Grave concern over plans to allow US-style bodies to operate in the NHS

From the BMJ website for Press Releases, 15th November 2017: "Grave concern" over plans to allow US-style bodies to operate in the NHS

Author contact:

Professor Allyson Pollock, Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK

Tel: +44 (0)7976 978 304

Email: This email address is being protected from spambots. You need JavaScript enabled to view it..uk

 

“Grave concern” over plans to allow US-style bodies to operate in the NHS

Experts say Health Secretary must consult properly on this major change

 

It is of grave concern that there has been no public consultation on government plans to enable accountable care organisations (ACOs) to operate in England, say experts in The BMJ today.

 

ACOs were conceived in the US in an effort to improve care and reduce growing health care costs. They involve government and private insurers awarding large contracts to commercial providers to run and provide services.

 

When large groups of providers are given a lump sum to provide care, the theory is that they will provide care that is better coordinated and without the incentives for overtreatment or unnecessary treatment that exist with fee for service arrangements.

 

But Allyson Pollock and Peter Roderick at Newcastle University argue that ACOs represent “a major and deeply worrying reorganisation of health services,” including what the government refers to as a “dissolution of the boundaries” between health and social care.

 

If ACOs are allowed to operate, they warn that “multi-billion pound health and social care budgets, including GP and public health budgets, can be given to ACOs under commercial contracts for up to 10 or possibly 15 years.”

 

They point out that the Secretary of State for Health, Jeremy Hunt, has consulted on some technical changes which would define “ACOs” and enable them to operate under contract. “But so far, there has been no public consultation about whether the law and the NHS should undergo this major change.”

 

NHS England (NHSE) says it intends to consult on a standard model contract for ACOs in 2018. “But if Hunt’s changes are brought in before then, the legal framework would facilitate ACO contracts to be brought in before the public consultation,” they add.

 

Hunt’s consultation failed to address many issues, they write. For example, why ACOs are necessary to achieve the stated policy objectives, and why the powers already given by Parliament to integrate services are insufficient to achieve the policy objectives.

 

In addition, nothing was said about how the ACO would be prevented from walking away from the contract or the applicability of freedom of information and human rights laws, and whether ACOs would be amenable to judicial review.

 

“Introducing ACOs is so fundamental that the proper way to do so would be for the proposals and their justification to be set out openly and clearly, as in a White Paper, and to invite wide public and professional responses – including in Scotland and Wales where the impact of ACOs is entirely unknown,” argue the authors.

 

“It is of grave concern that this has not been done to date. It is still open to Jeremy Hunt to do so.”

 

Further details - such as the fact that ACOs have in some cases not even saved any money and may have actually INCREASED expenditure in the USA - and important references are in an earlier press release in the BMJ: Jeremy Hunt must consult properly on accountable care organisations  

 

 

 

Health Campaigns Together "Health Summit" 4th Nov 2017

Over 420 delegates from all over England and Wales attended the "Health Campaign Together" one-day conference on Saturday 4th November, filling the main hall of Hammersmith Town Hall.

The morning started at 11am with rousing speeches from the Leader of Hammersmith and Fulham Council, Stephen Cowan and the Leader of Ealing Council, Julian Bell, recalling the support which their councils have given to resident-led campaigns to retain respectively Charing Cross and Ealing Hospitals. They have supported the campaign since before the publication in 2012 of the NHS report called "Shaping a Healthier Future" which paradoxically advocated closures of acute hospitals. There was a change of control in Hammersmith Council to Labour in May 2014, due in large part to the widespread distrust of the previous administration's handling of the threat to Charing Cross. In 2015 Hammersmith Council convened the Mansfield Commission, which heard evidence from expert witnesses and produced a report in December condemning the hospital closures in west London. Recently there has been a "war of words" over the precise meaning of the undertakings by Imperial College Healthcare NHS Trust (guided by the NHS). Imperial say: "No closure of Charing Cross before 2021", but these are weasel words. The people of Hammersmith deserve a better, longer-lasting assurance that their hospital will stay open as long as it is needed.

They were followed by Sarah Gorton, Head of Health at Unison, north Devon campaigner Annette Pearson, and a speaker from Save South Tyneside Hospital. Dr Chaand Nagpaul, the Chair of the BMA's Council, spoke particularly about the pressures on GPs (he was a GP for 27 years). The morning finished with the director of "Kes" and "I, Daniel Blake",  Mr Ken Loach in typical fiery form.

There were workshops based on topics, such as "Safe Staffing" with Dr Aislinn Macklin-Doherty and Dr Ben White (two campaigning Junior Doctors), "Naylor review, estates sell-off and PFI" with Prof Sue Richards from KeepOurNHSPublic and Vivek Kotecha from Centre for Health and the Public Interest. Jacqui Berry, NHS nurse and member of Unison's national executive (and star of very funny YouTube videos including one giving a clear explanation of "STP"s) led "Busting the pay cap" and there were others such as "fighting for mental health".  So many participants were instantly recognisable faces, active for years in NHS campaigning.

After a delicious light lunch, we were straight into more workshops, of which "setting up new regional networks" were very important to helping campaigners connect up and achieve "footprint"-wide results.

At the final plenary session Sam Fairbairn from "The People's Assembly" gave a speech against austerity and Sarah Cook from Unite the union reminded us of her members' work day and night for the NHS. There was a short video recorded especially for this conference by Jon Ashworth, shadow Sec of State for Health. Natalie Mehra of the Ontario Health Coalition gave an interesting comparison between Canadian and British health systems, Dr Gurj Sandhu, consultant in A&E at Ealing Hospital and Jacqui Berry, NHS nurse, gave accounts of their recent professional experience. John Lister, veteran founder of "Health Emergency" and co-chair of Health Campaigns Together closed the day with a call for non-affiliated groups to join HCT.

Labour Party Conference 2017 adopts motion for a publicly owned, publicly funded, publicly provided, publicly accountable NHS

 

At the Labour Party conference on Tuesday 26th Sept 2017 the following motion was tabled and adopted.

Composite 8: NHS

Alex Scott-Samuel, Socialist Health Associate and Doctors for the NHS proposed the motion: https://youtu.be/utFYHL1BSqQ?t=1h7m55s

Sue Richards, Islington CLP and Keep Our NHS Public seconded the motion: https://youtu.be/utFYHL1BSqQ?t=1h14m37s

Text of the motion

The NHS Accountable Care System (ACS) contracts announced on 7 August impose a basis for 44+ local health services to replace England’s NHS. This has by-passed Parliamentary debate and due legislative process.

On 9 August, the House of Commons Library revealed a doubling of the number of NHS sites being sold off. 117 of these currently provide clinical services. Like their US templates, ACSs will provide limited services on restricted budgets, replacing NHS hospitals with de-skilled community units. This will worsen health indicators like the long term increase in life expectancy, stalled since 2010.The ACSs and asset sell-off result directly from the 5 Year Forward View (5YFV) currently being implemented via Sustainability and Transformation Partnerships (STPs). The 5YFV precisely reflects healthcare multinationals’ global policy aims.

Labour opposes ACSs. New legal opinion finds STPs lack any legal powers or status under the 2012 Act: yet they seek through bureaucratic means to eliminate or override the already minimal remaining level of local accountability and democratic control over NHS commissioning and provision. They could eliminate remaining statutory powers and rights of local authorities, commissioners and providers.

Many of these also outline plans to establish ‘Accountable Care Systems’.

• Conference condemns the current Tory NHS pay cap for all staff and the scrapping of the university training bursary for health Students as significant contributors to the current staffing crisis.

• Conference welcomes the commitments made in the Labour manifesto to scrap the pay cap for NHS staff.

• This Conference calls on our Party to restore our NHS by reversing all privatisation and permanently halting STPs and ACSs. Labour is committed to an NHS which is publicly funded, publicly provided and publicly accountable. We therefore call on the Party to oppose and reverse funding cuts, meeting Western European levels.

• Conference opposes FYFV policy:

o down-skilling clinical staff;

o Tory cuts to the NHS including the Capped Expenditure Process;

o the sell-off of NHS sites;

o reclassifying NHS services as means-tested social care;

o cementing the private sector role as ACS partners and as combined health/social care service providers.

o replacing 7500 GP surgeries with 1500 “superhubs”

 

• Conference recognises that reversing this process demands more than amending the 2012 Health & Social Care Act and calls for our next manifesto to include existing Party policy to restore our fully-funded, comprehensive, universal, publicly-provided and owned NHS without user charges, as per the NHS Bill (2016-17).1

• Conference opposes the Naylor Report's call for a fire-sale of NHS assets and instead resolves that the next Labour government will invest at least £10 billion in the capital needs of the NHS

• Conference therefore calls on all sections of the Party to join with patients, health-workers, trade unions and all other NHS supporters to campaign for:

o increasing recruitment and training

o an NHS that is publicly owned, funded, provided and accountable;

o urgent reductions in waiting-times;

o adequate funding for all services, including mental health services tackling the causes of ill-health, e.g. austerity, poverty and poor housing, via a properly funded public health programme

o reversing privatisation, PFIs and the debts which they entail;

o reversing private involvement in NHS management and provision;

o recognition of the continuing vital NHS role of EU nationals;

o Constructive engagement with NHS staff-organisations

o rejecting the Tories Sustainability & Transformation Plans (STPs) as vehicles for cuts in services;

o urgent reductions in waiting-times;

o scrapping the Tories' austerity cap on pay-levels; restoration of NHS student bursaries;

o excluding NHS from free trade agreements and repeal and reverse the 2012 Act, to reinstate and reintegrate the NHS as a public service, publicly provided, and strengthen democratic accountability.

 

• Conference welcomes Labour's commitment to making child health a national priority, including investment in children's and adolescents' mental health services.

• Labour created our NHS. Labour must now defend it

 

Mover: Socialist Heath Association

Seconder: Islington South and Finsb

Thousands march on Parliament in anti-government protest - 1st July 2017

From AFP (posted on YouTube - 1st July 2017):

 

From BBC news on-line - published 1st July 2017

Thousands of people gathered in central London to demonstrate against the UK government's economic policies.

The protest was organised by a group called the People's Assembly Against Austerity.

Demonstrators met outside BBC Broadcasting House in Portland Place, before marching past Downing Street and on to Parliament Square.

The Labour leader Jeremy Corbyn was among the speakers who addressed crowds at The Not One Day More protest.

Speaking in Parliament Square, Mr Corbyn said: "The Tories are in retreat, austerity is in retreat, the economic arguments of austerity are in retreat.

"It's those of social justice, of unity, of people coming together to oppose racism and all those that would divide us, that are the ones that are moving forward."

Crowds in Parliament Square

The crowd chanted "oh Jeremy Corbyn" and "Tories out" during the rally, while many carried banners saying Justice For Grenfell.

Crowds march in central London

One protester told BBC News that "anger" had motivated her to join the protest, saying: "What's going on isn't good enough under the Tory government.

"There have been cuts to every single service you can think of. It's just the pure negligence. How can you be cutting vital services?"

The organisers said on Facebook that they "invite everyone - from campaigns and community groups across the country, from the trade unions, from political parties and any individual - to come together in one massive show of strength and solidarity".

The statement added: "We're marching against a government committed to austerity, cuts and privatisation.

"We're marching for a decent health service, education system, housing, jobs and living standards for all."

Downing Street did not want to comment on the protest.

Labour's Diane Abbott joins anti-government protest in London.

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