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“Liberals” and “Democrats” to meet with whole-hearted NHS abolitionist and orange-booker (Tory) Nick Clegg.

Conservative election poster 2010

Nick Clegg faces stormy conference as activists vent fury at NHS reform – UK Politics, UK – The Independent

Nick Clegg faces a challenge to his authority at the Liberal Democrats’ annual conference as party activists plan to rebel over four of the Coalition Government’s policies.

by Andrew Grice

When the Birmingham meeting opens tomorrow, grassroots members will challenge a ruling by conference managers to deny delegates a vote on the Government’s controversial NHS reforms. Although Mr Clegg extracted concessions from David Cameron, some Lib Dems believe they did not go far enough.

A conference vote in favour of further amendments to the NHS and Social Care Bill could undermine Mr Clegg’s attempt to convince the public that the Lib Dems are punching above their weight inside the Coalition.

The party is more democratic than the Conservatives or Labour and their conference decides party policy. Some activists fear that the current plan to stage a health debate without a formal vote would mark the first step towards the event becoming a “Conservative-style rally.”

Evan Harris, vice chairman of the party’s federal policy committee, said yesterday: “There is a lot of anxiety among party activists that the conference is being turned into an event where votes are avoided. That’s not our style.” Grassroots revolts are also in prospect over the Government’s plans to cut £350m from the legal aid budget and reduce state benefits for cancer patients and over its response to last month’s riots.

Lawyers plan to confront Mr Clegg over the withdrawal of legal aid from most cases of family breakdown, medical negligence, immigration, debt and welfare benefit, and to make claimants to pay legal fees out of compensation payments. The moves were rejected in a vote at the party’s spring conference.

Alistair Webster, chairman of the Liberal Democrat Lawyers’ Association, said: “I don’t think that, either inside the Government or in the parliamentary party, people have done anything like enough to push the [party’s] agenda. I’m more than disappointed – I’m appalled.”

27/11/13 Having received a takedown notice from the Independent newspaper for a different posting, I have reviewed this article which links to an article at the Independent’s website in order to attempt to ensure conformance with copyright laws.

I consider this posting to comply with copyright laws since
a. Only a small portion of the original article has been quoted satisfying the fair use criteria, and / or
b. This posting satisfies the requirements of a derivative work.

Please be assured that this blog is a non-commercial blog (weblog) which does not feature advertising and has not ever produced any income.

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

The NHS will be privatised – it doesn’t matter what the British people want | openDemocracy

In voting for the third reading of Andrew Lansley’s Health and Social Care Bill last week MPs voted to replace the NHS as a public service with a system of competing businesses – foundation trusts, social enterprises and for-profit corporations.

The government’s claim that the Bill does not mean privatisation is plainly specious: the truth of the matter is to be found in what Lansley’s health minister, Lord Howe, told a meeting of private health businessmen on the day the Bill was approved. He said it presented ‘huge opportunities’ for the private sector, and noted that commissioners of health care would be barred from favouring NHS providers. The truth is also to be found in the government’s leaked plans to hand over the management of NHS hospitals to private companies, and in the current and promised large-scale opening up of NHS work to ‘any qualified provider’.

Conservative election poster 2010

Lord Howe reiterated Tony Blair’s dictum that it doesn’t matter who provides care, so long as it is free to the patient. What this does is to treat as irrelevant everything that follows from introducing market dynamics. The basic fact about health care is that high quality care depends on a sufficient ratio of skilled staff to patients, whereas in the long run profits can only be made by reducing the skill-mix (to lower the wage bill) and cutting staff ratios. The resulting decline in care quality is already evident in privatised long term care and home care, and is now beginning to be seen in community health services and GP services. Once NHS trusts have to compete with for-profit companies they will be forced to follow suit.

The erosion of quality will be reinforced by two other powerful factors: a) the cuts being imposed in the NHS budget, leading to the withdrawal of some services and the scaling back of others; and b) rising costs due to marketisation.

The costs of market-based health care – from making and monitoring multiple and complex contracts, to advertising, billing, auditing, legal disputes, multi-million pound executive salaries, dividends, fraud, and numerous layers of regulation – will eventually consume 20 per cent or more of the health budget, as they do in the US. Neither the Care Quality Commission nor NHS Protect (the former NHS Counter-Fraud Unit) is remotely resourced enough, or empowered enough, to prevent the decline of care quality or the scale of financial fraud that the Bill will introduce.

The effect will be that people with limited means will be offered a narrowing range of free services of declining quality, and will once again face lengthening waits for elective care. To get high quality and more comprehensive care people will have to pay for private insurance and private care, if they can afford to. More and more NHS hospital beds will be occupied by private patients, further reducing the resources available for free care. Fixed personal budgets, like those already given to people for social care, are to be introduced for a growing range of chronic conditions, allowing those with resources to top up their allocations while leaving the rest to make do with ‘basic’ NHS provision.

None of this is wild speculation. It is either already happening or announced or readily foreseeable on the basis of current policy. To deny that the Bill means privatisation and the end of the NHS as a comprehensive service equally available to all is like denying that the earth is round.

The fact that MPs have nonetheless endorsed the Bill reveals something more serious than an ideological blind spot. It shows that they don’t really care that they are flouting the wishes of the electorate. Cameron promised categorically that there would be no further top-down reorganisation of the NHS, but is pushing through a reorganisation that amounts to a destruction of it, against the known wishes of a large majority of voters. Governments, we are told, must often take unpopular decisions. But this is not some incidental measure. We are talking about something fundamental to what, for more than half a century, has played a key part in making Britons equal citizens, and Britain a civilised and humane country. If democracy doesn’t mean that governments have to respect public opinion on something as important as this, what does it mean?

It is no less depressing that the Department of Health has been reduced to peddling more and more brazen lies, such as its ‘Department of Health Myth Buster’ document, published to coincide with the Third Reading debate. The principle seems to be that that if an official lie – such as that the Health Bill does not mean privatisation – is repeated often enough, most people will feel it must be true. Democracy depends on voters having trustworthy information. If we cannot trust departments of state, run by public servants, to tell the truth, who can we trust?

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

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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.

Save our NHS | The Socialist 14 September 2011

After minimal amendments, and in the face of continued public opposition, Andrew Lansley’s Health and Social Care Bill has passed through its third and final reading in the House of Commons.

The public sector workers’ union, Unison, has described the bill as causing “huge damage to patient care and [wasting] vast sums of public money. The plans will turn the NHS into a business where our taxes will increasingly pay for profit-driven companies to provide our health care.”

But it is not just the trade unions that are worried about this bill becoming law. The British Medical Association doctors’ organisation has explained that they “believe that the government’s reform plans pose an unacceptably high risk to the NHS, threatening its ability to operate effectively and equitably, now and in the future” due to a continued “inappropriate and misguided reliance on ‘market forces’ to shape services.”

The changes put forward in the bill represent the most fundamental attack on the NHS in its 63-year history. The bill’s implementation would mean there would no longer be a guarantee that necessary services be provided by the NHS, but only that services will be provided by “Any Qualified Provider”.

It would move the legal duty to provide health care away from the Health Secretary to local commissioners. It would mean the complete abolition of Primary Care Trusts. It would push all NHS Trusts into Foundation Trusts, breaking up the very idea of a national health services.

Clearly this bill must continue to be opposed, along with all the cuts and privatisations within the NHS.

BMA could join strikes over public sector pensions | GPonline.com

The BMA has refused to rule out industrial action over pensions after trade unions warned that government cuts could trigger the biggest strikes in a generation.

By Nick Bostock

As many as three million public sector workers could take part in industrial action on 30 November after leading unions announced plans to ballot their members over strikes.

A BMA spokeswoman said: ‘Our preferred way forward is still to reach an agreement with the government through negotiation, and industrial action is a last resort.

‘We’re in close contact with the other health unions, and as a group we’ll be looking at all issues relating to the negotiations, including the possibility of industrial action in the event that talks fail to make progress.

‘It doesn’t necessarily follow that a decision to take action by another NHS union means the BMA will take the same action.

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Conservative election poster 2010

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

Circle Health aims to take over Epsom NHS hospital | Society | The Guardian

After running up £38m deficit, hospital trust becomes target for stock market listed company

Randeep Ramesh

A stock market listed company is in the running to take over a failing NHS hospital in Epsom, in a move critics say is part of the government’s “privatisation agenda”.

Circle Health, with a market capitalisation of £120m, has formed a partnership with the Royal Surrey County hospital foundation trust to take over Epsom hospital. Circle, in which employees have a 49.9% stake, has already been named as the preferred bidder to take over Hinchingbrooke hospital trust in Cambridgeshire.

“We are very happy that progressive parts of the NHS are willing to work with us,” said Ali Parsa, the firm’s founder, who argued that his management could achieve “more with less”. He said that only better managers like Circle could hope to ensure the NHS finds £20bn in savings required by the government. “We have shown that we can deliver productivity improvements to the NHS of 13% a year. This is when the NHS sees productivity has fallen by 4% a year.”

The bid emerged just days after the Guardian revealed that the Department of Health had been in talks with a German company to take over NHS hospitals, the first tangible evidence that foreign multinationals will be able to run state-owned acute services, a market worth £8bn.

In 2010 there were 32 NHS trusts identified by the Department of Health as “underperforming” or “under review” – potentially open to private management.

Parsa said that Circle would “love to do a lot more. If we do not have national champions then we are going to let the Germans and the South Africans come in, in a few years’ time. We will have the Wimbledonisation of the NHS, where no British player ever wins. We need British companies to have management control, otherwise decisions are taken in foreign countries. Look at what happened with Cadbury’s. They closed down the factories. We don’t want that in the NHS.”

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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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