Tag Archives: outsourcing

NHS privatisation is killing people, says The Lancet

On the critical list: privatisation has triggered a major increase in NHS patient deaths because the services provided by private firms are of a significantly lower quality, according to a study published in The Lancet.

The oldest medical journal on the planet has published a report showing the NHS outsourcing – also known as privatisation – has caused a significant increase in patient deaths.

This is due to healthcare services being of lower quality since private firms were allowed to provide them.

The study states:

The privatisation of the NHS in England, through the outsourcing of services to for-profit companies, consistently increased in 2013–20. Private sector outsourcing corresponded with significantly increased rates of treatable mortality, potentially as a result of a decline in the quality of health-care services.

We found that an annual increase of one percentage point of outsourcing to the private for-profit sector corresponded with an annual increase in treatable mortality of 0·38% deaths per 100 000 population in the following year… Changes to for-profit outsourcing since 2014 were associated with an additional 557 treatable deaths across the 173 CCGs.

It elaborates:

We found significant increases in for-profit outsourcing between 2013 and 2020.

Since 2013, the annual numbers of treatable deaths in England has increased, breaking the trend of decreasing mortality for the previous 10 years.

We found significant positive associations: an additional £1 million spent on for-profit companies corresponded with average increases of 0·29 deaths for all CCGs in the following year.

Between 2014 and 2019, there were total yearly increases of £927 million spent on for-profit providers by all 173 CCGs included in this study sample. Based on the changes in for-profit spending and observed changes in treatable deaths for each CCG, we calculated that 557 additional deaths could have been attributed to changes in private-sector outsourcing between 2014 and 2019 across the 173 CCGs in the years for which we had data.

So, because of NHS privatisation, 557 people lost their lives, who should have been alive today.

And that’s before the Covid-19 pandemic hit the UK.

Strangely, there hasn’t been a whisper about this in the mainstream media. Did you see it on the TV news? It’s almost as if there’s been a blackout.

Source: Outsourcing health-care services to the private sector and treatable mortality rates in England, 2013–20: an observational study of NHS privatisation – The Lancet Public Health

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Tories force £100 million payout so outsourcing giant can chase over-75s for TV licence fee

The Conservative government’s relationship with private outsourcing firms is becoming more questionable by the day.

It has been revealed that the BBC is having to pay nearly £100 million to Capita so the firm can hire new staff to chase down senior citizens who fail to pay the TV licence fee.

People aged over 75 had been exempt from paying the fee because the government subsidised it – until George Osborne decided that he was going to axe the subsidy for no apparent reason other than cruelty.

The BBC was then forced between betraying all licence fee-payers by cutting its output significantly, or betraying over-75s by demanding that they pay the fee again.

It wasn’t any choice at all.

At least we’re all laying the blame where it’s due. As the Mirror article states:

Age UK charity director Caroline Abrahams said: “The BBC has taken this decision but in reality the principal responsibility lies with the Government.

“Until a previous administration transferred these free licences to the Corporation under a tapering funding arrangement they had taken the form of a welfare benefit for a generation, and to have done that without any consultation left a really bad taste in the mouth.

“The Government cannot absolve itself of responsibility for the upset and distress being caused to many of our over-75s today, the poorest and most isolated above all – and the sadness is that these older people have already endured so much over the last few months.

“The Government needs to sit down with the BBC urgently to keep these TV licences for over-75s free.”

Ms Abrahams’ suggestion is right – but we know the Tories won’t act on it.

They’ll say the Covid crisis, Brexit, and the collapse of the UK’s economy (all their own fault) mean the nation cannot afford to take back the TV licence subsidy.

In reality, though, the real reason is that they’ve given all the money to privatised outsourcing firms like Capita.

Source: BBC to spend ‘£100m of taxpayer cash chasing over-75s not paying licence fee’ – Mirror Online

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After private firm linked to Gove & Cummings helped cause ‘A’ level disaster, will new health ‘Institute’ go the same way?

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Dido Harding: Isn’t it funny how McKinsey was hired to work on an organisation fronted by a former McKinsey consultant? Did I type “funny”? I meant “sickening”.

Were you aware that the disastrous strategy to deprive lower-class students of their higher ‘A’ level grades was devised by a firm of consultants, apparently hired because of links to Michael Gove and Dominic Cummings?

I mention this because the same criteria seem to have been used to get advice about the “vision, purpose and narrative” of Matt Hancock’s new public health “institute”.

Public First, a policy and research firm owned by James Frayne and Rachel Wolf, who both formerly worked for Gove, was involved on the project with Ofqual since June after being granted a contract that was not put out to competitive tender.

Details of the contract have not been made public and Ofqual declined to say how much public money had been spent hiring the firm of Tory cronies.

The collaboration led to the result we all know:

The algorithm used by Ofqual downgraded 40% of the A-level grades assessed by teachers under the process set after the exams were cancelled, leading to a storm of protest from students, parents, school leaders and teachers, that culminated in a complete government U-turn on Monday and the system being scrapped.

Most of us would expect the Tories to be coming out with the usual “lessons will be learned” speech right now – but they can’t, because they haven’t.

The Johnson government has already hired McKinsey – under the same “exceptional circumstances” rules used to award the Ofqual contract to Public First – to play the same role.

And guess what? According to the Financial Times, the new National Institute for Health Protection’s boss – Dido Harding – is a former McKinsey consultant.

What a cosy, cronyist world they all inhabit.

There is one difference between the NIHP situation and Ofqual. We know how much of our money McKinsey has been paid: £563,400. At a time when the national debt has just topped £2 trillion, the Johnson government has shovelled another half a million of borrowed cash into private, profit-grubbing hands.

That’s a lot of money for something that I’m happy to bet will be a worse travesty than the ‘A’ level debacle.

Source: Firm linked to Gove and Cummings hired to work with Ofqual on A-levels | Education | The Guardian

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Did ‘body parts stockpile’ firm come unstuck because of an unrealistically-low bid for the contract?

Skwawkbox found this report, suggesting the contractor’s bid was too low.

Fellow left media site Skwawkbox has uncovered a new aspect of the ‘body parts stockpile’ scandal – that private firm Healthcare Environmental Services’ bid for the contract was unrealistically low.

It would be easy to lay all the blame for the current situation on the company – but if it is a money problem, it really is just another symptom of the Conservative government’s mania for providing public services on the cheap, no matter how bad the service then turns out to be.

Private companies make their bids artificially low – because they know the lowest bid will get the contract.

And then the contractor fails to do the job because the money it requested isn’t enough.

You’d have thought the Tories would have learned their lesson from Carillion.

They should have reviewed all private contracts after that fiasco.

If they didn’t, this scandal is less the fault of the company than the government.

ADDITIONAL: It seems a criminal investigation has been launched into the behaviour of Healthcare Environmental Services after the Environment Agency said the company had breached environmental permits.

It seems I was right: The Tory government is trying to blame the contractor for a scandal they caused themselves.

A private firm with a public contract for disposing of clinical waste has been unable to execute its contract in a ‘timely’ fashion, leading to a ‘pile up‘ of hundreds of tonnes of human body parts and other waste.

But the Department of Health’s management organisation for the English NHS, NHS England (NHSE), was told well over a year ago that the price bid by the winning contractor, Healthcare Environmental Services (HES) was ‘abnormally low‘ – and it went to court to defeat a legal bid to overturn the contract award.

Another firm that competed in the tender, Stericycle (then called SRCL), lodged a complaint that the winning bidder had put in a price that was unrealistically low. Stericycle’s legal action was an attempt to overturn the award – but was defeated in the High Court in July.

Source: Govt was warned body-parts firm’s bid was unrealistically low | The SKWAWKBOX

Lack of investment means waste firm with NHS contract has been stockpiling human body parts

The waste organs that have been stockpiled are the products of surgery, in many cases.

Lack of investment in the UK’s capacity for high-temperature incineration has created a ghoulish stockpile of human body parts awaiting proper disposal.

The company with the contract (of course, it had to be an issue with outsourcing to private contractors) to dispose of National Health Service waste including amputated limbs, infectious liquids and cytotoxic waste connected with cancer treatments is Healthcare Environmental Services Ltd.

And it is pleading innocence. For once, the contractor is not to blame, it seems.

The evidence is that the UK’s ability to incinerate this dangerous waste has diminished because the UK’s aging high-temperature incinerators have been allowed to fall into disrepair, meaning they break down for prolonged periods – and “zero waste to landfill” policies mean the little time that is available has been earmarked for other purposes.

This is clearly a failure by the Conservative government.

It seems the government was notified that too much waste has been building up, back at the end of July this year. But Healthcare Environmental says it has been warning environmental regulators – government environmental regulators – for the past year, and had been highlighting the reduction in incinerator capacity for several more years prior to that.

So the government has known about the problem for years.

And what has it done?

It told the company to make the waste organs safe by putting them in refrigerators. Brilliant.

Shadow health secretary Jonathan Ashworth isn’t satisfied at all. He said: “These are staggering revelations and given the number of NHS Trusts involved, along with wider environmental health implications, I’m disappointed the Health Secretary didn’t inform Parliament last month.

“We need a statement in the Commons next week from ministers detailing when the Government was first informed of this stockpiling, what support is now available to Trusts and what contingency plans are in place for the future.”

Personally, I wonder if this is an issue that has fallen through the “austerity” gap.

When David Cameron started slashing government investment in public services, he assumed that gaps in provision would be filled by the private sector, with profit-motivated companies rushing in to make a buck or two. Alternatively, he suggested that not-for-profit organisations would take over in some areas, in an intiative he called “The Big Society”.

The problem was that “The Big Society” disappeared without a trace and private enterprise didn’t touch anything that didn’t show an opportunity for quick profit. This was a time of recession, remember – there wasn’t the cash available for heavy investment.

It seems to me that Cameron had painted himself into a corner. He had managed to slither into office on the basis of his claim that he could make everything better by getting everybody to tighten their belts, but had actually meant the poor and working people would pay, while people of his own class would profit (they have tripled their incomes while the rest of us struggled on real-terms cuts in wages and/or benefits).

In short, he couldn’t get Big Money to pay for modernisation, and he wouldn’t pay for it with the public purse.

So he ignored it.

Now he is long gone, and Theresa May is in charge of a Tory government that is falling apart – not least because the consequences of Cameron’s cuts are coming home.

This is just one of them.

Theresa May announced that austerity was over in her conference speech (yes, I know it was a lie).

As the bills arrive for modernisation of the services Cameron neglected, I wonder how long it’ll be before she announces that it is reinstated?

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Ashworth: Presumption that government contracts should go to private firms is wrong

[Image: We Own It.]

Carillion’s collapse really has changed political thinking.

Here’s Labour’s Jon Ashworth explaining that outsourcing of government contracts, whether tied to Private Finance Initiative deals or not, leads to firms making their profit by cutting staff wages and conditions – which ultimately leads to a poorer service.

He’s absolutely right. This Writer has been saying for years that poor treatment of workers leads to a poor product.

Therefore it follows that, if private business cuts corners in order to make a profit, the only way to provide a decent service is to eliminate the profit motive and for the government to nationalise its work contracts.

The arguments against this are disproved by the facts. All the privatisation-loving Tories can do with future private contracts is confirm Mr Ashworth’s conclusion.

It will be painful to watch, but necessary – to ensure that everybody gets the message.


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As outsourcing contracts collapse, Tories are talking about charging for NHS services

An NHS contract to outsource care of older and mentally ill people collapsed after just eight months [Image: Getty].

An NHS contract to outsource care of older and mentally ill people collapsed after just eight months [Image: Getty].


This is where our money is going.

Because the Conservatives are keen to give public money to private enterprise, two NHS trusts banded together to become a service provider for older people and those who were mentally ill – and failed.

That means they were being paid our money for a service they couldn’t provide – so the people who needed the service didn’t get it.

They still need the service but the money has gone.

And now a Conservative MP has proposed charging people for NHS services.

No.

This fiasco happened because the Conservatives created a false need to pay private firms for services.

The answer is not to introduce more commercialism into the NHS, but to strip it out completely.

Private firms should be banned from competing for NHS contracts, and the service should return to being run on sound principles of financial competence.

That is the lesson.

But Tories won’t learn from it, because they are wedded to an outdated, market-driven philosophy that simply isn’t relevant to a service like the NHS.

A “catalogue of failures” resulted in the collapse of an £800 million NHS contract to outsource care of older and mentally ill people, the Commons spending watchdog warned.

An influential committee of MPs concluded that the NHS lacked expertise in procurement and it was “worrying” that untested contracting arrangements could form part of the plans being drawn up for further changes to services across England.

The Public Accounts Committee was scathing about the doomed deal between Cambridgeshire and Peterborough Clinical Commissioning Group (CCG) and UnitingCare Partnership, which collapsed after just eight months.

The cash-strapped CCG awarded a five-year contract to UnitingCare, an NHS consortium of Cambridgeshire and Peterborough NHS Foundation Trust and Cambridge University Hospitals NHS Foundation Trust, but the deal was scrapped in December 2015 after it ran into difficulties.

The MPs said: “The procurement exercise was undermined from the start by poor commercial expertise, a lack of realistic pricing, and weak oversight.

“The CCG accepted the lowest bid on the table, without seeking proper assurance that the two trusts, which had combined to form the UnitingCare Partnership, could deliver for that price.

“It was then grossly irresponsible of the trusts and the CCG to rush ahead with the contract without having resolved significant differences in their understanding of the contract price or indeed the scope of services that were included in that price.”

Source: NHS outsourcing contract collapses due to ‘catalogue of failures’ | The Independent

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Capita – another nail in the coffin of government outsourcing

150211Capita-logo

How much more corruption must the British taxpayer underwrite?

The latest private firm to face allegations that it took huge amounts of public money and used it corruptly is Capita.

That’s right – the outsourcing giant whose government contracts include taking over the Work Capability Assessment from discredited Atos in some parts of the UK, is facing an investigation into allegations that it used a major government contract to short-change small companies, resulting in some going out of business.

Capita took a minimum 20 per cent cut of the value of all contracts to administer a £250 million civil service training scheme, in a project hailed as a model of how to open up the public sector to small businesses and provide better value to the taxpayer.

But 12 companies involved in the scheme have now teamed up to demand that the Cabinet Office and the National Audit Office launch an investigation into Capita.

If it is found guilty, the company will join a roll-call of shame that includes PricewaterhouseCoopers (helping clients avoid tax while advising the Treasury on its policy to tackle tax avoidance), G4S (failure to provide security for London 2012, criminal tagging fraud), Serco (criminal tagging fraud) and A4e, if anybody can remember that far back.

To its shame, it seems the Coalition Government is still employing all of these companies.

Lucy Powell MP, Labour’s Shadow Minister for the Cabinet Office, said allegations against Capita included claims that firms had gone out of business due to late payments and government departments had been charged more for services than they were under previous arrangements.

“David Cameron promised the Government would pay small business suppliers within five days, yet his failure to act continues to damage our economy,” she said.

“Labour will shine a light on government outsourcing by ensuring firms delivering Government contracts comply with freedom of information requests.

“We will also back small businesses struggling under the Tories by cutting and then freezing business rates.

“And we have put forward a clear plan to tackle the scandal of late payment, ensuring late payers automatically pay interest to their suppliers, and outlawing bad payment practices such as firms being asked to pay for the right to be a supplier.”

That all seems good – and bolsters Labour’s claim to be good for business – but…

In order to make good on its FoI promise, Labour will have to strengthen the law to prevent contractor firms ducking requests in the same way that – for example – the Department for Work and Pensions is currently ducking demands to reveal the number of benefit claimants who have died since November 2011 – the DWP says it already has plans to publish the information, but on an unspecified date that keeps getting pushed further and further into the future.

Any business rate freeze must take notice of local conditions to ensure that no part of the UK is disadvantaged. At the moment there’s a postcode lottery, with businesses based in the most lucrative areas gaining an instant advantage. A blanket freeze would maintain that advantage, rather than levelling the field.

Also late payment controls must be robust enough to prevent firms from finding loopholes in order to delay.

In other words, while the broad strokes are good, the devil’s in the detail.

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The Conservative Party – nasty, stupid and clumsy

Is this the face of a 'Caring' Conservative? Or is he nasty and clumsy? And if he is, does that mean the supporters behind him are stupid?

Is this the face of a ‘Caring’ Conservative? Or is he nasty and clumsy? And if he is, does that mean the supporters behind him are stupid?

Independent luminary Andreas Whittam Smith reckons the Conservative Party in its current form is both nasty and stupid – and also clumsy, if his latest article is to be believed.

Nasty because of its aggressive behaviour – such as the decision to withdraw support for rescue operations that save thousands of migrants from drowning as they attempt to cross the Mediterranean to Europe.

Or because of benefit assessment policies that mean people living with progressive and degenerative conditions such as Parkinson’s, motor neurone disease and rheumatoid arthritis are being subjected to what a group of charities describes as “upsetting and unnecessary” examinations to see whether they will recover enough to look for work in the future – a pointless exercise because their conditions are flagged up from the start as progressive and degenerative; they’re never going to get better.

Or because, after the Resolution Foundation found that one-in-five employees (4.9 million people) earned less than the living wage, George Osborne is promising that if the Conservative Party wins next year’s general election, then most welfare payments that the working poor rely on – including child benefit, tax credits, jobseeker’s allowance, housing benefit and income support – will be frozen in April 2016 for two years. They are currently rising by 1 per cent a year. He will make the working poor poorer.

zTorypromise

Clumsy because they have imposed unpopular decisions on the people in an unfair way. Mr Whittam Smith defines fairness in terms of “the four main elements that go into creating a sense of procedural justice: Those concerned should have been able to play an active part in the process. The rules should be applied with sensitivity to individual situations. Decision-makers should be impartial and fair. And the agents of the system with whom people have to deal should treat them with respect.”

He continues: “There is no evidence that people living with progressive and degenerative conditions or members of the working poor or families struggling to pay care bills for elderly relatives have been consulted. There is no evidence of sensitivity to individual situations or else the bedroom tax legislation would have recognised the special difficulties of disabled tenants who are unable to share a bedroom and would have taken into account where homes have been specially adapted.

“As for the agents of the system with whom people have to deal, outsourcing many of these tasks has not produced happy results. Naturally the outsourced staff work by the book. They cannot be flexible or understanding. They are chiefly concerned with getting the job done as quickly as possible so as to reach the profits targets set by their employers. And then, in the final analysis, claimants are not dealing directly with the state at all but with a sort or mercenary army. Mutual respect cannot exist in these circumstances.”

Let’s expand on the last point for a moment, and connect it with the previous points about benefit assessment, with this snippet of information: An academic report from Edinburgh Napier University and the University of Stirling has confirmed that the Tories’ welfare reforms are not helping people to find work.

According to Alan Wyllie on the A Working Class Man blog, the report showed:

  • “The current welfare system is not helping people find work. Those who had moved into employment found work independently and not due to Jobcentre Plus services;
  • “There was limited support on offer to help recipients of out of work benefits move into work. Those participating in the Work Programme did not report that it was helpful;
  • “Most people wanted to work but issues such as childcare, illness and training made it difficult for them to do so;
  • “The current welfare system also does not appear to meet its aim of ‘make work pay’. People who had moved into work felt only slightly better off and continued to find it difficult to make ends meet;
  • “Benefit freezes or restricted increases have meant falling real-term incomes, with many study participants finding it hard to meet basic needs.

“The report concludes that: ‘Participants with a health condition or a disability, and those who were lone parents, reported that they wanted to be in work but faced considerable barriers to doing so, which were unlikely to be addressed by increasing conditionality.

“’According to the views of participants, stronger conditionality is unlikely to get more people into work, due to a lack of suitable work and barriers in the areas of education, skills, employability, childcare and health.’

“The researchers found that claimants who did not abide by the new conditions faced serious consequences.

“’The impact on benefit recipients who fall foul of new rules – or who are affected by a mistake on the part of a benefits agency that is not their fault – can be severe,’ they said.”

That’s nasty – not only have benefit changes been forced onto people without any regard for them, but they don’t even work.

However, this – moving back to Mr Whittam Smith – may be the Tories’ downfall. He points out: “Nowadays we are no longer a homogenous mass but an agglomeration of minorities. In my own circle of family and friends, for instance, there are people who are disabled and others with serious illnesses. There are those who are single parents, others who are retired. There are middle-aged people with back-breaking mortgages, others who are and young and ambitious. There are regular Church-goers as well as non-believers. There are people in jobs, and people who cannot find work. There are Londoners who can’t conceive of living anywhere else (I am one of these), and people who resent the capital city and all its works.

“Each of these minorities has its own particular concerns and needs, prejudices and resentments, but yet feels sympathy for any group that is badly treated.

“The Coalition led by its Conservative ministers has often gone about its work in an unfeeling, insensitive manner. And for that shortcoming there could be a price to pay at the next general election.”

Quite so – especially as they came into government under the banner of ‘Compassionate Conservatism’. What a terrible joke.

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