White elephant: Altrincham health and wellbeing centre will now never be used by NHS patients.
Tory Chancellor Philip Hammond gave in to demands from the Labour Party and agreed to stop signing Private Finance Initiative (PFI) deals in his Budget yesterday (October 29). Perhaps this is the reason:
Altrincham Health and Wellbeing Centre was meant to be the major new health hub for south Trafford – but it is to be converted into offices without a single patient ever crossing its threshold.
The building was constructed by local developer Citybranch for investment company Canada Life after a £35m deal.
Now NHS Property Services is leasing the building for an initial annual rent including utility bills for £2.4m, for 30 years, and it seems this cost was to be passed on to organisations renting space in the building.
But they can’t afford it.
St John’s Medical Centre said the move would cost its practice £70,000 a year, while Pennine Community Services said it was looking at £500,000 in extra overheads and Greater Manchester mental health trust £375,000.
At the heart of the matter is the Trafford Clinical Commissioning Group (CCG) – the organisation set up by Andrew Lansley’s Health and Social Care Act 2012 to oversee funding for NHS services in the area.
The building was that organisation’s baby – but it reneged on a promise to service providers about cost neutrality and they said the resulting rent would be too high.
Now the CCG wants to convert the building into commercial office space – costing another £7 million.
This means a piece of the National Health Service will be privatised without ever having been used by the public.
How will the CCG pay for NHS services in the meantime? And who will profit in the end?
This entire affair seems extremely questionable.
The people of Trafford need to know why their health service money was squandered on a £24 million white elephant that will never serve their community.
What has happened to their money?
Who has profited from it?
Who will profit from the plan to convert the building into office space?
And what will happen to the plan to modernise their health service?
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Theresa May: She might get her FreeStyleLibre diabetes tool on the NHS, but her government has made sure many members of the public have to pay a fortune for it.
An apparently innocent interlude in Prime Minister’s Questions has opened up a potentially-huge controversy for the Conservative government.
Labour MP Steve McCabe noted that Theresa May uses a FreeStyleLibre diabetes tool, which monitors her condition and warns her when she needs medication. He asked when it would be freely available on the National Health Service. Here’s the dialogue, from the official record of Parliamentary affairs, Hansard:
“Even the Prime Minister’s fiercest critics—I believe she has a few—must be full of admiration for the way in which she manages her diabetic condition and holds down such a tough and demanding job. I understand that she benefits from a FreeStyle Libre glucose monitoring system. Wouldn’t it be nice if she did something to make that benefit available to the half a million people who are denied it because of NHS rationing? Perhaps we could call it “help for the many, not the few”. [907106]
“I thank the hon. Gentleman for his comments. I do use a FreeStyle Libre, and it is now available on the national health service, but it is not the only means of continuous glucose monitoring that is available on the NHS. Yesterday I saw a letter from a child—a young girl—who had started on the FreeStyle Libre, but, because of the hypos that she had been having, had been moved to a different glucose monitoring system. There is no one system that is right for everyone; what is important is that those systems are now available on the NHS.”
Technically, she was correct and the FreeStyleLibre is available on the NHS.
But, thanks to Tory meddling, its availability to people with diabetes is based on a postcode lottery.
You may remember that Andrew Lansley’s hated Health and Social Care Act of 2012 imposed Clinical Commissioning Groups on the NHS. These are local organisations that decide which services should be available to patients in their areas, based on the amount of money that is made available to them. The creation of CCGs was justified with a claim that GPs would serve on them – but in fact GPs are far too busy and the work seems to have devolved to businesspeople.
Unite the Union surveyed the 3,392 CCG board members in 2015 and reported that 513 were directors of private healthcare companies: 140 owned such businesses and 105 carried out external work for them. More than 400 CCG board members were shareholders in such companies.
As a result, trust in CCGs’ ability, or indeed willingness, to provide the best-quality healthcare their budgets can afford is low. It seems the bias is more likely towards offering private firms the contracts they want, in order to appease shareholders who sit on these groups.
The FreeStyleLibre – together with those who use it – appears to be a victim of this system.
While it is nominally available on the NHS, as Mrs May claimed, it is not available to huge numbers of NHS patients because the CCGs in their area simply haven’t offered to pay for it. Instead, they have to fund it themselves at a cost of £100 per month.
That’s a “Diabetes Tax”, if you like, of £1,200 per year.
This information comes from a segment of the BBC’s Politics Live that I was lucky enough to notice:
Oh THIS is interesting! .@theresa_may lied to Parliament about her diabetes monitoring patch being available on the NHS. CCGs – brought in as part of the Tory privatisation programme – can refuse to fund it for patients. So May IS denying it to people. #PoliticsLive
Here’s the clip the programme put up on Twitter, in which Type 1 diabetic Tessa Nejranowski destroys Mrs May’s claim:
"I would say it is complete rubbish what the PM said yesterday. It's not widely available" @TNejranowski on access to diabetes patch as used by Theresa May #politicslive
The diabetes monitor that .@theresa_may uses costs £100 a month for people who have to pay for it privately because CCGs refuse to fund it. If you're diabetic, could YOU afford it? #PoliticsLive
Mrs May lied to Parliament. FreeStyleLibre is not available on the NHS – at least, not everywhere in England – and where it is not, people have to pay £1,200 a year to have it privately. That’s a “diabetes tax” imposed on people with the condition by the Conservatives.
And it’s about as strong an argument as any for the dissolution of the CCGs and the repeal of the Health and Social Care Act 2012. But you’ll have to wait for a Labour government before that happens.
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It seems there are very few, if any ‘qualified providers’ from the private sector currently working in the English National Health Service, according to the latest issue of Private Eye (#1382, p38).
It states: “When the government decided to flog off large chunks of the NHS, it insisted that private providers must ‘qualify and register’ before being allowed to offer NHS-funded services.
“But the NHS regulator Monitor never carried out the promised ‘assurance process’ to test whether providers were suitable or not. It confirmed that it held no register of ‘any qualified providers’ and a spokesman even said it would ‘love to know where there is a list’.
“Monitor only licenses organisations that hold NHS contracts worth more than £10 million a year. This leaves the vast majority of smaller ‘alternative’ providers and non-profit businesses unchecked.
“NHS England doesn’t check them either. Not only does it not hold any list, but it has also stopped providing support to local clinical commissioning groups to enable them to check the credentials of companies that are bidding for contracts. It has closed its online ‘Any Qualified Provider Resource Centre’, along with the Supply2Health website which at least listed contracts and current providers.
“All that can be found after a determined trawl through the Care Quality Commission website is a cobbled-together list of 41 mainly small-care providers, many of which have not been inspected, leaving the issue of whether they are ‘qualified’ open to question.
“Responsibility for deciding who ‘qualifies’ to carry out NHS work falls therefore not on those who are supposed to scrutinise and regulate NHS services but on local health purchasers. As the Health and Social Care Act doesn’t define what ‘qualified’ means, health ministers have neatly opened up a postcode lottery in healthcare when certain companies may be accepted as qualified by some local commissioning groups, but not others.”
In fact, it’s worse even than that.
Clinical Commissioning Groups (CCGs) were sold to the public on the premise that they would be composed of doctors – mainly GPs. But the CCGs’ own management teams are in fact steered by private sector consultants – McKinsey, Ernst & Young, PricewaterhouseCoopers, Capita, you know the names because they belong to all the usual suspects (see NHS SOS, Jacky Davis & Raymond Tallis (editors), pp24-25). Some of these organisations provide their own healthcare services, creating an opportunity for corruption that makes utter nonsense of the assurance ‘no decision about me, without me’ made by Andrew Lansley when he was pushing the Health and Social Care Act through Parliament.
So, if you live in England and you are told you need a health service that is only offered by a private provider – you demand to see proof that they are qualified to run the service. Who checked them? To what standard? Don’t be fobbed off with an assurance that the CCG has given them the thumbs-up – ask what organisation advised the CCG. Get to the bottom of the matter.
You might find that your ‘qualified provider’ doesn’t have any qualifications at all.
And then who’s liable if your treatment goes wrong?
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Back at the end of September the BBC News website ran a story on 91-year-old Harry Smith’s speech to the Labour Party Conference, in which he detailed the miserable state of healthcare before the arrival of the NHS and stated his fears for the future of the service under the Conservative Party.
This was all fine. What a shame Auntie’s unnamed reporter had to spoil it by adding in two extra paragraphs that parroted – almost word-for-word – comments made by Health Secretary Jeremy Hunt that seemed to contradict what Mr Smith had said. Tom Pride, over at Pride’s Purge, put the statements into an image, allowing people to compare Mr Hunt’s statements with the BBC’s. That image is reproduced again here:
The BBC report was clearly paraphrasing Mr Hunt’s words. No attempt was made to indicate that this was the government’s side of the issue; the offending paragraphs were stationed at the end – as statements of facts that contradict Mr Smith’s words.
That’s blatant government propaganda, in the view of this blog – especially as both statements are false.
That’s right – analyse the facts and Mr Hunt’s/the BBC’s assertions fall apart.
Did the government increase NHS spending in the UK? The BBC attitude was that it has, because the amount of money spent on the NHS – in England alone – has increased.
But Mr Smith wasn’t talking about England alone. Look at the BBC article (which has been revised since Vox Political complained) and you’ll see he refers to “the Britain of my youth”. The final paragraph (as it is now) does not separate England from the rest of the UK.
You may think that’s nit-picking. Try this instead: A “money-terms” increase in NHS spending is not what the Coalition government promised. The Coalition Agreement of 2010 promised a “real-terms” increase and that is what Jeremy Hunt said had happened in the comment from 2012. But spending on the NHS has fallen in real terms.
The BBC’s complaints director, Richard Hutt, in a letter of October 31, admitted as much: “My research suggests that spending on the NHS has increased marginally in terms of the amount of money spent… but as you are aware, if GDP deflators are applied a slight decrease is shown.”
But, following on from a previous BBC response in which we were told, “your blog talks about real-terms spending. Our original article did not, and had we wished to refer to real-terms spending, we would have said so,” he continued: “Nothing in the article indicated that the intention was to refer to “real-terms” spending and so I have difficulty in agreeing that this is how it would have been understood.”
Then what was the point of mentioning spending at all?
The promise was to increase “real-terms” spending, and “real-terms” spending has in fact decreased. Any reference to spending other than in “real-terms” is therefore irrelevant to the debate and can only confuse the issue in the minds of the public.
In the face of the facts, Mr Hutt – it seems – isn’t having this. Doesn’t that suggest that he has been told to whitewash the BBC – deny any wrong-doing, no matter what?
Let’s move on.
Does the Coalition support the founding value of the NHS that nobody, regardless of income, should be deprived of the best care? The easy answer to this is no, it doesn’t.
It was the work of a moment on a search engine to find a story demonstrating the opposite. It was this Daily Mailarticle, detailing the predicament of a gentleman who has been forced to pay £450 per month because his local Clinical Commissioning Group (brought into being by the Coalition government) would not provide him with a drug that is available free on the NHS elsewhere in England. Ironically, the cash-starved NHS in Wales is reported to have agreed to provide the drug.
In response, the BBC changed the wording of the last paragraph slightly, claiming that this changed the meaning. It didn’t.
The BBC’s Editorial Complaints Unit has done nothing but whitewash its story.
Never mind; there was still one more bullet in our gun. An email has just been sent to Mr Hutt, pointing out the words of Tom Pride that kicked off the whole affair:
“These are not facts. They are the opinions of a government minister being reported as facts by the BBC.
“That’s not news. It’s propaganda.
“Mind you, I don’t know why the reporter who wrote the article is so keen to remain anonymous.
“I mean, we all know that the reporting of unattributed propaganda from government ministers is a sackable offence for professional journalists in reputable news organisations.”
It’s best not to expect a reasonable response.
It’s clear we aren’t dealing with a reputable news organisation at all.
Health Secretary Jeremy Misprint Hunt, whose 10 per cent pay rise on his ministerial salary of around £140,000 is safe, said the health service could not possibly afford to add one per cent to workers’ pay. The minimum starting salary for a registered nurse is £21,478; Hunt’s pay rise alone could cover a one-per-cent increase for no less than 65 such nurses, and they are by no means the lowest-paid NHS workers.
The strike has come as The Times newspaper claimed that “senior Tories have admitted that reorganising the NHS is the biggest mistake they have made in government,” with at least £5 billion a year wasted on inefficiencies.
The paper’s online version is hidden behind a paywall, but its front page states: “David Cameron did not understand the controversial reforms and George Osborne regrets not preventing what Downing Street officials call a ‘huge strategic error’, it can be revealed.
“The prime minister and the chancellor both failed to realise the explosive extent of plans drawn up by Andrew Lansley, when he was the health secretary, which one insider described as ‘unintelligible gobbledegook’.
“An ally of Mr Osborne said ‘George kicks himself for not having spotted it and stopped it. He had the opportunity then and he didn’t take it.’
“The admission came during an investigation by The Times that has found at least £5 billion is wasted every year on inefficiences, such as overpaying for supplies, out of date drugs, agency workers and empty buildings, a study carried out for ministers said.”
The report raises several questions. Firstly, if Lansley’s reforms were a mistake, that doesn’t mean Cameron and Osborne would have proposed anything better. Tories are almost universally dedicated to the end of the National Health Service and the worsening of working-class health.
Secondly, if David Cameron did not understand Lansley’s plans, why did he allow them to go through? As Prime Minister, he is responsible for the activities of his government and a lack of comprehension indicates that he is not fit for the role – and never was. Is it possible that Cameron was swayed by the fact that Lansley was his mentor at the Conservative Research Department and he thought he owed a favour?
Thirdly, if Gideon didn’t spot it, what does that say about his abilities as Guardian of the Public Purse? (Actually, here’s a link to an article about his abilities in this regard. Read it and weep, George!)
Finally, and perhaps most importantly: How did the government let the NHS fall into this terrible condition? For the answer, we have to go back, again, to the Coalition Agreement.
22. NHS
The Government believes that the NHS is an important expression of our national values [From this we may conclude that the Tories (and their little LD friends) decided to change the NHS and make it reflect their values]. We are committed to an NHS that is free at the point of use and available to everyone based on need, not the ability to pay [Fail]. We want to free NHS staff from political micromanagement [Fail], increase democratic participation in the NHS [Fail] and make the NHS more accountable to the patients that it serves [Fail]. That way we will drive up standards, support professional responsibility, deliver better value for money and create a healthier nation [Fail].
We will guarantee that health spending increases in real terms in each year of the Parliament, while recognising the impact this decision will have on other departments [Vox Political has just spent several weeks demonstrating to the BBC that this has not happened].
We will stop the top-down reorganisations of the NHS that have got in the way of patient care. We are committed to reducing duplication and the resources spent on administration, and diverting these resources back to front-line care [Andrew Lansley’s Health and Social Care Act 2012 was the largest top-down reorganisation ever imposed on the National Health Service. It was also gibberish (as top Tories now concede) and has cost the service more money than it could ever hope to save].
We will significantly cut the number of health quangos [Clinical Commissioning Groups are quangos – so in fact it seems likely the number has increased].
We will cut the cost of NHS administration by a third and transfer resources to support doctors and nurses on the front line.
We will stop the centrally dictated closure of A&E and maternity wards, so that people have better access to local services [The Coalition government has never – let’s have that again: NEVER – refused permission for a plan to close A&E wards].
We will strengthen the power of GPs as patients’ expert guides through the health system by enabling them to commission care on their behalf [This refers, again, to CCGs. In fact, overworked GPs do not have time to plan and commission services, and have handed responsibility over, in most cases, to private health companies. This has opened the way for a huge amount of corruption, as these companies may commission services from themselves. More than one-third of doctors who are board members of CCGs have financial interests in private healthcare (NHS SOS, p 5].
We will ensure that there is a stronger voice for patients locally through directly elected individuals on the boards of their local primary care trust (PCT). The remainder of the PCT’s board will be appointed by the relevant local authority or authorities, and the Chief Executive and principal officers will be appointed by the Secretary of State on the advice of the new independent NHS board. This will ensure the right balance between locally accountable individuals and technical expertise.
The local PCT will act as a champion for patients and commission those residual services that are best undertaken at a wider level, rather than directly by GPs [Fail. This hasn’t happened]. It will also take responsibility for improving public health for people in their area, working closely with the local authority and other local organisations [Fail].
If a local authority has concerns about a significant proposed closure of local services, for example an A&E department, it will have the right to challenge health organisations, and refer the case to the Independent Reconfiguration Panel. The Panel would then provide advice to the Secretary of State for Health [Fail. The right to challenge seems to have been introduced but has been ineffective].
We will give every patient the right to choose to register with the GP they want, without being restricted by where they live [Fail. In fact, the Coalition has given GPs – or rather, CCGs – the right to choose the patients they want, meaning they can exclude patients with expensive, long-term conditions. This has an effect on the promise to provide care to everyone that is free at the point of use, of course].
We will develop a 24/7 urgent care service in every area of England, including GP out-of-hours services, and ensure every patient can access a local GP [Fail, for reasons indicated above]. We will make care more accessible by introducing a single number for every kind of urgent care and by using technology to help people communicate with their doctors [The service was launched in 2013 and was a complete and utter failure – it could not cope with demand on any level].
We will renegotiate the GP contract and incentivise ways of improving access to primary care in disadvantaged areas.
We will make the NHS work better by extending best practice on improving discharge from hospital, maximising the number of day care operations, reducing delays prior to operations, and where possible enabling community access to care and treatments.
We will help elderly people live at home for longer through solutions such as home adaptations and community support programmes.
We will prioritise dementia research within the health research and development budget.
We will seek to stop foreign healthcare professionals working in the NHS unless they have passed robust language and competence tests.
Doctors and nurses need to be able to use their professional judgement about what is right for patients and we will support this by giving front-line staff more control of their working environment.
We will strengthen the role of the Care Quality Commission so it becomes an effective quality inspectorate [The CQC has been rocked by the revelations of one cover-up after another, involving physical and psychological abuse of clients]. We will develop Monitor into an economic regulator that will oversee aspects of access, competition and price-setting in the NHS [Monitor has been turned into the enforcer of the government’s privatisation initiative].
We will establish an independent NHS board to allocate resources and provide commissioning guidelines [This is NHS England, which now takes decisions that would once have been in the hands of doctors. It can intervene in the running of any CCG, forcing changes where they don’t fall into line. It rigidly enforces spending limits].
We will enable patients to rate hospitals and doctors according to the quality of care they received, and we will require hospitals to be open about mistakes and always tell patients if something has gone wrong.
We will measure our success on the health results that really matter – such as improving cancer and stroke survival rates or reducing hospital infections.
We will publish detailed data about the performance of healthcare providers online, so everyone will know who is providing a good service and who is falling behind.
We will put patients in charge of making decisions about their care, including control of their health records [Jeremy Hunt wanted to sell your health records to private companies. Although the scheme was put on hold in February 2014, it seems to be running now. Your health records may already be in the hands of private companies].
We will create a Cancer Drugs Fund to enable patients to access the cancer drugs their doctors think will help them, paid for using money saved by the NHS through our pledge to stop the rise in Employer National Insurance contributions from April 2011.
We will reform NICE and move to a system of value-based pricing, so that all patients can access the drugs and treatments their doctors think they need.
We will introduce a new dentistry contract that will focus on achieving good dental health and increasing access to NHS dentistry, with an additional focus on the oral health of schoolchildren.
We will provide £10 million a year beyond 2011 from within the budget of the Department of Health to support children’s hospices in their vital work. And so that proper support for the most sick children and adults can continue in the setting of their choice, we will introduce a new per-patient funding system for all hospices and providers of palliative care.
We will encourage NHS organisations to work better with their local police forces to clamp down on anyone who is aggressive and abusive to staff.
We are committed to the continuous improvement of the quality of services to patients, and to achieving this through much greater involvement of independent and voluntary providers [Fail. The introduction of independent (read: private companies) and voluntary providers has been a costly disaster].
We will give every patient the power to choose any healthcare provider that meets NHS standards, within NHS prices. This includes independent, voluntary and community sector providers [Not true. The patient never has a choice].
The comments (in bold, above) relate only to a few of the calamities that have been forced on the NHS by the Coalition government (you may be aware of others) – and it is important to add that these took place only in England, where the Coalition has control. Health in Scotland, Wales and Northern Ireland is a devolved responsibility but the Tories and Liberal Democrats have tried to influence the provision of services by restricting the amount of money available to the other countries of the UK.
In addition, fears are high that the proposed Transatlantic Trade and Investment Partnership between the European Union and the United States of America will “lock in” the privatisation of health services, as corporations will be allowed to sue national governments if they impose changes that would affect a company’s profits. These claims have been rubbished by the European Commission and Tory ministers – but they would, wouldn’t they?
In summary: The last four and a half years have witnessed a sustained attack on the National Health Service in the United Kingdom, by a government that won most of its votes on a claim that it would protect and strengthen that organisation. It was a lie that has caused misery for millions – and is likely to have cost many, many lives.
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The BBC is sticking to its guns over a report that falsely claimed the Coalition government has increased spending on the NHS during each year it has been in office.
In its article on Harry Leslie Smith’s extraordinary speech to the Labour Party conference, the BBC News website desecrated his words by claiming: “The Conservative and Lib Dem coalition government has increased NHS spending each year during the current Parliament and both parties are committed to the founding values of the NHS that no-one, regardless of income, should be deprived of the best care.”
Fellow blogger Tom Pride leapt to the attack, pointing out that the BBC had copied comments made by Health Secretary Jeremy Hunt and presented them as facts –
Vox Political then stepped into the fray, and Yr Obdt Srvt wrote a sternly-worded complaint to the Corporation, together with an article about the issue which appeared on this site.
The BBC has now responded and is trying to wheedle its way out of trouble. Here’s the email:
Thank you for getting in touch about our report.
We stated that:
The Conservative and Lib Dem coalition government has increased NHS spending each year during the current Parliament and both parties are committed to the founding values of the NHS that no-one, regardless of income, should be deprived of the best care.
This is an accurate reflection of events as both parties did commit in the 2010 coalition agreement to pursue the original goals of the NHS.
However, because some readers were misinterpreting this to suggest the word “committed” represented an assertion by the BBC, the wording has been changed to say:
The Conservative and Lib Dem coalition government has increased NHS spending each year during the current Parliament and both parties committed in 2010 to the founding values of the NHS that no-one, regardless of income, should be deprived of the best care.
Not good enough, BBC!
This response makes no reference at all to the most glaring error in the article – the claim that the Coalition has increased spending on the NHS.
Did you notice the rows relating to changes in spending are all minus figures – meaning spending was less than intended? In those years when spending was known, it was less than for the 2009-10 financial year (when Labour was in office) meaning it is impossible for the BBC to claim that “the Coalition government has increased spending each year during the current Parliament” without revealing itself as a Coalition government propaganda organisation.
Claims that these spending figures relate only to England cannot invalidate them as the Coalition has limited the amount it provides to other countries in the UK. Funding for Wales, for example, has fallen by an average of 2.5 per cent per year, in real terms, between 2010-11 and 2012-13.
As for “both parties committed in 2010 to the founding values of the NHS that no-one, regardless of income, should be deprived of the best care“, take a look at this Daily Mailarticle, detailing the predicament of a gentleman who has been forced to pay £450 per month because his local Clinical Commissioning Group (brought into being by the Coalition government) would not provide him with a drug that is available free on the NHS elsewhere in England. Ironically, the cash-starved NHS in Wales is reported to have agreed to provide the drug.
Admittedly, the Daily Mail is always going to be a dodgy source of material, what with its long and well-deserved record of inaccuracy, but there are plenty of similar stories in the mainstream media.
So now we have a situation in which the BBC has lied to the public and, after the lies were pointed out, has tried to duck responsibility with more lies and evasion.
Faced with this kind of behaviour, there’s only one thing to do – publicise the transgression and demand a full public apology and correction.
Rest assured, you will read the next chapter of this story just as soon as the BBC responds. In the meantime, please share this article.
The first collection, Strong Words and Hard Times, is still available in either print or eBook format here:
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Andy Burnham, Shadow Health Secretary: He’d rather listen to real doctors than spin doctors.
The title of this article should seem brutally ironic, considering that the Coalition government famously ‘paused’ the passage of the hugely controversial Health and Social Care Act through Parliament in order to perform a ‘listening exercise’ and get the views of the public.
… Then again, maybe not – as the Tories (with the Liberal Democrats trailing behind like puppies) went on to do exactly what they originally wanted, anyway.
Have a look at the motion that went before the House of Commons today:
“That this House is concerned about recent pressure in Accident and Emergency departments and the increase in the number of people attending hospital A&Es since 2009-10; notes a recent report by the Care Quality Commission which found that more than half a million people aged 65 and over were admitted as an emergency to hospital with potentially avoidable conditions in the last year; believes that better integration to improve care in the home or community can relieve pressure on A&E; notes comments made by the Chief Executive of NHS England in oral evidence to the Health Select Committee on 5 November 2013, that the NHS is getting bogged down in a morass of competition law, that this is causing significant cost and that to make integration happen there may need to be legislative change; is further concerned that the competition aspects of the Health and Social Care Act 2012 are causing increased costs in the NHS at a time when there is a shortage of A&E doctors; and calls on the Government to reverse its changes to NHS competition policy that are holding back the integration needed to help solve the A&E crisis and diverting resources which should be better spent on improving patient care.”
Now have a look at the amendment that was passed:
“That this House notes the strong performance of NHS accident and emergency departments this winter; further notes that the average waiting time to be seen in A&E has more than halved since 2010; commends the hard work of NHS staff who are seeing more people and carrying out more operations every year since May 2010; notes that this has been supported by the Government’s decision to protect the NHS budget and to shift resources to frontline patient care, delivering 12,000 more clinical staff and 23,000 fewer administrators; welcomes changes to the GP contract which restore the personal link between doctors and their most vulnerable patients; welcomes the announcement of the Better Care Fund which designates £3.8 billion to join up health and care provision and the Integration Pioneers to provide better care closer to home; believes that clinicians are in the best position to make judgements about the most appropriate care for their patients; notes that rules on tendering are no different to the rules that applied to primary care trusts; and, a year on from the publication of the Francis Report, notes that the NHS is placing an increased emphasis on compassionate care, integration, transparency, safe staffing and patient safety.”
Big difference, isn’t it?
From the wording that won the vote, you would think there was nothing wrong with the health service at all – and you would be totally mistaken.
But this indicates the sort of cuckooland where the Coalition government wants you to live; Jeremy Hunt knows what the problems are – he just won’t acknowledge them. And he doesn’t have to – the media are run by right-wing Tory adherents.
So here, for the benefit of those of you who had work to do and missed the debate, are a few of the salient points.
Principal among them is the fact that ward beds are being ‘blocked’ – in other words, their current occupants are unable to move out, so new patients cannot move in. This is because the current occupants are frail elderly people with no support in place for them to live outside hospital. With no space on wards, accident and emergency departments have nowhere to put their new admissions, meaning they cannot free up their own beds.
Health Secretary Jeremy Hunt had nothing to say about this.
Andy Burnham, who opened proceedings, pointed out the huge increase in admissions to hospital accident and emergency departments – from a rise of 16,000 between 2007 and 2010 to “a staggering” 633,000 in the first three years of the Conservative-Liberal Democrat Coalition government.
Why the rapid rise? “There has been a rise in people arriving at A and E who have a range of problems linked to their living circumstances, from people who have severe dental pain because they cannot afford to see the dentist, to people who are suffering a breakdown or who are in crisis, to people who cannot afford to keep warm and are suffering a range of cold-related conditions.”
He said almost a million people have waited more than four hours for treatment in the last year, compared with 350,000 in his year as Health Secretary; the statement in the government amendment that waiting times have halved only relates to the time until an initial assessment – not total waiting time. Hospital A and Es have missed the government’s targets in 44 of the last 52 weeks.
Illnesses including hypothermia are on the rise, and the old Victorian ailments of rickets and scurvy are back, due to increased malnutrition.
Hospitals are filling up with the frail elderly, who should never have ended up there or who cannot get the support needed to go home because of a £1.8 billion cut in adult social services and support. This, Mr Burnham said, was “the single most important underlying cause of the A and E crisis”; ward admissions cannot be made because the beds are full. The number of emergency admissions of pensioners has topped 500,000 for the first time.
Ambulances have been held in queues outside A and E, unable to hand over patients to staff because it is full. That has left large swathes of the country — particularly in rural areas — without adequate ambulance cover.
The government is downgrading A and E units across the country into GP-run clinics, while pretending that they are still to be used for accidents and emergencies – in the middle of the A and E crisis.
People in England are reducing the number of drugs they are taking because they cannot afford to buy them. Families are choosing between eating, heating or other essentials, like prescriptions.
Competition rules have been stifling care, Mr Burnham said: “The chief executive of a large NHS trust near here says that he tried to create a partnership with GP practices and social care, but was told by his lawyers that he could not because it was anti-competitive.”
He added: “Two CCGs in Blackpool have been referred to Monitor for failing to send enough patients to a private hospital. The CCG says that there is a good reason for that: patients can be treated better in the community, avoiding costly unnecessary hospital visits. That is not good enough for the new NHS, however, so the CCG has had to hire an administrator to collect thousands of documents, tracking every referral from GPs and spending valuable resources that could have been spent on the front line.”
And the health trust in Bournemouth wanted to merge with neighbouring Poole trust, but competition rules stopped the merger taking place.
Mr Burnham demanded to know: “Since when have we allowed competition lawyers to call the shots instead of clinicians? The Government said that they were going to put GPs in charge. Instead, they have put the market in charge of these decisions and that is completely unjustifiable. The chief executive of Poole hospital said that it cost it more than £6 million in lawyers and paperwork and that without the merger the trust will now have an £8 million deficit.
“The chief executive of NHS England told the Health Committee about the market madness that we now have in the NHS: ‘I think we’ve got a problem, we may need legislative change… What is happening at the moment… we are getting bogged down in a morass of competition law… causing significant cost and frustration for people in the service in making change happen. If that is the case, to make integration happen we will need to change it’ – that is, the law. That is from the chief executive of NHS England.”
The response from current Health Secretary Jeremy Hunt needs to be examined carefully.
He said more than 96 per cent of patients were seen within four hours – but this conforms with Mr Burnham’s remark; they were seen, but not treated.
He tried to rubbish Mr Burnham’s remarks about scurvy by saying there had been only 26 admissions relating to scurvy since 2011 – but this misses the point. How many were there before 2011? This was an illness that had been eradicated in the UK – but is now returning due to Coalition policies that have forced people into malnutrition.
He dodged the issue of competition rules strangling the NHS, by saying that these rules were in place before the Health and Social Care Act was passed. In that case, asked Mr Burnham, “Why did the government legislate?” No answer.
As stated at the top of this article. he did not answer the question of the frail elderly blocking hospital beds at all.
The vote was won by the government because it has the majority of MPs and can therefore have its own way in any division, unless the vote is free (unwhipped) or a major rebellion takes place among its own members.
But anyone considering the difference between the Labour Party’s motion and the government’s amendment can see that there is a serious problem of perception going on here.
Or, as Andy Burnham put it: “This Secretary of State … seems to spend more time paying attention to spin doctors than he does to real doctors.”
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It seems the government has found a way to dissuade GPs from letting patients opt out of having their medical records sold to private firms – the threat of penalties or even an investigation into the way they run their practice.
Vox Politicalrevealed earlier this month that the government is planning to make a profit from selling the private records of NHS patients in England to healthcare and pharmaceutical firms.
The records are said to be ‘anonymised’, but in fact anyone buying your details will be able to identify you.
The system, originally called the General Patient Extraction Service (GPES), now the Health and Social Care Information Centre, may also be described as the care.data scheme. Health Secretary Jeremy Hunt wants you to think the information will be used for medical research and screening for common diseases, but in fact it could be used by private health companies as evidence of failures by the National Health Service, and could help them undercut NHS bids to continue running those services – accelerating the privatisation that nobody wanted.
Patients have the right to withhold their data, but they must specifically inform their medical practice of their wishes. This is why medConfidential created a web page containing a special opt-out form, along with a form letter in various formats, allowing patients to opt out themselves, their children and any adults for whom they are responsible.
Now GPs are living in fear of reprisals if they don’t deliver enough details to the new system.
According to GPonline.com, Health minister Dr Daniel Poulter failed to rule out penalising GP practices with a higher-than-average proportion of patients opting out of new NHS data sharing arrangements.
In a written answer to Labour MP and health select committee member Rosie Cooper, Dr Poulter also refused to say what level of patient opt-out from the scheme would trigger an investigation.
Asked whether practices would be penalised, who would investigate practices with a high opt-out rate, and at what threshold this would apply, Mr Poulter said: “NHS England and the Health and Social Care Information Centre will work with the BMA, the RCGP, the Information Commissioner’s Office and with the Care Quality Commission to review and work with GP practices that have a high proportion of objections on a case-by-case basis.”
Ms Cooper took this as an admission that GPs were “being threatened and bullied into ensuring patients don’t choose to opt-out”.
Reacting on Twitter, NHS national director for patients and information Tim Kelsey ruled out fines for practices where large numbers of patients opt not to share data. He wrote: “Nobody is going to get fined if patients opt out.”
None of this offers a good reason for you to leave your medical records unprotected – in fact, it gives you more reasons to opt out than before, and might provide GPs with the excuse they need to retaliate.
Doctors have been pushed further and further by the Conservative-led government’s changes to the NHS. For example, they were told they would have a greater say in where the money went, as members of Clinical Commissioning Groups (CCGs), but that was not true – they don’t have the time to take part in such decisions so they have been handed over to firms that are often part of the private companies now offering services to the NHS (for a price).
Now they are being told they may face reprisals if they do not betray the principle of doctor-patient confidentiality.
But you can only push a person a certain distance before they push back.
How will NHS doctors in England respond?
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It seems that Jeremy Misprint Hunt is trying to pretend that his planned law making it easier to close good hospitals to prop up bad ones (and boost private health firms in the process) is happening because “Conservatives genuinely care about the NHS”.
Writing in The Guardian, he tells us that Clause 118 of the Care Bill currently on its way through Parliament – the so-called Hospital Closure Clause, “is necessary because we need the power to turn around failing hospitals quickly and – in extremis – put them into administration before people are harmed or die unnecessarily.
“The process has to happen quickly, because when a hospital is failing lives can be put at risk. That is why it matters so much – and why, in opposing it, Labour are voting to entrench the failures they failed to tackle.”
For information, Clause 118 was included in the Bill after Mr Hunt lost a legal battle to close services at the successful and financially solvent Lewisham Hospital in order to shore up the finances of the neighbouring South London Healthcare Trust, which was losing more than £1 million every week after commissioning new buildings under the Private Finance initiative.
The private firms that funded this work were apparently charging huge amounts of interest on it, meaning that SLHT would never be able to clear its debt.
PFI was introduced by the Conservative government of 1979-97 and, sadly, continued by the Labour government that followed it.
It seems likely that it will contribute to the absorption of many NHS trusts by the private sector, as the effects of the Health and Social Care Act 2012 take hold.
Clause 118 means the Health Secretary will be able to close successful local hospitals in England on the pretext of helping neighbouring trusts that are failing – without full and proper consultation with patients and the public, or even agreement from the (in name alone) GP-led Clinical Commissioning Groups.
The resulting, merged, organisation could then be handed over to private firms who bid to run the service at a price that is acceptable to the government.
So it seems that this is a plan to speed up the process of privatisation, rather than anything to do with caring about the NHS.
It seems to me that Mr Hunt is trying to lull the public into false security by claiming the NHS is safe, in exactly the same way his forerunner as Health Secretary, Andrew Lansley, provided assurances before Parliament passed his nefarious Health and Social Care Act.
Mr Lansley said his law would increase the range of choice available to patients (it doesn’t; in fact, it increases the ability of service providers to choose which patients they treat, on the basis of cost rather than care); he said GPs would be able to commission the services they need for their patients (in practice, they don’t; the running of the new Clinical Commissioning Groups has been handed over primarily to private healthcare consultants, many of which are arms of private healthcare providers, creating a conflict of interest that is conspicuously never mentioned); and he said that CCGs would be able to choose who provides services on the basis of quality (they can’t; if they restrict any service to a single provider, they risk legal action from private healthcare firms on the grounds that they are breaching competition rules).
Mr Lansley lied about all those matters; it seems Mr Hunt is lying about this one.
Or am I mistaken?
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Why does the BBC want us to pay more attention to a squabble between this overprivileged cyclist and a policeman than to the wholesale privatisation of the National Health Service, for which we have all paid with our taxes?
In the mid-1990s I interviewed for a reporter’s job at the then-fledgeling BBC News website. I didn’t get it.
Considering the BBC’s current output and apparent lack of news sense, I am now very glad that I did not succeed. I would be ashamed to have that as a line on my CV.
Unfortunately, the BBC accounts for 70 per cent of news consumption on British television – and 40 per cent of online news read by the public. It has a stranglehold on most people’s perception of the news – and it is clearly biased.
Take today’s story about PC Keith Wallis, who has admitted misconduct in the ‘Plebgate’ affair by falsely claiming to have overheard the conversation between Andrew Mitchell and another police officer. He admitted the falsehood at a court hearing in the Old Bailey.
The case is important because he had been lying in order to support the allegation that Mr Mitchell had shouting a torrent of profanities at the other police officer, Toby Rowland, after being stopped from cycling through Downing Street’s main gates. PC Rowland had alleged that one of the words used had been the derogatory word “pleb”, and the resulting scandal had forced Mitchell to resign as Tory Chief Whip.
It casts doubt on the integrity of Metropolitan police officers – a further four are facing charges of gross misconduct.
However, the officer at the centre of the case – PC Rowlands – is not among them. He remains adamant that his version of events is correct and is suing Mitchell for libel over comments he made about the incident which the officer claims were defamatory.
This is the story the BBC decided to make the lead on all its news bulletins, all day. It contains no evidence contradicting PC Rowland’s allegations against Mitchell; the worst that can be said is that the admission of guilt casts a shadow over the entire Metropolitan police service – and in fairness, that is a serious matter.
But the fact is that people will use this to discredit PC Rowland and rehabilitate the reputation of an MP who was a leading member of the Coalition government until the incident took place – and that is wrong. It is an inaccurate interpretation of the information, but the BBC is supporting it by giving the story the prominence it has received.
In contrast, let’s look at the way it handled revelations about the Coalition government’s plans to change the National Health Service, back when the Health and Social Care Act was on its way through Parliament.
You will be aware that Andrew Lansley worked on the then-Bill for many years prior to the 2010 election, but was forbidden from mentioning this to anybody ahead of polling day (see Never Again? The story of the Health and Social Care Act 2012). Meanwhile all election material promised no more top-down reorganisations of the NHS. Former cabinet minister Michael Portillo, speaking about it on the BBC’s This Week, said: “[The Tories] didn’t believe they could win an election if they told you what they were going to do.” Considering the immensity of the changes – NHS boss David Nicholson said they were “visible from space” – this lie should have sparked a major BBC investigation. What did we get?
Nothing.
After Lansley released his unpopular White Paper on health, David Cameron tried to distance himself from the backlash by claiming “surprise” at how far they went. This was an early example of the comedy Prime Minister’s ability to lie (so many have issued from his lips since then that we should have a contest to choose the Nation’s favourite), as he helped write the Green Papers that preceded this document (see Never Again). If it was possible for the authors of Never Again to dig out this information, it should certainly have been possible for the BBC. What did we get?
Not a word.
In contrast to Cameron, Lansley, and any other Tory’s claims that there would be no privatisation of the NHS, KPMG head of health Mark Britnell (look him up – he’s an interesting character in his own right) said the service would be shown “no mercy” and would become a “state insurance provider, not a state deliverer”. This important revelation that the Tories had been lying received coverage in less popular outlets like The Guardian, Daily Mirror and Daily Mail but the BBC only mentioned it in passing – four days after the story broke – to explain a comment by Nick Clegg.
One of the key elements used to get members of the medical profession on-side with the Lansley Act was the claim that GPs would commission services. This was a lie. It was well-known when the plans were being drafted that general practitioners simply would not have time for such work and it was expected that they would outsource the work to private management companies – many of whom would also have a hand in service delivery. There is a clear conflict of interest in this. East London GP Jonathan Tomlinson told Channel 4 that the scale of private involvement would be so large as to include “absolutely everything that commissioning involves”. This was a clear betrayal of the promise to GPs. The BBC never mentioned it.
Another phrase trotted out by the Tories was that the changes would increase “patient choice” – by which we were all intended to believe patients would have more opportunity to choose the treatment they received and who provided it. This is a lie. The new Clinical Commissioning Groups created by the Act – and run, not by doctors, but by private healthcare companies on their own behalf – have a duty to put services out to tender unless they are sure that only one provider is able to offer a service. In reality, this means all services must be opened up to the private sector as no CCG could withstand a legal challenge from a snubbed private provider. But this makes a mockery of Andrew Lansley’s promise that CCGs could choose when and with whom to commission.
In turn, this means private firms will be able to ‘cherry-pick’ the easiest and cheapest services to provide, and regulations also mean they can choose to provide those services only for those patients they believe will cost the least money. Anyone with complicated, difficult, or long-term conditions will be thrown to the wolves. In other words, far from patients having increased choice, the Health and Social Care Act means private companies will be able to choose the patients they treat.
We are still waiting for the BBC to report this.
Add it all up and you will see that the largest news-gathering organisation in the UK – and possibly the world – sees more news value in a slanging match between an MP and a policeman than it does in the wholesale betrayal of every single citizen of the country.
Why do we allow this to continue?
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