NHS news review

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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.

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.

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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