Wednesday, 22 February 2017

Underfunding - the key to privatising public services

Whats going on tomorrow at Lancashire County Council?
There should be fireworks, but in the current climate it's likely to be more of of a damp fizzle.

In terms of our NHS there are 'TWO' important items on tomorrow's Agenda (Thursday 23rd Feb):

Agenda Item 4. Review of the Councils Business & Operating Model
Last April county council cabinet members agreed to commission a consultancy called Price Waterhouse Cooper (PwC) to look at how LCC could streamline (i.e. cut) services to save money. The budget allocated from central government to local governments such as LCC has been severely reduced over the years resulting in LCC having to make cut-backs such as closing libraries and bus-routes etc. To make up the shortfall, LCC are even considering raising council tax. Allegedly, LCC paid between £3m and £6m for PwC to do the survey and report.

Out with the begging bowl

The report shows it's so bad we're now having to beg the Tories (the council call it lobbying) for assistance with a £95m shortfall in resources for Adult Social Care forecast for 2020/21.

Underfunding public services - the Tories key weapon in privatisation

The government should be adequately funding LCC to enable them to manage, subsidise, and run local services such as care homes and district nursing, so increasing the council tax only means the public are paying twice for the same services. *Council tax is based on the value of a property.

But there's more to it; the report recommends devolving health budgets from central government down to local government (Lancashire). and thus absolving more of Jeremy Hunt's responsibility to provide healthcare to the masses. Integration means fragmentation........
The NHS isn't means-tested, but social care is. So integrating NHS services with social care services opens up the market to means-testing NHS services. Hence, patients will then have to pay for services which were previously free at the point of need.
Social care is involved so the report also recommends LCC agree to go along with the STP plans for their area. They call it 'Health and wellbeing integration', I call it privatisation. Its a very contentious report since NHS partners have not been involved in it. There's anger that LCC are to publish a detailed report, commissioned by the Council, which implies major NHS reorganisation without the report having any input from NHS partners (sound familiar?). link below..

Agenda Item 11. LCCs Health Scrutiny reporting back to full committee.
The health bit is in annex 2. This is simply what the scrutiny have been told by NHS England about the STP in their fancy slideshows. There isn't even a recommendation. Considering the importance of STPs, the report to LCC full committee from Health scrutiny really is the worst scrutiny analysis I've ever seen. It's as though health scrutiny have no objection - in fact, there is no objection. Take a look... link below

It's obvious even to a blind pig that the overall objectives of both agenda items is for central government to underfund public services to enable them to pursue their own privatisation agenda.

And with the Tories in their second term of office, they are now pushing the boat out.

It's our job to sink it


Item 4. Review of councils business services & operating model

Appendix to Item 4 (PDF) - PwC's Lancashire Public Service Delivery Model - An STP for public services?

Health Scrutiny Report on STP to full council

Friday, 17 February 2017

Research indicates STPs have a high risk of Failure

Research from the King's Fund indicates STPs have a high risk of Failure. Despite the introduction of the Sustainability and Transformation Fund, the financial reset and the use of a new financial `special measures’ regime, financial performance in providers continues to slide. 

As a result, reducing the net provider deficit to £250 million from the forecast £644 million at quarter one looks increasingly unlikely and indeed, there are greater risks it will rise rather than fall. This is despite a quarter of all trusts now reporting delays or cancellations of capital spending in order to support their finances.

Staff redundancies included in efficiency savings

The latest Quarterly Monitoring Report from the King's Fund think-tank shows that increasing numbers of health trusts in England are also looking to reduce their clinical workforce, with 29 per cent now planning to reduce their headcount.

Mental Health staff cuts targeted most

While relatively few acute hospitals plan to reduce the number of staff, more than half of mental health and community health service providers are now planning to cut staff numbers. This threatens the aspirations to raise the quality of care set out in the Five year forward view for mental health as well as long-term goals to improve services in community settings.
Alongside cuts to capital spending by trusts, more than half of CCGs are delaying or cancelling spending plans. This underlines the risks that the drive to cut deficits is having on the long-term transformation agenda for the NHS.

Unachievable savings

Looking forward to 2020/21, the STP process has not led to any greater optimism about the prospects for achieving the £22 billion in efficiency savings needed to deliver the STP/Forward View. While some 79 per cent of trust finance directors think there is a high or very high risk of failure, now 90 per cent of CCG finance directors say the same, sharply more pessimistic than in July before STP plans were submitted or the planning guidance issued.

STP funding withheld

With many organisations still expecting to end this year in deficit, no additional transformation funding available, and minimal real-terms growth in 2017/18 and 2018/19, NHS finance directors have found little to be optimistic about.


Monday, 13 February 2017

The NHS is not unaffordable, it's being starved

In this post we blow apart the MYTH that the NHS is 'unaffordable' noting the real reason for the current NHS crisis is under-funding to allow privatisation...

Last September [2016], the Office for Budget Responsibility [OBR] stated the NHS is easily affordable up to and beyond 2030.

Current Spending to fall under Tory Government

----- The NHS is not unaffordable, it's being starved ------

■ MYTH: We need to change since we can't afford the NHS in its present form.

■ FACT: the fallacy of the NHS being unaffordable has been debunked by all major health think tanks such as Nuffield trust & King's Fund along with the Office for Budget Responsibility (OBR) and other economists. A recent report from the OBR shows the NHS is easily affordable up to and beyond 2030.

The OBR figures show that the UK currently spends 7.4% of its GDP on healthcare, which is set to fall to 6.9% by 2020 under the current Tory government funding settlement. The health select committee have already shown that the £10b funding set aside to aid roll-out of Hunts NHS reforms (STPs) is less than half of what is needed to properly fund the NHS; indicating the real intention is to starve the NHS to meet privatisation requirements set up with Andrew  Lansley's Health & Social Care Act 2012 (the privatisation act).

The OBR figures show that this amount could easily increase to 8.8% by 2030 - evidently without an increase in general taxation. Appleby stated the 8.8% increase in spending is actually lower than the long-term growth in NHS spending. Average spend since 1954 is 4% a year, whereas an increase to 8.8% by 2030 would represent a growth of less than 0.1% a year.
So the irony is, even if we're at an 8.8% spend in 2030, the UK will still be at the same spending levels France, the Netherlands, Denmark, Sweden, Germany and Japan were  back in 2015 !
Prof. Appleby said “The real debate the UK needs to have is over how much more we want to spend on the NHS, not whether we need to change the way the health service is funded.”

The wish to move to a radically different model of health care is purely political ideology - what many now know as denationalisation of the NHS as Jeremy Hunt espoused in his co-authored booklet titled 'Direct Democracy'.

Finally, we're all aware that the Sustainability & Transformation Plans (STPs) are being rolled-out by the ex vice president of the U.S. private insurance firm UnitedHealth, and the models of care being proposed for England, such as 'Accountable Care Organisations' are based on the U.S. private insurance models.

So to conclude, I've included a health spend comparison table below showing that even though the UK spends less than the other countries shown, it comes out on top for efficiency, affordability (equity), access to care and outcomes. The USA on the other hand comes an abysmal bottom with the greatest spend and the worst outcomes.

Yet this Tory government want England to move to the failed U.S. model that most American citizens can't afford. And all for their Tory egotistical ideology and historical wishes of denationalising the NHS.  If that doesn't put the fight back in you, then reality hasn't hit home yet of what's happening to our NHS. This is a wake up call, a call to arms to save the NHS before it's too late.

References & related links

Nuffield Trust: New OBS figures show NHS ‘is still affordable’ [26.9.2016]

Thursday, 9 February 2017

As GP numbers fall, patients are more likely to pay to see them

 The reason the Tories want fewer GPs as per their STP plan is to narrow down the market ensuring the public will have to pay for GP services in future.

NHS England’s Sustainability and Transformation Plans (STP) see England divided into 44 “footprints” – which must achieve financial balance by next year.

The philosophy of health insurance is inline with the American model of health care where 'physicians' or GPs as we know them, charge patients per visit.  And who would be better than 'Simon Stevens', the boss of NHS England to introduce these 'U.S. models of care. 

Stevens, who worked for 10 years as vice-president of the American private insurance based company 
UnitedHealth, was appointed in 2014 as CEO of NHS England by the tory health secretary Jeremy Hunt. That's right; the same Hunt who imposed an unfair and unsafe contract on NHS Junior Doctors early last year.

Many Junior Doctors were so incensed by the 'imposing' nature of Hunts actions they pledged to leave the NHS in droves. And this does seem to be the case. Does Hunt care? not at all, it was all planned along while ago...

The frightening thing about both Hunt and Stevens is they both wish to see the American models of care(less) introduced in England. Remember, the U.S.A. does not have a universal healthcare system as here in the U.K. so is fully dependent on private insurers covering only those who can pay to see a doctor or visit hospital.
I've just explained to my GP about the plot to dismantle the NHS and in particular force GPs into federated practices operating on private-public partnerships. 

My GP mentioned if they were forced to join a GP federation they would quit the profession. But the real plot is just that, to demoralise GPs thus forcing a system that's understaffed ensuring patients in future pay for GP primary care services.

In a recent news article (below) the Clinical Commissioning Group chairperson clearly states that GP services will be more patient-centered. And that means only one thing: population - based care which is centred around insurance-plans and 'personal health budgets'.
In other words, many patients, knowing they will have to pay to see a GP, won't make a GP appointment. Result, fewer GPs needed as indicated in the news article.
Tory philosophy - "pay or stay away"

The NHS principle of free at the point of need is disregarded in this Tory bastardry. 
Why they are still in government is matter of tolerance, but tolerated by how many, and for how long?