the plot against the NHS

NHS news review: Cameron confirms that the intention is to privatise the NHS

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Best wishes for the new year.

Seven former presidents of the Faculty of Public Health accuse the Prime Minister of ploughing ahead with an “unprecedented marketisation” of services, which poses a “major threat” to the integrity of the NHS.

David Cameron confirms that the intention is to “… drive the NHS to be a fantastic business“. How is that anything other that the privatisation of the NHS?

Watch the video here VIDEO BLOG: Cameron wants the NHS “to be a fantastic business” « sturdyblog

Drop perilous NHS reforms, say leading health professionals – Health News – Health & Families – The Independent

David Cameron faces fresh calls to abandon his NHS reforms, as a group of leading public-health experts predicts that the changes will “exacerbate inequalities” in the health of the nation.

Seven former presidents of the Faculty of Public Health accuse the Prime Minister of ploughing ahead with an “unprecedented marketisation” of services, which poses a “major threat” to the integrity of the NHS.

In a letter to Mr Cameron, the group warns: “The Bill is likely to produce a ‘patchwork quilt’ health system that will vary hugely across the country, failing to meet the diverse needs of the population and undermining the health of vulnerable, minority groups.”
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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.

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Continue ReadingNHS news review: Cameron confirms that the intention is to privatise the NHS

NHS news review

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Colin Leys – co-author of ‘The Plot Against the NHS’ – has an article at Opendemocracy.

The NHS will be privatised – it doesn’t matter what the British people want | openDemocracy

In voting for the third reading of Andrew Lansley’s Health and Social Care Bill last week MPs voted to replace the NHS as a public service with a system of competing businesses – foundation trusts, social enterprises and for-profit corporations.

The government’s claim that the Bill does not mean privatisation is plainly specious: the truth of the matter is to be found in what Lansley’s health minister, Lord Howe, told a meeting of private health businessmen on the day the Bill was approved. He said it presented ‘huge opportunities’ for the private sector, and noted that commissioners of health care would be barred from favouring NHS providers. The truth is also to be found in the government’s leaked plans to hand over the management of NHS hospitals to private companies, and in the current and promised large-scale opening up of NHS work to ‘any qualified provider’.

Conservative election poster 2010

Lord Howe reiterated Tony Blair’s dictum that it doesn’t matter who provides care, so long as it is free to the patient. What this does is to treat as irrelevant everything that follows from introducing market dynamics. The basic fact about health care is that high quality care depends on a sufficient ratio of skilled staff to patients, whereas in the long run profits can only be made by reducing the skill-mix (to lower the wage bill) and cutting staff ratios. The resulting decline in care quality is already evident in privatised long term care and home care, and is now beginning to be seen in community health services and GP services. Once NHS trusts have to compete with for-profit companies they will be forced to follow suit.

The erosion of quality will be reinforced by two other powerful factors: a) the cuts being imposed in the NHS budget, leading to the withdrawal of some services and the scaling back of others; and b) rising costs due to marketisation.

The costs of market-based health care – from making and monitoring multiple and complex contracts, to advertising, billing, auditing, legal disputes, multi-million pound executive salaries, dividends, fraud, and numerous layers of regulation – will eventually consume 20 per cent or more of the health budget, as they do in the US. Neither the Care Quality Commission nor NHS Protect (the former NHS Counter-Fraud Unit) is remotely resourced enough, or empowered enough, to prevent the decline of care quality or the scale of financial fraud that the Bill will introduce.

The effect will be that people with limited means will be offered a narrowing range of free services of declining quality, and will once again face lengthening waits for elective care. To get high quality and more comprehensive care people will have to pay for private insurance and private care, if they can afford to. More and more NHS hospital beds will be occupied by private patients, further reducing the resources available for free care. Fixed personal budgets, like those already given to people for social care, are to be introduced for a growing range of chronic conditions, allowing those with resources to top up their allocations while leaving the rest to make do with ‘basic’ NHS provision.

None of this is wild speculation. It is either already happening or announced or readily foreseeable on the basis of current policy. To deny that the Bill means privatisation and the end of the NHS as a comprehensive service equally available to all is like denying that the earth is round.

The fact that MPs have nonetheless endorsed the Bill reveals something more serious than an ideological blind spot. It shows that they don’t really care that they are flouting the wishes of the electorate. Cameron promised categorically that there would be no further top-down reorganisation of the NHS, but is pushing through a reorganisation that amounts to a destruction of it, against the known wishes of a large majority of voters. Governments, we are told, must often take unpopular decisions. But this is not some incidental measure. We are talking about something fundamental to what, for more than half a century, has played a key part in making Britons equal citizens, and Britain a civilised and humane country. If democracy doesn’t mean that governments have to respect public opinion on something as important as this, what does it mean?

It is no less depressing that the Department of Health has been reduced to peddling more and more brazen lies, such as its ‘Department of Health Myth Buster’ document, published to coincide with the Third Reading debate. The principle seems to be that that if an official lie – such as that the Health Bill does not mean privatisation – is repeated often enough, most people will feel it must be true. Democracy depends on voters having trustworthy information. If we cannot trust departments of state, run by public servants, to tell the truth, who can we trust?

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Selected excerpts from ‘The Plot Against the NHS’ by Colin Leys and Stewart Player. Chapter One is available here. I highly recommend this book available from Merlin Press for £10.

The Plot Against the NHS #1

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Conservative election poster 2010

A few recent news articles about the UK’s Conservative and Liberal-Democrat coalition government – the ConDem’s – brutal attack on the National Health Service.

BMA Exposes Government’s Unjustifiable Changes in Healthy Pension Scheme | News Tonight

In a shocking revelation, it has come to light that the controversial Government plans to reform NHS pensions could put an extra £230,000 burden on GPs over their career. It has been reported that BMA forecasts have revealed that the NHS pension reforms made by the Government earlier this year are already raiding GPs up to £125,000 each over the course of their lifetimes.

Further, GPs will lose £124,500 by the time they reach 85, if the proposal produced in April, involving shift from use of the retail price index to the lower consumer price index to uplift NHS pensions, is passed.

Reacting to the unjustifiable changes to the financially healthy pension scheme, Dr. Hamish Meldrum, chair of the BMA council, said: “his isn’t about affordability; it’s about the Treasury looking for yet another quick hit from public sector workers. Doctors pursuing a career as a consultant or GP will have to pay significantly higher contributions in return for a much reduced pension at retirement”.
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Anger as ‘ludicrious’ referral gateway rejects up to a quarter of GP requests – newsarticle-content – Pulse

Exclusive GPs have been forced to formally complain to PCTs over a series of technical and administrative problems with referral management centres, with one practice claiming a quarter of its referrals have been rejected.

In NHS West Essex, GPs have been left frustrated by rejections and the insistence of administrators that referrals are resubmitted, sometimes several times, without having been triaged by its Central Referral Service.

Examples of rejections include a referral to a surgeon for diagnosis and removal of a lump refused because a minor surgery proforma was not attached, and a gynaecology referral refused ‘in error’.

A GP in Uttlesford, Essex, who wished not to be named, said: ‘I am vehemently opposed to referral management systems. It is intensely frustrating and is not working for administrative reasons and ludicrous technical problems.’

A practice manager at a practice in Essex claimed a quarter of its referrals had been rejected by the referral triage system: ‘I feel our patients are suffering. So many receive letters stating their appointments have been cancelled.’
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NHS spends nearly £16 million a year on headhunters – Telegraph

The NHS is spending nearly £16million a year paying recruitment firms to headhunt senior executives … it was revealed yesterday.

In one example, a primary care trust paid an agency more than £111,000 to fill the post of its chief executive, only to later promote its own deputy into the role.

The vast expenditure comes despite Government promises to cut back on “wasteful bureaucracy” among health trusts.

Health Secretary Andrew Lansley has pledged to reduce money spent on managers and pen-pushers by 45 per cent over the next four years. Hospitals are also being forced to axe thousands of front-line staff in an effort to save the NHS billions of pounds.

Yesterday, Freedom of Information figures revealed primary care trusts and strategic health authorities spent an estimated £15.9million paying recruitment firms to hire new managers.
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Darzi centres heralded as “massive waste of money” – News – Practice Business

PCTs struggle to justify Darzi centres after revelations of low patient numbers

Statistics from over 95 PCTs have revealed that 26% of Darzi centres have fewer than 500 registered patients, and that 35% had fewer than 1,000 patents.

The new information was gained through the Freedom of information Act and revealed via investigation by GP online that also found that over 12% of all Darzi centres had no registered patients whatsoever (though some stated that they did not offer this option). One of the centres had just a single registered patient.

Each PCT was forced to set up a Darzi centre under the previous government as part of a plan to provide primary patient care seven days a week between the hours of 8am and 8pm each day.

The centres cost around £1.1m each year and the General Practitioners Committee’s (GPC) negotiator, Dr Peter Holden, has stated that the on reflection the centres were “a massive waste of money”, saying that it was “outrageous” that centres had failed to register fewer than 500 patents.

Adelaide Surgery in Southampton has just 1,220 patients registered, GP Online reveals, despite receiving £907,000 in 2011/12, which means the centre receives around £743 per patient per year – or seven times as most GP practices.
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[I need to check, but I think that the real issue about Darzi centres (Polyclinics) is that PCTs were forced to provide them by government ~ Darzi clinics being the latest policy fad. ‘The Plot Against the NHS’ by Colin Leys and Stewart Player discusses Darzi clinics.]

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NHS news review – Colin Leys

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Healthy alternatives | Red Pepper

Colin Leys looks at how Scotland and Wales have rejected marketising the NHS

As expert commentators have amply shown, the coalition’s plan to privatise the NHS lacks any basis in evidence – no surprise there. What is less well recognised, and so far amazingly unmentioned in the debate, is that powerful evidence against privatisation exists on our own doorstep – namely, the fact that in Scotland and Wales the NHS is working well as a publicly provided and managed system, based on planning and democratic accountability.

Marketisation was tried, especially in Scotland, and rejected. The purchaser-provider split, which is at the root of the marketisation project, was introduced but then abandoned in both nations, and neither foundation trusts nor payment by results were introduced in either of them. PFI was used in Scotland under the first Labour government in Holyrood, and one private treatment centre for NHS patients was opened, but the SNP has since scrapped the use of PFI and taken the treatment centre into public ownership. Wales has used neither PFI nor private treatment centres. The NHS in both countries is once again planned and managed through a mix of democratically accountable central and local structures, as it was in England before the 1990s.
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We have an excerpt of The Plot Against the NHS reviewing Scotland and Wales’ approaches.

Selected excerpts from ‘The Plot Against the NHS’ by Colin Leys and Stewart Player. Chapter One is available here. I highly recommend this book available from Merlin Press for £10.

The Plot Against the NHS #1

The Plot Against the NHS #2

 

Continue ReadingNHS news review – Colin Leys

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It appears that all is not well following the recomendations of the future forum and the acceptance of its recommendations by the ConDem coalition government. Many NHS news articles highlight the fact that despite the many changes to the Destroy the NHS bill the privatising elements remain intact. The bill is still on course as the first stage of transforming the NHS into a restricted, privatised, insurance-based model of care.

It is clear that the revised Abolition of the NHS Bill does not satisfy the demands of the Liberal-Democrat Spring Conference due to the reliance on private providers. It is recognised that the Liberal-Democrats are facilitating the destruction of the NHS.

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.

Still a clear and present danger / Features / Home – Morning Star

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The NHS Future Forum, while having uncovered many faults throughout the legislation, was never asked to consider the ideological foundations behind the Bill.

This leaves Field between a rock and a hard place, having ensured new safeguards are applied while at the same time adding legitimacy to a significant departure from the founding principles of the NHS.

The Health and Social Bill remains a real threat to the NHS as a comprehensive service free at the point of use.
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All this means that the threat to NHS services and staff remains a clear and present danger. The Future Forum did little to assuage the fears of NHS staff who still face losing nationally determined pay, terms and conditions and will have little confidence in their job security which has been a hallmark of our National Health Service, established over 60 years ago by a Labour government.

The Health and Social Care Bill will now return to a public Bill committee of MPs of which I will be one.

How the coalition implements the NHS Future Forum recommendations in legislation and to what extent these recommendations change the direction of travel charted by the Bill will be known shortly.

One thing is certain – the Bill does far more than the coalition’s stated aims. Otherwise we would not need a Bill at all.

As I said in the Commons earlier this week, the changes set out by government this week are largely cosmetic. “You could put lipstick on a pig, but at the end of the day it was still a pig.”

Grahame Morris is Labour MP for Easington.

NHS: still on the road to privatisation | openDemocracy

On Monday, the Future Forum unveiled its long-awaited report on the Coalition’s NHS bill. Having now agreed to implement the majority of its recommendations, the Conservatives are keen to portray the episode as an example of a government willing to “listen” and improve “where it hasn’t got things right”. The reality is that their initial bill was a transparent attempt to privatise the NHS. Only the prospect of the Lib Dems voting it down forced any change. This was not a “listening exercise”, it was a last ditch attempt  to push the bill through with the minimum concessions necessary. The primary function of the bill remains in place: to introduce private sector provision throughout our health service.

The argument for Andrew Lansley’s NHS bill has been tenuous from the outset, encountering continual and vocal opposition. Recognising that the bill’s defeat would be catastrophic for his premiership, Cameron has desperately tried to repackage it whilst keeping the fundamentals in place. It has been a master class in the rhetoric and evasions of privatisation. But with minor tweaks there lies a danger that the bill will be accepted, both in the legislature and by the public, on the basis that it is less destructive than Lansley’s original proposals. This mentality of concessions and minor victories must be avoided. Instead, what must be continually asked is whether the bill is acceptable and legitimate in its current form – does it leave the NHS as a nationalised, coherent health service, and did the public vote for it?

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Lansley will tell his backbenchers that the fundamentals of the bill remain in place: GP Consortia commissioning services, and the private sector brought in through competition requirements. The involvement of private health firms has always been at the centre of these proposals and nothing in today’s report will worry them overly. In years to come, any niggling public safeguards can be slowly eroded.

The bill still represents a fundamental change to our NHS; it is a programme for widespread privatisation. Private services will expand, the truly national part of our health service will shrink, and incidents like Southern Cross could become more and more common. John Redwood’s claim on Question Time that providers must put “patients first” was typically disingenuous; corporations have a legal obligation to maximise shareholder value. They will be obliged to seek the maximum revenues and prices possible, and incur the minimal costs possible. They are profit maximisers, not charities, and a patient’s worth is measured in pound sterling.

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GMB On NHS Changes

GMB today set out its position on the recently published NHS Future Forum Recommendations.

Rehana Azam, GMB National Officer Public Services Section said “ The report and recommendations on the face of it appears that significant progress has been made. In reality there is much to be concerned about and until the details emerge as to what the amended Bill will look like the GMB remains of the view that Bill should be scrapped. The Bill in its current format will lead to the break up of the NHS and this break up continues to be the most significant threat to the NHS.
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HR Magazine – NHS reform will increase usage of PMI schemes, says Mercer

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Earlier this week, the Government announced it would be changing many of the initiatives that were to be implemented, following recommendations from the NHS Future Forum. According to Mercer, despite the proposed changes, companies should continue to prepare for further increases in corporate healthcare costs. GP consortia will work with healthcare professionals to ensure the most effective multi-professional involvement in the design and commissioning of services.

Consortia will also not take on the full range of responsibilities by April 2013, but when they have the right skills, capacity and capability to do so. Despite these changes, Mercer believes that giving these consortia control over budgets may still affect the quality of care and the length of waiting lists.

According to Naomi Saragoussi, principal in Mercer’s health and benefits business: “The devil is in the detail. While the Government has accepted the criticism of its policies and the plans to make the NHS more competitive appear to have been watered down, some areas lack clarity. It may be difficult for the consortia not to take a more commercial approach and prioritise more cost-effective treatments, despite their good intentions. We will have to wait and see.”
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Half-steam ahead on NHS reform but still on course » Hospital Dr

According to all accounts Captain Cameron and second mate Lansley have listened to the weather warnings of the Future Forum, have duly altered course and are now steering the SS Health Service into a bright new future.

Or are they? Closer examination of the small print suggests that we are in reality still heading into stormy waters and are the victims of a massive PR trick by the government who have managed to stay on course while persuading us that they have significantly altered the Health and Social Care Bill.

Lansley has reassured backbenchers that no red lines have been crossed and that the core principles of the Bill are untouched. On the same day that the papers were reporting Cameron’s “explicit rejection of further private sector involvement in the NHS” Lansley himself was addressing a conference of private companies eager to get involved in commissioning and providing NHS care.

One of the core principles of the Bill is to facilitate private involvement in commissioning and delivering NHS care (and anyone who still doesn’t believe that this is advised to read Colin Leys and Stewart Player’s compelling book The Plot against the NHS). All the policy levers for this – in particular GP commissioning and any willing provider, – remain in place. The emphasis of the role of Monitor has been altered but can easily be redirected once the well orchestrated political dust has settled.
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Selected excerpts from ‘The Plot Against the NHS’ by Colin Leys and Stewart Player. Chapter One is available here. I highly recommend this book available from Merlin Press for £10.

The Plot Against the NHS #1

The Plot Against the NHS #2

 

Continue ReadingNHS news review