Exclusive: GPs say they have firm evidence now that the government is planning to privatise the National Health Service as part of its reforms.
In a document seen by Channel 4 News, plans are laid out for how services will be bought for patients.
And family doctors say the details show for the first time the scale of the involvement of private companies. The document, Developing Commissioning Support: Towards Services Excellence, is a draft sent out to various health organisations.
Under the NHS reforms, GP practices will form consortia and they will manage about 60 per cent of England’s NHS budget. But it has been acknowledged that some GPs will not want to – or be capable of – managing such huge enterprises.
This document sets out how commissioning support units can be set up.
…
Dr Jonathan Tomlinson, an east London GP and blogger, said: “The document says that GPs who are wanting to design services from their patients will have to get support from private companies. However that support is so comprehensive as to include absolutely everything that commissioning involves.
“In other words, looking at the needs of their local population, choosing and designing the services that they need, managing the contracts, monitoring the quality. There’s almost nothing left for us to do. And it even goes so far as saying that they can see a role for GPs perhaps in managing learning difficulties or other small local community services but even then private companies will be doing the directing.”
This all comes a fortnight after the Department of Health signed a deal with the private company, Circle, to run Hinchingbrooke Hospital in Cambridgeshire. However, GPs say this document goes further. Circle will be in charge of “providing” a service. This will be the private sector purchasing patient care and ultimately deciding what they do and do not want to buy.
…
The British Medical Association is now to discuss the document at its council meeting on Thursday. But Channel 4 News understands that members of the BMA’s GP committee reacted with fury when they were shown it last week and have demanded the leadership takes a stronger stand against the reforms.
The Royal College of GPs is also planning to discuss it at its next council meeting.
The think tank, the Kings Fund, said that it had always been acknowledged that GPs would not do the commissioning – or buying of care – on their own.
Professor Chris Ham, King’s Fund chief executive, said: “What GPs are worried about is that they will have to increasingly rely on the private sector to provide them with the expertise they need to manage £60bn of public money. There could be benefits from that if they get access to better, more expert people but of course there are real concerns this is a further step towards the privatisation of some aspects of NHS services.”
…
Conservative election poster 2010
A recent news article about the UK’s Conservative and Liberal-Democrat (Conservative) coalition government – the ConDem’s – brutal attack on the National Health Service.
Lord Freud, Tory welfare reform minister says that the Con-Dem coalition scum government want to stop GPs signing patients off on long-term sick leave. This appears to be a particularly ridiculous decision by the Con-Dem coalition scum government which ignores the fact that it is GPs that will have intimite knowledge of their patients’ health issues.
BMJ Careers reports that huge numbers of Consultants are taking early retirement because they’re angered by ongoinging changes to the NHS.
The Royal College of Nursing reports that 50,000 jobs are under threat or have already gone in the health service in England. The Con-Dem coalition scum government disputes the figure.
100,000 NHS workers are expected to participate in the 30th November day of action over public-sector pensions.
Two nonsense NHS stories.
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.
C4 investigation reveals government’s work capability assessment programme is clogged with costly, unresolved cases
Thousands of ill and disabled people have become trapped in a revolving door of medical assessments and appeals at a cost of £80m, with many claimants on their second and third attempts to overturn rulings that remove their benefits.
The government’s drive to cut Britain’s multibillion-pound welfare bill by moving long-term unemployed people off sickness benefit and into work is at risk of descending into chaos, according to a Channel 4 news investigation.
The work capability assessment programme, which assesses benefit claimants to see whether they are fit for work is “teetering on the brink of collapse” as the system becomes clogged up with appeals.
Ministers introduced more stringent medical tests as part of welfare reforms designed to cut the number of people claiming incapacity benefits, currently at 2.4 million. They say sickness benefits are too often abused as an excuse for being out of work, and have pledged to end what they call the “something for nothing” culture.But the number of appeals by claimants who believe they have been incorrectly assessed as medically able to work has quadrupled in two years, with the projected numbers for 2011-12 expected to reach 240,000.
…
Stripping GPs of the power to sign patients off on long-term sick leave could lead to “fewer wasted lives”, a Tory minister has insisted.
Lord Freud said the Government wanted to intervene earlier to stop patients drifting into “unnecessary” on-going state support.
A Coalition-commissioned report due next week will recommend that independent assessors rule on long-term sickness instead of GPs.
…
Government is embarking on the biggest shake-up of the welfare state since its formation and the reforms include reassessing all sickness benefit claimants and replacing sick notes with fit notes that set out what work individuals are able to carry out while ill.
…
A report by BMJ Careers today shows that the number of consultants who take voluntary early retirement in 2011 has soared up by almost three quarters compared with 2010. According to the BMA, this staggering rate reflects consultants’ growing dissatisfaction in terms of the ongoing changes within the NHS.
The report, based on new data obtained from the NHS Business Services Authority Pensions Division demonstrates that the number of consultants who have opted for voluntary early retirement before the age of 60 has risen by 72.4% from 2010 to 2011. Whilst 98 consultants opted for voluntary early retirement in 2010, the numbers increased to 169 in 2011. The proportion of consultants opting for early retirement has almost doubled over the last 5 years from 7.3% in 2006 to 14.0% in 2011.
Deputy chairman of the BMA’s Consultants Committee, Ian Wilson explained that the reasons why many consultants chose to retire at the earliest possible opportunity is based on a combination of factors, including changes to NHS pensions, working increasingly long hours and increased work intensity, partly caused because of less junior doctors’ being available due to working time restrictions, as well as the reform of the NHS.
Dr. Wilson declared:
“Anecdotally doctors are telling us all the time that if they could retire, they would retire, whereas in the past doctors tended to want to carry on for as long as they were able to. People are feeling disempowered by NHS structures and NHS functioning, and there’s an attraction for people to retire from the rat race.”
…
…
The RCN has been closely monitoring job cuts since April 2010.
The posts it has identified have either being lost already or are due to be cut by March 2015.
Many of them do not involve redundancies as the NHS tends to cut posts by not replacing staff who leave or retire.
The total highlighted – 48,029 – is the equivalent of shutting four large hospital trusts.
It includes all types of staff from administrators and porters to doctors and nurses.
The union also carried out an in-depth look at 41 trusts where cuts were being made.
In total, nearly half of the posts under threat were clinical and the scale of the cutbacks represented nearly a tenth of the workforce on average.
In the worst cases over 20% of the workforce was due to be culled.
The RCN said the findings were proof that the savings the NHS has to make – £20bn over the next four years – could not simply be achieved through efficiencies.
…
Growing waiting lists force the Con-Dem scum government to introduce waiting list targets.
Labour pledges to repeal NHS bill when they are re-elected.
GMB union to join the 30th Novermber public sector strike on the Con-Dem government attack on pensions.
Stafford Hospital is employing army medics to keep its Accident & Emergency department open. I didn’t realise that army medics had proper qualifications.
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 government has been forced to abandon its opposition to NHS waiting time targets and introduce a new rule to halt the growing number of patients not being treated within the promised 18 weeks.
The U-turn is a surprise because the health secretary, Andrew Lansley, had previously criticised waiting times measures introduced by Labour to speed up patient care as “arbitrary Whitehall targets”.
But fresh evidence that waiting times are creeping up, despite David Cameron’s pledge to keep them low, has forced Lansley to change tack and impose an extra treatment directive on the NHS. He had previously castigated targets as unnecessary, likely to distort NHS staff’s clinical priorities and part of a bureaucratic “top-down” system he intended to overhaul.
It has been prompted by the disclosure that, among the 2.6m patients waiting for treatment at any time, almost 250,000 (9.4%) do not get treated within the 18 weeks guaranteed in the NHS constitution. Among these, about 20,000 patients have been left untreated for at least a year.
On Thursday Lansley warned the NHS in England that, as of next year, no more than 8% of all patients waiting at any one time would be allowed to have had their treatment delayed by 18 weeks or more.
…
All provisions that turns health and social care services into a market-based system will be removed, says Andy Burnham
Labour have pledged to repeal the coalition’s controversial health and social care bill if they are re-elected, opening a new front in the debate over the NHS’s future.
Shadow health secretary Andy Burnham committed the party to undoing the proposed radical reorganisation of the English NHS in a speech on Wednesday. “Labour will inherit a very different NHS – lots of damage will have already been done. And let me make it clear – if the bill in parliament goes through, we will repeal it”, he told delegates at the Royal College of Midwives’s annual conference in Brighton.
“We will return the NHS to a national system based on the principle of collaboration on which it was founded in 1948,” added Burnham, who also emphasised that, in making that pledge he was “not talking about protecting the status quo”.
His remarks are likely to be welcomed by medical organisations and campaigners against health secretary Andrew Lansley’s planned legislation, which has been approved by the House of Commons and is currently in its committee stage in the House of Lords.
But a source close to Lansley claimed Burnham, Labour’s last health secretary who returned to the shadow role in shadow cabinet reshuffle, was in effect proposing yet another restructuring of the NHS which staff would not support.
…
The GMB has voted to join a national strike over pensions to be held later this month.
The Nov. 30 walkout has been planned in protest against public sector pension reforms. A total of 33 percent of GMB members met and voted in favour of the strike by more than 4-1.
“It is now clear that millions of workers will be protesting on 30 November at the government’s attack on jobs and pensions,” GMB National Secretary Brian Strutton said.
Although the union has voted to join the strike, Strutton said there was still time for the government to negotiate and settle the issue of public sector pensions.
Strutton added: “The government has already accepted that the original proposals were unfair and wrong. It is not too late for the government to pull back from this confrontation and scrap this attack on pensions.”
The GMB is one of the UK’s largest unions with more than 600,000 members, including NHS and local government workers from England, Wales, Scotland and Northern Ireland.
UCATT, the union of construction workers, also voted recently to join the strike.
The strike, originally called by the TUC, has the support of 15 unions protesting against the government’s proposal to make public sector workers pay more and work longer to earn their pensions.
…
ARMY medics have been drafted in to keep an NHS hospital running for the first time in Britain – because it does not have enough staff.
Stafford Hospital has been forced in to the move to keep its accident and emergency department open during the day.
But the hospital, which is currently at the centre of an inquiry into hundreds of deaths between 2005 and 2008, will still shut A&E at night due to staff shortages.
And the situation will reach crisis when the military medics pull out.
The hospital offered £100,000 salaries and £500 per extra four-hour shifts, but its poor reputation and a national shortage of NHS consultants made hiring impossible.
So two emergency consultants, used to battlefield medicine, and four senior nurses also provided by the Ministry of Defence will keep the ward open.
But Mid Staffordshire NHS Foundation Trust chiefs decided the department, which has only four of the six consultants it needs, must shut between 10pm and 8am from December 1 for three months. And the Trust admitted without “urgent action”, there “will be significant risks following withdrawal of the military support”.
…
Addressing the ‘tax gap’ is a vital part of tackling the deficit. Figures produced for PCS by the Tax Justice Network show that £25 billion is lost annually in tax avoidance and a further £70 billion in tax evasion by large companies and wealthy individuals.
An additional £26 billion is going uncollected. Therefore PCS estimates the total annual tax gap at over £120 billion (more than three-quarters of the annual deficit!). It is not just PCS calculating this; leaked Treasury documents in 2006 estimated the tax gap at between £97 and £150 billion.
If we compare the PCS estimate of the tax gap with the DWP estimate of benefit fraud, we can see that benefit fraud is less than 1% of the total lost in the tax gap (see diagram opposite).
Employing more staff at HM Revenue & Customs would enable more tax to be collected, more investigations to take place and evasion reduced. Compliance officers in HMRC bring in over £658,000 in revenue per employee.
If the modest Robin Hood tax – a 0.05% tax on global financial transactions – was applied to UK financial institutions it would raise an estimated £20–30bn per year. This alone would reduce the annual deficit by between 12.5% and 20%.
Closing the tax gap, as part of overall economic strategy, would negate the need for devastating cuts – before even considering tax rises.
Our personal tax system is currently highly regressive. The poorest fifth of the population pay 39.9% of their income in tax, while the wealthiest fifth pays only 35.1%. We need tax justice in personal taxation – which would mean higher income tax rates for the richest and cutting regressive taxes like VAT and council tax.
Cut the real waste
While it is not necessary to cut a penny in public expenditure due to the ‘deficit crisis’, there are of course areas of public spending which could be redirected to meet social needs.
In the civil and public services, we know there are massive areas of waste – like the £1.8 billion the government spent on private sector consultants last year. The government could get better advice and ideas by engaging with its own staff and their trade unions.
There is also the waste of the government having 230 separate pay bargaining units, when we could have just one national pay bargaining structure.
There are also two other large areas where government costs could be cut.
Trident
The current Trident system costs the UK around £1.5 billion every year.
A private paper prepared for Nick Clegg (in 2009, when in opposition) estimated the total costs of Trident renewal amounting to between £94.7bn and £104.2bn over the lifetime of the system, estimated at 30 years. This equates to £3.3bn per year.
At the time Nick Clegg (now Deputy Prime Minister) said: “Given that we need to ask ourselves big questions about what our priorities are, we have arrived at the view that a like-forlike Trident replacement is not the right thing to do.”
The 2010 Liberal Democrat manifesto committed the Party to: “Saying no to the like-for-like replacement of the Trident nuclear weapons system, which could cost £100 billion.”
PCS policy is to oppose the renewal of Trident and invest the money saved in public services, whilst safeguarding Ministry of Defence staff jobs.
War in Afghanistan
The war in Afghanistan is currently costing £2.6 billion per year. The war is both unwinnable and is making the world less safe. More important than the financial cost are the countless Afghan and British lives that are being lost in this conflict.
The PCS alternative…
There is no need for cuts to public services or further privatisations
Creating jobs will boost the economy and cut the deficit. Cutting jobs will damage the economy and increase the deficit
We should invest in areas such as housing, renewable energy and public transport
The UK debt is lower than other major economies
There is a £120 billion tax gap of evaded, avoided and uncollected tax
The UK holds £850 billion in banking assets from the bailout – this is more than the national debt
We could free up billions by not renewing Trident
End the use of consultants
…
17.05.11: Steve Bell on David Cameron's NHS reforms speech
