National Health Service

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“It’s a tough gig, and here-today gone-tomorrow politicians shouldn’t be able to make decisions that negatively impact on it. The NHS is more important than politics.” — Adam Kay, author of "This is Going to Hurt".ref

The National Health Service (NHS) is the collective name for the four publicly-funded healthcare systems in the UK: NHS England, NHS Scotland, NHS Wales, and Health and Social Care in Northern Ireland. Each is accountable to its relevant government.

Structure

Do some kind of pictorial diagram here, showing how the NHS works. These videos are useful: Oct.2017, Jun.2013, and Jun.2013.

NHS Digital

  • Apr.17.2018: Every hospital tested for cybersecurity has failed. All 200 hospitals and other NHS organisations tested so far have failed cybersecurity checks, according to a report by MPs that finds not enough has been done to protect patients from hackers. All 200 trusts tested on cybersecurity by NHS Digital have failed, the MPs said. Lord O’Shaughnessy, the health minister, said: “We have supported [cybersecurity] work by investing over £60 million to address key weaknesses and plan to spend a further £150 million over the next two years.” Chris Smyth, The Times.
  • Jan.25.2018: ORG slams NHS Digital's data off-shoring plan as a 'dangerous move'. Jim Killock says it could open up patient data for 'surveillance purposes'. NHS Digital this week published guidance for health and care organisations that want to use the public cloud to store patient data - a topic becoming even more important with the impending GDPR legislation. Jim Killock, executive director of the Open Rights Group, said that the off-shoring of sensitive patient data is a "dangerous move" and could have serious ramifications. Killock is especially critical of the UK-USA Privacy Shield arrangement. Carl Leonard, the principal security analyst at Forcepoint, is also sounding the alarm bells. Tom Allen, The Inquirer.

Negligence

  • Feb.06.2018: Jeremy Hunt orders review of medical manslaughter charges. The govt is to review how criminal manslaughter laws apply to medical professionals. The review will report by April and be led by Sir Norman Williams, a former Royal College of Surgeons of England president, who is senior clinical adviser to the health secretary. The Ministry of Justice will also be involved. It will look at any lessons for the professional regulators from the Bawa-Garba case, consider how to clarify the difference between ordinary error and gross negligence manslaughter, and how to ensure mistakes are learnt from rather than covered up. The Times, Kat Lay

IT / Technology

  • Apr.1.2018: GP at Hand app cuts off patients from regular NHS doctor. Patients who sign up for a new service that promises an NHS doctor “in minutes” on their smartphone day or night are being cut off from their usual family doctor. The "GP at Hand" app, which offers remote consultations with doctors, is part of a new wave of online services backed by the NHS. When users sign up in an online process that takes 3 minutes, they are removed from their GP's books and registered to a practice in west London. Babylon Health, the company behind the app, says users are notified of the move in a “prominent disclaimer” during sign-up. GP at Hand is promoted partly as a way to help overstretched doctors, but Dr Jackie Applebee, of Tower Hamlets local medical committee in east London, said it increased their burden. She also accused the app of disrupting NHS funding models by deregistering younger or healthier patients while leaving those with complex problems. GP at Hand patients are being registered to a practice formerly known as Lillie Road Medical Centre. Comments: GP practices in England received £85.35 per weighted patient in the latest fiscal year (ending April 2017), probably much more in London. Those tens of thousands of patients being moved to a different practice is making someone a lot of money. These services are refusing to register the chronically sick, the frail elderly and housebound. Luke Vance Barr, The Times.
  • Feb.07.2018: Computer flaws "cause hundreds of NHS patients to die each year". Experts said that there was “not a word to describe how bad” the computers that hospitals relied upon were. While it was possible to write software that was “correct, safe and secure”, there was little incentive for manufacturers if it was not a precondition of the packages being bought by NHS bodies, they said. The Times, Kat Lay
  • Aug.02.2011: NHS Pulls the Plug on its £11bn IT System. A plan to create the world's largest single civilian computer system linking all parts of the National Health Service is to be abandoned. Instead, local health trusts and hospitals will be allowed to develop or buy individual computer systems to suit their needs. The Commons Public Accounts Committee (PAC) said the £11.4bn programme had proved "beyond the capacity of the Department of Health to deliver" (Margaret Hodge), and that part of the problem had been weak leadership from NHS chief executive David Nicholson. Supplier Computer Sciences Corporation (CSC) has yet to deliver the bulk of the systems it is contracted to supply and has instead implemented a large number of interim systems as a stopgap. Another provider, BT "has also proved unable to deliver against its original contract". Cost to date: £24.4m.
    Oct.2002: The Cabinet Office Department for Health launches the NHS National Programme for IT.
    2006: Accenture, the largest contractor involved, walked out on contracts worth £2bn, writing off £hundreds of millions. Months earlier, US supplier IDX, contracted to provide software in and around London, also withdrew, making a $450m (£275m) provision against future losses from the 2 contracts.
    2007: The govt misses its first deadlines; a report by the King's Fund criticises the govt's "apparent reluctance to audit and evaluate the programme". Oliver Wright, The Independent.

Reform

  • Jan.19.2018: Listen to the Lords: if NHS spending is to rise, reform is non-negotiable. ... The right approach would be to assess the greatest value to be achieved from any limited extra spending for the NHS. The danger is that the question of value is submerged beneath the wish to expand the NHS budget. The key reference point is the Wanless Review in 2002. While some important reforms were introduced in the Blair years, overall, the degree of chance was very limited. In 2007, the Kings Fund concluded that, "thus far the additional funding has not produced the improvements in productivity assumed in the 2002 review". This led directly to the efforts to reinvigorate primary care and focus on quality, under Ara Darzi in 2008 [a]. After the interruption of the Health and Social Care Act 2012, the Five Year Forward View (2014) very much carried forward the Darzi ideas. The Five Year Forward View implementation is moving far too slowly. The report by the House of Lords Committee on the Long-Term Sustainability of the NHS does much better. It advocates that the NHS budget should rise at least in line with GDP beyond 2020. It also notes that "service transformation is at the heart of securing the long-term future of the health and care systems". If NHS spending is to increase, the Lords' Committee offers the best way to do it. Rather than abandoning the reform efforts of the last 15 years, it sees them as essential parts of the NHS future. Reform, Andrew Haldenby
  • [a] https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/228836/7432.pdf

Corruption

  • Jun.03.2018: Cash for patients — doctors take huge kickbacks in rehab scandal. Psychiatrists have been routinely taking thousands of pounds in kickbacks from upmarket private clinics as inducements to refer vulnerable people suffering from addictions. The commissions, which are prohibited under General Medical Council (GMC) rules, are blamed for increasing the cost of private care at a time when NHS treatment is under pressure. Drug-related deaths in the UK are at an all-time high. Undercover reporters from The Sunday Times filmed one psychiatrist admitting that he had been paid a huge sum — estimated to be £50,000 — for referring a single female patient. Some of the kickbacks were paid by the exclusive Life Works clinic, based in Surrey, owned by the Priory Group. A number of British doctors are also said to have been paid one-off fees of 25,000 Swiss francs (£19,000) for referring patients by the Kusnacht Practice, a clinic for multimillionaires based in Switzerland. Whistleblowers have disclosed that the Kusnacht clinic handed out an enormous reward fee — estimated to be at least £150,000 — to the UK-based medical professional who referred the late singer George Michael to the practice two years ago. The clinic is understood to have charged the singer £1.5m. Dr Bhaskar Punukollu, at his consulting room in the private Nightingale Hospital in central London. Dr Filippo Passetti, a consultant psychiatrist based in Harley Street. Dr Marios Pierides, a London-based psychiatrist. Jonathan Calvert, George Arbuthnott, Michael Selby-Green, Paola Tamma and Tom Wills, The Sunday Times. See also Cash for patients: desperate addicts remortgaged homes, middlemen cashed in.
  • Jan.26.2012: NHS reform leaves Tory backers with links to private healthcare firms set for bonanza. THE private health bosses set to profit from the Tory NHS shake-up are today unveiled as party donors. Findings come as ministers reveal reforms which could kill off the NHS. A Mirror investigation can today reveal private health firms set to cash in on Conservative plans to rip apart the NHS have poured a fortune into the party. The tycoons, who have made huge sums from the healthcare industry, have donated around £750,000 since David Cameron became leader. Hedge fund boss John Nash is one of the major Conservative donors with close ties to the healthcare industry. He and wife Caroline gave £203,500 to the party over the past five years. The cash included £21,000 which was given directly to Health Secretary Andrew Lansley to bankroll his office before the Conservatives took power. At the time the Lib Dems slammed the payments as a “staggering conflict of interest”. The City tycoon was chairman of Care UK plc, which makes most of its money from the NHS, when most of the donations were made. Mr Nash continued to work as a consultant to the firm, which provides walk-in centres, GP surgeries and other specialist services, after selling his majority stake to a private equity firm last year. The “hedgie” is also a founder of City firm Sovereign Capital, which runs a string of private healthcare firms. Fellow founder Ryan Robson is another major Tory donor who has given the party £252,429.45. His donations included £50,000 to be a member of the party’s “Leader's Group”, a secretive cash-for-access club. The would-be MP, who tried but failed to get selected as the election candidate in Bracknell, is managing partner at Sovereign Capital. The healthcare firms it is involved with include Choice Care Group and Christchurch Court, which provide specialist and residential care and City & County Healthcare, which provides help to vulnerable people. Sovereign also runs the Complete Group, which cares for adults and children, Eden Supported Housing, the National Fostering Agency, RehabWorks, Select Living Options and Tracscare. Nursing and care home tycoon Dolar Popat has given the Conservatives £209,000. The Ugandan-born dad-of-three has amassed an estimated £42m fortune as founder and chief of TLC Group, which provides services for the elderly. Mr Cameron made the businessman a peer shortly after entering No.10 in May.2011, and Lord Popat’s donations include a £25,000 gift registered a week after the Tories’ health reforms were unveiled in Jul.2011. IC Technology, which provides computer services to the NHS, has handed the Tories £70,000 over the past two years. Philip Scott, chief of the Priory Group, has donated £20,000. The famous Priory Clinic is private but Mr Scott has revealed in the past most of its income comes from NHS or local council referrals. Balding Mr Cameron also got money from an up-market firm treating hair loss. The Trichological Clinic Ltd, which operates out of Harrods, gave the Conservatives £10,000 last year. Senior Tories who helped formulate the party’s health policy in Opposition have had links to private firms. Shadow minister Stephen O’Brien's office received 3 payments totalling £40,000 from Julian Schild. Mr O’Brien was moved to International Development after the election. A second shadow health minister Mark Simmonds accepted a US trip to Boston worth £4,512 from private health provider BUPA. Simmonds missed out on a ministerial job in the govt. The Conservative Party insisted private donations do not influence policy-making decisions. James Lyons, The Mirror.

Outsourcing

  • Jun.02.2018: Labour consults on plan for major NHS restructuring. Jon Ashworth says Labour will flesh out how it would dismantle Andrew Lansley’s structural NHS reforms to bring more health provision back in-house, in a wide-ranging consultation on NHS restructuring under a future Labour govt. The party is committing for the first time to a wholesale restructure of the health service. Former Conservative health secretary Lansley generated controversy when he introduced sweeping reforms in his Health and Social Care Act 2012. The reforms saw primary care trusts disbanded and new clinical commissioning groups buying and providing local healthcare services, with NHS contracts opened to the voluntary and private sectors. “But these structures are not fit for purpose, over the coming months I want to consult on how we move to an NHS based on partnership and planning where privatisation is banished and we restore a universal public NHS." The Nuffield Trust said Labour should tread cautiously in embarking upon a radical restructure. The outsourcing of a number of NHS services has come under scrutiny in recent months. Last month, a National Audit Office report found that the outsourcing of primary care support services to Capita had put patients at risk and that Capita was incentivised through the contract to close existing services to minimise its losses. The NAO said the arrangement had led to widespread failure of service delivery. May is expected to announce an increase for the NHS budget for the next few years; and is under pressure from some cabinet ministers including the health secretary, Jeremy Hunt, to commit to around 4%-a-year increases for the rest of the parliament. Jessica Elgot, The Guardian. NAO report is here, May.17.2018.

Privatisation Agenda

This should have its own page, with a timeline. Michael Moore's documentary on how the American #FatCats are licking their chops over the NHS: link > http://watchdocumentaries.com/sicko/

  • Jul.10.2020: Boris Johnson plans radical shake-up of NHS in bid to regain more direct control. Health secretary Matt Hancock is said to be frustrated by his lack of authority over NHS England boss Simon Stevens. The proposals will restrict NHS England’s operational independence and the freedom Stevens has to run the service. Dominic Cummings' health adviser, health adviser,. is a member of the taskforce. Denis Campbell, '.
  • Oct.20.2019: How Bio Products, our blood plasma supplier, ended up with China. There was an outcry when Dan Poulter, a Tory health minister, agreed to sell Britain’s supplier of blood plasma to private equity firm Bain Capital. At the time (2013) Bain promised to transform the Hertfordshire-based company into a “life sciences champion”. But 3 years later, Bain sold it on to a Chinese buyer. Now America’s foreign investment watchdog has raised an alert over its new owner — and demanded that Bio Products Laboratory (BPL) sell off its US division, which collects blood plasma from donors. NHS patients have relied on blood plasma from America since 2002, after fears that some British blood was contaminated with a harmful protein. In 1975, Lord (David) Owen decided the NHS should take control of its own supply and took what was then Plasma Resources UK into public ownership. In 2002, after contamination fears, the Department of Health bought an American blood plasma collection business, DCI Biologicals. After Creat bought BPL, it snapped up a German plasma supplier, Biotest AG. At this point the Committee on Foreign Investment in America decided to act. It was concerned about Creat’s access to the personal data of donors and receivers — and demanded swift action. Sabah Meddings, John Collingridge, The Times. See "Letters: Clarity on blood plasma " here
  • Jan.07.2019: NHS chiefs tell Theresa May it is time to curb privatisation. Document demands repeal of 2012 legislation on automatic tendering of care contracts. Simon Stevens, chief executive of NHS England, demands that the prime minister repeals significant key sections of the Health and Social Care Act 2012. The document warns that the legislation, which was pushed through by then health secretary Andrew Lansley despite huge opposition, is damaging the NHS and stopping it from making vital improvements to the care patients receive. It outlines how Lansley’s shake-up has damaged the NHS, which May has previously acknowledged. The Act obliges NHS Clinical Commissioning Groups in England to tender out any contract worth £615,278 or more. This has led to a huge increase in the number of contracts awarded to profit-driven firms such as Virgin Care and Care UK. An estimated £8.7bn of the health service budget went to non-NHS providers of care in 2017-18. The British Medical Association urged May to heed the NHS leaders’ plea. Denis Campbell, The Guardian.
  • Dec.20.2018: Public health budgets to tackle causes of early death slashed by £85 million. On the last day that parliament sat this year, the govt let slip that public health budgets for local authorities will be slashed by £85m next year, as it quietly announced the 3.3% cut for 2019/20. The Mental Health Foundation: “This is the latest year-on-year cut as part of the govt's plan to reduce the size of the public health grant by an average of 3.9% in real terms every year until 2020. Martin Bagot, The Mirror.
  • Dec.15.2018: The private A&E will see you right now. Private casualty units have begun targeting families fed up with lengthening waits at NHS accident and emergency departments. The market for private treatment for non-urgent operations is worth more than £5 bn. The Times disclosed this week that rising NHS waits for surgery are pushing more patients to pay for their own care. Such spending is up more than 50% in 5 years. HCA, BMI, Casualty First is leafletting local homes. LaingBuisson provides intelligence on the private healthcare business. The Department of Health said "Word Salad". Chris Smyth, The Times.
  • Sept.05.2018: Labour criticises Tories over key NHS roles going to party peers. Labour has criticised the growing number of Conservative politicians being handed key jobs in the health service. Lord Prior of Brampton will become the 3rd Tory member of the House of Lords in an influential position in the NHS when he takes up the role as Chair of NHS England in Nov.2018, subject to approval from MPs. He will work closely with Simon Stevens, the organisation’s chief executive, a former Labour special adviser on health, as it prepares to unveil its 10-year plan for how it will spend the £20.5bn extra funding Theresa May announced in June. Prior has previously said private healthcare firms should be allowed to take over struggling NHS hospitals and suggested the service’s basis as a tax-funded service might have to be rethought. Dido Harding, a Tory peer, businesswoman and friend of David Cameron, is the chair of NHS Improvement. Lord Ribeiro, a former president of the Royal College of Surgeons, is the chair of the Independent Reconfiguration Panel, a group of experts that advises the health and social care secretary, Matt Hancock, on which hospital units should close as a result of NHS plans to improve care. The British Medical Association also voiced unease. ... Liberal Democrat MP Norman Lamb, a former health minister, defended the move. Denis Campbell, The Guardian.
  • Aug.02.2018: Demise of small GP surgeries helps patients, says health chief. Arvind Madan, NHS England’s head of primary care, says the end of small GP surgeries could be good for patients, and that the amalgamation of small, independent practices into bigger groups should be welcomed. In all markets there is some degree of difficulty for a proportion [of them]. He said that practices should take up the opportunity created to be part of new primary care networks covering 30,000 to 50,000 patients, which were made up of larger teams that included nurses, pharmacists and mental health workers. His comments were criticised by GP union leaders. The British Medical Association’s GP committee deputy chairman, said: “Small practices are often delivering the best standards of care to patients, who are seeing the same doctor who is embedded within the community and has a detailed knowledge of individuals’ medical history. Michelle Drage, chief executive of Londonwide local medical committees (LMCs), said: “For general practice to do ‘everything you would want for your family’ it shouldn’t be placed in a market. Market success or failure should not be the measure by which we judge it.” Rachel McMahon, chairwoman of the England Conference of LMCs, said “My personal opinion is that the highest levels of patient satisfaction seem to be from patients who are registered with smaller practices, as they are able to experience a more personalised service.” But it's not so easy to privatise small surgeries. Kat Lay, The Guardian.
  • Jul.19.2018: Tory underfunding has FORCED the overstretched NHS to privatise £1 BILLION of urgent care as a last resort. Private firms have cashed in to the tune of £1Billion due to overstretched hospitals being forced to outsource and privatise urgent services as a last resort. In what is an alternate guise for the gradual privatisation of the NHS, it appears that due to the woeful underfunding imposed by the Conservative government, NHS Trusts and hospitals are having – through sheer desperation – to pay (and often to overpay) private companies to provide essential services, which the NHS is too stretched to provide itself. Often, it is hip and knee surgery, where prospective patients are sent to private clinics. The decisions are usually taken as a last resort, where the alternative would be to cancel the care. The state of affairs is yet another example of the false economy at the heart of Tory policy. The news follows on the back of the recent £20bn spending boost announced by May for the NHS – too little, too late. Indeed, the National Audit Office stated that the boost is nowhere near enough to satisfy the NHS’ financial needs. Furthermore, the so-called ‘Brexit dividend’, which was supposed to fund the spending increase, has been revealed for the thin mist it is by the Office for Budget Responsibility. It is a dire situation that, disgusting, the new pro-privatisation Health Secretary, Matt Hancock, will be extremely happy with – especially given that Hancock is only really doing the bidding of privateers, having received £tens of thousands in donations from the Chairman of an organisation who literally want to abolish and privatise the NHS. William J Richardson, Evolve Politics.
  • Jul.04.2018: A Labour MP just nailed why the Conservatives looked so peculiar at PMQs. ... ... Since the Conservatives came to power in 2010, they have systematically – and some would say intentionally – brought the NHS to its knees. The Conservative-led government introduced legislation in 2012 that has allowed private companies to scoop up the most profitable parts of our health system, and be paid for it handsomely with our taxes. Of course, that profit goes into some fat cat’s wallet, rather than back into the health system. Meanwhile, the Conservatives have starved the NHS of adequate funds, forcing numerous trusts into financial trouble. Conveniently for private providers, this makes the NHS unable to stump up competitive bids on service contracts. In fact, it’s seemingly struggling to provide some services at all. Recently, the NHS revealed it’s considering axing 17 routine procedures, including tonsil removal, except in certain cases. So Burgon called it right. The Conservatives voted against the NHS 70 years ago. And their actions suggest they want rid of it today, despite donning badges at PMQs. Tracy Keeling, The Canary.
  • Aug.24.2017: Outsourcing firm and US healthcare insurer team up to run STP. The Nottingham and Nottinghamshire STP (Sustainability and Transformation Partnerships) has awarded a £2.7m contract to Capita to help turn the STP into a more formal health body in charge of local budgets and healthcare – because it said it did not have the expertise in-house. The deal is part of the STP's development into an ACS (Accountable Care System) which would take control and responsibility of budgets and commissioning for the entire population of the area. Capita has handed large parts of the contract, which runs during this financial year, to Centene UK, which is part of the major US healthcare insurer Centene Corporation – a firm with the strapline "better health outcomes at lower costs". BMA News understands Capita will mainly be involved in the "assurance" work necessary but Centene will be the "boots on the ground" in developing the ACS. The latest developments for the STP programme – which began last year and saw England carved into 44 areas for local leaders to drive care improvements and savings – was announced by NHS England chief executive Simon Stevens at the NHS Confed 17 event in Liverpool earlier this Summer. The process in Nottingham was driven by NHS England who told areas across the country they needed to be partnered with organisations across the world who had experience of delivering major changes similar to the ACS process. Nottingham’s ACS lead Stephen Shortt described the move as "a unique opportunity". British Medical Assocation.
  • Jul.27.2017: Labour demands inquiry into privatisation of NHS-owned recruiter. Labour Party argues NHS Professionals, which helps NHS England avoid gaps in rotas and saves £70m per year, should be kept in public hands. Labour has asked the National Audit Office to look into why Jeremy Hunt is selling a profitable and effective company the Department of Health owns. Staffline The Guardian, Denis Campbell
  • Jun.03.2015: NHS regulators to take over health services in three English regions. NHS regulators are to take control of health services in three entire regions of England where hospitals are failing: Essex, North Cumbria and Northern, Eastern and Western Devon. Key NHS bodies and regulators will impose a newly-devised and euphemistically named “success regime” on the three parts of the country, and push through determined action to ensure hospitals, GP surgeries and other NHS service providers work together much more closely to tackle deep-seated problems which previous initiatives have failed to banish. Monitor, NHS Trust Development Authority. Denis Dampbell, Diane Taylor, The Guardian.

2016 / 2015

  • Mar.27.2015: The 'ninja' NHS privatisers you've never heard of... The Strategic Projects Team (SPT), a shadowy organisation initially set up within the NHS to design the Hinchingbrooke deal. Co-founder Stephen Dunn said "Change is a combat sport.". Peachy, when you're playing with other people's lives and money. However, their list of failed projects is long: On the back of Hinchingbrooke, SPT started open competitions to ‘franchise out’ the running of both George Elliot Hospital in Nuneaton, and the Weston in Weston-super-Mare, with companies like Care UK and Circle throwing their hats into the ring. Both projects resulted in expensive U-turns with the planned sell-offs being abandoned - but only after a £million had been spent on administering the process, in George Eliot’s case. The SPT was also behind the beleaguered privatisation of pathology services around the country; and the friends and family, designed by MacPherson and Dunn, rolled out across the NHS at huge cost, and slammed as ‘inappropriate’, ‘unreliable’ and highly questionable as a measure of patient experience. When not trying to flog hospitals off - of which more later - SPT has also been ‘intervening’ in hospitals, as in Bedford, which has recently lost services to both Circle and US health giant, UnitedHealth Group. SPT appear not to have spent any time reflecting on the aborted privatisations of Hinchingbrooke and elsewhere, their costs, or consequences. As a speaker from SPT’s law firm and last night’s hosts, Wragge & Co, said: ‘Business doesn’t research things to death’. If it doesn’t work, bin it, move on. SPT was originally set up by senior NHS officials in the East of England, a pioneer region when it comes to private sector involvement in the NHS (and coincidentally home to Andrew Lansley’s Cambridge constituency). They provided the 'air cover' for SPT’s controversial operations. SPT’s other co-founders are Sir Neil McKay, now with healthcare industry consultants GE Healthcare Finnamore, although at the same time still advising a ‘local NHS body in the Midlands’; and Andrew MacPherson, current SPT managing director. MacPherson’s background is in customer services in the transport business. His experience of the NHS prior to running SPT was as a non-exec director of his local hospital. Dunn has since moved on to the Trust Development Authority, where he helped decide the fate of many other small hospitals like Hinchingbrooke. More recently, he was given his own one to run, his local hospital in West Suffolk, where he says he is ‘very keen to see if we can create a Kaiser Permanente-type organisation’, referring to the US health insurer’s model. Big contracts are now up for grabs, with SPT running the bidding process - but to whom do they answer? more... Tamasin Cave, SpinWatch.

2014 / 2013

2012 / 2011

  • Jan.19.2011: NHS reform leaves Tory backers with links to private healthcare firms set for bonanza. The private health bosses set to profit from the Tory NHS shake-up are today unveiled as party donors. Private health firms set to cash in on Conservative plans to rip apart the NHS have poured a fortune of over £750,000 into the party since David Cameron became leader.
    Hedge fund boss John Nash donated £203,500 over the past 5 years. The cash included £21,000 which was given directly to Health Secretary Andrew Lansley to bankroll his office. Nash was chairman of Care UK plc and continues to work as a consultant to the firm. After selling his majority stake to a private equity firm last year. He is also a founder of City firm Sovereign Capital, which runs a string of private healthcare firms.
    Fellow founder Ryan Robson is another major Tory donor who has given the party £252,429.45. His donations included £50,000 to be a member of the party’s “Leader’s Group”, a secretive cash-for-access club. The would-be MP, who tried but failed to get selected as the election candidate in Bracknell, is managing partner at Sovereign Capital. The healthcare firms it is involved with include Choice Care Group and Christchurch Court, which provide specialist and residential care and City & County Healthcare, which provides help to vulnerable people. Sovereign also runs the Complete Group, which cares for adults and children, Eden Supported Housing, the National Fostering Agency, RehabWorks, Select Living Options and Tracscare. Nursing and care home tycoon Dolar Popat has given the Conservatives £209,000. Popat has amassed an estimated £42m fortune as founder and chief of TLC Group, which provides services for the elderly. Mr Cameron made Popat a peer shortly after entering No.10 in May.2010, and Lord Popat’s donations include a £25,000 gift registered a week after the Tories’ health reforms were unveiled last July.
    IC Technology, which provides computer services to the NHS, has handed the Tories £70,000 over the past two years. Philip Scott, chief of the Priory Group, has donated £20,000. The famous Priory Clinic is private but Mr Scott has revealed in the past most of its income comes from NHS or local council referrals.
    The Trichological Clinic Ltd, which operates out of Harrods, gave the Conservatives £10,000 last year.
    Shadow minister Stephen O’Brien’s office received 3 payments totalling £40,000 from Julian Schild. Mr Schild’s family made £184m in 2006 by selling hospital bed-makers Huntleigh Technology. Mr O’Brien was moved to International Development after the election. And shadow health minister Mark Simmonds accepted a US trip to Boston worth £4,512 from private health provider BUPA. Mr Simmonds missed out on a ministerial job in the govt. James Lyons, The Mirror.
  • Jan.17.2011: David Cameron accused of destroying NHS with privatisation plans. In a key speech today, the PM will say he wants more "competition" and "greater independence" for hospitals and schools. And in a worrying sign for thousands of workers, David Cameron is to claim he wants "one of the great legacies of this govt to be the complete modernisation of our public services". Strategic Health Authorities and Primary Care Trusts will be axed. But a report by the NHS Confederation which represents doctors, administrators and medical groups, said the reforms were "extraordinarily risky". The Mirror, Jason Beattie

Agenda for Change

Agenda for Change (AfC) is the current National Health Service (NHS) grading and pay system for NHS staff, with the exception of doctors, dentists, apprentices and some senior managers. It covers more than 1 million people and harmonises their pay scales and career progression arrangements across traditionally separate pay groups, in the most radical change since the NHS was founded.

Pay Cap

  • Jun.08.2018: A million NHS workers agree to pay rise worth 6.5% over three years. Members of 13 unions in England accept deal to end 1% pay cap but GMB rejects it. Only the GMB’s NHS members voted against the deal, by almost nine to one. The health secretary, Jeremy Hunt, said the “incredibly well-deserved pay rise” would amount to up to 29%, with some of the biggest increases for the lowest paid. The Guardianname=Haroon Siddique.
  • Mar.23.2018: Why the govt's pay rise for NHS workers is barely a pay rise at all. After 7 years, the govt have finally lifted the NHS pay cap. Pay was frozen for 2 years from 2011, and increases have been capped at 1% since. Over the period, inflation has whittled away at the real terms value of pay; a nurse today is paid 10% less in real terms than 2011, an eye-watering pay cut of £3,214. Following years of campaigning and months of negotiations, more than a million NHS staff have been offered a 6.5% pay rise over 3 years. As IPPR have shown, the pay cap has contributed to a growing NHS workforce crisis – that the govt could no longer ignore. The govt simply could not afford to continue the pay squeeze any longer. While the headline cost of the deal is large – £4.2bn – IPPR analysis shows nearly 50% is returned to the Treasury almost immediately in higher tax receipts and lower welfare spending. In addition to securing this pay rise, the NHS trade unions have secured additional funding to pay for it. However, this is only a partial victory. (...) Joe Dromey, The New Statesman.

Paying for Treatment

In Apr.2015, changes were made to the way the NHS charges overseas visitors for NHS hospital care. These changes also affect some former residents of the UK. The changes were made so that the NHS does not lose out on income from migrants, visitors and former residents of the UK, who may be required to pay for their hospital treatment costs while in England.
Within England, free NHS hospital treatment is provided on the basis of someone being ‘ordinarily resident’. It is not dependent upon nationality, payment of UK taxes, national insurance contributions, being registered with a GP, having an NHS number or owning property in the UK. The changes which came into effect from April affect visitors and former UK residents differently, depending on where they now live.
Treatment in A&E departments and at GP surgeries remains free for all.

  • Jan.22.2019: Dying man given bill for tens of thousands of pounds for NHS treatment. Before 2017, migrants and visitors to the UK not eligible for free healthcare were entitled to receive it and be billed afterwards. But 2 years ago, in a bid to eliminate so-called "health tourism", the Conservative govt introduced new regulations. These require NHS Trusts in England to charge refused asylum seekers, those who have overstayed their visa, certain EU citizens and those from Iceland, Liechtenstein, Norway and Switzerland who are not studying or working for most healthcare. They can still see a GP free of charge, but they must pay up to 150% of the cost of their hospital care before they can be treated. Sarah Johnson, '.

Cost of Drugs

  • May.28.2018: Clamp down on overpriced drugs, NHS bosses told. The NHS is being urged to overhaul the way it pays for unlicensed medicines after The Times revealed that Boots billed taxpayers £3,220 for a mouthwash used by cancer patients that can cost £93. The NHS is overpaying a range of suppliers by up to £30m a year for medicines known as "specials" that are prescribed for non-standard treatments. NHS records show that the owner of Boots has charged up to £3,220 for a pain-relieving mouthwash for cancer patients after sourcing them from a sister company. The equivalent quantity of the bespoke mouthwash has been bought by other pharmacists for £93.42. The Times previously revealed how Boots billed the NHS £1,579 for a pot of moisturiser that other pharmacies obtained for less than £2. The government has referred the findings to the Competition & Markets Authority. A spokeswoman for the Pharmaceutical Services Negotiating Committee, which represents the industry, said: “[The committee] would support in principle an extension of [the specials] section of the drug tariff. We do not support excessive pricing.” On Saturday Steve Brine, the care minister, said: “The public will take a dim view of any company found to be exploiting our NHS. Where there is evidence of collusion between pharmacies and suppliers, action will be taken and offenders penalised.” Walgreens Boots Alliance Inc denied overcharging and said it complied with the law. Paul Morgan-Bentley, Billy Kenber, The Times.
  • Apr.12.2018: Non-profit’s $300 hepatitis C cure as effective as $84,000 alternative. Hepatitis C is a blood-borne viral infection that can lead to liver cirrhosis, cancer and death. US drugmaker Gilead Sciences's Harvoni tablet is too expensive for govts to roll out mass hepatitis C treatment programmes. Gilead has come under pressure from US rival AbbVie Inc, which launched a new hepatitis C medicine, Mavyret, last year with a shorter, 8-week treatment course at $26,400. DNDi costs $300 for 12 weeks = $3,600. The UK has an estimated 215,000 hepatitis C cases. Julia Kollewe, The Guardian.

NHS Trusts

  • NHS trustWikipedia-W.svg,
    See main article: NHS Trusts
    (todo)
  • Established under the National Health Service and Community Care Act 1990, and were set up in five waves.
  • The trusts are effectively public sector corporations.
  • The trusts are regulated by NHS Improvement.
  • Each trust is headed by a board consisting of executive and non-executive directors, and is chaired by a non-executive director. Starting in Nov.2014, board members are subject to a Fit and Proper Person test. All trust boards are required to have an audit committee consisting only of non-executive directors, on which the chair may not sit. Hospital board members have a duty to act on signals of poor performance on quality and safety data, and yet many of the papers presented to them have been found to be lacking good data visualisations.[2]
  • Sept.2015: Jeremy Hunt: "I think we do have too many trusts as independent organisations", where mergers between trusts and the establishment of chains of hospitals were being discussed.[3]
  • Oct.2015: Simon Stevens ... he did not expect the remaining NHS trusts to become Foundation Trusts; "We are frankly kidding ourselves if we think the non-FTs are going to pass the kinds of criteria that have been set by Monitor".[4]
  • There are several types of NHS trusts: Foundation, Acute, Ambulance, Mental Health...
  • 2013: Under the old system there was a wide range of NHS trusts – such as acute trusts, ambulance trusts, and mental health trusts – that managed NHS hospital care in England, including community care and mental health services. Today most of these services are provided through NHS foundation trusts and NHS trusts providing ambulance services, emergency care services, or mental health services.[5]
  • Apr.16.2018: Hospital Trusts accused of ‘backdoor privatisation’. Hospital trusts are spending £millions setting up arm’s-length private companies, which health unions fear will turn staff transferred into them into “second-class employees”. 15 trusts in England have already spent £3.2m between them creating wholly owned subsidiaries. 19 NHS Trusts have already set up at least one wholly owned subsidiary, eight of which have had an estimated 3,000 staff – mainly cleaners, porters and maintenance workers – moved into them. At least 16 other Trusts are considering doing the same with 5,000 more personnel. Such firms can bring tax and VAT benefits for trusts that set them up. Linkback: Unison, Jonathan Ashworth, NHS Providers. Denis Campbell, The Guardian. See also The Guardian, Feb.14.2018

Accountable Care Organisations

  • aka ACOs
  • Currently in NHS Reform; this lot should go in there too.

Jeremy Hunt and NHS England want to turn local NHS bodies into ACOs.

  1. ACOs will be given the money for your care as an insurance premium, and will pay out only for certain treatments, like an insurance company.
  2. ACOs will in many cases be handed over to actual insurance companies and other private firms.
  3. ACOs will be able to decide what care is free and what they can charge patients for.
  4. ACOs will be paid more if they "save" money, ie. spent less money on front-line services.
  5. ACOs wil be subject to commercial rules and will hide behind the veil of "corporate confidentiality".
  6. ACOs are not recognised in any Act of Parliament and as such have no legal basis.

In other words, they are not "accountable" and their primary focus is on profit rather than patient care. Their introduction, if successful, will mean we no longer have a National Health Service.

Sustainability and Transformation Partnerships

See main article: NHS Reform#Sustainability and Transformation Partnerships


General Practitioners

In the medical profession, a general practitioner (GP) is a medical doctor who treats acute and chronic illnesses and provides preventive care and health education to patients.

General Medical Services

GMS describes the range of healthcare provided by GPs (family doctors) as part of the NHS. The NHS specifies what GPs, as independent contractors, are expected to do and provides funding for this work through arrangements known as the General Medical Services Contract. The GMS contract is a UK-wide arrangement with minor differences negotiated by each of the four UK health departments. A new contract is issued each year. Good timeline in here

Personal Medical Services

Apart from GPs in the GMS, primary care is also provided through Personal Medical Services (PMS) and Alternative Provider Medical Services (APMS) contracts. See Review of PMS Contracts, NHS England, Feb.2014.

  • May.17.2018: Previously ‘Outstanding’ GP surgery which the Tories privatised and handed to Virgin Care now in ‘Special Measures’. Sutherland Lodge Surgery in Chelmsford, Essex, was rated as outstanding. Then, the Tories cut its Personal Medical Services funding by £400,000, forcing its GP partners out. Virgin Care took over and, 18 months later, the Surgery has been rated inadequate by the Care Quality Commission. In the private hands of Virgin Care, Sutherland Lodge Surgery has seen the standard of care dispensed within its four walls disintegrate. To make the failures all the more despicable, Virgin Care has wrought this degradation while receiving more funding than under the previous contract, which it took over from. Following an FoI request by GPonline, it has transpired that the contract value of the deal awarded to Virgin Care is 14% higher than the previous arrangement. William J Richardson, Evolve Politics.

Articles

  • Jan.07.2019: What is the NHS long-term plan and can it achieve its aims? Despite extra funding, central idea of plan for NHS England is to do more with less. Stevens is attempting a gradual transformation of the NHS – a tightening up and smartening up. He wants to dump the Lansley free market reforms. But the biggest problem, worsened by Brexit, will be staffing. Sarah Boseley, The Guardian.

2018

  • Jun.13.2018: NHS Chiefs are needlessly handing Tax Avoidance Advisors £Millions in vital NHS funding. These outfits are not providing healthcare services - even though they claim to. They are not even providing the worker. If the actual healthcare worker contracts directly with the NHS, then this can be a healthcare service. Essentially, the NHS has contracted with these companies, who then assume the 'employer role' (contrived) - then the NHS forces their contractors to work through these companies- then they claim to provide a healthcare service. A bit more complicated than this (its meant to be so as to confuse), but essentially it doe not work in law. BTW, they also use these to avoid paying deemed employer taxes i.e employer NI & apprenticeship levy- this is paid by the healthcare worker on top of their own taxes- despite being avoid deemed employee. Comments section. William J Richardson, Evolve Politics.
  • May.30.2018: Million patients hit by closure of GP surgeries. More than a million patients have been forced to change GP surgery in the past five years, with closures up tenfold as family doctors abandon the NHS. Jeremy Hunt, the health secretary, has promised to recruit an extra 5,000 GPs by 2020, saying that hospitals will be overwhelmed if the NHS does not get better at looking after elderly people locally. However, more than 1,000 family doctors have been lost since he made his pledge. ... GPs are typically independent contractors paid by the NHS for each patient they look after. As older, sicker patients need a doctor more often, this model has become less viable and Mr Hunt has conceded GPs are on a “hamster wheel of 10-minute appointments, 30 to 40 of them every day, unable to give the care they would like to.” A spokeswoman for NHS England said: “More than 3,000 GP practices have received extra support thanks to a £27m investment over the past 2 years ... blah blah blah". Chris Smyth, The Times.
  • Jun.02.2018: Hospitals are massively overspending. But more money is not the answer. The stated £1bn deficit is probably closer to £4bn. Yet a radical rethink of the system is needed – not more quick-fix cash bungs. Nuffield Trust and Health Foundation analysis shows that between 2010 and 2017, the number of patients having to be readmitted to hospitals in England within 30 days rose by more than 19% – from 1.16 million to 1.38 million. Even more worryingly, they identified a 41% rise in emergency readmissions for potentially preventable problems such as blood clots, pneumonia and pressure sores. These figures suggest that the NHS is now locked in a cycle of hugely overworked staff making avoidable mistakes, which in turn create more demand – and more pressure. Against this backdrop there are moves to raise the threshold for some surgical procedures. The draft policy on hip replacement, for example, says it will be restricted to patients whose osteoarthritis is having a substantial impact on their quality of life – and who have not responded to treatments such as painkillers, exercise, physiotherapy and losing weight. No amount of cash should be allowed to distract from the hard truth that the only way to ensure the financial and clinical sustainability of the NHS is continuing and accelerating the slog of system reform begun almost 4 years ago with the Five Year Forward View. Richard Vize, The Guardian.
  • Apr.18.2018: ‘Having leg amputated was my best decision’. Hannah Moore, 21, had her right leg cut off below the knee two years ago after an ingrowing toenail when she was 15 caused sepsis and left her in excruciating pain and using a wheelchair. Ulcers formed on her foot and despite 50 operations and numerous skin grafts they would not heal. The NHS would not amputate so her family paid for a private operation. The Times.
  • Apr.15.2018: Girls of 12 get birth control on NHS. Figures from NHS Digital — the IT arm of the NHS — show 10,600 girls aged 16 or under had implants fitted in 2015-16 and 2016-17; 39 were aged 12 or under. The devices, implanted in the upper arm for up to 3 years, provide a supply of the hormone progesterone to block egg release. Patient confidentiality rules mean no parental consent is needed. In some areas of the country the devices are being fitted in schools. This has sparked criticism that the NHS is enabling young girls to have illegal, underage sex without their parents’ knowledge, exposing them to the risk of exploitation. Sir Roger Gale, Tory MP for North Thanet in Kent where the implants are offered in schools, said: ‘We have to remember that the child is having underage sex and that is against the law ... When you start dishing them [implants] out like Smarties in schools I think that is a very bad idea.” Norman Wells, director of the Family Education Trust, said: “The govt needs to wake up to the fact that a casual attitude towards underage sex is exposing children and young people to the risk of sexual exploitation.” Natika Halil, chief executive of the Family Planning Association charity, said it was “vital” for under-16s to be able to access advice about sexual health. Mary O'Connor, The Times.
  • Apr.11.2018: Health experts call for ‘Chilcot-style inquiry’ into excess prescription drug deaths. Leading British health experts are calling for a Chilcot-style inquiry into why they say tens of thousands of people continue to die every year through the overprescription of drugs. In Nov.2017, a Cambridge University study found 50% of over-65s take at least five drugs a day. Many scientists are compromised by the grants they rely on from pharmaceutical companies, the experts argue. Between 2009-14 "Big Pharma", including companies such as GlaxoSmthKline, was given $13bn in fines for criminal behaviour including hiding data on harms of drugs and manipulating results. The medics are also calling for a complete overhaul of “misinformed” national dietary guidelines they say is actually fuelling the obesity crisis. Dr Aseem Malhotra said "I have slowly and reluctantly come to the conclusion that honest doctors can no longer practice honest medicine. Poor quality research, influenced by vested interests has resulted in an epidemic of misinformed doctors and misinformed patients leading to poor clinical outcomes and the unwitting practice of unethical medicine due to the lack of transparency in the prescription of medications, which are now estimated to be the third most common cause of death after heart disease and cancer. As there are so many commercial influences throughout the system that are hindering progress in revolutionising medical care, I think there needs to be a Chilcot-style inquiry to resolve this issue as a matter of urgency." Linkback: Obesity, Big Pharma, Misinformation, Dr Peter Wilmshurst. Paul Gallagher, The iNews.
  • Apr.06.2018: NHS failure is inevitable – and it will shock those responsible into action. As performance deteriorates, correcting the failures of yesterday becomes the first requirement of today, leaving even less time and fewer resources to deal with today’s problems, which continue to be more than the NHS can handle. So the rate of decline accelerates. And breaking points appear. As facilities and staff are stretched further and further, continuing to provide a service but an ever more inadequate one, they eventually reach a point where there is no more slack and the NHS simply runs out of capacity. Jan Filochowski, The Guardian.
  • Mar.31.2018: Drug firms must give £33m of profits to NHS. The govt is to claw back up to £33m a year by requiring manufacturers of all branded medicines to return almost 8% of the net income from sales to the NHS. This includes Gilead, which makes breakthrough hepatitis C treatments that have shown a high success rate in curing the disease without causing the damaging side-effects of other drugs. Despite the effectiveness of the new drugs, because of their high cost NHS England has limited the number of hepatitis C patients that can be treated to 10,000 a year. A 12-week course of one Gilead drug, Sovaldi, has a list price of almost £35,000. Lord O'Shaughnessy, a health minister, said that the changes would "keep costs down and ensure patients have access to medicines at a price we can afford". Billy Kenber, The Times.
  • Mar.23.2018: More cash will force the NHS to address tougher questions than money. Hopes are rising for a solution to the funding crisis, but investment must be used to reshape the health service not perpetuate inefficiency. NHS trusts are running an underlying deficit in the region of £3.7bn. Many hospitals are beset with serious inefficiencies. The drive for integration is bringing further wastage in time and money as each local area tries to bend legislation designed for fragmentation and competition towards collaboration. This is spawning an ever more complex array of Heath Robinson legal structures, which even lawyers specialising in this field find tortuous and opaque. It could even provide an opportunity to dispense with the purchaser/provider split. Richard Vize, The Guardian.
  • Mar.19.2018: Official figures mask A&E waits. Doctors and MPs called for a change to how "trolley waits" were reported in England after an investigation by The Times. Official numbers show that 2,770 A&E patients had to wait more than 12 hours for a bed last year. These NHS statistics only capture the time between a doctor deciding a patient needs to be admitted and then being found a place on a ward. If the time is recorded between arriving at A&E and being found a bed, the number of patients who had to wait in emergency departments for more than 12 hours leaps to at least 67,406 patients, 24 times higher. Sarah Wollaston, Conservative chairwoman of the Health Select Committee, said that long waits in A&E raised patient safety concerns. Rachel Power, chief executive of the Patients Association. An NHS England spokesman said the number of waits has dropped 20+% in the last year. Kat Lay, The Times.
  • Mar.06.2018: NHS trusts accused of creating "dozens of Carillion-style meltdowns". Thousands of non-medical staff are being transferred to subsidiary firms in a bid to cut tax bills and reduce salaries and pension payments. The Guardian, Denis Campbell
  • Mar.01.2018: NHS manager numbers up but GPs and nurses in decline. The NHS is losing nurses and GPs while senior managers are the fastest-growing staff group. Candace Imison of the Nuffield Trust think tank, said: "The NHS spends relatively little on management compared to other countries, so I'm not too worried by the relatively small increase. What does worry me is the GP and nursing numbers. This isn't a question of the NHS intentionally reducing numbers. We haven't trained enough in recent years and there is no strategy in place which will guarantee that changes." The Times, Chris Smyth
  • Jan.24.2018: {{{title}}} The Guardian.
  • Jan.23.2018: Southmead Hospital considering creating its own private company to employ staff. NHS bosses at two major hospital trusts are planning to set up their own private company to employ all non-medical staff. The "wholly-owned subsidiary company" would be owned and managed by the NHS Trust, but in theory would not be subject to the same rules about paying VAT or paying new staff under the conditions enjoyed by NHS staff. Trust bosses have paid £12,000 to QE Facilities Ltd to conduct the feasibility study. QE are a private company set up by Gateshead Health NHS Facility in the north-east of England, who are now acting as a consultancy firm to NHS trusts across the country. One reason given nationally for setting up a private company to manage the hospitals is the NHS has to pay VAT, while a private company can claim VAT back from the Exchequer. But those expressing concern about the move labelled this 'a smokescreen', and claimed the real reason would be the savings a private company could make – at the expense of its workers' pay and conditions. (... ...) Bristol Post, Tristan Cork
  • Jan.23.2018: Lots of good timeline-links in this Twitter thread. @ChukkaUmunna
  • Jan.23.2018: Doctors blocked by Home Office from taking up vital NHS jobs. Recruits from overseas not being paid enough to satisfy immigration rules. The Guardian, Lisa O'Carroll << @PeterStefanovi2
  • Jan.23.2018: The Guardian view on NHS funding: no platform for Boris Johnson Boris Johnson's intervention was about his ambition, not the NHS. He is playing politics with the health service to enhance his own standing. Nothing new there. Simon Stevens, boss of NHS England, has done an extraordinary job of neutralising the damage caused by Andrew Lansley’s disastrous Health and Social Care Act 2012 without actually repealing it. He is reimagining a system of integrated healthcare which should hugely improve the experience of patients – particularly those with several chronic conditions, who often find themselves in a distressing maze. There are two reasons to be cautious about this approach. The first is that the whole process is driven by a desperate need to save money. It is not primarily about doing health better, but doing it cheaper. The Guardian, Editorial
  • Jan.23.2018: NHS patients having to be sectioned to get help, says regulator Care Quality Commission finds rise in detentions due partly to strain on healthcare system. The Guardian, Sarah Marsh
  • Jan.23.2018: Conservative MPs are not particularly thrilled with Theresa May’s response on NHS/social care this Sunday evening. @AshCowburn
  • Jan.23.2018: NHS demise: Incompetence or a deliberate act of capitalist vandalism? Suspicions that the demise of Britain’s public services is an act of deliberate capitalist vandalism have surfaced following a winter of discontent for the health service. The London Economic, Jack Peat
  • Jan.23.2018: NHS bosses ordered trusts: Lie to the public about scale of winter crisis – claim. Emails from NHS Improvement told Trusts to boost their treatment figures by including data from walk-in centres, in conflict with guidance issued by NHS England in 2015. It means trusts' performance since last October, when the first email was sent, may have been artificially inflated. Vox Political, Mike Sivier
  • Jan.22.2018: THIS is why the NHS is struggling. Vox Political, Mike Sivier
  • Jan.21.2018: Excellent anti-NHS-privatisation Tweet thread: @ThePileus
  • Jan.21.2018: The NHS is suffering because it has become a political football. Everything in Britain is seen through the prism of tribal ideology. The Guardian, Opinion
  • Jan.20.2018: Senior Conservative MP urges Jeremy Hunt to put the brakes on backdoor NHS privatisation. Sarah Wollaston said the arguments for the development of the new ACO policy have "not been well aired publicly". The govt hopes the plans will dissolve the boundary between health and social care systems and integrate services, with the aim of improving the health of local populations. The Independent
  • An apple a day? What’s keeping doctors away?, Medium, Michael O'Conor
  • Jan.14.2018: Doctors and nurses: "When May and Hunt tell the public the NHS is not in crisis, that is a lie". Ambulances queuing up outside A&E, operations cancelled for lack of beds… Could this winter prove the last straw for our struggling National Health Service? Those on the frontline speak out... The Guardian, Denis Cambell, Kit Buchan, Kathryn Bromwich
  • Jan.20.2018: Whenever the #Tories claim success on reducing the numbers on sickness benefits show them this and remind them they were in power from 1979 to 1997. Not something they can blame #Labour for. @MyLegalForum (graphs)
  • Search Beastrabban's Weblog: https://beastrabban.wordpress.com/?s=esther+mcvey
  • Jan.18.2018: Tories planning to hand private firms ’10-15 year NHS contracts’ to stop Labour from renationalising. Dr Graham Winyard, a former Medical Director in the NHS has exposed deeply worrying details of 'secret' plans hatched by the Health Secretary Jeremy Hunt to force through a 'raft of secondary legislation' that essentially allows the Conservative Party to hand unprecedented 10-15 year contracts to private healthcare firms to run NHS services – contracts that would be hugely expensive for any future govt to get out of. Evolve Politics, Chris Turnbull
  • Jan.18.2018: NHS: Thanks for the free work, Linux nerds, now face our trademark cops.' Devs quit, suggest Britain's health service bosses used them to bag Microsoft deal, The Register, Paul Kunert
  • Jan.15.2018: Hunt's secret NHS plan opens the door to further privatisation. Jeremy Hunt and NHS England's latest big idea is #Accountable Care Organisations (ACOs). These bodies would be allowed to make most decisions about how to allocate resources and design care for people in certain areas. At the moment, that's done by public bodies whose governance is regulated by statute, set up by parliament after wide consultation and sometimes fierce debate. ACOs, by contrast, can be private and for-profit bodies. They are not mentioned in any current legislation and would have no statutory functions. They are not subject to the statutory duties imposed on other parts of the NHS. Hunt is planning to lay a raft of secondary legislation - which doesn't require a full parliamentary vote - in Feb., so that the first ones can be up and running by Apr.01. The ACOs are going to be given long-term commercial contracts of between 10–15 years. We know these are difficult to get right and expensive to get out of. I'm working with 4 colleagues to challenge these proposals through judicial review. Our case is not concerned with whether ACOs are a good or bad idea. That's for parliament and the public to decide, not the courts. Our case is that such a radical and significant change cannot lawfully be introduced and implemented without public consultation, parliamentary scrutiny and primary legislation. Politics.co.uk, Dr Graham Winyard
  • Jan.11.2018: The Tory plans for social care could accelerate the privatisation of the NHS. In their manifesto, the Tories revealed that they want to reform funding of long-term social care by adjusting means testing and scrapping a proposed cap on all individuals’ lifetime costs. Theresa May couldn't come up with a better person than Jeremy Hunt to implement that political ideology. The Mirror, Dr Kailash Chand
  • Jan.10.2018: Tory announces ‘chair’ solution to NHS winter crisis. Philip Dunne thinks pressures on the NHS can be handled, as long as patients have a chair to sit on. Vox Political, Mike Sivier
  • Jan.10.2018: Today's PMQs proved that Corbyn would be just as useless as Theresa May at saving the NHS. Today’s exchanges were the usual pointless trading of statistics, insults and irrelevancies, while the health service goes from bad to worse. I know this is a subject on which Corbyn’s supposedly left-wing rhetoric is popular, but it is one on which public opinion is wrong. Private providers are not the problem in the NHS; they could be an important part of the solution. The tragedy of Prime Minister’s Questions is that there are row upon row of MPs on both sides of the House, but especially among the extinct Blairite volcanoes on the Labour side, who knew that what matters is who can provide the best service, free, at the point of need, not whether it is private or public. Yet both sides, with the honourable exception of Andrew Murrison, sit there watching the pointless show, pointlessly. The Independent, John Rentoul
  • Jan.10.2018: Top Oxford hospital cuts cancer care due to lack of staff. Too few specialist nurses to fill oncology posts. The Times, Chris Smyth
  • Jan.10.2018: Tory announces ‘chair’ solution to NHS winter crisis. Philip Dunne MP just told parliament if people dont have hospital beds in A&E "there are seats to sit on". Vox Political, Mike Sivier
  • Jan.08.2018: Assura (Virgin Care) 400 clinics, NHS not being privatised? (screenshot) @PostersAndMe
  • Jan.08.2018: Tory health minister Philip Dunne tells Commons 'most hospitals have seats' for patients who can't be found a bed in an emergency. Not sure that's going to fly. (HoC video) Labour shadow health minister Jonathan Ashworth tabled an urgent question. HuffPost, Kate Forrester
  • Jan.08.2018: As for Wasserman, he was one of the two ministers, who prepared various documents for the privatisation of the NHS for Maggie Thatcher. She was forced to back down from this policy after there was a mass cabinet revolt, and her personal private secretary, Patrick Jenkin, told her just how bad the American system was. Nevertheless, it did not stop her from trying to get more people to get out private health insurance – she aimed at 25% of the British public. {... ...} Beastrabban's Weblog

2017

  • Sept.2017: USA companies are already inside the NHS. Remember the current boss of NHS England quango is Simon Stevens, a man who previously worked for the largest USA health insurance company United Health. 999 CallForNHS.
    • Aug.30.2017: The Americanisation of the NHS, happening right here, right now. This is a project long in the making and the ground has been prepared and developed by every government over at least the last 30 years. The American health care industry and their representatives’ role is key to understanding what has happened, what is happening, and what is about to happen. Public Matters
  • Apr.13.2017: How Michael Ashcroft Is Back to Buying Tory Influence. Lord Ashcroft stopped donating to the Conservative Party under David Cameron, but his business interests are aligning with govt policy once more. Vice News, Solomon Hughes (check out links in the article)
  • Mar.2017: Next Steps On The NHS Five Year Forward View, NHS England
  • Feb.03.2017: Former Tory govt health adviser joins US firm involved in NHS privatisation. Former govt health adviser Nick Seddon has joined US firm Optum as Executive Vice President involved in NHS privatisation just 4 months after he left his political role in Jul.2016 – a move campaigners say demonstrates the “wafer-thin partition” between Tory policy makers and the private health industry. Health management company Optum is part of multinational insurance firm UnitedHealth Group. Seddon, Cameron’s health adviser from 2013, was formerly head of communications at Circle Health], which became the first private healthcare company to run an NHS hospital, Hinchingbrooke in Cambridgeshire, in 2011. Head of NHS England, Simon Stevens, is also a former UnitedHealth executive. Optum provides 156 NHS organisations, which it calls its "partners", services such as contract negotiations and medication management. The Independent, Katie Forster

2016

x

2015

  • Mar.10.2015: NHS bureaucrats on more than £140,000: 20 bosses award themselves higher salary than PM. One executive took home £280,000 last year - double the PM. Some 70 other executives earn more than the £125,000 recommended cap. MPs said the salaries were 'shocking and obscene' given tight NHS cuts. Trust bosses: Redbridge CCG, Bromley CCG. The NHS has spent £225million on the so-called revolving-door payoffs on 5,200 staff since 2013. Tory MP Charlotte Leslie, who sits on the Commons Health Select Committee, said: "It is incredible that senior managers are getting paid this kind of money when the NHS is struggling for funds to meet soaring demand". Steve Glenn at e-reward said bosses were paid a lot to ensure they did not take lucrative private-sector jobs. Sophie Borland, The Mail Online.
  • Jan.06.2015: Universal healthcare: the affordable dream. Universal healthcare is often presented as an idealistic goal that remains out of reach for all but the richest nations. That’s not the case. Look at what has been achieved in Rwanda, Thailand and Bangladesh. How has UHC been afforded in those countries or states that have run against the widespread and entrenched belief that a poor country must first grow rich before it is able to meet the costs of healthcare for all? The alleged common-sense argument that if a country is poor it cannot provide UHC is, however, based on crude and faulty economic reasoning. 1.Providing UHC is compatible with allowing the purchase of extra services for the especially affluent. 2.Reduction of economic and social inequality also has instrumental relevance for good health. 3.Many medical and health services are shared, rather than being exclusively used by each individual separately. 4.Universal coverage prevents the spread of infectious diseases and cuts costs through better epidemiological care. The case for UHC is often underestimated because of inadequate appreciation of what well-organised and affordable healthcare for all can do to enrich and enhance human lives. Dual role of healthcare in directly making our lives better: reducing our impoverishment in ways that matter to all human beings – as well as helping to remove poverty, assessed even in purely economic terms. Anartya Sen, The Guardian. See also Universal health careWikipedia-W.svg

2014

2013

  • Jul.18.2013: Why not... privatise the NHS. The NHS was created by the post-war Labour government in 1948. The central principle - that health services will be available to all and financed entirely from taxation - has been an article of faith in British politics ever since. But privatisation is a slippery concept. Thomas Cawston: The case for privatisation: competition can drive real improvements in care. Oliver Huitson: The case against privatisation: health care is not the place for markets. BBC News, Brian Wheeler

2012

  • Oct.24.2017: Ten scandals since 2010 that show Britain is ruled by the loony right. Remember what Andrew Lansley did after he was let loose on the NHS in 2010. He threw in a grenade of re-disorganisation that wasted billions – billions that will never be fully counted. Ever since, the head of NHS England has struggled to stitch back together its blasted fragments, as hosts of acronyms and new brass plates come and go. ExecReview, Polly Toynbee
  • Sept.06.2012: Andrew Lansley was a disaster who deserved to be sacked. Andrew Lansley, former secretary of state, took a wrecking ball to NHS structures, alienated every interest group and patronised those who disagreed with him. By every measure of high political office, he was a disaster and he deserved to be sacked. It is tempting to construe Lansley's departure as further strengthening the already near-omnipotent position of Sir David Nicholson, the commissioning board chief executive, but that does not necessarily follow. As shadow minister for the disabled, Jeremy Hunt expressed concern about the detrimental impact of bureaucracy and regulation on providers. The Guardian, Richard Vize
  • Mar.20.2012: NHS reform: health and social care bill passes its final hurdle. Final vote for the bill ended more than a year of debate and several last-minute attempts to overturn or delay the legislation. The Guardian, Juliette Jowit

NHS Wales

  • 2018.01.10: Straight lies from @theresa_may on Welsh NHS funding. Spending per person on health & social services increased by 4.5% in Wales 2016/17 - the highest increase of any of the four UK countries. Spending per person in Wales stood at £2,811, some 8% higher than in England. #PMQs (more) @WelshLabour

Funding Care for the Elderly

Assessment

  • Jun.01.2018: Care homes to cut fees when residents die. Elderly or disabled people seeking care and support to carry on living at home face waits of up to 6 weeks to be assessed and many of those who receive help have had visits cut back. The charity Age UK said average spending per head had fallen from £439 in 2009-10 to £379 in 2016-17 due to cuts in council budgets. About 50,000 fewer people are receiving domiciliary care each year. Greg Hurst, The Times.
  • 2018.01.08: Royal commission could find cure for ailing NHS. Labour has one solution to the crisis, which is to spend more money. The Conservatives have another, which is to spend more money but for Labour to promise not to attack them for the tax rises they use to do it first. Of course, that's not quite how they're putting it - they're doing things like calling for a Royal Commission or an "honest debate" or to "take the health service out of politics". The Times
  • 2017.03.03: Is a ‘death tax’ for social care about to be announced? Reports suggest that Theresa May and Philip Hammond are looking at funding at least some social care costs by making a claim on people’s estates once they have died – a form of inheritance tax, or, as the Conservatives usually dub it, a ‘death tax’. The King's Fund, Nicholas Timmins
  • 2014: The Barker report "A new settlement for health and social care", from an independent Commission on the Future of Health and Social Care in England established by The King’s Fund, called for review of wealth and property taxation as a means of raising money. The King's Fund
  • 2012: Andrew Lansley put forward an idea that also involved a claim on people’s estates, but Cameron and Osborne would not buy it. The Times
  • 2010.03.30: Spectre of 'death tax' haunts Andy Burnham's care revolution. Labour stood accused of hiding plans for a "death tax" to fund universal social care for elderly people in the small print of a long-awaited white paper published today. Andrew Lansley, shadow health secretary, said "if Labour win the election, they'd introduce plans for a death tax to pay for care." The white paper opts for a comprehensive funding option in which "people get their care free when they need it in return for a compulsory contribution". Guardian, Nicholas Watt
  • 2010.03.30: Building the National Care Service, HM Govt
  • 2010.02.15: Labour's 'secret plan for a 10% death tax' raid on the estates of Middle Britain to fund social care for the elderly, Mail Online

The Founding of the NHS

  • 2018.01.09: Conservatives opposed nationalisation of hospitals, as did Herbert Morrison (in cabinet). Only the BMA opposed the principle of the NHS. By 1954 Bevan had realised his mistake and wrote of returning hospitals to local government, @BillElison >> Local Government Management of the Hospitals, Socialist Health Magazine, Mar.12.1954

Fraud

The Naylor Review aka Funding

  • May.18.2018: NHS privately planning to develop Royal Free nurses' home into luxury flats. The NHS is privately marketing a 100-year-old hospital building that provides affordable housing for 52 nurses and other key workers to property developers to create a One Hyde Park-style complex of luxury flats overlooking Hampstead Heath. A password-restricted website set up by the Royal Free London NHS foundation trust describes the 1.6 acre site as “the last major development site in Hampstead with an unrivalled position between the heath and Hampstead Village”. The building, which was dedicated by Queen Mary in 1921 and rededicated by the Prince of Wales in 1992, houses 52 nurses, teachers and other key workers paying affordable rents of £551.09 a month for single rooms with shared kitchens and bathrooms. The residents have been told they may have to vacate the premises by July 2020 but the trust said it is “committed to finding them alternative, affordable accommodation should the site be sold”. The plans state that no affordable housing need be incorporated into the development. The trust has given guided tours of the site to local property developers and estate agents. ToDo: who sits on the Trust's Board?? Rupert Neate, The Guardian.

Disintegrating the NHS, Bit by Bit

Health and Social Care Act 2012

  • Jun.09.2012: Right-Wingers Speak With Forked Tongue: Tory NHS lies and what REALLY lies behind them. What did health professionals say about the changes as the Bill was discussed in Parliament? Simple: absolute rejection. Out of all of the health professional bodies, only one did not reject the bill outright – and that one (the Royal College of Surgeons) said it 'considers that the Health and Social Care Bill, if passed, will damage the NHS and widen healthcare inequalities, with detrimental effects on education, training and patient care in England.' The comments of the others, as you will imagine since they rejected the bill and called for its immediate withdrawal, were no less damning. You can read them in detail here. The SkwawkBox.