Shadow Health Secretary John Healey criticises the Destroy the NHS Bill as introducing … “more bureaucracy, more complex decision making and more wasted cost.”

Crapita complains about not getting enough business from intended and proposed NHS privatisation.

ConDems release plans to replace NHS trust management with private managers. There is an obvious danger here – that NHS trusts will be deemed to be failing so that they can be replaced by private managers. It’s the “failed states” scenario of international politics played out in the NHS.

The Hospital Consultants and Specialists Association warns of a perfect storm in the NHS.

A few recent news articles concerning the UK’s Conservative and Liberal-Democrat coalition government – the ConDem’s – brutal attack on the National Health Service.

Government ‘learned little’ from Health Bill pause, says Labour | GPonline.com

Shadow health secretary John Healey said the changes to the Health Bill had been a ‘political fix’ designed to ‘buy off’ the widespread opposition to the NHS reform plans.

He said the closer people look at the amended Health Bill ‘the less they will like the changes’ and ‘the more concerned they will become’.

But he warned that the government is ‘railroading’ the Bill through parliament, allowing little time for scrutiny of the changes. He also raised concerns that only 64 of the 299 clauses are being sent back to the House of Commons for further debate by MPs.

‘The government has only allowed 10 scrutiny sessions… which means there will be around seven minutes for each amendment for scrutiny,’ he said.

Mr Healey meanwhile said that the cost of reorganisation is likely to rise as a result of the changes to the Health Bill.

He said: ‘The government is introducing more bureaucracy, more complex decision making and more wasted cost.

‘Commissioning, which is currently being done by PCT, will soon be split with at least five bodies.’

He also warned that the government is unlikely to carry out a new impact assessment of the updated Bill, meaning the NHS is being asked to implement a ‘far reaching set of changes’ without knowing the costs or the wider implications.

He said ‘Far from removing confusion and uncertainty in the NHS about the plans for the future, the government with its announcements and amendments is making that confusion and uncertainty greater.’

HealthInvestor – Article: NHS not making use of outsourcing partnerships, says Crapita’s Bryant

Delays to the government’s Health Bill and short-sighted policies in NHS trusts are holding back Crapita’s outsourcing operations in the sector, the company’s managing director for health has said.

Beverley Bryant, who joined Crapita last year after a stint at the Department of Health, said that despite the need to make huge efficiency savings under the government’s QIPP agenda, trusts were generally failing to reorganise their back office functions accordingly.

“Trusts are still working on their budgets on a year-by-year basis, when in reality if they want to make savings next year and the year after they are going to have to come out to market this year,” she told HealthInvestor.

“We’re trying to get the message across that if you centralise and streamline back office services across a number of NHS trusts, you can make big savings. But at the moment there aren’t many big projects doing that.”

Bryant also suggested that NHS bodies might not be “as used to the partnership approach to outsourcing as local authorities are”. But she added: “We’re confident that once a few start to do it, more will follow.”
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Outrage over plan to use private managers in the NHS | Public Finance — official CIPFA magazine

Unions have reacted with fury to government plans to bring in private sector firms to run failing NHS trusts, while health service professionals have accused the Department of Health of recycling old failed policies.

In a June 4 document, Developing the NHS performance regime, health minister Ben Bradshaw set out plans for minimum standards of quality, safety and financial management.

Trusts failing to meet the standards – part of a performance management framework that will be distinct from the Healthcare Commission’s inspection regime – will be deemed to be ‘challenged’ and given a set timescale to improve.

Those that fail to lift their performance will have their management team replaced in one of three ways: by a fresh team of NHS managers; takeover by a foundation trust; or by the introduction of a private sector management team under contract.

Dr Jonathan Fielden, chair of the British Medical Association’s consultants committee, speaking at the BMA consultants’ conference, asked: ‘How much do they want to offend their backbenchers? How much do they want to demoralise the talent in the NHS that can do so much if not always played down and insulted by ministers? How little do they know of the complexities of the NHS? You can’t just fly in management.’

Unison senior national officer Mike Jackson agreed that it was ‘unlikely that private sector managers would have the necessary experience of delivering acute and emergency services to bring long-term benefits’.

He added: ‘There is a strong public service ethos in the NHS which would be severely damaged by bringing in private management.’
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Climate is ripe for a perfect storm in the NHS » Hospital Dr

The Hospital Consultants and Specialists Association (HCSA) is a trade union that represents the interests of senior hospital and medical staff

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Many trusts are openly saying that they can’t pay the bills and are resorting to draconian measures to balance the books. At the same time NHS staff remain under a pay freeze, redundancies are becoming the norm and staff are being asked to accept higher pension contributions in return for a lower pension income. Morale is low; and goodwill rapidly destroyed as the NHS is forced to manage a financial crisis not of the staff’s making.

Where does patient care stand in this mess? Many treatments are being put on hold or restricted. Care of the elderly is regularly reported as being sub-standard. Waiting times are lengthening; tensions within the NHS increasing.

Reform can only be built upon a solid platform and I fear that the sinking sands will inevitably lead to structural collapse. Raiding surplus pension funds to bail out the business is Maxwellian, dangerous and ill-conceived. How often are we told: “Staff are the greatest NHS asset?” Well now is the time for politicians to put their support for the NHS to the test.

The perfect storm is not a cheap sound bite. Until or unless NHS staff are valued, respected and treated fairly, the storm clouds will loom large.

More to follow.

The British Medical Association (BMA) renews its opposition to the Destroy the NHS Bill and calls for it to be abandoned in its entirety.

Steve Field who lead the government’s ‘Listening Exercise’ on NHS ‘reforms’ says that the report is possibly wanting on addressing [edit: neglected] the cap on private patients.

A few recent news articles concerning the UK’s Conservative and Liberal-Democrat coalition government – the ConDem’s – brutal attack on the National Health Service.

BBC News – Doctors reject revised NHS plans

Doctors have rejected the government’s revised NHS plans, urging their union to take a tougher stance.

Delegates at the annual British Medical Association conference voted in favour of calling for the Health and Social Care Bill to be withdrawn by 59%.

The union initially welcomed concessions by ministers this month on competition and patient choice.

But doctors at the Cardiff meeting said it was time to keep pushing the government “further and harder”.

The plans involve opening up the health service to greater competition and giving GPs a lead role in spending the NHS budget.

Amid mounting criticisms the government put the changes on hold in April. Two weeks ago ministers attempted to appease opponents by watering down certain aspects of the plans.

But delegates at the BMA said they were still not satisfied – despite pleas by BMA leader Dr Hamish Meldrum not to vote in favour of a series of critical motions.

One of those was calling for the bill underpinning the changes to be withdrawn.

Dr Meldrum said he would continue to ask for more.

But he added: “If you push too far you may lose some of the ground you have taken.”

But delegates were not convinced with 59% voting in favour of the motion.

Dr Jacqueline Applebee, a GP from London, said the overhaul would result in one of the “biggest ever social injustices” as it would lead to charges for services and backdoor privatisation.
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38 Degrees | Blog | NHS Poll results – what should we do next?

Over the past few weeks, tens of thousands of us have been helping decide what we should do next with the NHS campaign by taking part in a survey on the 38 Degrees website.

Thanks to the huge outcry against their original plans, the government was forced to make some changes. They’ve changed parts of the wording and made a few real improvements – but some of the most dangerous problems remain.

We’ve not won yet – but we definitely have made progress. According to Andrew Lansley’s original timetable, the NHS changes would be law by now. Together, we’ve helped stop that happen.
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NHS forum GP admits private patient doubts | Society | The Guardian

The government is facing renewed pressure over its health bill after the GP who led its “listening exercise” admitted he should have done more to flag up concerns about private patients in NHS hospitals, and grassroots doctors meeting in Cardiff demanded further changes.

Labour warned that the health secretary, Andrew Lansley, was still planning to create a “full-scale market” after Steve Field acknowledged that the government would leave hospitals vulnerable to European Union competition law due to the presence of private patients in NHS hospitals. Concerns about a backdoor privatisation of the NHS prompted David Cameron and Nick Clegg to appoint Field to lead the Future Forum review.

As Field was addressing MPs, who are considering the bill again at committee stage, doctors in the British Medical Association defied their leadership to pass a motion at their annual conference criticising the “respray” of the health and social care bill.

Field said a majority of NHS staff who attended his meetings had raised concerns about government plans to lift a cap on the number of private patients using NHS hospitals.

Labour said lifting the cap, which was introduced in 2006, would help foster a free market approach in the NHS.

Field said: “If you wanted a gut feeling from what was happening in the listening exercise – the feeling was actually the private cap should stay because people felt that would provide the protection. But it should be reviewed and put at a reasonable level.”

He admitted he had second thoughts about failing to mention the cap in his report. “To be honest, we didn’t put as much in our report as perhaps we could have done. In fact, it was one area, when we reread the paper at the end, we might have been stronger on.”
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Recent NHS news articles

• the reforms to NHS ‘reforms’ are merely cosmetic and that the intention to destroy the NHS remains
• doctors are the most trusted profession but that this is at risk from proposed changes to the NHS
• some Liberal-Democrats realise that the reformed NHS ‘reforms’ do not satisfy the demands of the Spring conference
• cuts
• doctors prefer working in Wales due to the Welsh Assembly retaining a more traditional NHS
• the British Medical Journal calls on the government to abandon it’s Destroy the NHS Bill.

A few recent news articles concerning the UK’s Conservative and Liberal-Democrat coalition government – the ConDem’s – brutal attack on the National Health Service.

Andrew Lansley attacked for new NHS privatisation plans – mirror.co.uk

ANDREW Lansley has been accused of making only cosmetic changes to his NHS proposals as documents showed he was pressing ahead with privatisation.

The Health Secretary yesterday published 181 amendments to the botched Health and Social Care Bill, following an outcry from nurses and doctors.

But the changes do not alter Government plans for private firms to take over huge swathes of the NHS.

Critics were angry that health experts have just two days to look at the proposals before a Commons vote.

In particular, ministers seem to have backtracked on pledges to beef up the NHS watchdog Monitor, intended to rein in competition.

Opponents said health bosses could in future claim they were using private firms “in patients’ interests”.

Shadow Health Secretary John Healey said: “Plans to break up the NHS remain.”

Pulse – Doctors remain ‘most trusted’ profession

Doctors have come out on top again when it comes to occupations that the public trust – but the BMA chairman has warned that this trust could be put at risk in the future by the Government’s health reforms.

An Ipsos MORI survey of 1,026 people found that 88% trusted doctors to tell the truth, with the profession beating 20 other professions on honesty, including judges, clergyman and priests, and the police. Just 8% of respondents felt doctors did not tell the truth, and 4% said they did not know.

Doctors also placed number one in the same poll in 2009 and 2010.

The results came as BMA chair Dr Hamish Meldrum warned that the current high levels of trust that existed could be severely tested by the Government’s NHS reforms.

Speaking ahead of the BMA’s Annual Representative Meeting next week, Dr Meldrum said that retaining the current trust would ‘be key to getting through the challenges we face over the next few years’.

‘There is a danger that this trust could be put at risk by some of the Government’s plans,’ he said.

‘Doctors will have a greater role in planning and shaping health services and having a greater say about what is best for patients.’

‘But this will only work if it is a shared responsibility and the Government must be truthful about its intentions for the NHS and its future.’
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UNISON Press | Press Releases Front Page

UNISON, the UK’s largest public service union, is warning that the government is encouraging staff to risk their jobs and patient services by encouraging them to set up social enterprise schemes in the NHS.

A National Audit office report into establishing social enterprises under the old ‘ Right to Request scheme’, found little hard evidence of the benefits of the scheme. However, the Government is planning to forge ahead and replicate it as – the ‘Right to Provide’ programme, risking patient services in the process.

Christina McAnea, UNISON’s Head of Health, said:

“The government is setting these enterprises up to fail. As fledgling organisations they will have to try and compete on an open market with private companies under its ‘Any Qualified Provider scheme’ – there is no offer or assurances about levels of business. The result will be either the collapse of services and jobs, or transfer into the private sector, with patients shunted from one provider to the next”.

“The government needs to take stock of this report and do some proper analysis of their programmes before they damage the NHS irreparably.”

Liberal Democrats say in leaked email: keep challenging ‘bad’ NHS plans | Politics | guardian.co.uk

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In a leaked email the former Lib Dem MP Evan Harris, who has led the charge against the original Andrew Lansley blueprint, has condemned the revised plans as “bad”.

This is what Harris wrote in the email, part of an email chain seen by the Guardian:

There is a view that we should keep quiet, say we had a victory and hope no-one notices this stuff – but I think that is not realistic. The plans remain bad for the NHS, go beyond the coalition agreement and we must insist on sovreignty (sic) of conference on major issues not in the CA [coalition agreement].

Harris has already indicated publicly that he is not happy with the revised plans which were launched by David Cameron, Nick Clegg and Andrew Lansley at Guy’s Hospital on 14 June. On 18 June Harris told the Guardian there were “new threats” hidden within the reworked NHS.
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BBC News – NHS told to avoid ‘slash and burn cuts’

NHS chiefs are at risk of making “slash and burn” cuts to services in a drive to save money, doctors’ leaders say.

British Medical Association chairman Dr Hamish Meldrum said he was concerned about the impact across the whole UK.

Reports have emerged of restrictions on a range of “low priority” treatments, while waiting times are under pressure.

The NHS Confederation, which represents health managers, agreed that any cost-saving measures must be well-thought through.

Speaking ahead of the union’s annual conference, which starts later, Dr Meldrum said there needed to be more transparency and debate about cuts.
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Doctors ‘happier’ to be working in Wales than England amid proposed NHS changes – Health News – News – WalesOnline

Doctors in Wales say today they are “happy” to be working in Wales rather than across the border because of proposed changes to the NHS in England.

In a survey of more than 5,000 doctors in Wales, 86% told the British Medical Association Cymru they are “glad” to be working here.

And in an endorsement of the radical reforms to the health service in Wales two years ago, eight out of 10 doctors said successive Welsh governments have been right to seek to remove the internal market and competition from the NHS.

The Welsh Government has reaffirmed its commitment to uphold Aneurin Bevan’s founding principles for the NHS and maintain a health service free from market forces.

This is in stark contrast to the NHS in England and the proposals put forward by the UK coalition government.
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Bury the NHS reform bill, says BMJ | InPharm

The influential British Medical Journal has called on the government to abandon its healthcare reform bill, which it says has not been improved by the recent amendments.

The BMJ’s deputy editor Dr Tony Delamothe and editor Dr Fiona Godlee have made a scathing attack on the reforms and the changes agreed via the Future Forum.

Their editorial published today on BMJ.com states: “it would be better for the NHS, the government, and the people of England to sweep [the amended Health and Social Care Bill’s] mangled remains into an unmarked grave and move on.”

Dr Delamothe and Dr Godlee say the Future Forum recommendations will add further layers of bureaucracy to the health service and would leave “the NHS with a similar proportion of bureaucrats to the Austro-Hungarian empire on the eve of the first world war—and about as flat footed”.

The authors argue that the most important problem facing the health service is the need to make £20 billion of efficiency savings over the next four years and this urgent issue is not being addressed. And they question, as they have done in previous BMJ editorials: “What is the rationale for the changes proposed in the bill?”
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A few recent news articles concerning the UK’s Conservative and Liberal-Democrat coalition government – the ConDem’s – brutal attack on the National Health Service.

BBC News – No apology over Leicester NHS chief’s ‘no pay’ e-mail

A hospital boss has refused to apologise for sending an e-mail to staff warning they might not get paid due to a financial “crisis”.

It came as managers at Leicester’s hospitals met to discuss how to deal with a £6m overspend.

The chief executive of the University Hospitals of Leicester NHS Trust defended telling staff they might not get paid unless cuts were made.

He said it was the toughest crisis the hospitals had faced in 10 years.

He said he was sorry if people were upset by it, but would not apologise for the message it contained.
‘Recruitment freeze’

The e-mail was sent to staff last week warning them of “catastrophic” money issues.

It said: “There’s a real issue about whether we will be able to pay our staff by August or September.”

In a bid to ensure the trust could pay its staff, health bosses have agreed to an immediate freeze on all but essential locum, bank and agency expenditure.

There will be a recruitment freeze on all but essential posts and and a more efficient use of operating theatres will be put in place.

Mr Lowe-Lauri said: “That deals with the today issues. As for tomorrow, this is the bigger job.
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Pulse – Rebel doctors launch renewed fight against ‘cosmetic’ health bill changes

The group of doctors including GPC member Dr David Wrigley and consultant Dr Jacky Davis – a long-standing opponent of market-led reforms – have penned an open letter to the medical profession outlining their concerns, claiming the changes announced last week had done ‘nothing to reassure us’ about the bill’s ‘underlying aim to impose a fully-fledged market on the NHS’.

The letter, which the doctors have signed in personal capacities, claims the Government has crossed the ‘red lines in the sand’ of the BMA and RCGP in order to stay on course with its original plans, as demonstrated by the scaling back rather than removal of Monitor’s role to promote competition, and the retention of the Any Qualified Provider policy.

It says the Government’s response also confirms its intention to surge ahead with policy directions opposed by the BMA including the outsourcing of the function of commissioning to private companies, exposing the system to ‘a whole new raft of even less identifiable conflicts of interest’; and extending personal health budgets.

It adds that even the good parts of the ‘curate’s egg’ – as described by BMA chair Dr Hamish Meldrum, the introduction of GP-led commissioning, had ‘gone rotten’ as a result of the increasing powers handed to the NHS Commissioning Board.

The letter also cites a study by researchers from the London School of Hygiene and Tropical Medicine, published in the BMJ last week, which described how the bill could allow private companies to strip NHS assets ‘leading to more a expensive system that will deliver worse quality of care’.

It concludes: ‘We therefore totally reject the repeated claims of the Coalition leaders that their reforms will deliver greater NHS efficiency and that there will be ‘no NHS privatisation’.

‘Even the supporters of clinically led commissioning must be highly concerned with a return of central control in the NHS via a strengthened NHS Commissioning Board and clinical senates. Thus, even the potentially “good part” of Dr Meldrum’s “curate’s egg” has now gone rotten.’

‘In conclusion, the simple fact is that the Government’s proposed changes to the bill are mainly cosmetic in nature. There are no ‘significant’ policy changes that will alter the general direction of travel and we believe the proposals will actually create even more problems for the NHS by increasing the tiers of bureaucracy.

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Pulse – Open letter to the medical profession: Now is the time to get tough on NHS reform

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In conclusion, the simple fact is that the Government’s proposed changes to the bill are mainly cosmetic in nature. There are no ‘significant’ policy changes that will alter the general direction of travel of the reforms and we believe the proposals will actually create even more problems for the NHS by increasing the tiers of bureaucracy. It is at this point that we would remind Mr Clegg that “no bill is better than a bad bill”. He would also do well to listen to views of his fellow liberal Democrat colleague, Dr Evan Harris, who dismissed the NHS Future Forum report as “cliché-ridden, trite nonsense” at the Social Democrat Forum last weekend.

It is incumbent on us as doctors to ensure our patients will always have access to a health service that does not differ across the country, a health service that is there when you need it and does not require an insurance policy or self funding if you need some extra care that your personal budget won’t fund. 
The NHS is facing the biggest threat in its history and as its founder, Anuerin Bevan famously said: ‘It will last as long as there are folk left with the faith to fight for it.’

We therefore urge members of the medical profession to take up the fight for the NHS by continuing to oppose this damaging bill and call for its withdrawal. We urge them to lobby their MPs, members of the House of Lords, and BMA representatives by highlighting what this bill means for the NHS, the profession and our patients.

Dr David Wrigley, GP, Carnforth, Lancashire

Dr Clive Peedell, Consultant clinical oncologist, James Cook University Hospital, Middlesbrough

Dr Jacky Davis, Consultant Radiologist, Whittington Hospital

Professor Ian Banks, President of European Mens Health Forum and Professor of Men’s Health, Leeds Metropolitan University

Mrs Anna Athow, Consultant Surgeon, North Middlesex Hospital

Written in personal capacities and all are members of BMA UK Council