Monthly Archives: November 2011

NHS news review

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Conservative election poster 2010

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.


The Evening Standard has secured a decision by the Information Commissioner Christopher Graham that Lansley and the ‘Department of Health’ has to publish a secret report on the risks being taken with the NHS.

“The document is expected to reveal the risks to patient safety, finances and the very workings of the NHS from the unprecedented reshaping of the health service.”

Andrew Lansley ordered to reveal secret health report | Politics

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Labour’s former health spokesman John Healey, who put in a similar FOI request for the risk documents which was also upheld by the Information Commissioner’s Office, was scathing about the department’s conduct.

He said: “The year-long cover-up is a disgrace, especially when doctors, nurses, patients groups and the public are all so worried about the Tories’ NHS plans. The commissioner’s report is a demolition job of Lansley’s attempts to keep the truth from the public.”

He called on David Cameron to order the Health Secretary to “hand over the documents in full”.

In his ruling, Mr Graham said: “Disclosure would significantly aid public understanding of risks related to the proposed reforms and it would also inform participation in the debate about the reforms.”

Many commentaries on the private company Circle Healthcare running Hinchingbrooke hospital.

Andrew Lansley’s NHS is all about private sector hype | John Lister | Comment is free | guardian.co.uk

The government’s decision to sign a 10-year contract worth £1bn for an untested private company to manage the heavily indebted Hinchingbrooke hospital really is the triumph of hype over experience.

The hype has come thick and fast from Circle Healthcare’s smooth-talking boss, former Goldman Sachs banker Ali Parsadoust (known as Ali Parsa), who gives the impression that Circle is some kind of altruistic workers’ co-operative, while in fact it is controlled by private equity and hedge funds. Far from handing control to the workers, Circle takes a negative view of trade unions and will have to resort to old-fashioned cuts in the workforce if it is to generate the “efficiency savings” it needs to put the hospital into surplus.

More hype has come from the architect of the contract, NHS East of England’s director of strategy Dr Stephen Dunn, an enthusiastic advocate of private sector provision (which he denies is privatisation), whose unstinting efforts to secure this deal won him an award this year from HealthInvestor magazine.

But there is little in Circle’s record to justify Dunn’s belief that the company has the expertise to take on a project on the scale of Hinchingbrooke. The company has yet to make a success even of running its two tiny (30-bed) private hospitals, which were extravagantly expensive to build, and has run up six years of losses so far: hardly a good base to take on the bigger challenge of managing of a debt-ridden NHS general hospital 10 times the size and many more times more complex.

Even the NHS workforce that Circle will be attempting to manage at Hinchingbrooke is three times larger than the grand total of 568 people working for the whole Circle group. Only one of the company’s senior managers has any experience of managing an NHS hospital and he has left the company to rejoin the NHS. And so far they have set out no concrete proposals on how they plan to save money and turn around the finances when they take over in February.

Bungling privateer takes over Hinchingbrooke hospital / Britain / Home – Morning Star

A health privateer that posted millions in losses last year became the first company to get the green light to take over an NHS hospital today.

Circle, described as a “John Lewis-style” business because it is partly owned by clinicians, has signed a 10-year contract worth £1 billion to run Hinchingbrooke Health Care NHS Trust in Cambridgeshire.

The contract, which starts in February, marks the first time a private company delivers a full range of NHS district general hospital services.

Other firms only operate units within the NHS, such as hip replacement centres.

Unison head of health Christina McAnea warned that the takeover was “an accident waiting to happen,” put patients at risk and could lead to a second Southern Cross-style crisis.

The company has been given the task of combating Hinchingbrooke’s £39 million debt – though Circle itself recorded £27.4m losses in 2010.

Health Emergency director John Lister said the sums didn’t add up.

“It defies all logic when Circle cannot make a profit on its own tiny hospitals that it be handed over the running of an entire NHS hospital,” he said.

“Hinchingbrooke is 10 times bigger than any hospital Circle has ever run, with a vastly larger workforce as well as A&E.

“It will be totally out of its depth.”
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How the Tories fake co-op friends are biting a chunk out of the NHS | openDemocracy

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Today you will hear repeated mentions of ‘mutualism’ and ‘employee owned’. Indeed, journalists are being briefed that Circle is what ministers regard as a model mutual – a ‘John Lewis’ approach to public services. Circle even provides information, via the Cabinet Office’s mutual helpline, about setting up new healthcare mutuals.

Circle is not a mutual. Indeed, it stretches the term slightly to call John Lewis a mutual (rather than an employee owned partnership). Circle Healthcare is minority owned by senior clinicians – not all of the hospital staff – and majority owned by private backers, including major Conservative Party donors. It is a listed business with the primary purpose of turning a profit, rather than delivering benefit to its members (let alone patients).

To use the term “mutual” in the same breath as “Circle Healthcare” is crass misrepresentation. It is a discredit to the century and a half development of the co-operative and mutual movement, which grew from working people pooling their resources to benefit themselves and their communities, intimately entwined with the labour and trades union movements.
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RCN demands transparency as firm takes over hospital | News | Nursing Times

The Royal College of Nursing today called for full “openness and transparency” over the deal signed by the government last night which hands a private company management control of an NHS trust.

The contract, signed at 11pm on Wednesday night hands Circle Health a 10-year management franchise of Cambridgeshire-based Hinchingbrooke Health Care Trust, beginning in February 2012.

Royal College of Nursing chief executive and general secretary Peter Carter said the deal was a “hugely significant development, with wider implications for the provision of health services across the UK”.

He added: “It is vital that there is full openness and transparency around the deal and that Circle continues to provide a comprehensive range of services that can be easily accessed by the local community.

“We know the NHS is under huge financial pressure to save £20 billion by 2014 and that Hinchingbrooke Hospital is carrying about £40m of debt. These financial gaps must not be plugged by cutting local services such as accident and emergency in the future.
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Clare Gerada discusses her opposition to the Health and Social Care / Destroy the NHS Bill.

Private company Circle to run a hospital for profit.

Tax boss most wined and dined mandarin – study | Business | The Guardian

HMRC head David Hartnett attended 107 events in three years, with accountancy firms among those extending largesse

Britain’s most senior official in charge of collecting tax was named yesterday as the most wined and dined mandarin in Whitehall. According to an investigation, David Hartnett, the permanent secretary for tax at HM Revenue and Customs, accepted invitations to eat and drink 107 times over the past three years.

Prominent among those extending corporate largesse were the top accountancy firms, which are paid by big business to find ways of avoiding paying tax.

Hartnett, 59, who lists his recreations as food and wine in Who’s Who, has been accused of being too cosy with large corporations. He emerged top of the league in an investigation by the Bureau of Investigative Journalism, a not-for-profit body based at City University London, which collated more than 3,000 instances of hospitality given to top civil servants in the past three years.

Hartnett sat down with representatives of the “big four” accountancy firms 27 times. He ate with KPMG 10 times and went to one reception. He also accepted hospitality from PricewaterhouseCoopers seven times, Ernst & Young four times and Deloitte three. Last September he clocked up four dinners, two lunches and two breakfasts paid for by, among others, unnamed private equity chief executives, PWC and KMPG. On 17 September he had breakfast courtesy of the now merged City firms JP Morgan and Cazenove, followed by lunch the same day with accountants from BDO Stoy Hayward.

Corporate hospitality is part of Hartnett’s approach to raising tax from big firms. Rather than confronting them, he has relied on persuading them to pay their share of tax.

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Protesters demand resignation of HMRC boss for colluding with tax avoiders | Left Foot Forward

Protesters are descending on Whitehall today to demand the resignation of HM Revenue & Customs (HMRC) boss Dave Hartnett for his role in approving deals that allow big companies to avoid billions in tax.

Activists from UK Uncut and Occupy London are protesting Hartnett’s role in approving “secret sweetheart deals” to allow feral companies to dodge billions in tax – money that could have been used to fund public services going into the pockets of the irresponsible rich.

Hartnett was made to answer MPs’ questions over the scandal, which enabled Vodafone and Goldman Sachs to effectively rob the taxpayer of £6 billion and £10 million respectively. MPs on the public accounts committee have accused Hartnett of abusing his position to “cover up his own mistakes”.

A survey in 2010 revealed Hartnett to be Britain’s most ‘wined and dined’ civil servant, treated by corporations 107 times in three years. Commentators from across the political spectrum and even Conservative MPs have also called on Hartnett to resign.

As Occupy London’s Kyshia Davey says:

“HMRC has just announced it will be going after 146,000 pensioners to demand hundreds of pounds from them following a tax code cock-up. Meanwhile, its boss is striking secret deals with opulent corporations to let them off billions of pounds in tax.

“Hartnett is fatally undermining public confidence in the UK’s tax system at a time of austerity and he must resign immediately.”

And UK Uncut’s Sam Gilbert adds:

“Whilst 25,000 rank-and-file staff at HMRC have been fired, leaving the organisation almost incapable of functioning, Hartnett has been carving out a career as the most ‘wined and dined’ civil servant in Whitehall.

“The money from Vodafone’s £6bn tax dodge alone could have prevented all of the cuts in public services over the past year.”

All in it together?

MPs hit out at Vodafone ‘tax let-off’ – UK Politics – UK – The Independent

HM Revenue & Customs officials were criticised yesterday for
allowing Vodafone to pay just £1.25bn in a tax dispute with the
Government, despite a potential tax bill of what could be as much
as £8bn.

MPs from the Commons Public Accounts Committee quizzed tax officials over deals made with Vodafone and investment bank Goldman Sachs. HMRC branded reports earlier this year that Vodafone escaped paying £6bn in tax “absurd”.

But Stephen Barclay, an MP on the committee, put the possible sum even higher. “We are looking at potentially £8bn of tax lost,” he said. “We’re looking at a company that was given five years to pay even though it was sitting on a cash pile.”

HMRC officials were also questioned about a debt deal with Goldman Sachs, which is believed could have cost the taxpayer a potential £10m.

Tax chief Dave Hartnett said an error that slashed Goldman Sachs’ debt was dealt with through a staff member’s annual appraisal. HMRC has been accused of giving Goldman a “sweetheart” deal that waived £10m of interest on a £30m bill from a failed tax avoidance scheme on bankers’ bonuses. Mr Hartnett is said to have personally sealed the agreement with a Goldman executive last November, after being advised by an official that there was a “legal impediment” to charging interest.

 

Conservative election poster 2010

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.

New Statesman – Royal College of GPs chair attacks NHS reforms

Royal College of GPs chair attacks NHS reforms

Clare Gerada tells the New Statesman: “This reform is so large you can see it from outer space”

In this week’s magazine, Clare Gerada, physician and chairman of the Royal College of General Practitioners, talks to the New Statesman’s Sophie Elmhirst about her fears for the future of the NHS, David Cameron’s betrayal, and the ways in which patients will suffer as a result of Health Secretary Andrew Lansley’s reforms:

We’ve got three big things going on at the same time – a massive reorganisation of the health service, alongside a serious financial situation, alongside the NHS having to make £20bn efficiency savings. So it is difficult to say which one is going to cause “X, Y, Z”, but certainly patients are going to experience longer waiting lists; they’ll see less choice available. Irrespective of whether the government says there is going to be more choice: there won’t be more choice.

In line with the General Practitioners’ Committee’s stance against the reform bill’s Quality Premium, Gerada is outspoken about performance-related bonuses for GPs:

In the [reform] bill, the government is suggesting that GPs be rewarded for keeping in budget. There is no problem in GPs having an incentive to practise good, evidence-based medicine. Where it becomes a step too far is where we are rewarded for keeping patients out of hospital. Because you have to trust me, you have to trust that I have stopped you from going to hospital because it is in your best interests, not because I am going to get £10, £15, £20 or whatever it is. And that begins to distort the doctor/patient relationship, which has to be fundamentally built upon trust — otherwise what’s the point of it?

Gerada speaks of being “absolutely surprised” by the reforms proposed by a coalition government she has had no discussions with:

Like others, I heard David Cameron say “no top-down reorganisation of the NHS”. I was so relieved, because I had lived through 15 reorganisations . . . [But this reform] isn’t so much putting GPs in charge of commissioning, but about dismantling the systems and the architecture of the NHS.

The NHS is our NHS. It is one of the last things that we as the people – the taxpayers – own, and by owning it our Health Secretary and our parliament is responsible for it. For £120 billion of taxpayers’ money, somebody has to be accountable to parliament. . . . It is symbolic if [Health Secretary Andrew Lansley] is no longer accountable for our national health service.

 

BBC News – Circle in deal to run Hinchingbrooke NHS hospital

A groundbreaking £1bn, 10-year deal for a private firm to run a struggling NHS hospital has been confirmed.

Circle, which is part-listed on the London Stock Exchange, is to take over Hinchingbrooke hospital in Huntingdon, Cambridgeshire, from 1 February 2012.

The deal will see Circle assume the financial risks of making the hospital more efficient and paying off its debts but the hospital will stay in the NHS.

The company must maintain services but unions fear staff numbers could be cut.

Although private sector firms already operate units that treat NHS patients – such as hip replacement centres – the firm will become the first non-state provider to manage a full range of NHS district general hospital services.

Hinchingbrooke hospital is one of about 20 hospitals in England which has faced an uncertain future, and the possibility of closure, because of long-term financial problems.

It is carrying about £40m of debt and its financial status has been given a high risk red rating by the NHS. The franchise deal with Circle was developed after concerns that the hospital had become unviable, and a local campaign to maintain services.

Circle describes itself as a social enterprise because 49.9% is owned by a partnership of employees. Others see it as a private business as the rest is owned by its parent company, Circle Holdings, which is listed on the stock market.
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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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Bob Hudson discusses how Lansley and the ConDems are getting away with destroying the NHS.

NHS cuts in North Yorkshire.

Wendy Savage supports the campaign to prevent NHS Gloucestershire transferring community hospitals to a Community Interest Company.

Department of Health legal gag on an NHS whistleblower makes a mockery of the many recent DoH claims on whistleblowers.

UK Uncut

Student protest November 9, 2011
Student protest November 9, 2011

Philip Green is a multi-billionaire businessman, who runs some of the biggest names on British high streets. His retail empire includes brands such as Topshop, Topman, Dorothy Perkins, Burton, Miss Selfridge and British Home Stores.

Philip Green is not a non-dom. He lives in the UK. He works in the UK. He pays tax on his salary in the UK. All seems to be in order. Until you realise that Philip Green does not actually own any of the Arcadia group that he spends every day running. Instead, it is in the name of his wife who has not done a single day’s work for the company. Mrs Green lives in Monaco, where she pays not a penny of income tax.

In 2005 Philip Green awarded himself £1.2bn, the biggest paycheck in British corporate history. But this dividend payout was channeled through a network of offshore accounts, via tax havens in Jersey and eventually to Green’s wife’s Monaco bank account. The dodge saved Green, and cost the tax payer, close to £300m. This tax arrangement remains in place. Any time it takes his fancy, Green can pay himself huge sums of money without having to pay any tax.

Before the election, the Lib Dems liked to talk tough on tax avoiders. But as soon as they entered the coalition, this pre-election bluster became just another inconvenient promise they quietly forgot. In August David Cameron appointed the country’s most notorious serial-tax avoider to advise the government on how best to slash public spending. Not a single Lib Dem minister uttered a word of complaint. A Guardian editorial denounced this as “shameful”.

Philip Green’s £285m tax dodge could pay for:

* The full, hiked up £9,000 fees for almost 32,000 students
* Pay the salaries of 20,000 NHS nurses

And if that’s not reason enough to take action against Sir Philip, it is worth noting that he has built his £5bn fortune on the back of sweatshop labour, using Mauritius sweatshops where Sri Lankans, Indians and Bangladeshis toil 12 hours a day, six days a week, for minimal pay.

In the press

* Philip Green is an odd choice for efficiency tsar
* Philip Green’s tax affairs should be investigated, Lib Dem MPs urge
* Sir Philip Green under attack over personal tax affairs
* Vince Cable’s dig at Sir Philip Green’s tax status
* Sir Philip Green tax avoider gets job on the side

Conservative election poster 2010

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.

Why reforms are destroying the essence of the NHS | Society | guardian.co.uk

The NHS will be unrecognisable in 10 years’ time, says Bob Hudson, if the current bill succeeds – which it looks likely to do

• Bob Hudson is a professor in the School of Applied Social Sciences, Durham University

“How is Lansley getting away with it?” I was asked recently by a senior NHS manager. Given that the NHS bill looks likely to make the statute book in the teeth of well-nigh universal opposition, it’s an interesting question. Part of the answer lies in the policy rhetoric – an attractive world of shared decision-making (“no decision about me without me”, said the white paper), with the cosy and familiar GP’s surgery said to be “the new headquarters of the NHS”. Who could possibly object?’

Opening up public services to greater patient engagement is indeed a desirable objective, but the crucial (and little debated) issue is how this is undertaken. The bill’s decentralised model of professional-patient interaction seems to offer a palace of varieties – better sources of information for patients, listening to the patients’ experience via Patient Reported Outcome Measures, recognition of the “expert patient” in the case of many long-term conditions, the roll-out of personal health budgets and – most important – the prioritisation of patient choice in the “any qualified provider” (AQP) model. It is not an agenda without virtue, but does it tell the full story?

There are other ways of increasing the stake of the public in decision-making. The most recognised route is through some form of representative democracy, and here again the government trumpets the virtue of its proposed changes – the 2010 consultation paper on democratic legitimacy, for example, boasted that “for the first time in 40 years there will be real democratic accountability and legitimacy in the NHS”.

Student protest November 9, 2011
Student protest November 9, 2011

There seems to be much on offer in this respect, too, but closer scrutiny suggests a flawed approach: health and wellbeing boards will have few formal powers and could degenerate into talking shops; clinical commissioning groups have little transparency and only vague obligations; foundation trusts in the future will be accountable only to feeble governing bodies elected by a small membership; and the new Local HealthWatch organisations will be weak and underfunded. Meanwhile the really big beasts – the NHS Commissioning Board and Monitor – will hold huge sway over local decision-making, yet be totally unaccountable to localities. Individual citizens wishing to help shape their local health services will not find it easy to gain leverage in this world.

The limitations of the “individual co-production” and “representative democracy” proposals should alert us to the real agenda for opening up the NHS – increasing diversity of supply. Although there is much rhetoric in official documents about the importance of social enterprise models and the role of the third sector, it is clear that the main alternative supply will come from the private sector. NHS staff are rightly suspicious of the denuded version of social enterprise being offered to them, consisting of guaranteed short-term contracts followed by competitive tendering against larger and better-equipped private providers. Meanwhile, the AQP agenda privileges patient choice above any other considerations (such as equity, quality and continuity) and makes the unlikely assumption that patients will readily assume the role of rational consumers. Transparency and accountability simply do not figure in this model.
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NHS cuts decisions due (From York Press)

HEALTH bosses in North Yorkshire are now deciding how to deliver far-reaching savings following recommendations that bed numbers must be cut.

The loss of 200 hospital beds in York and North Yorkshire was only one of the “essential” measures needed to help the local NHS authority save £230 million by 2015, according to an independent report published in August on behalf of the region’s strategic health authority.
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Professor in NHS battle | This is Gloucestershire

THE campaign to stop community hospitals leaving the NHS has been boosted by a visit from campaigner Professor Wendy Savage.

There was standing room only at public meeting in Stroud where she said they must fight to keep the NHS public.

Prof Wendy Savage, a General Medical Council Member, backed the campaign to stop NHS Gloucestershire transferring community hospitals to a Community Interest Company. The transfer is on hold following a legal challenge. Prof Savage also attacked the Government’s Health and Social Care Bill.

“What they are setting out to do is make the NHS into a market,” said Prof Savage. “If this goes through people will see the NHS being broken up into competing businesses.”

Chief executive of NHS Gloucestershire Jan Stubbings said: “If taken to its logical conclusion, the legal challenge would mean that services would be competitively tendered.”

Medicine Balls, Private Eye, Issue 1301, November 9, 2011 | drphilhammond.com

The most keenly awaited NHS employment tribunal in years has ended in secrecy, making a mockery of the government’s commitments to transparency, accountability, patient safety and the protection of whistleblowers. Gary Walker, the former chief executive of the United Lincoln Hospitals Trust (ULHT), lost his job in February 2010 after blowing the whistle on how government targets were harming patient care. The trust claims he was sacked for saying ‘fuck’ nine times over 2 years.

The tribunal was important because Walker had blown the whistle both to his SHA chief executive, Barbara Hakin – now the DoH’s Director of Commissioning – and the NHS chief executive David Nicholson. The allegation that the two most senior managers in the NHS may have played a role in the destruction of Walker’s career whilst failing to address patient harm should have been dissected under oath but the NHS legal machine ensured the claim was ‘settled’ on the eve of the tribunal.

Walker is now not able to speak about the case. Ever. Neither can any of his many witnesses who were prepared to testify about serious cases of patient harm, fiddling of figures, the bullying behaviour of the strategic health authority and a whitewash external review that only looked for bullying ‘in writing.’ Neither will any witnesses confirm or deny the existence of any gagging clause. All those who were due to testify against the trust, the SHA, the DoH, Nicholson and Hakin – and substantiate allegations of ‘third world care’ and avoidable patient harm – have been so effectively silenced at public cost that they are too scared to say how or why.
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Cameron and Lansley have been claiming that NHS cancer figures are bad while actually they are extrememly good.

38 Degrees explain their legal advice about the Health Secretary’s responsibilities: It’s about distancing the Health Secretary from responsibilty for the NHS.

http://www.ukuncut.org.uk/targets

The banks have run the global economy into the ground. Bankers, encouraged by the government, gambled recklessly with our money, and they lost. Spectacularly. Remember 2008? In the UK, the government decided it had to step in with a bail-out because these banks were ‘too big to fail’. According to the Bank of England, the cost of this bail-out now exceeds £1trillion. The result is that all high street banks- from Barclays to RBS- owe their existence to public financing.

What did we get for our billions? A banking system that serves ordinary people rather than the super-rich? No. Regretful bankers who refuse to reward themselves with massive bonuses? No. How about increased financial regulation to ensure this crisis couldn’t happen again? No. The government has done nothing to stop it being business as usual for banks.

What’s worse, the money that was given to the bankers is the money now being taken from the poorest in society, guaranteeing a rise in poverty, debt and inequality. Nearly £7 billion will be paid out in bank bonuses this year. This sum is more than the first wave of public spending cuts. We are not all in this together because it’s us who will pay if education, health, housing, libraries, woodland and much, much more, disappears from our lives.

Who’s telling us we must make these cuts? A government led by a cabinet of millionaires, in bed with the bankers, which is now pulling off an audacious con-trick in front of our eyes.

This is how their story goes. The crisis was caused by a bloated public sector. We binged away all our money on luxuries like healthcare and free education and council services, care for the elderly, for people with disabilities, school sports and free school meals for children living in poverty. Now the country is bankrupt and we must repent, detox, cut back. We have to relinquish our welfare state to appease the circling money men. Welcome to the Age of Austerity but don’t worry because we are all in this together.

We say – don’t believe their lies. This is their crisis, but there is no austerity for the bankers.

 

Conservative election poster 2010

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 cancer figures contradict David Cameron and Andrew Lansley’s claims | Society | The Guardian

The prime minister and health secretary have criticised the NHS on cancer, but new figures suggest the service is a world leader

David Cameron and Andrew Lansley’s repeated criticisms of the NHS’s record on cancer have been contradicted by new research that shows the health service to be an international leader in tackling the disease.

The findings challenge the government’s claims that NHS failings on cancer contribute to 5,000-10,000 unnecessary cancer deaths a year, which ministers have used as a key reason for pushing through their radical shakeup of the service.

In fact, the NHS in England and Wales has helped achieve the biggest drop in cancer deaths and displayed the most efficient use of resources among 10 leading countries worldwide, according to the study published in the British Journal of Cancer.

“These results challenge the feeble justification of the government’s changes, which appear to be based upon overhyped media representation, rather than hard comparable evidence. This paper should be a real boost to cancer patients and their families because the NHS’s performance on cancer is much better than the media presents. It challenges the government’s assertion that the NHS is inefficient and ineffective at treating cancer – an argument for reforming the NHS,” said Prof Colin Pritchard, a health academic at Bournemouth University.
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38 Degrees | Blog | NHS bill: “hands-off clause” advice

A few months ago, we asked one of the legal experts we funded for his view on the “autonomy clause”, or Clause 4 in the bill.

The full advice is here, but below are the main points on the “hands-off clause”.

Our legal advice:

30. However, what is proposed to be a new section 1C of the NHS Act 2006, does seem to me to be of importance. This would read

―1C Duty as to promoting autonomy
In exercising functions in relation to the health service, the Secretary of State must, so far as is consistent with the interests of the health service, act with a view to securing—

(a) that any other person exercising functions in relation to the health service or providing services for its purposes is free to exercise those functions or provide those services in the manner that it considers most appropriate, and

(b) that unnecessary burdens are not imposed on any such person.”

31. Therefore, so long as the Secretary of State does not think that it is inconsistent with the interests of the NHS, s/he must positively act to allow any other person exercising health service functions to do so in the way that that person thinks appropriate. This is what I described in conference as a “hands off” clause. Although the Secretary of State keeps some form of oversight, it is the other persons and bodies delivering the health service whose views are important as to how those services are to be delivered. This is further explained in the Explanatory Notes as follows

74. This clause seeks to establish an overarching principle that the Secretary of State should act with a view to promoting autonomy in the health service. It identifies two constituent elements of autonomy: freedom forbodies/persons in the health service (such as commissioning consortia or Monitor) to exercise their functions in a manner they consider most appropriate (1C(a)), and not imposing unnecessary burdens from those bodies/persons (1C(b)). The clause requires the Secretary of State to act with a view to securing these aspects of autonomy in exercising his functions in relation to the health service, so far as is consistent with the interests of the health service.

75. This duty would therefore require the Secretary of State, when considering whether to place requirements on the NHS, to make a judgement as to whether these were in the interests of the health service. If challenged, the Secretary of State would have to be able to justify why these requirements were necessary.

32. This kind of wording is often used in statutes to mean that a public body only has the power to act when steps to be taken are “really needed” or “essential”, rather than because the public body thinks something is desirable or appropriate. A court looking at this kind of wording would expect the public body (the Secretary of State in this case) to demonstrate why no other course of action could be followed, which is a high test to meet.

33. I think the reference to potential challenges at the end of this note is significant and reflects the limit of the Secretary of State’s powers. If the Secretary of State attempts to use his or her powers to impose requirements on commissioning consortia, for example, then there could well be a judicial review challenge from a consortium which opposed the requirements on the basis that they infringed the principle of autonomy in the new section 1C and could not be justified as necessary or essential. This approach replaces the, more or less, unfettered power that the Secretary of State has to make directions currently to be found in s8 NHS Act 2006 (as explained above), with a duty not to interfere unless essential to do so. It is also noteworthy that the same “autonomy” or “hands off” duty is also placed on the NHS Commissioning Board, by what would be a new s13E of the NHS Act 2006 (and it is, of course, the Board who will have closer contact with commissioning consortia than will the Secretary of State).

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The Mirror reports that Shadow Health Secretary Andrew Burnham has called for the Health and Social Care / Destroy the NHS Bill to be dropped.

Boston & Skegness Conservative MP Mark Simmonds is paid £50,000 a year to advise a private health firm that stands to make a fortune under Coalition plans for the NHS. Further similar revelations about the motivations of MPs would be useful.

More on the NHS Croydon £25Million black hole.

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:

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.

The government are forced to claim that there is no alternative to making drastic public sector cuts as they know that people would never accept their plan otherwise. By repeating the same lies over and over again, they hope to brainwash people into inaction.

There are alternatives to the cuts, and we are not all in this together. But unless we take action, and take the facts to our friends, our families and those around us, they will get away with it.

Conservative election poster 2010

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.

Shadow Health Secretary Andy Burnham: It’s time to Drop the Bill – mirror.co.uk

WHEN he was looking for votes, David Cameron made a simple promise on the NHS: If he became PM, there would be no more top-down re-organisations.

He even put it in the Coalition Agreement. But after entering No10, he ordered the biggest and most dangerous upheaval of the NHS since it began in 1948.

GPs don’t want it. Nurses don’t want it. But, most importantly, patients don’t want it – because they can all see it spells the end of the NHS as we know it.

Nye Bevan famously said there would be an NHS for “as long as there are folk left with the faith to fight for it”.

Now that fight is upon us – and I know Mirror readers will sign the petition to save the NHS from this damaging “reform”. Our aim is to rally people in a deafening roar. It’s time for the Government to put the NHS first. It’s time to Drop the Bill.

‘Shock’ over MP’s health links – Community – Skegness Standard

A SKEGNESS councillor has accused a local Conservative MP of walking a dangerous ethical minefield after it was reported that he is paid £50,000 a year to advise a private health firm that stands to make a fortune under Coalition plans for the NHS.

Last week the national press revealed that Boston & Skegness member Mark Simmonds is paid £400 an hour to advise Circle Health, which was the first firm to win control of an NHS hospital under government reforms.

Mr Simmonds has stressed that his involvement with Circle Health is on his official register of interests in parliament and that no rules have been broken.

But Skegness Coun Mark Anderson has spoken of his shock at the news, and has branded it a worrying conflict of interests.

“I’m obviously very concerned about his involvement in this at a time when our own local health care, such as Boston’s Pilgrim Hospital, is having such difficulties.

“There are so many problems at Pilgrim Hospital and he’s even made a statement before that he wouldn’t send his own family there in its current state – and yet he lets his own constituents continue to go there while he’s earning money from private care.

“There are ethical questions here. It’s a sad reflection – it looks like he’s using his position as MP.”
…

Hospitals hit by NHS Croydon deficit (From Kingston Guardian)

Millions of pounds will have to be cut from NHS budgets after a massive hole was discovered in the finances of a neighbouring trust.

Independent auditors were called into NHS Croydon after a deficit of up to £25m was discovered by its financial team.

NHS Kingston will not be asked to bail out the trust but neighbouring NHS Richmond will be asked to increase the surplus it makes this year from £4.2m to £5.6m. Another trust, NHS Wandsworth, will be asked to find £14.5m, up from its original target of £12.3m.

Health campaigner Geoff Martin, of London Health Emergency, said: “In the run-up to the busy winter months, NHS Croydon patients will die unnecessarily as a result of this.

“I think the people who created this crisis and have presided over it should be forced to resign.”

NHS Kingston has been temporarily merged with Croydon, Richmond, Sutton and Merton, and Wandsworth in the run-up to spending power being fully handed over to GP commissioners next April.

A spokesman for the new organisation, called NHS South West London, admitted it had a “significant budgetary challenge” and was developing an action plan to get back into the black, using existing financial resources if possible.

The trusts are already trying to find £64.5m in savings out of their joint £2.2bn budget as part of a review of healthcare in south-west London.

Continue ReadingNHS news review