NHS news review: Letter from BMA’s GPs committee to all English GPs

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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 British Medical Association’s general practitioners committee has agreed a motion opposing the ConDem government’s Health and Social Care / Destroy the NHS Bill. The resolution represents a hardening of the BMA’s opposition to the bill. The letter can be read here. Here is the resolution that was passed.

“That the BMA’s general practitioners committee, which represents all GPs in the UK:

• Formally reaffirms its opposition to the NHS health and social care bill

• Believes that if passed the bill will be irreversibly damaging to the NHS as a public service, converting it into a competitive marketplace that will widen health inequalities and be detrimental to patient care

• Believes the bill will compromise the role of GPs, and could cause irreparable damage to the relationship between GPs and their patients.

• Believes the bill to be complex, incoherent and not fit for purpose, and almost impossible to implement successfully, given widespread opposition across the NHS workforce.

• Believes that passing the bill will be an irresponsible waste of taxpayers’ money, which will be spent on unnecessary reorganisation rather than on patient care, as well as increasing the running costs of the NHS from the processes of competition, and transaction costs

• Believes that GPs’ participation in CCGs does not equate to support for the bill, but that GPs are there to defend their patients’ interests and mitigate the adverse impact of the bill

• Supports clinically led commissioning believing this will lead to improvements in patient care in the NHS, and believes this can be more effectively achieved within existing legislation

• Calls upon the coalition government to withdraw the bill and instead enter into productive dialogue with the BMA to agree a way forward for clinically-led commissioning.

 

 

Continue ReadingNHS news review: Letter from BMA’s GPs committee to all English GPs

In other news: disability and workfare

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Independent living for disabled at risk from cuts, say MPs

Independent living for disabled people is being put at risk by the combined impact of cuts to social care and benefits, MPs and peers warned today.

Cuts to care and different benefits are interacting in a “particularly harmful” way for disabled people and many service users fear they will be forced into residential care as a result, Parliament’s joint committee on human rights said in a report.

It cited increases in eligibility thresholds for social care, the closure of the Independent Living Fund to new claimants, cuts to housing benefit and the replacement of disability living allowance by personal independence payment, which will see 500,000 people lose out on the benefit.

The committee called on the government to assess the cumulative impact of these cuts on disabled people and consider the introduction of a right to independent living.

Your top ten disability cuts

1) Scrapping disability living allowance and replacing it with the personal independence payment from 2013 for working-age adults. This reform, which will include a new assessment system, is designed to cut the number of claimants by 20%, meaning 360,000 people will lose out on support, saving the government £360m in 2013-14 and £1.075bn in 2014-15.

2) Scrapping the mobility component of disability living allowance – worth up to £50 a week –  for publicly-funded care home residents and children in residential special schools. This money pays for transport for residents to leisure activities or to visit friends. It will affect 80,000 people, saving the government £135m a year.

3) Cutting social care support for severely disabled people through the Independent Living Fund. The ILF is now closed permanently to new clients. This means that people who would previously have had their council social care packages topped up by the ILF will have this no longer. The ILF itself will be scrapped from 2015 onwards, raising questions about the future funding of existing claimants.

4) Social care cuts. Councils with social services responsibilities in England face average cuts in their budgets of 4.7% next year on the government’s figures. Many are increasing eligibility thresholds or means-tested charges, both of which will hit disabled people’s access to care and income levels.

5) Supporting People cuts. Councils are planning average cuts next year of 17% from their funding of supported housing schemes for groups including people with learning disabilities or mental health or substance misuse problems, a survey has found.

6) Welfare cuts for incapacity benefit claimants following reassessment. 1.5m incapacity benefit claimants will be reassessed on their fitness to work from 2011-14, using the controversial work capability assessment. The government expects 23% to be deemed fit for work, meaning they will be transferred to jobseeker’s allowance, meaning they will lose £25 a week or more.

7) Cuts for employment and support allowance (ESA) claimants. This is a big one. The government expects to save £2bn in 2014-15 by time limiting ESA (the successor benefit to incapacity benefit) for some claimants to one year. Those losing out will be those found to have some future prospect of working, with support, who claim ESA on the basis of national insurance contributions not on the basis of their low incomes. This comes in from 2012.

8) Cutting the rate at which benefits increase each year. This apparently technical change – it means the value of benefits will increase in line with the consumer price index rather than the typically higher retail index – will net the government almost £6bn a year. This will affect DLA, attendance allowance, carer’s allowance and employment and support allowance and make many disabled people and their carers poorer than they would otherwise have been.

9) Cutting mortgage interest relief. The National Housing Federation has estimated that 64,000 disabled homeowners could be at risk of losing their homes due to the government’s decision to reduce support with mortgage interest payments for them by cutting the interest rate at which support is given.

10) Housing benefit. Many disabled people will be affected by the cuts to housing benefit, and there have been warnings that many will be driven into further poverty and possible homelessness. An estimated two million disabled people live in the private rented sector and many will be affected to the cuts to the benefit, which include capping payments and cutting housing benefit levels by 10% for those who have been on jobseeker’s allowance (and many more disabled people will be on JSA due to point 6 above).

 

Youth contract ‘only helping one in ten’

Only one in ten young people will be aided by the government’s youth contract policy, the Trade Union Congress (TUC) claims in a report released today.

The report also claims the unpaid work experience scheme is not helping young people find work.

The government, it says, needs to be more ambitious if it is to reverse some of the highest rates of young unemployment in years.

Paul Bivand, who authored the report, said: “It is vitally important that actions to help young people can be shown to work. Young people themselves want to know this, so do co-workers in the workplace, and so do the employers who are placing their reputations at risk.

“We would hope that good quality work experience with training would have a small positive effect compared to Jobcentre Plus support, but the evidence needs to stand up to critique. We are not there yet.”

It recommended the introduction of a job guarantee scheme, the strengthening of regulations on apprenticeships and the establishment of a government goal that by 2020 young people in Britain should be as well qualified for jobs as those in any other developed country.

The report also claimed that 51% of young people who have been on the Work Experience program are no longer claiming benefits after 13 weeks. This figure, however, is roughly the same for all young people.

TUC general secretary Brendan Barber said that the government’s austerity policies like tuition fees and the scrapping of the EMA have made things worse for young people.

He echoed the fears that the new youth contract would not be nearly sufficient.

 

“The sanction regime remains in place”

It is reported that sanctions have been removed from the DWP’s “Work Experience” scheme, which is one of five workfare schemes which compel people to work without pay on threat of welfare sanctions. But is this another example of the DWP’s willingness to mislead the public?

There is no sign that sanctions have been lifted in the DWP’s press release which states: “The sanction regime remains in place.” Chris Grayling seems to be painting a murkier picture in TV interviews. Speaking to Sky, he first claimed “If somebody sits down with [the employer] after a couple of weeks and says ‘This really isn’t working out, I don’t want to carry on’, they wouldn’t be sanctioned. I was happy to agree to that.” But by the end of the interview, he offers an example which suggests that it will be in exceptional cases only that sanctions won’t be applied.

 

With workfare, the devil is in the detail, and until the DWP publishes some we’re inclined not to trust a department which this week has edited official documents to remove references to workfare being mandatory. If DWP Work Experience were no longer compulsory on threat of benefit sanction, then this would be a big step in the right direction, and we could expect jobseekers to receive letters like this one (currently sent to 16-17 year olds who are not mandated to take part) rather than its usual letter. But it does not seem that this is the case and either way we should beware that George Osborne said of the scheme: “Young people who don’t engage with this offer will be considered for mandatory work activity”.

Thousands of people of all ages are still forced to take part in workfare schemes that compel people to work unpaid. 850,000 people are expected to be referred to the Work Programme, which can include six months of workfare, by the end of this year alone. Another 24,000 people have already been placed on Mandatory Work Activity, and the Community Action Programme criminalises the unemployed by sentencing them to six months of unpaid community service. It is not at all clear whether today’s news affects the Work Experience component of the Sector Based Work Academies, a fifth mandatory scheme.

Importantly, today DWP also reported that they would expect people on ESA – a benefit for sick and disabled people – to begin on the Work Programme within 3 months. People placed in the “Work Related Assessment Group” by ATOS can face unlimited workfare placements.

Most people have two problems with workfare: that it is forced and that it is unpaid. There is evidence that workfare replaces paid work and no evidence that workfare schemes have created a single new job. The companies who continue involvement with the government’s schemes can afford to pay the people doing the work but they choose not to.

In fact, businesses should beware that legally they may owe jobseekers working in their stores the minimum wage. Until the last week’s cover-up, the government advice for Work Programme providers stated: “Where you are providing support for JSA participants, which is work experience you must mandate participants to this activity. This is to avoid the National Minimum Wage Regulations, which will apply if JSA participants are not mandated.” (See the chapter 3, point 14 of the guidance before and after.)

The government is clearly under pressure: in the last two weeks, thousands of people have taken action to end forced unpaid work in the UK and the campaign continues to gather momentum. Workfare affects all of us: it is replacing paid work and undermining the minimum wage. That is why this issue will not go away.

Thirty actions against workfare are taking place across the UK on Saturday 3rd March. Asda, Barnardos, British Heart Foundation, Holiday Inn, Pizza Hut, Savers and Wilkinsons are using workfare through the Work Programme. There are hundreds of others. Take action with us!

 

 

 

 

Continue ReadingIn other news: disability and workfare

NHS news review

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Cabinet colleagues on board with NHS shakeup, insists Andrew Lansley

Health secretary says Liberal Democrats instrumental in making reforms ‘stronger’

 

The Liberal Democrats were fundamental in helping to make the controversial NHS reforms “stronger”, embattled health secretary Andrew Lansley has said.

Lansley insisted his cabinet colleagues were on board with the massive shakeup – despite claims that three fellow Tories had deep concerns about the plans – and praised the input of his party’s coalition partners.

“If there had been a Conservative government, we would have started out in a different place,” he told BBC2’s Newsnight. “The bill is better as a result of the coalition coming together to shape it.”

He admitted he had always known there would be uproar over the bill, noting that all previous health secretaries who had attempted to push through changes had faced the same response.

“There’s always noise,” he said. “The NHS matters so people make a lot of passionate remarks about it. Ken Clarke, who is a fabulous communicator, far better than I am, he tried reform in the early 1990s and the BMA [British Medical Association] said that it was the end of the NHS as we know it.

“There is no way of undertaking major reform imagining that you’re not going to be misrepresented and distorted … We’ve reached the stage where quite a lot of the disinformation out there is a problem, because people are saying things that are literally not true.”

 

Living on borrowed time? The changing frontiers of the NHS debate

 

What do you think those determined to save the NHS can do at this stage?

The important thing is not to let up. Everyone should just intensify what they are already doing. The time between now and the end of the parliamentary session is critical. People are tired, but so are the government. They are badly rattled. A good illustration of this was the ill-judged so-called summit with representatives of the medical professions called by Cameron on 20 February, to which only representatives of the few who support the bill were invited. This was so obvious that as a public relations exercise it proved seriously counter-productive. Government spokespeople were left lamely claiming that there would be other summits to which (they implied) those who had been excluded would be invited. The more people show that their opposition is deep and will be long-lasting, the more rattled the government will become.

The charade of the report stage in the Lords, which is about to begin, needs to be exposed. The media are already describing the new amendments as important when they are not. Pressure needs to be kept on the media, and not least the BBC, to show some objectivity and balance their coverage by inviting genuine expert critics of the bill to take part in their panel discussions of it.

It is important to focus on the Lib Dems. Lansley’s ham-fistedness has attracted most of the flak but the Lib Dem MPs and peers are providing him with cover by going through the motions of obtaining ‘concessions’ while in reality enabling the bill to be passed. The Lib Dem President, Tim Farron, has already blinked, calling for the competition chapter of the bill to be removed, while acknowledging that this may not go far enough for Lib Dem activists (it won’t). Delegates to the Lib Dem conference, and Lib Dem councillors standing in the forthcoming local elections, need to be heavily lobbied. Everyone should also write a letter to as many Lib Dem MPs and peers as they can, and get others to do the same.

The bill wasn’t in the Conservatives’ election manifesto, let alone in the Lib Dems’, nor was it in the coalition agreement. It has no electoral mandate. It is a private sector ramp, masterminded by McKinsey.  Lib Dems must be left under no illusions. They need to understand that if they allow the Conservatives’ bill to become law they are morally and electorally finished.

 

Continue ReadingNHS news review