Not for sale – except under the Tories: It turns out that the money given to private health businesses within the NHS has more than doubled in the last 11 years or so.
This is fun – except if you’re from the King’s Fund, of course.
… and the Tory government…
Have a look:
An influential ‘independent’ think-tank that once recommended the cutting back of ‘acute’ health services has published a Twitter thread claiming that the Tories’ privatisation of the NHS is a ‘myth’, because – supposedly – the proportion of NHS spending on provision by private firms has stayed ‘broadly stable’ for the past ten years.
Pro-NHS campaigner ToryFibs demolished this nonsense with plain fact, in a response quoting the official figures from the House of Commons Library that show the proportion of NHS spending going to private – and usually Tory-donating – firms has almost doubled in that period.
Have YOU donated to my crowdfunding appeal, raising funds to fight false libel claims by TV celebrities who should know better? These court cases cost a lot of money so every penny will help ensure that wealth doesn’t beat justice.
It should not. The only reason Jeremy Hunt is making that claim is, he’s so deeply involved with private health he probably needs a paid doctor to help screw him into his underwear in the morning.
His claim that there are diminishing resources (read: funds) for the NHS makes sense only in the context of his belief that health should be a profit-making industry.
But the instant you start clawing back money in search of that profit, you start harming service users. We have evidence of this from the past four years of Tory cuts and sell-offs.
Let’s look at this “revered” Mayo clinic, with its marble foyers. Marble foyers? Clearly this organisation is charging a fortune for its services and investing the money, not in clinical care, but in cosmetic augmentations.
There’s no room in the NHS for that kind of nonsense.
And Hunt wants us to believe that these fabled marble foyers have something to do with “quality and safety”?
He needs proper medical care to bring him to his senses.
The fact is that quality and safety were built into the NHS, right up until his forerunner, Andrew Lansley, passed a law to gut the service and hand its vital organs over to the privateers – and their marble foyers.
Quality and safety are part of the NHS right now – except in areas Mr Hunt has decided to starve of funds, because he wants people to think publicly-funded health provision isn’t as good as that provided by an expensive firm of profit-making money-grubbers with marble foyers.
Oh, and it may interest you to know that Mr Hunt used his King’s Fund speech to complain about the cost of cleaning up patients who are left with infections or complications after operations – around £100,000.
But who, exactly, hands over 6,000 patients per year to the NHS for this expensive service (that’s a cost of £600 million)?
I don’t know if they all have marble foyers, but they certainly do all have contracts provided by Mr Jeremy Hunt.
The NHS should look to the USA for inspiration in its battle to meet demand with diminishing resources, health secretary Jeremy Hunt has said.
Speaking at the King’s Fund’s annual conference on Wednesday, he said the Government had not been given enough credit for its investment in the health service during difficult economic times, and challenged managers and staff to make savings by ‘thinking about quality and safety not as an optional extra’.
Mr Hunt said the NHS could learn these lessons from institutions such as the revered Mayo Clinic, which runs 20 hospitals in the USA.
He asked: ‘What does this clinic that Arab kings visit with its amazing marble foyers have that is at all relevant to us? One of the reasons it has marble foyers is they have created so much value by making quality their business strategy.
‘The way we unlock the resources we really need because of the pressures on the NHS is by thinking about quality and safety not as an optional extra but as an intrinsic business strategy.’
This is all part of what This Writer reckons we should be calling ‘NHXit’.
The Conservatives have already cut real-terms funding to the English NHS.
Now they are ensuring that the service won’t work with secret plans to cut delivery in important areas.
The plans have to be secret because otherwise people will know that their publicly-funded health service is being deliberately sabotaged by their government – right?
That would not suit the Tories because they want to whip up a storm of protest at the failings of the publicly-funded service – so they can then hand it over to private hands.
Of course, the Tories didn’t really have a chance with this because the plans were always bound to come into the public domain before they were ready.
What is perhaps more disheartening is the fact that it won’t make a difference to many people – they will simply sit back and accept the destruction of the health service as they know it.
One wonders what it will take to motivate them – Jeremy Hunt driving a stake through an elderly relative’s heart while screaming, “Leaner, fitter, stronger,” perhaps?
NHS chiefs are trying to keep plans to cut hospital services in England secret, an investigation has found.
Full details of 44 reviews of services around the country – which involve closing some A&Es or, in one case, a whole hospital – are yet to emerge.
That is because NHS England told local managers to keep the plans “out of the public domain” and avoid requests for information, the King’s Fund suggested.
Managers were even told how to reject freedom of information requests.
The King’s Fund report did not include any details of cuts, but from the leaks and plans that have been published so far a partial picture is emerging of what is involved.
Plans in south west London to close one of five hospitals – St George’s, Kingston, Croydon, St Helier or Epsom
The North Tees proposal to centralise specialist services, including A&E, on two sites. It would lead to services being downgraded at one of the three major hospitals in the area
In Devon bosses are looking at whether to close some A&E, maternity and stroke services at hospitals across the county so they can be centralised at bigger sites
In Merseyside there has been talk of merging four hospitals – the Royal Liverpool, Broadgreen, Aintree and Liverpool Women’s – to plug a £1bn shortfall, according to leaked documents
Plans in Birmingham and Solihull involve reorganising maternity services with fears this could result in fewer units
Bosses at North Central London have talked about a consolidation of services on fewer sites, leading to fears that the Whittington Hospital could lose its A&E
During its research, the King’s Fund carried out interviews with staff involved in four of the reviews, known as sustainability and transformation plans (STPs). These were done on an anonymised basis.
The local managers said they had been told to keep the process “private and confidential”, which one described as “ludicrous”, while another said the leadership had made the “wrong judgement call” in its approach to managing the process.
Keep the NHS public: These demonstrators don’t want the NHS to be funded by private means. They want a publicly-run service, catering for everyone, regardless of their means to pay.
A junior health minister in the House of Lords has called for an independent inquiry into ways of changing the way the National Health Service is funded, away from taxation and towards insurance and user charges.
It’s the Conservative Party’s dream come true – but you probably missed it because it was announced very quietly last Thursday (July 9) in a House of Lords debate on the “sustainability” of the NHS, by the unelected Tory Government’s Under-Secretary of State for NHS Productivity, Lord David Prior. One suspects he may have overstepped his job description.
The gist of the debate is presented in this Open Democracy post. Basically, Tory Lords called for “a plurality of funding” to make the NHS sustainable. Rather than taxing the rich (who can afford to pay), they want to tax the sick (who can’t).
Astonishingly, Labour peers didn’t have a lot to say against the idea. Pro-privatisation Lord Warner (why is he Labour, if he’s pro-privatisation?) said: “A wise Government should begin now the process of helping the public engage in a discourse about future funding of the NHS.”
Prior, summing up, said that, although he preferred a tax-funded NHS, “if demand for healthcare outstrips growth in the economy for a prolonged period, of course that premise has to be questioned.”
He called for an independent inquiry on healthcare funding – perhaps to be carried out by the King’s Fund or Nuffield Trust – ignoring the fact that the King’s Fund’s Barker Review has rejected user charges and called for more taxes to pay for healthcare, through a review of inheritance tax and national insurance increases – which George Osborne has recently cut.
This plan, coupled with the recently-announced possibility of social security becoming based on private insurance, would pronounce the death sentence on the Welfare State.
The Open Democracy article asks: “Are we being nudged towards an inefficient, unfair ‘pay NHS’ in the only way possible – undemocratically?”
It seems so.
Let’s nip this one in the bud.
Back in 2011, David Cameron told the world: “We will not be moving towards an insurance scheme, we will not introduce an American-style private system. In this country, we have this most wonderful, precious institution and idea. That whenever you’re ill, however rich you are, you can walk into a hospital or surgery and get treated for free. No questions asked. No cash asked. I will never put that at risk.”
It seems that now would be an excellent time to contact your MP (via the Write To Them website if you like), reminding them of Cameron’s words.
Then – as a Vox Political reader suggested in a comment to the Facebook page, point out that an unelected junior health minister, Lord Prior, has suggested to Parliament that he plans to launch an inquiry to consider whether we should move away from a tax-funded NHS, towards one funded by insurance and co-payments.
Finally ask if it is now official government policy to consider such a move to an insurance or user-fee funded NHS, away from the core principles that have been in place since the 1940s.
Don’t forget to ask all your friends to do the same.
This government only listens if enough people raise their voices.
Let’s give David Cameron and his ministers a reason to prick up their ears.
Life imitating art: I made this poster months ago, and it is pleasant that its words were echoed by Andy Burnham in the NHS debate.
It was a debate the Labour Party could not win at the vote; the Coalition has the weight of numbers and is always going to vote down a motion that criticises its decisions and record – in this instance, it called for “much-needed honesty” in the public debate on the NHS, and “in particular, NHS spending”.
But it was also a debate that had to take place, and Andy Burnham, the Shadow Secretary of State for Health, was right to put the arguments before the public. Anyone listening to the arguments with an open, if inquiring, mind could see that Labour has won this argument.
The Opposition Day debate in the House of Commons yesterday was called by Mr Burnham after Andrew Dilnot, head of the UK Statistics Authority, wrote to caution the government that its claims of increased spending on the health service, year on year, during every year of the current Parliament, were inaccurate. He stated that the figures show a real-terms cut in expenditure between the 2009-10 tax year when Labour was in power, and 2011-12.
In fairness, the next sentence of the letter went on to say that, “given the small size of the changes and the uncertainties associated with them, it might also be fair to say that real-terms expenditure has changed little over this period”. Even so, that is not an agreement that funding had increased; it is an assertion that the best the government could say is that funding has been at a standstill.
Mr Burnham pointed out two drains on NHS funding that have taken £3.5 billion out of the system – savings of £1.9 billion that went back to the Treasury instead of being ploughed back into NHS services as promised, and £1.6 billion spent on Andrew Lansley’s vanity-prompted, ideologically-based top-down reorganisation that brought private companies into the NHS with disastrous results.
(I think my own opinions may have intruded into the narrative of the last paragraph, but since these conclusion will be obvious to anyone who reads what follows, I feel justified in drawing attention to them here)
I hope we all know what the promises were. The 2010 Conservative Manifesto stated: “We will increase health spending in real terms every year”; the Coalition Agreement said “We will guarantee that health spending increases in real terms in each year of this Parliament”. And week after week, ministers from the Prime Minister downwards have claimed that is exactly what they have delivered. Until recently, the Conservative Party website prominently stated: “We have increased the NHS budget in real terms in each of the last two years”. And on October 23, from the Health Secretary, Jeremy Hunt, to the House of Commons: “Real-terms spending on the NHS has increased across the country.”
But there’s a mismatch here, said Mr Burnham. People have heard that spending is increasing, but what they have seen is an ever-increasing list of cuts to funding and services. Along with other Labour MPs, he delivered a devastating list of these cuts in support of his claims. These included:
750 jobs cut at Salford Royal Hospital, with a total of 3,100 job losses across hospitals in that area, and two walk-in centres closed.
Cuts to the mental health budget.
A broken pre-election promise not to close accident and emergency at Queen Mary’s, Sidcup; it closed after the general election.
A plan to close accident and emergency at Lewisham Hospital.
Cuts to cancer networks.
£1 billion spent on managerial redundancies when patients are seeing treatment restricted and nurses laid off in their thousands.
7,134 nursing posts have been lost since the Coalition came in, 943 in the last month alone.
Training places are being cut by 4.6 per cent this year, after a 9.4 per cent cut in 2011-12.
125 separate treatments have been restricted or stopped altogether since 2010.
More than 50,000 patients have been denied treatments, kept off waiting lists, and there have been big falls in operations for cataracts, varicose veins, and carpal tunnel syndrome. “We have heard claims about reducing waiting lists but that is because people can’t get on the waiting list in the first place,” said Mr Burnham.
West Midlands Ambulance Service advised on Tuesday that there are about half a dozen hospitals in the West Midlands whose A&E staffing situation is so critical that it is having a knock-on effect to turnaround time of ambulances.
In Bolton, South Tees, Maidstone and Tunbridge Wells, large numbers of staff have been given 90-day redundancy notices.
The consequences were clear, according to the shadow Health Secretary:
74 per cent of NHS leaders described the current financial position as the worst they had ever experienced or very serious, he said. “The reason the government’s cuts feel much deeper is because they are contending with the added effects of a reorganisation that nobody wanted and that they pleaded with the former Secretary of State to stop. Cuts and reorganisation – it’s a toxic mix. As trusts start to panic about the future, increasingly drastic cuts are being offered up that could have serious consequences for patient care.”
Leading on from this, he said the Care Quality Commission found that 16 per cent of hospitals in England did not have adequate staffing levels. “I am surprised a warning of this seriousness hasn’t received more attention,” Mr Burnham said.
“The Prime Minister has cut the NHS – fact,” said Mr Burnham. “But just as he airbrushed his poster, he has tried to airbrush the statistics and has been found out.
“What I find most troubling about all of this, and most revealing about the style of this government and the way it works, is that even when they are warned by an official watchdog, they just carry on as if nothing has happened. When they admitted cutting the NHS in 2011-12 by amending their website, what was the excuse that they offered to Sir Andrew? ‘Labour left plans for a cut.’ Simply untrue.
“According to Treasury statistics, Labour left plans for a 0.7 per cent real-terms increase in the NHS in 2011-12. From then on, we had a spending settlement giving real-terms protection to the NHS budget. It was this government that slowed spending in 2010-11, which allowed the resulting £1.9 billion underspend to be swiped back by the Treasury, contrary to the promise that all savings would be reinvested, and it was this government that still has published plans, issued by HM Treasury, for a further 0.3 per cent cut to the NHS in 2013 and 2014-15 – contrary to the new statement that they have just put up on their website.”
He said the Coalition parties’ arrogance “seems to give them a feeling that they can claim black is white and expect everyone to believe it“. (Would it be in poor taste to hope that, in this case, Douglas Adams is proven correct and they all have terminal experiences the next time they venture onto a zebra crossing?)
“The lethal mix of cuts and reorganisation is destabilising our hospitals,” said Mr Burnham. “They are the first to feel the full effects of the free-market ideology that they have unleashed on the NHS. No longer a ‘One NHS’ approach, where spending is managed across the system, but now a broken-down, market-based NHS. The message to Britain’s hospitals, from this government, is this: ‘You’re on your own. No bailouts. Sink or swim. Oh, but if it helps, you can devote half your beds to treating private patients.’
“So we see increasing signs of panic as they struggle to survive in this harsh new world. And we see half-baked plans coming forward to reconfigure services, with an effort to short-circuit public consultation. Will the Secretary of State today remove the immediate threat to Lewisham A&E by stating clearly that it is a straightforward breach of the rules of the administration process to solve the problems in one trust by the backdoor reconfiguration of another? In Greater Manchester, will he ensure that the future of all A&E provision is considered in the round, in a citywide review, rather than allowing the A&E at Trafford to be picked off in advance? And in St Helens and Mosley, will he reverse the previous SoS’s comments when he told the CCGs they had no obligation to honour financial commitments to the hospital, entered into by the previous PCTs?
“It’s chaos out there, and [the Health Secretary] urgently needs – in fact, they all need to get a grip, not just the Secretary of State; all of them.
“Cuts and reorganisation are resulting in a crude drive to privatise services, prioritising cost over clinical quality. Across England, deals have been signed to open up 396 community services to open tender under ‘any qualified provider’. But these deals are not subject to proper public scrutiny as the deals are held back under commercial confidentiality. In Greater Manchester, plans are advanced to hand over patient transport services to Arriva, despite the fact that an in-house bid scored higher on quality, and despite the fact that the CQC recently found serious shortcomings with the same provider in Leicestershire. Nobody has asked the patients who rely on this service whether they want this change.
“‘Any qualified provider’ is turning into the NHS version of compulsory competitive tendering, a race to the bottom and a rush to go for the cheapest bid, regardless of the effect on patients and services. What clearer symbol could their be of a privatised, cut-price, Coalition NHS than the decision in Greater Manchester to award patient transport to a bus company.”
In the NHS constitution, patients and staff “have the right to be involved, directly or through representatives, in the planning of healthcare services, the development and consideration of proposals for changes in the way those services are provided, and in decisions to be made affecting the operation of those services”. So Mr Burnham asked: “Why doesn’t he just press the pause button now, and ask people if they want their ambulance services run by a bus company? ‘The NHS belongs to the people,’ says the first line of the NHS constitution – not when this government has finished with it, it won’t!
“People will remember the personal promises this Prime Minister made on the NHS to win office. Promises it now seems had more to do with his desire to de-toxify the Tory brand than with any genuine regard for the NHS.
“No top-down reorganisation of the NHS – broken.
“A moratorium on hospital changes – broken.
“And real-terms increases in every year of this Parliament – broken.
“They can now see the chaos that the breaking of these promises is visiting on the NHS: Nurse numbers – cut.
“Health visitors – cut.
“Mental health – cut.
“Cancer networks – cut.
“Cataract operations – cut.
“The man who cut the NHS, not the deficit.”
How did the Coalition combat these assertions? First with an attempt to divert the debate onto the NHS in Wales, overseen by a Labour Assembly Government, where spending has been cut. This was a matter that has exercised David Cameron very much during recent Prime Minister’s Questions, and it was welcome to see Mr Burnham set the record straight as thoroughly as he did yesterday.
He said the Coalition has given to the Welsh Assembly Government a real-terms funding cut of £2.1 billion – and this is the truth of it. I remember discussing the matter with Assembly members last year and it seems that even funding, which had been set aside to cushion the expected blow of cuts from Westminster, had been clawed back by the UK Treasury, with no regard for the consequences to Welsh NHS patients.
“They have done their best to protect health spending in that context,” Mr Burnham said. “Since 2010 there has been no reduction in frontline staff, particularly nurses, unlike [the UK] government. The Welsh Assembly are doing the best they can with the awful hand of cards which [this] government dealt them.”
Next, Mr Burnham was asked if he regretted “removing and reducing health spending to old people and rural areas, which happened under his watch”. It appears that this was a fabrication, dreamed up by the questioner, as Mr Burnham said it bore no relation to reality: “There was no reduction in health spending on my watch. I left plans for an increase. He illustrates my point.”
We heard that the chief economist of the King’s Fund, John Appleby, said that before the general election, the former chancellor had left plans for 2011-12, 2012-13 that would see a cut in real terms.
“I did the deal,” said Mr Burnham, “just months before the general election, protecting the NHS in real terms.
“At the election I was arguing for real-terms protection. I said it would be irresponsible, yes, to give real-terms increases over and above real-terms protection because the only way [to] pay for that would be taking it off councils, hollowing out the social care budget.”
One Tory who seemed particularly keen to assert his superiority said she was “very disappointed” to hear Mr Burnham “talking down the NHS”. She claimed that, before the election, the NHS knew it was facing an “unprecedented efficiency challenge”. And she said that, under Labour, productivity in the NHS fell continuously. Would the shadow health secretary acknowledge the achievements of the NHS in achieving a productivity gain?
This member got what she deserved – a three-word dismissal: “Productivity hadn’t fallen.” It’s a classic Tory ploy, criticising the opposition’s previous record to take the heat off their own current policies. But it doesn’t work when it’s based on a falsehood.
All of these were interjections from backbenchers. We could expect more high-quality responses from the Health Secretary himself, couldn’t we?
Judge for yourself.
“This government is spending more on the NHS than Labour would have, and because that money has moved from the back office to the front line, the NHS is performing better now than it ever did under Labour,” said Jeremy Hunt, the well-known misprint, providing no proof to support his claims.
“In 2011-12, spending went up by £2.5 billion in cash terms, 0.1 per cent in real terms, on 2010-11. And this year, 2012-13, it will go up again, as it will in every year of the Parliament.” But this did not address Andrew Dilnot’s assertion – that spending had dropped from 2009-10 levels. He was being selective with his statistics, and one can only conclude that he was trying to avoid dealing with an inconvenient fact. This was the point at which I knew Labour had won the argument.
“He [Andy Burnham] can hardly come to us, criticising our plans for NHS spending, if his own plans would have led to not higher, but lower NHS spending.” Note that it had already been stated that this was not what Mr Burnham had been doing. He made it clear that he would have protected levels of spending.
Mr Hunt joined the attack on the Welsh Government by stating that Labour has announced plans to cut the NHS budget by eight per cent in real terms, “despite an overall settlement protected by Barnett” (the Barnett settlement is a funding plan for devolved governments. Note that Mr Hunt did not say what the settlement was, and we are therefore deprived of the ability to determine whether this settlement is fair). Mr Hunt went on to ask of his Labour counterpart, “Will he condemn the choice that Labour made in Wales? If he doesn’t want to condemn that, let me tell him what the BMA says is happening in Wales. They talk of a ‘slash and burn’ situation. They talk about ‘panic on the wards’. Would he want that to be repeated in England?” He seemed not to have noticed Mr Burnham stating this is exactly what is already happening.
On a personal note, I use hospitals in Wales – a lot. My girlfriend is disabled and I myself have had occasion to seek hospital treatment. It has always been timely, professional, conducted in a calm, warm, welcoming atmosphere. I have seen no signs of panic on the wards, and if any aspect of the service is being slashed and burned, I haven’t experienced it myself. I have absolutely no complaints about the health service in Wales; if I were to level criticism anywhere, it would be across the border in England.
The final shot in the Wales mini-debate came from a Labour member, who wondered if the cut in Welsh health funding “has got anything to do with the cuts in capital spending from the Westminster government?”
This member added: “And has he any comment to make on National Audit Office figures that show spending on health in Wales is higher than that in England? Or does that not fit with his fictitious version of events?”
Fictitious. That’s exactly right. Now contrast Mr Hunt’s approach to questions from the opposition with the style already displayed by Mr Burnham – who, as evidenced above, tackled his critics head-on, answering them directly with the required facts.
The question was: Will he confirm just how many nurses have been cut under this government’s watch? The answer? “The nurse to bed ratio has gone up. The average bed is getting an extra two hours of nursing care, per week, than under Labour.”
That’s not an answer, and the Labour backbenchers knew it. Smelling blood in the water, another asked: “Why won’t he answer the question put to him – how many nurses have lost their job on his watch? Don’t tell me about nurse-to-bed ratio – answer the question.”
Fat chance! The response, again avoiding a direct answer, was: “The number of clinical staff in the NHS has gone up and not down. I don’t want to micro-manage every hospital in the country and tell them how many doctors and how many nurses.”
Mr Hunt returned to the Coalition line on NHS spending: “”We are increasing spending by £12.5 billion; he [Andy Burnham] thinks that is irresponsible.”
He was, of course, shot down – by two separate comments. One female Labour member stated: “My understanding of that english is that things had not changed much, in any circumstances, but the Secretary of State has said, consistently, he and the government were pledged to an increase. There is nothing in that letter [by Andrew Dilnot] to suggest that any increase has occurred.
And I believe it was Dame Joan Ruddock who said: “I find it impossible to find a record of this extra spending. It seems the reality is cuts and reductions to services.”
No point in listening beyond that. Coalition demolished.
Note: I apologise for the lack of information on who said what, other than the Health Secretary and his Shadow. I’m afraid I was too busy taking down what people were saying to catch their names, as they flashed up on my computer screen. It is not my intention to cause offence.
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