A former adviser to Tony Blair who has spent a decade at the top of an American private healthcare giant has been appointed to run the NHS in England.
Simon Stevens, the architect of Labour’s health reforms who left the UK in 2004 to take up a lucrative post at the American company UnitedHealth, was welcomed by the Health Secretary, Jeremy Hunt, as a “reformer and an innovator”.
But his selection as chief executive of NHS England will raise concerns among critics who claim the NHS is being “softened up for privatisation”.
… one senior doctor told The Independent that the medical profession may view Mr Stevens with suspicion. “Clinicians will remember him as an architect of New Labour’s marketisation of the health service,” he said. “He was very pro the idea of opening up provision to multiple providers. He was keen on having competition as a lever in the NHS… Nicholson was seen as a centralist, very into the state. Stevens will be seen as the opposite. A lot of the profession, especially those committed to traditional NHS values will see this as a very different slant.”
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Care Quality Commission says performance at 44 out of 161 acute hospital trusts in England is cause for concern
Accident and emergency
One in four NHShospitals is a cause for concern over the quality or safety of the care it provides to patients, the service’s statutory watchdog has warned.
In an analysis of all 161 acute hospital trusts in England that is the most comprehensive ever carried out, the Care Quality Commission (CQC) says it is worried about aspects of care at 44 (27.3%) of them.
Performance in some areas is so inadequate that it poses a risk or an elevated risk to patients.
The sheer number of hospitals about which the regulator is concerned dwarfs the 14 trusts that Professor Sir Bruce Keogh, the NHS’s medical director, investigated earlier this year. Eleven of those 14 were put into special measures as a result of inadequacies he uncovered.
Companies running care services are among many avoiding millions in tax through a legal loophole. In the first of a series, Emily Dugan and Richard Whittell report
Companies receiving lucrative government contracts to run care services looking after tens of thousands of vulnerable people are avoiding millions of pounds in tax through a legal loophole.
The firms are cutting their taxable UK profits by taking high-interest loans from their owners through the Channel Islands Stock Exchange, an investigation by Corporate Watch and The Independent has found. By racking up large interest payments to their parent companies, they are able to reduce their bottom line and cut their tax bills.
The news will increase concern about NHS reforms that are seeing private companies take more responsibility for services. It also raises questions about the Government’s commitment to tackling corporate tax avoidance, which David Cameron has said “corrodes public trust”.
Over the course of this week, The Independent will reveal how more than 30 UK companies, including some of the UK’s most recognisable brands, are benefiting from this legal tax loophole, known as the quoted Eurobond exemption. HMRC considered restricting the use of the loophole in 2012 but never took action.
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Doctors say prime minister’s pledge is unachievable, as analysis shows only 1% of surgeries open all weekend
Dr Clare Gerada, chairwoman of the Royal College of GPs said: ‘you do not find a solution by beating us around the head constantly, but by supporting and investing in us.’ Photograph: Frank Baron for the Guardian
Senior doctors have condemned the prime minister’s pledge that GP surgeries will open from 8am to 8pm seven days a week as unrealistic and unachievable, as a Guardian analysis of existing opening times showed that just 1% of practices see patients on both weekend days and three-quarters are shut all weekend.
Only 100 (1%) of the 9,871 surgeries in England listed on the NHS Choices website are currently open for part of Saturday and part of Sunday, while overall just one in seven – 1,439 (14.6%) – open at all on a Saturday.
Those that are open offer access to a GP for on average only three hours and 25 minutes, far less than during an 8am to 6.30pm standard weekday. Three out of four (7,561 – 75.6%) surgeries are shut all weekend.
Even at surgeries that do see patients at the weekend, opening hours can be brief. Although four practices in Sheffield, Coventry, Wirral and King’s Lynn open for 14 hours on a Saturday, the Village Hall surgery in Nottingham is open for just 30 minutes that day. More than 30 others open for an hour or less.
The findings underline the scale of the task David Cameron faces in honouring his promise, which earned widespread media coverage when he announced it at the Tory conference. Millions who find it hard to see a GP at a suitable time would benefit from the dramatic extension of opening hours, he pledged: “We want to support GPs to modernise their services so they can see patients from 8am to 8pm, seven days a week.”
But doctors’ leaders claim there are far too few GPs to staff such an expansion of opening times and the NHS is too cash-strapped to afford it. They have also questioned whether enough patients will want to see a GP outside normal weekday surgery hours, especially at weekends, to justify the move.
Family doctors’ organisations warn that a large majority of patients who visit surgeries during usual weekday opening hours could face longer waiting times and not be able to see their regular GP if ministers press ahead with the plan.
And at the heart of this issue is the critical lack of support for disabled children within their own community, support that other families simply take for granted – be it access to the right school or nursery place, or to leisure activities they can enjoy.
Recent research by the disability charity Scope has found that two thirds of families with disabled children cannot get this most basic state and local authority support in their own area. Instead they have to travel or stay away from home, often creating many more difficulties in terms of increased time and costs for families that are already struggling.
…
David Cameron recently said ‘When you’ve had the privilege of bringing up a profoundly disabled child, you suddenly realise there are two different sets of places: those that are disabled-friendly, that are accessible, that are helpful; and those that aren’t… And what this all about really, is greater equality in our country, making sure that all places are more friendly, and accessible to disabled people.’
But this welcome and undoubtedly genuine sentiment is sadly nowhere to be seen in the reforms in the Children and Families Bill. The Government must rectify this if families with disabled children are to be included in David Cameron’s vision to be most ‘family friendly government ever’.
