private medical insurance

  • Tories 'relaxed' about NHS crisis because they think election is won

    By Neil Roberts  From GPonline.com - 27th April 2017

    "The government is 'relaxed' about the crisis in general practice because it thinks Labour can't win the general election, a former GP and health commentator has said.

    Former GP Dr Phil Hammond, who covers health policy for Private Eye, said that ministers were ‘very relaxed’ about the NHS because they believe there is no effective opposition.

    Plans to create large-scale Accountable Care Organisations to run health and social care services across the NHS would eventually lead to all GPs becoming salaried employees, he added.

    Citing a source ‘close to Jeremy Hunt’ Dr Hammond told the annual conference of Londonwide LMCs (Local Medical Committee) on Thursday: ‘They don't believe that Labour is electable. They are very relaxed about the state of the NHS, very relaxed about the queues in casualty, waiting lists going up again, and the disaster in general practice, because they don't believe Labour offers a credible opposition.’

    Dr Hammond said the Conservative government viewed the NHS as ‘a service for poorer people’ and wanted those who can afford it to take out private medical insurance.

    NHS privatisation

    ‘They want private companies to do as much NHS work as possible. And they want the NHS to be allowed to do as much private work as it wants to do. That is their ideology and agenda and they don't believe there is an opposition fighting that.’

    Dr Hammond, who was one of the first journalists to expose the Bristol babies heart scandal in the 1990s, warned GPs that under NHS England drive towards accountable care systems they could all end up in a salaried service.

    The NHS, he said, was ‘keen to move to a model of accountable care organisations where we unify primary, secondary care, social care.’ 

    He added: ‘Ultimately this will make all GPs salaried and working for a large accountable care organisation in a particular area.’

    The Conservative Party did not respond to a request for comment".

     

    SOH  Comment:

    The vast majority of the electorate know nothing about this. It has not been alerted to the detail of Health and Social Care Act 2012 and Simon Stevens' plans from 2014 for co-called "Sustainability and Transformation Plans". The STPs include American-style "Accountable Care Organisations" - the stress is on the word "accountable" or "cost-controlling". They are part of an entirely new and untried, root-and-branch reorganisation of the NHS which the present Government is bringing in very, very quietly.

    The NHS will be unrecognisable. The National Health Service will disappear and be replaced by many Regional ("footprint"-based) organisations linking local federations of GPs, local acute services and local government authorities. Each "footprint" organisation (ACO) will have a capped budget - no more deficits, no more overspending. Gone over your budget? No more medical service.  The management of the local ACO will devote its energies to finding ways to "deny service". Uninsured and poor Americans know all about this.....

  • Wake up to the Accountable Care Organisation threat!

    Calderdale and Kirklees 999 Call for the NHS article of 1st March 2017

     

    Simon Stevens, the NHS England Chief Executive,  just told the Public Accounts Committee that some Sustainability and Transformation Plans will soon get going as Accountable Care Organisations or systems.

    This sounds like more tedious, senseless jargonising.

    Indeed one MP, Anne Marie Morris, was so bemused by what Simon Stevens was saying, she asked if they were all smoking dope.

    But behind the jargon smokescreen – whether wacky baccy or not - setting up Sustainability and Transformation Plans to run the NHS as Accountable Care Organisations opens up the NHS to privatisation on a bigger scale than anything seen so far.

    And it is a mechanism for limiting the range of care that the NHS offers, and for denying care to patients who are judged to offer poor value for money.

    This would mean the end of the NHS as a service that provides the full range of health care to anyone who has a clinical need for it.

    How does this work?

    Sustainability and Transformation Plans require the speedy dismantling of the NHS to turn it into a health service that is based on American private health insurance systems – such as United Health,  the former employer of Simon Stevens, now NHS England’s Chief Executive.

  • This is the biggest change to the NHS you've never heard of: "STP"s

    The NHS has lost over 50 percent of its bed capacity in the past 25 years. Our bed to population ratios are now below Eastern European countries. Further hospital closures will simply be disastrous.

     

    The government's Sustainability & Transformation Plans (STP) have been shrouded in secrecy. Despite being the biggest change to the NHS since the Health & Social Care Act 2012, they will not be voted on in parliament.

    So what exactly are the STPs? The NHS will be divided up into 44 footprints, but you need a glossary to translate these terms. Sustainability means cuts. This is part of the drive towards £22bn in cuts by 2020 – bearing in mind that we've already had £15bn in NHS cuts in the last parliament generating a manufactured crisis. Cuts mean a massive programme of hospital closures across the country and it will also lead to mergers and permanently selling off the NHS estate of land and assets.

    The bogus narrative around unsustainability and unaffordability has been spun by the private healthcare and insurance industry, captured politicians and the media. In truth, we spend much less on healthcare than other advanced economies.

    In order for these footprints to receive funds, there are strings attached. The footprints will have to sign up to transformation, which basically means privatisation. The footprints will have to adopt unproven models of care.

    The bigger picture here is integrated healthcare. It sounds great but it's imported from the US. The NHS five year plan – the Five Year Forward View – specifically states that the NHS should emulate US style integrated or accountable care. Integrated care organisations are springing up all over the place.

    This is all being sold as care in the community, but there are no extra resources for GP and community services.

    In fact, we already have a major bed crisis. The NHS has lost over 50 per cent of its bed capacity in the past 25 years. Our bed to population ratios are now below Eastern European countries. Further hospital closures will simply be disastrous.

  • "How to Dismantle the NHS in 10 Easy Steps" by Dr Youssef El-Gingihy, an East London GP. 978-1-78535-045-0 Zero Books

     

     

    In 70 pages this slim volume sets out in 10 chapters the legislative changes and the 30-years history of creeping privatization which are crippling our NHS.

    The main points are:


    - In the 1980s the NHS internal market was introduced: Primary Care Trusts as "purchasers" and NHS hospitals trusts as "providers". The politicians wanted "competition" despite all medics saying that what you really need in healthcare is collaboration rather than competition.

    - At about the same time John Major introduced PFI deals for new hospitals, there which makes the final bill for a new hospital at least 7 times the original cost (and sometimes up to 50 times!) And it comes with strings for expensive "facilities management" (maintenance).

    - Corporate takeover:
    Primary Care Trusts could commission care from Alternative Providers of Medical Services, i.e. companies employing salaried GPs (e.g . United Healthcare, Atos and Virgin). Out-of-Hours care contracts were won by Harmoni, Serco and Take Care Now.

    - From 2003 hospital trusts could become "Foundation Trusts": this meant that they became financially free-standing, independent businesses. But with that came intense pressure to cut costs, leading to dangerously low staffing levels at Mid Staffs.

    - A "Payments by results" - a national tariff of fixed prices - was introduced. Since 2010 the Gov has reduced (by 3% year on year), not increased, the prices paid for each completed treatment despite the increase in population and the average age of the population. Revenue to hospitals could only increase if hospital doctors completed more and more treatments. And of course admin costs soared. Hospitals and doctors were working harder and harder to push more patients through.

    - The reduced tariffs and the freeze on all medical salaries for 5 years has produced "efficiency gains" - but at the cost of exhausted and frightened medical and management teams, and dangerously unstable finances (collapse of South London hospitals trust and the near-loss of Lewisham hospital).

    - To plug the gaps in staffing hospitals trusts have paid through the nose to agencies for temporary staff.

    - What incentive is there for even the most dedicated registrar to stay in a system which is demonstrably financially unstable?

    - In an attempt to meet the targets and understand the new environment, hospitals trusts have employed expensive management consultants to guide them - draining even more money out of their budgets.

    - In a move related to uncontrolled immigration not to NHS problems, the Home Office is refusing to renew visas of non-EU nurses if they are not earning at least £35K after 3 years. More fees to agencies.....

    - It seems very likely that "personal health budgets" for social care will be extended into medical care, and then "co-funding", and then... private medical insurance will be essential to ensure adequate medical care. "Free NHS care at the point of delivery" will have finally gone!!!

     

    I would add some other points:

    - There is ample evidence that Jeremy Hunt, Virginia Bottomley, Stephen Dorrell, Patricia Hewett and many members of present and past Conservative and Labour governments have had or still have financial links to private providers to the NHS. The "revolving door" between a senior cabinet appointment and directorship in the private health sector is active. The present CEO of the NHS, Simon Stevens, is a life-long health manager, but he spent 10 years working in CEO roles for United Health Group companies in the US.

    - It also seems very likely that the new and very complex contracts with private companies will provide plenty of opportunities for healthcare fraud at the expense of the patient. Fraud is difficult to detect and expensive to prosecute.