The March rally is intended to add to that pressure by demonstrating the broad coalition of opposition to Bill.
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Two thirds of NHS staff believe maternity care will change under Andrew Lansley’s contentious reforms, according to a survey.
In a YouGov poll of over 1600 staff, 68% said they believe the bill will lead to changes for ‘basic services’.
Along with maternity care, this also includes services such as cancer screening and the ambulance service.
The poll also shows 71% think the health secretary is doing bad job, and 78% believe more patients will be excluded from NHS care under the reforms.
It is the first independent poll on the NHS plans to be conducted across all the medical professions, at a range of management levels.
David Babbs is executive director of 38 Degrees – the non-profit political activist group whose members paid for the poll.
He said: ‘For over a year 38 Degrees members have been telling Andrew Lansley to stop ploughing on regardless and to start listening to the concerns of the public and health care professionals.
‘Time and again Lansley’s tried to claim that the silent majority of NHS staff support him. This poll shows that’s not true.’
The survey was conducted on 17-26 January this year and also shows that 84% of health workers surveyed have no confidence that the right balance between competition and collaboration will be struck.
The full poll results are available to download here.
Been reflecting on the big issues of the early 21st century ~ authority based on an opaque belief system and the use of fear, fake manufactured terrorism, a totally unsearchable one – unsearchable even to large, official, state databases, a violent murder by Blairs & Co’s state for the dual purposes of supporting fake manufactured terrorism and identifying the one, etc.
A few recent news articles about the UK’s Conservative and Liberal-Democrat (Conservative) coalition government – the ConDem’s – brutal attack on the National Health Service.
The Guardian has consistently been the best of corporate reporting on the NHS. This article is recommended.
Threat of Lords revolt compels health secretary to change NHS bill amid claims of ‘sheer panic’ in government over opposition
The health secretary will perform a dramatic climbdown over his reforms this week in a desperate attempt to prevent a cross-party revolt among peers who fear that the changes would lead to the fragmentation of the NHS.
Amid growing concern in Downing Street that health policy is becoming the government’s achilles heel, ministers will table a series of amendments to the health and social care bill that will oblige Andrew Lansley to maintain the NHS as a national public service and, his critics say, limit his ambitions to expand the role of the private sector.
The changes will also spell out the kind of services that must be offered by GPs and will effectively ban them from withholding certain forms of care from patients.
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An unrepresentative group of doctors claims that the British Medical Association is not representative of GPs’ views on ConDem plans to destroy the NHS. The ConDem’s attack on the NHS is opposed by the British Medical Association, the Royal College of General Practitioners, the Royal College of Nursing, the Royal College of Midwives and many more professional medical bodies. The ConDem’s attack on the NHS is nearly universally opposed by the medical profession.
In a letter to The Daily Telegraph, the heads of more than 50 new doctors’ groups argue that the British Medical Association’s policy of “blanket opposition” to the Health and Social Care Bill fails to represent GPs’ views. …
The letter has been signed by 56 GPs who are helping set up clinical commissioning groups (CCGs) across England. Under the Bill these will effectively replace primary care trusts (PCTs) and be handed their budgets. …
A few recent news articles about the UK’s Conservative and Liberal-Democrat (Conservative) coalition government – the ConDem’s – brutal attack on the National Health Service.
The Academy of Medical Royal Colleges intended to issue a joint statement of opposition to Health Secretary Andrew Lansley and the Con-Dem coalition government’s proposed changes to the NHS.
Lansley became aware of the letter and lobbied secretaries of the Royal Colleges to prevent the letter being issued.
The statement was not issued after objection by the Royal College of Surgeons. There are suggestions of another objection by the Royal College of Obstetricians and Gynaecologists.
Andrew Lansley attacks the BMA (British Medical Association) as being “politically poisoned” for opposing the Con-Dem government’s attack on the NHS.
Speaking at Liverpool’s Alder Hey children’s hospital, Lansley said: “Look back to 1948 when the BMA denounced Aneurin Bevan as ‘a would-be Führer’ for wanting them to join a National Health Service. And Bevan himself described the BMA as ‘politically poisoned people’. A survey at the time shows only 10% of doctors backed the plans.”
The same Guardian article claims defeat for the government in it’s attempt to abolish the Health Secretary’s responsibility to provide the NHS.
However, later in the day, Lansley performed his most significant U-turn yet on the bill over the highly charged issue of the health secretary’s “constitutional responsibilities” to the NHS, which a House of Lords committee had warned would be “diluted” by the proposals.
Faced by a united front – led by Labour’s Lady Thornton and the Liberal Democrats’ Lady Williams – health minister Earl Howe conceded defeat by withdrawing proposals that had sparked major concern and backing the alternative amendment. It explicitly states: “The secretary of state retains ministerial responsibility to parliament for the provision of the health service in England.”
This claim appears unreported elsewhere and I’ve tried to verify using Lords’ Hansard without success.
I am likely to return to Lansley’s comments on the BMA since it seems a particularly nasty, underhand attack.
A few recent news articles about the UK’s Conservative and Liberal-Democrat (Conservative) coalition government – the ConDem’s – brutal attack on the National Health Service.
Academy of Medical Royal Colleges outline ‘significant concerns’ about coalition’s heath and social care bill
Britain’s medical establishment has decided to toughen its stance against the coalition’s controversial NHS shakeup. All but one of the 20 medical colleges that represent medical professionals have come out against the government’s proposals to change the service.
The Academy of Medical Royal Colleges (AoMRC) agreed the move on Tuesday when its members, who represent all the different medical specialities, said it held a “full, long” debate on the bill.
The Guardian has obtained a draft statement that says: “The Medical Royal Colleges and Faculties of the AoMRC continue to have significant concerns over a number of aspects of the health bill and are disappointed that more progress has not been made in directly addressing the issues we have raised.”
The medical bodies say that “unless the proposals are modified the academy believes that bill may widen rather than lessen health inequalities and that unnecessary competition will undermine the provision of high quality integrated care to patients.
“The Academy and Medical Royal Colleges are not able to support the bill as it currently stands.
“The academy is deeply concerned that the upheaval caused by the changes in the bill will distract the NHS from the huge task of meeting the current financial challenges.”
However, the Royal College of Surgeons will continue to support the “aims of the reforms”, saying that these would help “to modernise the health care system”.
Unlike the full-throated opposition of the British Medical Association, the Royal College of Nursing and the Royal College of Midwives, the draft statement says “the academy and colleges retain these concerns but they will work with the government and NHS organisations to ensure that the NHS provides the best possible care to patients should the bill become law”.
The move follows decisions by the BMA, RCN and RCM, which together represent the bulk of the NHS’s medical workforce, to call for the bill to be dropped. The NHS Confederation, which speaks for 95% of the NHS’s employers such as hospitals and ambulance services, has voiced concern at the lack of clinical support for the bill. …
An increasing number of Conservative MPs are starting to think the unloved health reforms ought somehow to be killed.
David Cameron was rattled in the Commons today by an attack on his health reforms – and with good reason. The NHS reorganisation is a disaster on many fronts. It is unloved by doctors, poorly understood by the public and, after a series of mangling amendments in parliament, barely even resembles the vision first outlined by Health Secretary Andrew Lansley. The likeliest outcome from the whole thing is protracted chaos and worse services. This time it will be very hard for the Tories to blame the mess on Labour’s legacy.
Opinion polls traditionally show Labour well ahead of Conservatives in terms of who is trusted to look after the NHS. Crucially for Ed Miliband, this is also an issue that is personally associated with David Cameron. The pledge to avoid “top down reorganisations” came from Conservative leader’s lips. So did the promise to protect health spending in real terms. That will be very hard to achieve even if inflation comes down – at least not without imposing harsher cuts elsewhere. The Labour front bench think the NHS is one policy area where they might be able to puncture Cameron’s famous Teflon coating. I have even heard it said by MPs, and not just from Labour ones, that the NHS alone could cost the Tories a majority at the next election. …
… Mr Cameron worked hard in opposition to convince the public that the Tories could be trusted with the health service. Yet the zeal with which his government has pursued these reforms has undermined his earlier reassurances. Mr Lansley’s supporters, determined not to lose face, insist that it is “too late” to abandon the bill but that is precisely what the government should do. No reasonable person believes that the NHS, subject to enormous demographic pressures, can be preserved in aspic, but these reforms will exacerbate, rather than diminish, its challenges. Mr Cameron once spoke of his desire to put an end to “pointless reorganisations” of the health service. He will not get a better chance than this.
The government’s cuts strategy – and why it’s wrong
Firstly, we need to get the ‘debt crisis’ in perspective. The table opposite shows UK debt relative to other major economies.
From 1918 to 1961 the UK national debt was over 100% of GDP. During that period the government introduced the welfare state, the NHS, state pensions, comprehensive education, built millions of council houses, and nationalised a range of industries. The public sector grew and there was economic growth.
Today, the coalition government wants to turn back the clock. It is set on dismantling the NHS and comprehensive education, and it is attacking the welfare state. It is not doing this because the country is on the verge of economic collapse, it is doing it because it is ideologically opposed to public services and the welfare state, and committed to handing over more of our public assets to big business.
Cutting public sector jobs will increase unemployment. This would mean increased costs for government in benefit payments and lost tax revenue. If people’s incomes are taken away or cut through pay freezes they will spend less. Less consumer spending means cuts in the private sector, and lower VAT revenues.
Internal analysis by HM Treasury proves this to be the case. Leaked documents estimated that over the next six years 600,000 public sector jobs would be cut, and 700,000 private sector jobs would also be lost – based on the current government’s policies.
Job cuts are therefore counterproductive. Mass job cuts would worsen the economic situation by reducing demand in the economy, and providing less tax revenue.
The government claims it can make cuts of between 25% and 40%, and still “protect frontline public services”. This is impossible – not just because ‘frontline services’ are being cut, but because services rely on ‘back office’ support staff. For example, cutting support staff like NHS cleaners has meant an increase in healthcare acquired infections, costing the NHS £1 billion. All public services require tax revenues to fund them, yet HM Revenue & Customs has cut 25,000 staff in recent years, which has led to uncollected tax at record levels and a growing tax gap.
The impact is likely to be highly divisive too. There is evidence of this already in the UK. In areas where public sector workers have already been laid off, retail sales have fallen faster than the UK average. In nations and regions where public sector workers make up a high proportion of the workforce, major public sector cuts could destroy local economies. Any attack on the public sector will also disproportionately affect women, as 68% of the public sector workforce is female. The public sector also has a much better record of employing disabled workers too.
The global race to cut labour costs is central to the economic collapse we have seen around the world. Squeezed consumers are defaulting on mortgages and personal debts, and are less able to spend in the economy. In the UK, the value of wages has declined from nearly 65% of GDP in the mid-1970s to 55% today. Over the same period, the rate of corporate profit has increased from 13% to 21%. It is no coincidence that in this period trade union rights were severely restricted, large swathes of the economy privatised, markets deregulated and corporation tax slashed.
There is an urgent need to rebalance the economy in the interests of people over big business.
The experience of Ireland
Ireland shows how cutting public spending can damage the economy. The crisis in Ireland was caused by the collapse of its banking sector. The massive cuts in spending and public sector pay that followed have
increased unemployment and sapped demand, causing the economy to shrink further. Because of this, Ireland is now considered more at risk of sovereign default than before it started making cuts. Historical research clearly demonstrates that budget cuts actually provoke increases in the national debt by damaging the economy.
Economic growth and public investment
Investing in public services is the solution to the deficit crisis. Instead of cutting jobs, we should be creating them. Jobs are not created by bullying people on benefits into jobs that don’t exist. Instead there are several areas where public sector jobs urgently need to be created.
It has been estimated that over a million ‘climate jobs’ could be created if the government was serious about tackling both climate change and unemployment – these would include areas like housing, renewable energy and public transport investment including high speed rail, bus networks and electric car manufacture.
Today there are 1.8 million families (representing over 5 million people) on council house waiting lists. There is an urgent need to build affordable housing for these people, which would also help reduce housing benefit payments.
The UK lags behind much of the rest of Europe in the development of a high-speed rail network, which would have the potential to create thousands of jobs and reduce carbon emissions by shifting passengers and freight away from road and air travel. Much of the country outside of London also needs huge investment in bus services – and, just as we should invest in electric car technology, we should also invest in electric buses and tram networks.
Only 2.2% of UK energy comes from renewable sources compared with 8.9% in Germany, 11% in France, and an impressive 44.4% in Sweden. If we are committed to tackling climate change and ensuring domestic energy security there needs to be investment in renewable energy technology.
All of these industries would generate revenue – people are billed for electricity, buy tickets to travel on public transport, and pay rent for council housing.
Research by Richard Murphy (of Tax Research) has shown that the state recoups 92% of the cost of creating new public sector jobs – through lower benefit payments and increased tax revenues.
The banks
We should never forget that it was the banking sector that caused the recession, and is ultimately responsible for the huge debts that the UK has amassed. Despite causing the crisis, the banking sector has escaped any significant regulation, and bankers are again awarding themselves huge bonuses.
The table opposite clearly shows how UK debt accelerated after the banking crisis in 2008. As a result of the UK government’s £1.3 trillion bailout to the financial sector, the government still owns over £850 billion in bank assets. This figure is roughly equal to the total UK debt.
The UK has an 84% stake in RBS and a 41% stake in Lloyds TSB. In addition, the state also owns Northern Rock and Bradford & Bingley. Under public ownership and control these assets could yield significant annual income to the Government, and could be used to meet social needs and tackle financial exclusion.
The case against privatisation
As a result of the government’s agenda to slash the public sector, privatisation, outsourcing and the Private Finance Initiative (PFI) are a fast growing threat to civil and public services despite the many performance failures of past privatisations.
Privatisation is no solution to the national debt. Evidence confirms that after transfer to the private sector the terms and conditions of workers are worse than before, the public sector loses any revenue stream while ultimately keeping the risk, and services to the public decline or cost more:
In the DWP, welfare is now described as “an annual multi-billion pound market”, and despite the department’s own research showing that Jobcentre staff outperform the private sector in helping people back to work, all contracts for welfare programmes are now outsourced.
Qinetiq was a company formed from the privatisation of the Defence Evaluation and Research Agency (DERA). In 2007, the 10 most senior managers gained £107.5m on a total investment of £540,000 in the company’s shares. The return of 19,990% on their investment was described as “excessive” by the National Audit Office. In 2009, Qinetiq offered its staff a pay freeze.
Although the economic downturn has led to a drying up of bank finance for PFI projects, the government has got round this by funnelling public funds – through the Treasury’s Infrastructure Finance Unit – to state owned banks who then loan finance to PFI consortia (which then claim inflated returns to government for the next thirty years, greatly exceeding the money given to them). The journalist and antiprivatisation activist George Monbiot observed, “the Private Finance Initiative no longer requires much private finance or initiative”.
Public services were won by trade union struggles in an effort to establish the basis of a civilised society. Driven by the desire for maximum profits, the private sector fails to provide effective and efficient public services.
Tax justice
Addressing the ‘tax gap’ is a vital part of tackling the deficit. Figures produced for PCS by the Tax Justice Network show that £25 billion is lost annually in tax avoidance and a further £70 billion in tax evasion by large companies and wealthy individuals.
An additional £26 billion is going uncollected. Therefore PCS estimates the total annual tax gap at over £120 billion (more than three-quarters of the annual deficit!). It is not just PCS calculating this; leaked Treasury documents in 2006 estimated the tax gap at between £97 and £150 billion.
If we compare the PCS estimate of the tax gap with the DWP estimate of benefit fraud, we can see that benefit fraud is less than 1% of the total lost in the tax gap (see diagram opposite).
Employing more staff at HM Revenue & Customs would enable more tax to be collected, more investigations to take place and evasion reduced. Compliance officers in HMRC bring in over £658,000 in revenue per employee.
If the modest Robin Hood tax – a 0.05% tax on global financial transactions – was applied to UK financial institutions it would raise an estimated £20–30bn per year. This alone would reduce the annual deficit by between 12.5% and 20%.
Closing the tax gap, as part of overall economic strategy, would negate the need for devastating cuts – before even considering tax rises.
Our personal tax system is currently highly regressive. The poorest fifth of the population pay 39.9% of their income in tax, while the wealthiest fifth pays only 35.1%. We need tax justice in personal taxation – which would mean higher income tax rates for the richest and cutting regressive taxes like VAT and council tax.
Cut the real waste
While it is not necessary to cut a penny in public expenditure due to the ‘deficit crisis’, there are of course areas of public spending which could be redirected to meet social needs.
In the civil and public services, we know there are massive areas of waste – like the £1.8 billion the government spent on private sector consultants last year. The government could get better advice and ideas by engaging with its own staff and their trade unions.
There is also the waste of the government having 230 separate pay bargaining units, when we could have just one national pay bargaining structure.
There are also two other large areas where government costs could be cut.
Trident
The current Trident system costs the UK around £1.5 billion every year.
A private paper prepared for Nick Clegg (in 2009, when in opposition) estimated the total costs of Trident renewal amounting to between £94.7bn and £104.2bn over the lifetime of the system, estimated at 30 years. This equates to £3.3bn per year.
At the time Nick Clegg (now Deputy Prime Minister) said: “Given that we need to ask ourselves big questions about what our priorities are, we have arrived at the view that a like-forlike Trident replacement is not the right thing to do.”
The 2010 Liberal Democrat manifesto committed the Party to: “Saying no to the like-for-like replacement of the Trident nuclear weapons system, which could cost £100 billion.”
PCS policy is to oppose the renewal of Trident and invest the money saved in public services, whilst safeguarding Ministry of Defence staff jobs.
War in Afghanistan
The war in Afghanistan is currently costing £2.6 billion per year. The war is both unwinnable and is making the world less safe. More important than the financial cost are the countless Afghan and British lives that are being lost in this conflict.
The PCS alternative…
There is no need for cuts to public services or further privatisations
Creating jobs will boost the economy and cut the deficit. Cutting jobs will damage the economy and increase the deficit
We should invest in areas such as housing, renewable energy and public transport
The UK debt is lower than other major economies
There is a £120 billion tax gap of evaded, avoided and uncollected tax
The UK holds £850 billion in banking assets from the bailout – this is more than the national debt
We could free up billions by not renewing Trident
End the use of consultants
What you can do
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A few recent news articles about the UK’s Conservative and Liberal-Democrat (Conservative) coalition government – the ConDem’s – brutal attack on the National Health Service.
BMA leaders will meet this week with the Royal College of Nursing and other medical royal colleges to build a united front in opposition to the Health Bill.
GPC deputy chairman Dr Richard Vautrey said the intention was to ‘provide a united position against the Health Bill but in support of appropriate changes to the NHS’.
The meeting, planned for Thursday 26 January, follows a wave of attacks on health secretary Andrew Lansley’s NHS reforms.
A House of Commons health select committee report this week warned that NHS services were being ‘salami-sliced’ in a bid to hit the £20bn savings target set by NHS chief executive Sir David Nicholson.
A recent poll of RCGP members found that 98% would back a call for the Health Bill to be withdrawn if this was made in tandem with other royal colleges.
The Royal College of Nursing and the Royal College of Midwives last week declared a policy shift on the Health Bill, declaring their opposition to the Bill ‘in its entirety’.
The BMA has also called for the Health Bill to be withdrawn. Dr Vautrey hit out at Mr Lansley’s response to criticisms of his health reform programme.
‘I don’t think stonewalling in that way is the way to increase engagement with health professionals and patients.
‘I think he at the moment appears to be not fully taking on board the seriousness of the increasing opposition.’
Dr Vautrey added that Mr Lansley had ‘repeatedly outlined his desire for greater clinical engagement and a greater voice for patients’. ‘No one disagrees with that,’ he said. ‘We think he’s going about it in the wrong way.’
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To the Tories, health is a huge untapped business opportunity – but the backlash could still derail their privatisation bill
Unless decisive action is taken in the next few weeks, the National Health Service is heading for disaster. The battle over the coalition’s plans to turn England’s NHS inside out has been going on so long, the details are so arcane and claims of concessions so regular, it would be easy to imagine that the worst had been averted and common sense prevailed.
But that could not be further from the case. As the health secretary Andrew Lansley boasted last autumn – after the Conservatives had accepted a “pause” in the progress of their health market and privatisation bill while Liberal Democrats were pacified with cosmetic concessions – its “fundamental principles remain”.
It was a rare moment of candour. As a group of lawyers and health academics spell out in the Lancet medical journal this week, if the health and social care bill is passed in its amended form it will abolish England’s model of “tax-financed, universal healthcare”, pave the way for a “US-style health system” based on “mixed funding” and fatally undermine “entitlement to equality of healthcare provision”.
Meanwhile, the preparations for this lurch towards market-driven private provision – at a cost of £3bn – are already causing havoc with the government’s parallel attempt to drive through the deepest cuts in the history of the NHS.
So the hapless Lansley was on the back foot again yesterday, dismissing as “Westminster nonsense” the onslaught from the Commons health committee, which accused ministers of “salami slicing” NHS services and blamed the reorganisation for creating “disruption and distraction” from the task of effective reform and saving money.
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The Tories suffered another setback to their brutal Welfare Reform Bill this Monday.
The House of Lords voted to exclude child benefits from the cap, following fears that over 100,000 children would be plunged into poverty.
The bill would impose a cap on benefits of £500 a week for a household.
It is one of a number of attacks on welfare that it hopes would save between £6 billion and £7 billion pounds a year.
But work and pensions secretary Iain Duncan Smith pledges to overturn the Lords’ amendment when the bill returns to the House of Commons.
He says the bill would be “pointless” without the cap on child benefit.
Large sections of the media are cheering him on.
Since the new cap would apply to the whole household rather than individual children, it amounts to a harsh tax on large families.
Economist Tim Leunig calculates that “after rent, council tax and utilities, a family with four children would have 62p per person per day to live on. That is physically impossible.”
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Hundreds of low paid NHS workers at Guy’s and St Thomas’s trust in London have been told to leave their subsidised accommodation with just three months’ notice.
The trust accommodation office sent a letter to residents earlier this month informing them of its plans to sell off the housing.
The accommodation currently has 800 places for NHS workers, but this number is expected to be cut by around half.
The trust is also imposing a two-year limit on how long people can live in the accommodation. Those remaining will be charged rent at market rates.
This spells disaster for many of the low paid residents living in the homes. Some have been there for up to 20 years.
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A few recent news articles about the UK’s Conservative and Liberal-Democrat (Conservative) coalition government – the ConDem’s – brutal attack on the National Health Service.
Health Secretary Andrew Lansley responds to criticism by a committee of MPs by calling their brand new report “out of date” and “unfair”.
The government’s controversial NHS shake-up is hindering efforts to find ways of slashing health spending without cutting vital services, MPs warned yesterday.
In a highly critical report, the health select committee said hospitals were resorting to short-term “salami slicing” as they try to find £20 billion in efficiency savings by 2014/15.
But in a stinging criticism of Health Secretary Andrew Lansley’s reorganisation, it said the process “continues to complicate the push for efficiency gains.”
There was a “marked disconnect between the concerns expressed by those responsible for delivering services and the relative optimism of the government” over achieving cuts, the committee noted.
The attack is especially wounding as the committee is chaired by former Tory health minister Stephen Dorrell and is dominated by Conservative and Lib Dem MPs.
It comes days after all the major health unions – representing doctors, nurses and midwives – expressed their “outright opposition” to the Health and Social Care Bill.
The British Medical Association, the Royal College of Nursing and the Academy of Medical Royal Colleges are also holding a summit on Thursday evening to discuss the Bill.
The Royal College of Nursing has today (24 January) responded to a Health Select Committee report into public expenditure saying it agrees that forging ahead with reforms has caused disruption and distraction at a time of austerity within the NHS.
“We concur with the report findings,” said RCN Chief Executive & General Secretary Dr Peter Carter. “We feel that the dual impact of the reform process and the full extent of the efficiency savings is now seriously destabilising the NHS. Indeed, in our opinion the bill has created such turmoil that it should be stopped. Now is the time for the Government to get a grip of the situation and work with organisations such as the RCN to stabilise the health service.”
The findings of the Health Select Committee chime with many of the concerns nursing staff have raised about efficiency savings. RCN research has shown that some NHS trusts are making short-term cuts to services and nursing posts in an attempt to make savings, rather than engaging in intelligent service redesign. The RCN says that in England alone, 48,000 NHS posts are earmarked to go.
“This will undoubtedly have a deep and potentially dangerous impact on patient care,” added Dr Carter. “As the report acknowledged, long-term planning and more integrated health and social care services could provide huge benefits for patient care.
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Andrew Lansley, the Health Secretary, has defended his NHS reforms, describing a highly critical report by MPs as “out of date” and “unfair” to the health service.
Mr Lansley insisted that the NHS was delivering efficiency savings and improvements for patients following a warning from MPs that the overhaul of the NHS is hindering efforts to slash health spending without cutting vital services.
“I think the select committee’s report is not only out of date but it is also, I think, unfair to the NHS, because people in the NHS, in hospitals and in the community services are very focused on ensuring that they deliver the best care to patients and that they live within the financial challenges that clearly all of us have at the moment,” Mr Lansley told ITV Daybreak.
“I am afraid the evidence points to the fact that they are doing that extremely well.”
His remarks follow a highly critical report from the Commons Health Select Committee which said hospitals were resorting to short-term “salami slicing” as they try to find £20 billion in efficiency savings by 2014/15.
In a stinging criticism of Mr Lansley’s reorganisation, it said the process “continues to complicate the push for efficiency gains”.
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A few recent news articles about the UK’s Conservative and Liberal-Democrat (Conservative) coalition government – the ConDem’s – brutal attack on the National Health Service.
Andrew Lansley’s health reforms face a fresh crisis as a powerful committee of MPs says the changes are obstructing efforts to make the NHS more efficient and that they fail to address the most urgent health challenge of modern times – how to care better for an expanding elderly population.
A highly critical report by the cross-party select committee on health, due to be published on Tuesday or Wednesday, comes as the medical establishment prepares to stage its own summit on Thursday to discuss concerns over the health and social care bill. The report, a late draft of which has been seen by the Observer, will cause alarm in Downing Street as it is the work of a committee with a Tory and Liberal Democrat majority and is chaired by Stephen Dorrell, a former Conservative health secretary.
One of its key messages is that Lansley’s far-reaching attempts to restructure the NHS in England and devolve more power to GPs are making it more difficult to deliver on a separate target of £20bn of efficiency savings by 2014-15. The report echoes the widespread view in the medical profession that it is deeply unwise to be inflicting far reaching structural reform on the NHS at the same time as asking it to make huge savings.
The MPs say that instead of finding savings by innovation and greater efficiency, many hospitals and trusts are simply cutting services, despite Lansley’s assurances that this would not happen. It says: “The reorganisation process continues to complicate the push for efficiency gains. Although it may have facilitated savings in some cases we heard that it more often creates disruption and distraction that hinders the ability of organisations to consider truly effective ways of reforming service delivery and releasing savings.”
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NickClegghas defended the coalition government’s NHS reforms in England, saying the health service could not be “frozen in time”, following a barrage of criticism from a cross-party group of MPs.
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The deputy prime minister insisted ministers had gone a long way to allay concerns over the future of the NHS. A report from the Commons health select committee this week, a late draft of which was seen by the Observer, is expected to warn that far-reaching attempts to restructure the NHS will make it more difficult to deliver £20bn of efficiency savings by 2014-15.
Clegg told the BBC’s Andrew Marr Show on Sunday: “We have said there is going to be no privatisation of the NHS by the back door … and that there is a proper way to account for the NHS, but we don’t want people to think that we can freeze [the NHS] in time and it will all be OK.
“I haven’t seen [the report], but of course we will look at it. There is a totally legitimate question [asked by the committee] about how you conduct reform when at the same time you are making savings.”
Clegg said that making people on the front line more responsible for the use of NHS money would help, not hinder. He said: “I think that no one should believe we are helping the NHS by sticking our heads in the sand and saying ‘no change’.”…
Shadow Secretary of State for Health Andy Burnham says that the Government’s controversial health reforms threaten to push the NHS “over a cliff edge”.
Mr Burnham accused the coalition of reneging on its promise not to impose ‘top down reorganisation’ and claimed that the proposed changes to the NHS may be dangerous.
“I think if these changes go ahead it will be the end of the National Health Service as we know it. It will be a plan to put market forces at the very heart of our health services. In essence it is a privatisation plan for the NHS,” said Mr Burnham.
Andrew Lansley’s health reforms are contained in the health and social care bill, which will return to the House of Lords next month. This Thursday the British Medical Association, health workers unions and other interested parties who want the bill scrapped will hold a summit in London.
A few recent news articles about the UK’s Conservative and Liberal-Democrat (Conservative) coalition government – the ConDem’s – brutal attack on the National Health Service.
Royal Colleges and the BMA (British Medical Association) restate their opposition to evil Con-Dem coalition government attempts to abolish the NHS. Lying scumbag and Health Secretary Andrew Lansley responds by claiming that they actually support his plans despite their repeatedly stated opposition and by accusing them of acting politically.
Relations between the Government and health professionals sank to a new low after Andrew Lansley accused them of opposing his NHS reforms because they were upset about cuts to their pay and pensions.
Union leaders reacted furiously to the Health Secretary’s claim that they wanted “to have a go” at the Government and his suggestion that they were not addressing his NHS shake-up on its merits. Mr Lansley is under fresh pressure after the Royal College of Nursing (RCN) and Royal College of Midwives (RCM) joined the British Medical Association in calling on the Coalition to drop its NHS and Social Care Bill.
Mr Lansley told the BBC the legislation was essential in order to give nurses and doctors clinical leadership. He said: “[The RCN] used to be a professional association that was working with us on professional issues and will carry on doing that, but now the trade union aspect of the Royal College of Nursing has come to the fore, they want to have a go at the Government… about things like pay and pensions.” He added: “It’s a purely political operation.”
Mr Lansley claimed the RCN and RCM supported the principles of the Bill. “What they are actually unhappy about is pay, pensions and jobs. I complete understand that. But if there were no Bill the same issues would have to be addressed. We inherited a deficit, we are having to manage the NHS within limited increases, but actually next year the NHS budget is going to go up by 2.8 per cent.”
Mr Lansley denied suggestions that his decision to allow hospitals to raise 49 per cent of their income from private patients was an issue, as hospitals had no limit at the moment. “You have to see the political nature of this. The RCN does not like private activity,” he said. But Dr Peter Carter, general-secretary of the RCN, rejected Mr Lansley’s claims, saying: “We are disappointed that the Secretary of State would suggest that nurses and healthcare assistants would put self interest before that of patients.”
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The number of hospital patients forced to wait more than 18 weeks for NHS treatment has risen by almost half since the Coalition came to power, new figures show.
In May 2010, 20,662 patients referred for treatment in hospital had to wait longer than the recommended time, according to Department of Health data.
But by last November that figure had grown to 29,508 – an increase of 8,846, or 42.8 per cent.
A third of hospital trusts across England (47) are now failing to meet the goal of 90 per cent of their inpatients being seen within 18 weeks of being referred by a GP – almost four times as many as in the middle of 2010.
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Healthcare rationing is now everywhere – and don’t think being slim and a non-smoker makes you immune
If you’re overweight or you smoke, you won’t be able to have your hip replaced or your gallbladder removed. Before being put on a waiting list, you’ll have to make efforts to mend your wicked ways. That is what one consortium of GPs in Hertfordshire has decided. And with the government determined to save £60bn from the NHS, it’s unlikely to be the last to agree to this kind of rationing of resources.
Fair enough, you may say. The risks of operations are reduced if you are slim and don’t smoke. Obesity contributes to osteoarthritis of the hip and gallstones, as well as diabetes and high blood pressure. Every smoker in the land must know that they are running an increased risk of lung cancer, and lung and heart disease. Clearly, the risks of anaesthetic complications are higher if you’re a heavy smoker or very fat. And why should slim, non-smoking taxpayers bear the cost of the lumpen puffers?
But this cannot be a defensible position. The Hertfordshire GPs are surely going to have to rethink. Their ruling will potentially affect nearly one quarter of all adults in their area (in 2009 22% of men and 24% of women in England were obese – with a body mass index over 30), and a third of women and nearly half of men if they include overweight people (with a BMI of 25-30). It is completely unrealistic to assume that telling people they can’t go on the waiting list for a much-needed operation until they lose weight will yield any result except despair. Fat is a class issue nowadays. The richer you are, the less likely you are to be fat. Healthy food’s expensive. The factors are complex, and responsibility lies with individuals, schools, health professionals, government and the food and advertising industries – not with a bunch of GPs flexing their commissioning muscle.
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Patient safety in Welsh hospitals is being compromised by a drive to save money, says a nursing union.
The Royal College of Nursing (RCN) says the Welsh government has warned NHS managers to hit financial year-end targets despite a £50m shortfall.
RCN Wales director Tina Donnelly said members in several health boards reported concerns on patient safety.
The Welsh NHS Confederation denied safety was being undermined and said it remained a priority.
Ms Donnelly said nurses had reported having to work shifts with reduced staff numbers, as well as experiencing shortages of basics such as bed linen.
“They really are finding it very, very difficult in the last three months of this financial year,” she said.
“Staffing levels are a lot lower and also their grading is being reduced, which reduces the level of supervision which they are able to have in clinical practice.”
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The British Medical Association (BMA) is urging the government to reconsider their pension plans as thousands of doctors may take industrial action.
A meeting of BMA Council, the association’s governing body, resulted in the decision to reject the government’s recent pension propositions – in support of the views of tens of thousands of doctors and medical students.
A national survey of 46,000 found that 84% wanted to reject the latest proposals, while 63% would be willing to take industrial action to pursue changes. Over a third of doctors aged 50 and over said they will retire early if the current changes go ahead.
The government’s current proposals include a rise in members’ contributions, those that currently pay 8.5% will pay 14.5%, an increase in the Normal Pension Age resulting in new doctors having to work until they are 68 and a change in pension accrual methods, to a career average revalued earnings (CARE) scheme for all doctors.
Dr Hamish Meldrum, Chairman, BMA Council says: “Doctors are at the forefront of attempts to save the NHS £20 billion, while trying to protect patient care, are in the midst of huge system reform in England, which is causing chaos in many areas, and are about to enter a fourth successive year of a pay freeze.
“Now on top of this, they are facing wholesale changes to their pension scheme, which was radically overhauled less than four years ago and is actually delivering a positive cashflow to the Treasury.
“Industrial action remains a last resort and the Government must urgently reconsider its damaging plans. The action we are considering is unprecedented in recent decades. This demonstrates the current level of discontent among NHS staff.”
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Firstly, we need to get the ‘debt crisis’ in perspective. The table opposite shows UK debt relative to other major economies.
The table opposite clearly shows how UK debt accelerated after the banking crisis in 2008. As a result of the UK government’s £1.3 trillion bailout to the financial sector, the government still owns over £850 billion in bank assets. This figure is roughly equal to the total UK debt.
If we compare the PCS estimate of the tax gap with the DWP estimate of benefit fraud, we can see that benefit fraud is less than 1% of the total lost in the tax gap (see diagram opposite).