Labour Lords criticise Destroy the NHS / Health and Social Care Bill as a “mess” and a “catalogue of compromises”.

The Kings Fund warns of the health situation in London with nobody responsible and huge deficits forecasted.

Many Clinical Commissioning Groups (CCGs) are behind (over) budget raising the prospect of cuts.

The Royal College of Physicians states that consultants provide many more than their contracted hours for free.

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.

NHS Reforms A ‘Catalogue Of Compromises’, Labour Lords Claim

Labour has launched a scathing attack on the Government’s wide-ranging health reforms, branding them a “mess” and a “catalogue of compromises”.

Health spokeswoman Baroness Thornton hit out at the proposed changes as peers began an extended sitting on the Health and Social Care Bill.

The Lords was forced to sit more than three hours earlier than usual in a bid to complete the Bill’s marathon committee stage by the Christmas recess next week. As day 12 of debate got under way, Lady Thornton focused on the role of the independent regulator for all healthcare services, Monitor.

“The Bill is a mess. It is a sad catalogue of compromises,” she said. “We believe that Monitor is being asked to fulfil too many functions, set too many priorities, some of which are potentially in conflict with each other.”

Lady Thornton called for the section of the Bill dealing with Monitor to be rewritten to make it “simpler and more coherent”.

Labour had introduced independent regulation of quality into the NHS. But it did not accept “the handing over of economic regulation of the NHS to a quango”.

She told the House: “There is a place for competition. It is not, and never can be, the main driving force for reform of the NHS. We are against promotion of competition for its own sake as this Bill originally intended.
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BBC News – NHS London needs ‘urgent change’, says King’s Fund

London’s NHS is in “urgent need of change” but there is a risk there will be no one in charge to push that change through, according to a report.

The King’s Fund said there could be a “responsibility vacuum” in organising services when the strategic health authority is abolished in April 2013.

The independent think tank’s report also warned there were huge health inequalities across the capital.
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The report said London’s NHS could face severe financial difficulties over the next few years, with 18 hospitals forecast to have a net deficit of £170m by 2014.

It also said GP performance was often poor with people’s satisfaction with GP services lower than elsewhere in the country.

The charity added many London trusts would struggle to meet the government’s deadline to become foundation trusts by 2014, as currently only 16 out of 42 trusts have foundation status.

Chris Ham, chief executive, said: “London’s NHS is in urgent need of change, but the risk is no-one will be behind the wheel to push through the changes needed to improve patient care.
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Related: Health News – Report criticises quality of NHS care in London RCN shares concerns about health services in London – RCN

GPs lose grip on budgets as CCGs slide into red – Pulse

Exclusive GPs who have taken over budgets from PCTs under the Government’s NHS reforms are sliding millions into the red, according to financial assessments that lay bare the scale of the challenge facing clinical commissioning groups.

A Pulse investigation into CCG budgetary control across 55 PCTs raises questions over their capacity to constrain costs and deliver planned savings, with two-thirds of those reporting figures currently missing their financial targets.

GP commissioning leaders warned the deteriorating financial situation might force them to toughen up restrictions on referrals from practices, despite new figures showing GP referrals fell by 4% last quarter compared with a year ago.

Overall, 29% of PCTs are currently behind budget for 2011/12, with just 9% forecasting they will not meet their financial targets by April 2012.

But among 29 CCGs able to provide figures, 66% were behind budget, while four of the 20 making end-of-year forecasts said they would still be in deficit at the end of the financial year even after bringing in tough measures to catch up.
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Concern over NHS relying on consultants’ good will | Royal College of Physicians

Consultant physicians are increasingly working above and beyond their contracted hours. The NHS is relying on this good will to deliver the service that patients need. The amount of time consultants have to spend with trainees is decreasing and some specialties are experiencing low levels of growth in consultant numbers.

Dr Andrew Goddard, Director of Royal College of Physicians Medical Workforce Unit, said:

‘This census shows that senior doctor expansion has fallen and that the NHS remains reliant on doctors working longer than their contracted hours. Consultants contracted hours have fallen significantly as hospitals strive to save £20 billion over the next three years. Despite this, consultants continue to work the hours they have done in previous years and so the amount of ‘goodwill work’ is increasing year-on-year.

‘Furthermore, consultants are finding themselves less available to teach trainees, often having to do jobs that would have previously been done by junior doctors. This is really worrying as training of future senior doctors is vital to high quality patient care in the NHS.’

Each week, consultants are working 11.5% of their contracted hours extra free. This figure jumps to 14% for doctors who work part time. Overall, this ‘goodwill’ work accounts for the equivalent of 1,450 fulltime consultants, up by 205 compared to 2009. Despite working longer hours, 51.8% of consultants say that time available to spend with trainees has reduced during the past three years. This change may result from the fact that consultants are spending more time doing jobs that would previously have been done by a junior doctor.
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UK Uncut

We start with some simple points of agreement. The brutal cuts to services about to be inflicted by the current Government are unnecessary, unfair and ideologically motivated. The coalition are particularly fond of two obscene catchphrases: ‘There is no alternative’ and ‘We’re all in this together.’ Both slogans are empty and untrue. The cuts will dismantle the welfare state, send inequality sky-rocketing and hit the poorest and most vulnerable hardest. A cabinet of millionaires have decided that libraries, healthcare, education funding, voluntary services, sports, the environment, the disabled, the poor and the elderly must pay the price for the recklessness of the rich.

Austerity-economics is the policy of the powerful. It cannot be stopped by asking nicely. We cannot wait until the next election. If we want to win the fight against these cuts (and we can win) then we must make it impossible to ignore our arguments and impossible to resist our demands. This means building a powerful grassroots mass movement, able to resist the Government cuts at every turn.

UK Uncut

The Government’s Line lies

“There is no alternative.”

We are told that the only way to reduce the deficit is to cut public services. This is certainly not the case. There are alternatives, but the government chooses to ignore them, highlighting the fact that the cuts are based on ideology, not necessity.

• One alternative is to clamp down on tax avoidance by corporations and the rich and tax evasion, estimated to cost the state £95bn a year
• Another is to make the banks pay for free insurance provided to them by the taxpayer: a chief executive at the Bank of England put the cost of this subsidy at £100bn in a single year

Either the tax avoided and evaded in a single year or the taxpayer subsidy to the banking industry could pay for all of the £81bn, four-year cuts programme.

“We are all in this together.”

Since the banking crisis:

• average pay of FTSE 100 directors has risen 55%,
• corporation tax has been cut,
• the government have not delivered on a manifesto pledge to clamp down on tax avoidance, instead cutting staff at HMRC,
• bank profits and bonuses are back in the many billions (last year banks paid out over £7bn in bonuses and just four banks made £24bn in profit),
• there has been no reform of the banks.

David Cameron himself has said that the cuts will change Britain’s “whole way of life”. Every aspect of what was fought for by generations seems under threat – from selling off the forests, privatising health provision, closing the libraries and swimming pools, to scrapping rural bus routes. What Cameron doesn’t say is that the cuts will also disproportionately hit the poor and vulnerable, with cuts to housing benefit, disability living allowance, the childcare element of working tax credits, EMA, the Every Child a Reader programme, Sure Start and the Future Jobs Fund to name a few.

The facts speak for themselves; we are not all in this together, we are paying for the folly of reckless bankers whilst the rich profit

It is confirmed that NHS Croydon is £35 million in debt.

GMB members at Western Hospital, Swindon complain of harassment by hospital contractor Carillion and intend to ballot for strike action.

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.

NHS Croydon admits to £35 million overspend as council expresses “shock and disappointment” | This is Croydon

NHS Croydon has announced it has overspent by as much as £35 million this financial year.

The primary care trust (PCT) blamed “higher activity in hospitals” and “understated budget setting” as the main causes of its “significant budgetary challenge”.
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NHS Croydon told the Advertiser this evening that the overspend for 2011/12 had been reduced to around £23 million “following the release of financial reserves”.

A spokeswoman said: “As a result of the ongoing detailed analysis of all Croydon PCT budget lines over the last few months we have identified a significant budgetary challenge for Croydon 2011/12.

“We believe we are spending between £30m and £35m more on healthcare than we have in our budget which equates to six per cent of our annual spend on the population of Croydon.

“We are taking robust action to resolve this problem. We are developing a detailed action plan to get back into balance and ensure robust financial planning for the future to live within the funding we are given each year from central government.”
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Swindon NHS Ballot

Carole Vallelly GMB Regional officer said “GMB members at the hospital had a private meeting with Paul Kenny GMB General Secretary when he visited them at hospital today (Monday 12 December). He was told of the myriad problems members are experiencing at the hands of managers of Carillion. He was told that these problems have as their root the PFI contractor’s failure to deal properly with concerns over holiday arrangements, shift arrangements and general consultation with the staff. Instead they face a culture of bullying, harassment and discrimination.

They asked that their concerns be reported to the Central Executive Council (CEC) of the union so that they could be given authority to ballot for strike action to get the problems addressed. I will now take steps to consult members to ensure that there is a full report to next CEC asking for authority to move to an official strike ballot on this matter.”

Paul Kenny speaking after his meeting with members said “GMB is calling on Swindon and Marlborough NHS Trust to investigate these allegations of bullying, harassment and discrimination in the contract run in their name by Carillion.

There is no place in a modern health service for bullying, harassment or discrimination. Either the Trust takes action about this or the union members will”.

The wrong cure

How cuts will make Britain more unfair

The government says that its cuts programme is not just unavoidable, but also fair and progressive. Is this true?

You can argue about the meaning of fair, but progressive has a definition. If what the government is doing is progressive it would take from the rich and give to the poor (or at least hit them much less than the rich).

Independent experts say the cuts are not progressive.

Let’s first look at the changes in tax and benefits, and then at the impact of cuts in services.

Tax and benefits

Whether changes in tax and benefits are progressive is relatively easy to measure as these are flows of cash.

The Institute of Fiscal Studies is well respected as an independent analyst. It says that the government’s claim that the tax and benefit changes in the budget and spending review are progressive is wrong.

This graph is from their analysis of George Osborne’s first budget:

It shows the biggest losers are the poorest 10 per cent of families with children.

The IFS also had this to say about October’s spending review:

Our analysis (of the budget) shows that … the impact of all tax and benefit measures yet to come reduces the incomes of lower income households by more than that of higher income households, with the notable exception of the richest 2% of the population who are the hardest hit. Therefore the tax and benefit changes are regressive rather than progressive across most of the income distribution. And when we add in the new measures announced yesterday this finding is, unsurprisingly, reinforced. So our analysis continues to show that, with the notable exception of the richest 2%, the tax and benefit components of the fiscal consolidation are, overall, being implemented in a regressive way.

This is the IFS analysis of all government policies on tax and benefit by 2015. The poorest lose the most. It is only the impact of the previous government’s tax increases for the wealthy that make the top ten per cent bigger losers than some of those who are poorer.

Spending cuts

Working out the impact of the cuts in spending on services is harder. Some parts of public spending benefit all of us – such as many environmental protection measures.

But other parts of public spending do benefit some people more than others. To give a simple example the richer you are, the less likely that you use the bus.

Researchers for the TUC trawled official statistics to gather information about how different income groups benefit from public spending. With these figures, and by assuming that everyone benefits equally from spending like environmental protection and defence, they were able to work out whether the cuts were progressive.

This chart shows the value of the services lost as a proportion of household income.

Again the impact of the cuts is much harder on the poor and those in the middle than it is on the rich. The poorest ten per cent suffer 15 times more than the richest.

The impact on women

The Womens’ Budget Group is a group of independent experts who have been working with the Treasury to analyse the effect of economic policies on women.

This is what they said about the impact of the Spending Review:

• Lone parents and single pensioners – most of whom are women – will suffer the greatest reduction in their living standards to public service cuts. Lone parents will lose services worth 18.5% and female singles pensioners services worth 12% of their incomes.
• Overall single women will lose services worth 60% more than single men as proportions of their incomes, and nearly three times the amount lost by couples.
• The cuts will lead to hundreds of thousands of women losing their job. 53% of the jobs in the public sector services that have not been protected from the cuts are held by women. The pay and conditions of all public sectors workers, 65% of whom are women, are likely to deteriorate.
• Cuts in welfare spending fall disproportionately on women’s finances. Child benefit is paid almost 100% to women; while 53% of housing benefit claimants are single women. Both benefits have been cut significantly in real terms and eligibility has been tightened.