privatisation

  • 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.....

  • Private firms receive £2.3m to draw up STP plan for North Central London

    Peter Blackburn for BMA 19th January 2017

     

    Private firms have been paid a ‘shocking’ £2.3m to draw up controversial plans which will cut health and social care spending by more than £1bn in a part of London.

    According to health leaders drawing up the North Central London STP (sustainability and transformation plan), six-figure sums were paid to eight different companies – including accountants Deloitte and management consultants McKinsey – for services stretching from ‘administrative support’ and ‘financial modelling’ to ‘communications support’.

    A firm called Consultants Methods Advisory Ltd, which describes itself as ‘shaping public services for the digital age’, racked up the biggest costs, invoicing £617,850 for ‘programme management office and strategy support’.

    Doctors leaders described the figures as ‘appalling’.

    BMA council chair Mark Porter said: ‘While hospitals fall into crisis, social care hits rock bottom and the Government blames hard-working GPs for its political choice to underfund the NHS, every penny of health service money becomes more desperately valuable and doctors will find it galling to see that so much vital resource has been handed to consultancy firms for their part in failing plans which, ultimately, may never come to fruition, while frontline staff struggle to provide safe patient care in a service increasingly becoming unfit for purpose.’

     

    Pick and choose

  • NHS to use private firms to beat the winter crisis

  • Don't Slash, Trash and Privatise our NHS

     

     

  • Thatcher pushed for breakup of welfare state despite NHS pledge

    PM declared the health service was ‘safe with us’ but secretly pressed on with radical proposals, archives reveal

    The plan commissioned by Margaret Thatcher and her chancellor, Sir Geoffrey Howe, included proposals to charge for state schooling.

     

     

    Margaret Thatcher secretly tried to press ahead with a politically toxic plan to dismantle the welfare state even after a “cabinet riot” and her famous declaration that the “NHS is safe with us”, newly released Treasury documents show.

    The plan commissioned by Thatcher and her chancellor Sir Geoffrey Howe included proposals to charge for state schooling, introduce compulsory private health insurance and a system of private medical facilities that “would, of course, mean the end of the National Health Service”.

    Some of her cabinet ministers believed they had buried the plan, drawn up by a seconded Treasury official, Alan Bailey, from the Central Policy Review Staff (CPRS), at a special cabinet meeting on 9 September 1982.

    Nigel Lawson in his memoirs said the paper of “long-term public spending options” had been buried after what he described as “the nearest thing to a cabinet riot in the history of the Thatcher administration”. In her own memoirs, Thatcher claimed to have been “horrified” by the CPRS paper and insisted that she and her ministers had never seriously considered it.

    The CPRS paper had been partially leaked and she was only able to quell the subsequent furore by famously pledging the “NHS is safe with us” at the October 1982 Tory party conference. Downing Street briefed that the toxic plan had been “shelved”.

     

    Photo: Handout

     

    But Howe’s Treasury private office papers released by the National Archives on Friday confirm that not only had that special cabinet meeting taken place to discuss the plan but that two months later, far from being buried, Thatcher was still secretly trying to press ahead with it.

    The Treasury papers show that once a clutch of tricky byelections were out of the way she was keen to keep pushing the plan and held a series of meetings in December to “to soften up the big three spenders” under her chairmanship “to resolve any immediate political anxieties”.

    The papers also show after the 9 September cabinet showdown Howe rejected an approach from the Adam Smith Institute, the rightwing libertarian thinktank, to back their “slightly oddly-named Omega Project” despite it being personally endorsed by Thatcher’s own economic adviser, Sir Alan Walters.

    The Omega Project papers said the plans were modelled on research by a rightwing US thinktank for the incoming Ronald Reagan administration. It also argued for many state services to be replaced by “more efficient alternatives from the private sector”.

     

    Photo: HM Treasury

     

    Howe rejected the approach in a note on 29 September 1982 not because he objected to their proposals to dismantle the welfare state but because he feared its “ill-researched proposals, which will be portrayed as strongly resembling our own, might prove an embarrassment”. The then chancellor added: “Every proposal will be seized on and hung (round) our necks. Cf CPRS Report. I see v. (underlined twice) great harm.”

    The Treasury papers show that “no real action” was taken on the CPRS “radical right manifesto” until November 1982. “The prime minister (we understand privately) did not want to stir this up before the cabinet discussions on the 1982 survey, nor risk any adverse publicity while the last two by-elections were pending. The leaks of the CPRS report did not help,” a senior Treasury official, Peter Mountfield, told Howe in a confidential note entitled “Follow-up of cabinet discussion on long-term public expenditure”.

    “The prime minister has arranged a series of meetings with the main spending ministers to discuss the follow-up to the discussion in cabinet on 9 September. The ministers involved are Sir Keith Joseph (7 Dec, 11 am), Mr Fowler and Mr Nott (14 Dec, 9.30 and 15 Dec 5.30.). You and the chief secretary will be invited to each meeting.”

    Joseph was education secretary, Norman Fowler was health secretary and John Nott was defence secretary. The CPRS paper proposed to cancel Trident and halt the growth in defence spending.

    “The only paper formally before the meetings will be the original interdepartmental report on long-term trends in public expenditure... The CPRS paper on options is technically a non-paper, but will be in everyone’s minds (and no doubt in their briefing folders too),” Mountfield told Howe.

    The chancellor was told the objective of the meetings was “designed to soften up the three big spenders. Without their support the operation will not work. Your main aim, I suggest, should be to ensure that no sacred cows are prematurely identified. Given the prime minister’s concern about the NHS, this may be difficult. But we want to make sure that the ministers concerned do not close off any options at this stage, and, if possible, put their personal weight behind the exercise.’’

     

    Photo: HM Treasury

    These papers flatly contradict Thatcher’s claim that the CPRS proposals were never seriously considered by ministers. The Treasury files released on Friday 25th November 2016 do not record what happened at the meetings with the big three spenders.

    But a Treasury official’s note on 28 October 1982 to the then chief secretary to the Treasury, Leon Brittan, gave an indication of the depth of internal opposition Howe and Thatcher faced. “DHSS (health and social security) officials say there is no chance that Mr Fowler would agree to a further study of this idea. I imagine in the circumstances, and especially given the prime minister’s speech at Brighton it is difficult to press them.”

    In his memoirs, Howe reflects that although the row had postponed the “fundamental debate” he had hoped to start, until after the 1983 general election, “nothing from the Treasury’s point of view is ever as quite as bad as it seems”.

    He reported that the impact of what he called the “CPRS furore” had ensured ministers made no new spending pledges and had “set the pace for our forthcoming 1983 manifesto”.

    Save Our Hospitals note:

    Please see a paper published six years later by the Centre for Policy Studies in January 1988: Oliver Letwin and John Redwood: "Britain's Biggest Enterprise: Ideas for radical reform of the NHS":

    https://www.cps.org.uk/files/reports/original/111027171245-BritainsBiggestEnterprise1988.pdf

     

     

  • Junior Doctors seize PR initiative before all-out strike on 26th and 27th April

    Dr Rachel Clarke and Dr Dagan Lonsdale are two campaigning junior doctors. They are tired of Mr Hunt's abandoning talks between the BMA and the Government, and they have set up shop outside Richmond House, the Dept of Health's headquarters in Whitehall, waiting for him to appear and re-start talks:

     

    junior-doctors.jpg

     

    They have even brought their sleeping bags:

     

    Junior doctors sleeping rough outside Whitehall in protest over contracts

     

    After 24 hours another pair of junior hospital doctors will take up the relay, for 12 hours per day for 7 days.


    As Deeney21 writes under the Independent's article yesterday (http://www.independent.co.uk/news/uk/politics/junior-doctors-begin-permanent-protest-outside-department-of-health-a6981871.html):

     

    Those who think this dispute is about greed need to wake up! As a junior doctor myself I can tell you that this is not the vocation of choice if making money is towards the top of your career wish list. Almost all junior doctors will have got top marks in their A levels – if they were concerned with money a career in the city/law/dentistry would have been a much smarter choice. To further reinforce this point if a junior doctor realised after completing med school that money was a major driver for him they would go and work for a pharmaceutical company (after completing the first two foundation years) rather than stay working in the NHS. Thirdly, although for various reasons it is seldom publicly said, it is the opinion of many junior doctors (and many others!) that this whole dispute and contract is part of a longer term Tory strategy to bring the NHS to its knees, enabling the Govt to justify privatization. If doctors were greedy, we would be looking forward to the day when this happens because private hospitals pay significantly better than the NHS (look how much doctors in the US are paid!)

  • " 'Our' NHS?" an article on the Kensington, Chelsea and Westminster Today.co.uk website

    The article "Our" NHS(October 2015) by film director and producer John Furse, a resident of Kensington and Chelsea, argues that behind the trusted logo "our" NHS is becoming "their" NHS, its services increasingly outsourced to private sector providers. And at a far greater cost to the NHS than if it remained its own provider... Is it surprising that NHS costs, as a percentage of GDP, have doubled since the first major privatisation legislation in 1990?

    It includes biographies of the Chairman, Sir Richard Sykes, and directors of Imperial College Healthcare NHS Trust. Their backgrounds, with the exception of the chairman, are exclusively in the financial/ hedge fund/ large accountancy firms sector.

    Sir Richard is a prominent biochemist, his CV includes chairmanships of GlaxoSmithKline and currently three biotech/health tech companies.

    He’s also chair of think-tank Reform, who want total public spending cut along with taxes so that individuals can provide for their own healthcare needs and obtain high quality services more ‘efficiently’. Paying for your GP visits is one of their wheezes.


    ....The Imperial Trust has other non-executive private sector notables on its board – Jeremy Isaacs, founder of hedge fund JRJ, with an arm in tax haven Jersey. His CV includes spells as a Goldman Sachs director and a Lehman’s overseas CEO until 2008, Lehman’sannus implodius. He is joined by Rothschild executive vice chairman Dr Andreas Raffelm, and Sarika Patel, partner in Zeus Capital, an investment bank heavily into infrastructure and real estate, who are also Imperial Trust board members.

    Patel has held ‘key roles’ at accountancy giant Grant Thornton. Such accountancy behemoths are the ‘fixers’ between corporate and investment big hitters and their targets. Imperial has a biggie in Sir Gerald Acher, a senior partner at mega auditors KPMG.


    With friends like these, who needs enemies?


    The directors of the Chelsea and Westminster Trust are less well-known to supporters of Charing Cross hospital, so it's worth reproducing these biographies here:

    Chelsea & Westminster Hospital NHS Foundation Trust’s non-executive chair is Sir Thomas Hughes-Hallett, a former banker who promotes the line that “The NHS can’t afford to treat us all for free. It’s time we paid for our care”. Begging the obvious question that if we could bail out his lot, why not the NHS?

    His vice-chair is Sir John Baker, whose CV includes leading the UK electricity privatisation programme before becoming CEO of privatised National Power plc. Chelsea & Westminster Trust non-executive director is Jeremy Jensen, director of Aaronite Partners, specialists at ‘restructuring’ distressed businesses. He’s also director of MPG Hospital Holdings who own, operate, and lease UK hospitals. Adding her mergers and acquisitions expertise is former BP exec Eliza Hermann.

    He concludes:
    ....a publicly funded and serviced NHS is far cheaper than a privatised one. Bank bailouts and Quantitative Easing (QE) have been a revelation – governments can actually print billions without causing rampant inflation or the collapse of their currencies.

    Whether through QE, taxes, and/or bonds, our government could in fact fully fund the NHS, particularly with interest rates set to remain at historic lows. It’s also an investment that produces tens of thousands of jobs, healthy workers, and consumers old and young with spending power to stimulate the economy.

    But the NHS, like most of our politicians, has been infected by 30 years of a free-market ideology whose true workings have been exposed by the 2008 Banking Crash and its aftermath. The boards of our local hospitals are overseeing the turning over of NHS assets and services to the private sector are symptomatic of that infection.

  • "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.

     

  • "How to Dismantle the NHS in 10 Easy Steps" by Dr Youssef El-Gingihy, an East London GP: meeting Wednesday 7th October at Charing X Sports Club at 7.30-9.30pm

     

     

     

     

  • Rally for the NHS - Tuesday 10th March 2015 7pm Hammersmith Town Hall

     


     

     

  • NHS England's new 5-year plan announced

    New NHS boss Simon Stevens made headlines today presenting NHS England's latest 5-year plan. The plan is clearly based in part on the experiments on North West Londoners under the banner of "Shaping a Healthier Future". So we've become accustomed to promises of more care in the community, site integrated care, acute specialisms - aspirations in themselves as uncontroversial as apple pie. 

     
    The real issue is about resources
  • Tory links to health agencies exposed as Hunt lines up next NHS sell-off in England

     

    From Opendemocracy.net/OurNHS/Jos-Bell/

    Tory links to health agencies exposed as Hunt lines up next NHS sell-off in England

    Whilst understaffed wards and surgeries turn to well-connected private sector agencies to fill the gaps created by Cameron's health 'reforms', the NHS's own in-house recruitment agency is to be sold off, it has emerged.

    Image: Martin Shovel

    Last week it emerged that Jeremy Hunt plans to sell off the National Health Service in-house recruitment agency, there NHS Professionals, before the election. The agency was established in 2000 to reduce the amount spent on recruitment fees. It has 40,000 workers on its books, providing bank nurses to 65 NHS trusts.

    Christina McNea, UNISON’s head of health, is outraged:

    "Selling off NHS Professionals might inject short term cash, but will cost NHS trusts vast amounts in the longer term and deliver worse results.”

    It’s the Department of Health’s second attempt to privatise the agency - in 2010 they failed to find a buyer. This time they have given the sell-off to the same bank that ran the Royal Mail privatisation, suggesting another gone for a song sell-off.

    Despite a turnover of about £450million, the agency operates with low profit margins, with most funds going to staff pay rather than commission. Selling off the state staffing agency will merely raise the cost of temporary staffing for trusts.

    Temporary staff costs have already risen 20% between 2011 and ’13, a Nursing Standardinvestigation found.

    Last year, Jeremy Hunt spent £1.4bn on NHS redundancies - then spent £3.9 billion filling the gaps with temporary agency staff in the NHS – tripling costs in just 3 years.

    7,000 frontline clinical staff have been axed since 2010, the Department of Health has admitted.

    Understaffed wards turn to private firms that supply agency nurses and doctors. These firms have pocketed millions in profits over the past year – charging up to £1,000 per shift.

    Meanwhile, owners of these companies are earning up to £2million a year.

  • US giant United Health leads firms seeking £1bn worth of NHS contracts: preparing for "galloping" privatisation "The Observer" 30th August 2014

    Calls for greater disclosure on NHS chiefs' meetings with private US health insurer

    Critics warn of more privatisation as UnitedHealth leads firms seeking £1bn worth of contracts
    UnitedHealth used to employ Simon Stevens, above, NHS England’s chief executive.

    A handful of consultancy firms and a health insurance giant bidding for NHS contracts have been operating a discreet forum at which they receive regular briefings from senior health service managers charged with ushering in the new era of competition among its providers. The revelation has raised fears that the NHS is falling victim to a land grab by a few powerful business interests.

    Documents obtained under the Freedom of Information Act by the campaign group Spinwatch shine a light on the workings of an obscure group whose existence and limited membership has alarmed campaigners who want the NHS to remain public.