NHS news review

Monitor to employ 600 at an average salary of over £50,000.

Private health firms are experiencing a boost in business from NHS cuts.

The ConDem coalition government eases information requirments for private healthcare providers.

The ConDem coalition government hides the cost of reforming the NHS until after the third reading of the Destroy the NHS / Health and Social Care Bill. It is disappointing that the government resorts to such subterfuge.

Conservative election poster 2010

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

NHS ‘watchdog’ set to become ‘bureaucratic monster’, says Unite

Monitor – the government’s revamped organisation to regulate competition in the NHS – is set to become ‘a bloated bureaucratic monster’, Unite, the largest union in the country, has warned.

Unite said that Monitor’s running costs were set to soar from £72 million-a-year to £82 million – with a 600-strong staff being paid twice the national average wage of £26,000.

Unite said that ministers were creating a bloated, old fashioned bureaucracy which would be responsible for handing over lucrative NHS contracts to the ‘government’s friends’ in the private healthcare sector.

Monitor was expecting to spend a further £14 million-a-year on consultants and £4 million in legal fees, according to the Department of Health’s own Impact Assessment report.

Monitor is a lynchpin of the government’s Health and Social Care Bill, currently before Parliament, with the remit of promoting choice, competition and collaboration – which Unite says are contradictory and confusing aims.

Unite national officer for health, Rachael Maskell said: ‘It is equally disgraceful that the Impact Assessment team have been unable “to develop a robust monetary estimate of the benefits of changes to the regulatory regime”.

‘All this indicates that a revamped Monitor is not being geared for the benefit of patients, but as a conduit to channel lucrative NHS contracts to private healthcare companies, many of whom have bankrolled the Tory party since David Cameron became leader.’

‘Monitor anticipates employing about 600 staff at an average cost of £84,000 each, which would include salaries, National Insurance contributions, any pension provision and other costs.’

‘This works out at average annual salary levels of more than £50,000 – double that of the average national salary of £26,000. A bloated bureaucratic monster is being created – so much for all the ministerial chatter about efficiency savings. This is being paid for by cuts to frontline services, as well as staff pay and terms and conditions.’

Grasp the nettle now – before it’s too late / Features / Home – Morning Star

As Andrew Lansley’s hugely controversial and largely unaltered Health and Social Care Bill faced its crucial vote in the Commons, unelected Tory Health Minister Lord Howe was smugly assuring a conference of grasping private-sector companies that the Bill offers them “genuine opportunities” to take over large chunks of the NHS.

There would be profitable opportunities galore – both in the provision of certain profitable services and in supplying management expertise to help GPs decide how to spend local budgets.

Howe recognised that “the NHS will not give up their patients easily.”

But of course that’s why the Bill, which sailed through a docile Commons with a majority of 65, will stack the odds against public-sector providers and open up most of the £100 billion NHS budget in England to cherry-picking private companies.

It will scrap any pretence at strategic planning or equitable provision by abolishing primary care trusts and strategic health authorities and strip away the thin veneer of local accountability, putting a new national body, the NHS Commissioning Board, and the regulator Monitor – led by pro-market fundamentalist and former McKinsey consultant David Bennett, who was also at the conference with Howe bigging up the private sector – firmly in charge.

Monitor will draw up the list of “any qualified providers” which GPs will have to offer as “choices” when patients need further treatment.

The Bill, coupled with the massive £20bn cuts programme to be achieved by 2014, will also pull the financial rug from under dozens of major NHS hospitals, forcing them to close services, merge with neighbouring trusts and axe staff to stay afloat.

At the same time it will encourage many foundation trusts to maximise the numbers of wealthy private patients they treat, by removing all limits on the amount of money they can make.

While David Cameron and his arrogant, lying ministers falsely claimed support from “the Royal College of GPs, the Royal College of Physicians, the nurses, people working in the Health Service,” we all know that quite the opposite is the case.

The Bill is even opposed by a large majority of GPs, who are the only people apparently set to benefit from its proposals, making Lansley possibly the first politician in history to seek to force £80bn in commissioning budgets into the hands of people who insist they don’t want it.

The Bill is also rejected by the BMA, which has promised to step up its lobbying against the Bill in the Lords, by Royal Colleges, and by almost every academic and think tank not in the pay of the neoliberal right wing.

Every health union is also against the Bill, but the mass campaign that was needed to stop it has still not taken off – a year after the TUC voted unanimously against the outlines of the Bill, as set out in Lansley’s white paper.

NHS rationing boosts private healthcare firms – report | Business | The Guardian

NHS costs squeeze means longer waiting lists – and growing numbers of patients opting to pay for operations, say private firms

by Denis Campbell

Private healthcare firms are experiencing an increase in business caused by the financial squeeze across the NHS in England, a new report on the sector shows.

Independent providers are benefitting from the growing number of patients who are choosing to pay for their own care after having treatment delayed or denied altogether by an NHS primary care trust (PCT).

In a survey of 101 influential industry figures – including chief executives, investors and advisers – 34% said budgetary pressure in the NHS had led to increased demand for private healthcare.

While the reasons were not given, experts said the NHS’s need to cut costs was prompting patients to fund their own hip or knee replacement, hernia repair or cataract removal. “We are certainly picking up that some patients are being asked to wait longer than they would have expected and are therefore deciding to pay for themselves rather than wait,” said David Worskett, chief executive of the NHS Partners Network, which represents more than 30 firms – both for-profit and not-for-profit – that work with the NHS.

Worskett said “misguided” decisions of many PCTs to force patients to wait many months for treatment, often until the next financial year, lay behind the growing trend. Many PCTs are rationing access to care as the NHS struggles to adjust to a 0.1% annual increase in its budget, after years of big rises, and the need to make £20bn of efficiency savings by 2015.

The trend is a boost for a UK private health market which that was hit hard by the downturn in 2008 and for which recovery since has lagged behind that seen elsewhere in Europe, according to Credit Suisse. It is contained in HealthInvestor magazine’s annual study of the industry’s fortunes in conjunction with law firm Nabarro, called The Healthcare Industry Barometer 2011, which is published today.

The NHS will soon be less accountable: that’s good news for the health reform lobby | openDemocracy

While battle rages over the government’s controversial reforms of the NHS, the Department of Health has sneaked out two toxic changes that could seriously damage your health by promoting ignorance and restricting your rights as a citizen.

The two changes appear to be unconnected but are extremely helpful to new private providers of NHS medical services. One will limit the information that the private firms have to provide under the Freedom of Information Act to patients and relatives, the other will help them by abolishing the collection of health statistics on the services they provide and the quality of staff they employ.

The first has been revealed by the authoritative Campaign for Freedom of Information who are rightly demanding that Andrew Lansley, the health secretary, amends the law so patients can be protected. See their letter .

The second comes from a very convoluted consultation exercise launched the day after the August bank holiday and trumpeted by Anne Milton, the public health minister, as a drive against “red tape”.

This proposes to slash the collection of statistics by the Department of Health by 25 per cent in a rather uneven and unclear way. But it is clear that the aim is to “minimise the burden” on the NHS and in particular the new private providers.

Half the statistics collected on the NHS workforce – which are used to improve staff training and forecast the need for skilled staff – are to be dropped. The consultation document says: “This will be of significance for non-NHS providers of NHS services as it will determine the minimum workforce information they would be required to provide.”

Ministers ”hid impact of NHS reforms” – Public Service

Labour’s shadow health secretary John Healey has attacked the government for slipping out details on the cost of reforming the NHS the day after the House of Commons finished debating the legislation.

The Department of Health published the revised impact assessment on 8 September but, Healey said, this was prepared and signed off on 1 September.

Healey said in the Commons: “Last week MPs were asked to debate, amend and pass the Health and Social Care Bill with no new information of the costs and consequences of the biggest reorganisation in NHS history because the government had promised a new impact assessment following the Future Forum recommendations.

“The day after the debate, the new impact assessment was then smuggled out with no press statement. It shows Monitor, the new economic regulator, plan to employ 600 staff at an average cost of £84,000. And most importantly, it shows a health minister signed off the assessment on 1 September – a full five days before the Bill was debated last week.

“It’s a disgrace these facts were kept hidden from MPs and the public before such a critical and controversial debate.”

UNISON News | The public service union | ‘Save the NHS – kill the bill’

“Save the NHS and kill the bill.” That was the rallying cry from UNISON president Eleanor Smith as the TUC debated the government’s NHS plans and the All Together for the NHS campaign to defeat them.

“Our NHS is number one in equity, number one in quality and number one in safety,” said Ms Smith, who works in the health service as a theatre nurse.

But just a week ago, she recalled: “MPs began a two-day debate to wash their hands of the NHS. And on Wednesday night they voted to pass the Health and Social Care Bill.”

Now, she said, in terms of Parliament “all that stands between the government and our NHS is the House of Lords.”

And make no mistake, she added, “the bill hasn’t changed. Yes, they had what they laughingly called a listening exercise. Yes, there have been tweaks. But all the essentials are still there.”

The bill still removes the health secretary’s responsibility to deliver a health service in England, “any qualified provider” remains, allowing private companies to provide services instead of the NHS and the cap on NHS hospitals treating private patients has been lifted.

And in an age of austerity and cuts, warned Ms Smith, “hospitals will be forced to do all they can to raise cash from whatever source”.

‘There is still time to protect the NHS,’ TUC Congress told | The Chartered Society of Physiotherapy

The government’s proposed health service changes have nothing to do with improving the NHS, promoting better integration, or keeping the NHS safe for future generations, the CSP told the TUC Congress today.

CSP industrial relations committee chair Alex MacKenzie said the Any Qualified Provider policy and the Health and Social Care Bill would put the free market above all other considerations, leading to fragmented services, a postcode lottery for care, rationing and the undermining of professional collaboration.

Seconding composite motion 10 at Congress, which ‘deplored’ the government’s health reforms because they would ‘break up the NHS and put profits ahead of patients’, Ms MacKenzie said ‘overseas healthcare companies are rubbing their hands. The Coalition is waving to them – ‘come over here, Britain’s open for business, the rest of the country might be struggling, but there’s money to be made on the NHS’.

Pointing out that the NHS was ranked number one in the world for quality, equity and safety despite costing less per head than many other major developing countries, Ms MacKenzie said there was no case for radical upheaval. The CSP and other health unions would continue to oppose the reforms, she said.

‘It isn’t all over yet.’

‘The Bill has still to go through the House of Lords and then back to the Commons.

‘There is still time to protect the NHS.’

The vote was carried.

 

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C’mon, let’s go

 

They say “Thank you sir”

 

I say “Thank you comrade. Come the revolution”.

edit: The point I’m trying to make here is:

Whenever you’re called sir or madam (or whenever you have a similar opportunity, say

“Come the revolution”, “we will prevail”, “we need a fucking revo” or something similar).

It is going to happen.

 

Continue ReadingC’mon, let’s go

NHS news review

Conservative election poster 2010

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

NHS reform bill must be resisted, leading doctors tell royal colleges | Society | The Guardian

Letter urges professional bodies to stop co-operating with reforms it says most grassroots doctors do not support

by Randeep Ramesh

More than 150 scientists, surgeons and doctors have written to NHS professional bodies calling on the medical establishment to demand that the government withdraws its controversial health bill.

Co-ordinated by the NHS Consultants’ Association, the medics have written to presidents of the royal medical colleges urging them to stop co-operating with the government’s proposed NHS reforms.

The move comes as the British Medical Association begins to mobilise a public campaign against the bill, and coincides with the suggestion of Clare Gerada, chair of the Royal College of General Practitioners, that family doctors hire lawyers to cope with the conflicts of interest they would face over the commissioning reforms.

The letter says the health bill, devised by the health secretary, Andrew Lansley, is not supported by the majority of the medical profession and is not in the best long-term interests of either patients, doctors or the royal colleges.

The plan would, the doctors argue, lead to “marketisation and privatisation” of the English NHS, as well as promote competition with a new regulator, and remove the health secretary’s duty to provide a comprehensive health service. The letter highlights a poll of more than 1000 doctors from the British Medical Journal, showing 93% want Lansley’s bill withdrawn, and suggests there is a lack of democratic legitimacy. The government needs to “reform its reforms”, following the public and professional backlash this year, and the changes have been expensive, the writers say: savings from the changes would bring in £4.5bn over the next four years, £700m less than the government first envisaged.

The doctors are also concerned at the emollient tone of some royal colleges. The Academy of Medical Royal Colleges told MPs there were too “many disadvantages” in delay, while Norman Williams, president of the Royal College of Surgeons, said his body largely backed “the aims of the reforms to modernise the health care system”. The letter claims “colleges are out of touch with the views … of the majority of grassroots doctors”, and accuses them of failing to safeguard their own principles, a key role being to “promote the underlying principles of medical professionalism and leadership”.

The bill, the letter says, cannot pass without the medical profession’s support.

“The colleges have a rare opportunity to make a stand for the NHS, medical profession, and patients. We therefore call upon the Academy of Medical Royal Colleges to act in the public interest by publicly calling for the withdrawal of the health and social care bill.”

‘Timebomb’ fear as ‘rationing by stealth’ of operations hits NHS – Telegraph

“Rationing by stealth” is hitting the NHS, the Royal College of Surgeons (RCS) has claimed, after official figures were released showing a steep fall in the number of people referred to hospital by GPs. by Stephen Adams

Department of Health statistics show the number of referrals made by GPs in the year up to July was 4.7 per cent lower than for the same period in 2010.

These referrals had shown a 3.5 per cent increase at the same stage last year, according to the department.

The number of patients attending for outpatient appointments has also fallen, by 2.7 per cent.

Professor Norman Williams, president of the RCS, described the figures as “extremely disturbing”.

He said: “These data provide further evidence that rationing by stealth is occurring across the NHS.

“Such a steep reduction in the number of referrals by GPs suggests that patients are being given limited access to specialist clinical advice and could be missing out on treatments.”

He went on: “If correct this is extremely concerning for surgeons across the NHS.

“Stopping referrals is only storing up problems for the future – a timebomb which will end up costing the NHS and taxpayer more in the long-term.

“The rise in waiting times for orthopaedic surgery is an indicator that demand for surgery is not reducing and that the issue of rationing needs to be addressed. It will not go away.”

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NHS news review

The Destroy the NHS / Health and Social Care Bill passed it’s third reading yesterday with a mjority of 65. The bill will now pass to the House of Lords.

Many doctors and professional medical associations raised serious objections to the bill. The Royal College of Nursing and the Royal College of General Practicioners took exception to Prime Minister David Cameron’s claim that they supported his proposals.

Colin Leys – co-author of ‘The Plot Against the NHS’ – has an article in the Guardian.

Campaign group 38degrees responds to the government’s so-called Myth-busting nonsense and to many claims made by Andrew Lansley yesterday.

Selected excerpts from ‘The Plot Against the NHS’ by Colin Leys and Stewart Player. Chapter One is available here. I highly recommend this book available from Merlin Press for £10.

The Plot Against the NHS #1

The Plot Against the NHS #2

Conservative election poster 2010

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

Health professionals deny Cameron’s claim they back NHS shakeup | Politics | The Guardian

 

David Cameron faced embarrassment when medical leaders rejected his claim that they supported the government’s health reforms.

The row came hours before the health and social care bill was approved by MPs, after Cameron hailed the profession’s support at prime minister’s questions.

“Now you’ve got the Royal College of GPs, the physicians, the nurses, people working in the health service, supporting the changes we’re making,” he said.

The bodies questioned the prime minister’s claim. Peter Carter, general secretary of the Royal College of Nursing, told the BBC: “While we acknowledge that the government has listened to our members in a number of areas, we still have very serious concerns about where these reforms leave a health service already facing an unprecedented financial challenge.

“At a time when the NHS needs to find £20bn in efficiencies, tackle waste, work harder to prevent ill-health, and deal with an ageing population, we are telling MPs this bill risks creating a new and expensive bureaucracy and fragmenting care.”

Clare Gerada, chairwoman of the Royal College of General Practitioners (RCGP), said: “The college supports putting clinicians at the centre of planning health services. However, we continue to have a number of concerns about the government’s reforms, issues we believe may damage the NHS or limit the care we are able to provide for our patients.

“As a college we are extremely worried that these reforms, if implemented in their current format, will lead to an increase in damaging competition, an increase in health inequalities, and massively increased costs in implementing this new system. As independent research demonstrates, the NHS is one of the most efficient healthcare systems in the world and we must keep it that way.”

The end of the NHS as we know it | Colin Leys | Comment is free | guardian.co.uk

What Wednesday’s vote on the health and social care bill shows more clearly than anything is that many, if not most, of the political elite no longer care whether they are carrying out the wishes of the electorate, and barely pretend that we are any longer a democracy.

The prime minister promised before the 2010 election not to introduce any “top-down reorganisations” of the NHS; to say he, Andrew Lansley and Nick Clegg lack an electoral mandate for the bill is an understatement. It is also an understatement to say that they have not told the truth about the bill’s intentions, and that they have reduced Department of Health statements, such as its latest so-called MythBuster document, to a level of brazen mendacity that demeans a once great office of state.

The principle seems to be that if an official lie – such as that the bill does not imply privatisation – is repeated often enough, most people will feel it must be true. And by using existing powers to abolish PCTs and set up “pathfinder” so-called GP consortia, and making arrangements with foreign private companies to take over NHS hospitals, the government has also pre-empted such debate as MPs are inclined to have. The Conservative MP Dr Sarah Wollaston, who originally denounced the bill, now says that changes have already gone too far to oppose it any further – a remarkable statement of political impotence.

The bill will end the NHS as a comprehensive service equally available to all. People with limited means will have a narrowing range of free services of declining quality, and will once again face long waits for elective care. Everyone else will go back to trying to find money for private insurance and private care. More and more NHS hospital beds will be occupied by private patients. Doctors will be divided into a few who will become rich, and many who will end up working on reduced terms and with little professional freedom for large corporations (the staff of the hospitals that are being considered for handing over to private firms will have noted that the firms in question want “a free hand with staff”).

The one serious obstacle to the bill’s promoters has been the impact of social media: 38 Degrees, Facebook, expert bloggers and tweeters. Along with the million-plus people who work for the NHS, a steadily growing portion of, especially, younger voters, have been exposed to a different narrative and see through the spin. At the moment most of them may be more cynical than politically active. But if the bill becomes law and the reality begins to be felt in people’s daily lives it is this counter-narrative that will make sense. MPs – and now the Lords – would be well advised to ponder the implications of this.

38 Degrees | Blog | Busting the NHS myths

Yesterday morning at 9:31 the Department of Health published a “myth buster” on a government website. It is published below, along with a number of corrections (shown in red).

TOP MYTHS

MYTH: The Health Secretary will wash his hands of the NHS
The Bill does not change the Secretary of State’s duty to promote a comprehensive health service.

This is very carefully worded. It totally avoids addressing one of the main issues with Andrew Lansley’s plans – that the bill would remove the “Duty to Provide” a health service currently contained in s.3(1) and 1(2) of the 2006 Act. Why do you continue to dodge the issue Mr Lansley?

MYTH: Bureaucracy will increase significantly
We are abolishing needless bureaucracy, and our plans will save one third of all administration costs during this Parliament.

The plans may abolish some bureaucracy, but our legal advice warns that the plans have the potential to increase bureaucracy too. See the quote from pages one and two of the executive summary, below:

The procurement regime is a complicated and developing body of rules and case law which gives rise to enforceable rights in the High Court and makes available draconian remedies and penalties for breach of the Regulations. The practical and financial implications of ensuring that goods and services are procured compliantly are considerable. There is a real risk that there will be a deficit of incumbent expertise in new consortia to cope with the regulatory burden. It appears however that the government has simply failed to grapple with the frontline issues in procurement, has wholly underestimated the increasing rather than diminishing complexity in the area and has had no or perhaps little regard to the administrative and financial burdens arising from the regime.

Taken from: IN THE MATTER OF THE HEALTH AND SOCIAL CARE BILL AND THE APPLICATION OF PROCUREMENT AND COMPETITION LAW – an independent legal opinion provide by Rebecca Haynes of Monkton Chambers.

MYTH: NHS hospitals will be managed by foreign companies
Even if independent sector management is used, NHS assets will continue to be wholly owned by the NHS. And there would be rigorous checks to ensure that any such independent provider is reputable and fit for purpose.

We note that they are confirming that this is not a myth, it is a fact.

38 Degrees | Blog | Save our NHS: What Lansley said in the House of Commons

Below is a transcript (copied from Hansard) of the specific things mentioned, along with our comments (shown in red).

Mr Lansley: This Bill, for the first time, stops the Secretary of State—and, indeed, Monitor or the NHS commissioning board—from trying deliberately to increase the market share of a particular type of provider. If the previous Labour Government had put such a requirement in law when they were in office, hundreds of millions of pounds would not have been paid to independent sector treatment centres to carry out operations that were not required and never took place. If the Opposition had their way this afternoon, the safeguards that we intend to put in place would not be available.

In its response to the opportunity provided by Report stage, the Labour party is being not progressive but reactionary, while the trade unions are being misleading in the presentation of their campaign. To be specific, the trade unions and other proxy organisations such as 38 Degrees have gone to some trouble to misrepresent the Bill in order to attack it.

That’s simply not true. We have not misrepresented information, deliberately or otherwise. If the Secretary of State still believes we have then we would invite him to provide examples. We note Mr Lansley made this statement inside the House of Commons – where libel laws do not apply.

 

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