Huddersfield hospital closure program, is Chorley hospital next?

The Lancashire hospital trust running Chorley & South Ribble hospital are considering following the same program that proposed closing Huddersfield Royal Infirmary last year.

On the 20th of October last year, Huddersfield Royal Infirmary, run by Calderdale and Huddersfield NHS Foundation Trust, was proposed by the local CCGs to be closed and demolished under their STP program titled 'Right Time Right Care Right Place'. 

Due to similarities, Lancashire Teaching Hospitals (LTH), the trust who run Chorley & South Ribble hospital are now considering following the same program as Calderdale, and are discussing joint communications with the Calderdale & Huddersfield trust. From the LTH board report....

"A slide presentation had also been circulated which provided an outline of a visit that had been undertaken to Calderdale and Huddersfield NHS Foundation Trust to discuss their [STP] programme which was similar in content to the Our Health Our Care programme".

A patient safety risk had been introduced as the Preston Primary Care Centre group were not prepared to support out-of-hours cover at Chorley and the Chorley Medics had relocated from the Chorley and South Ribble Hospital site [to Euxton]. Risks highlighted through loss of income and financial consequences in relation to the urgent care centre service. 

NOT ENOUGH BEDS - OOPS, WE'VE CLOSED THEM

Lancashire Teaching Hospital trusts October 2016 board report states that 78 out of 90 beds had been introduced following the CQC inspection in July 2014 but have now been decommissioned. 

Ironically, the Lancashire Trust now claim there is not enough capacity in acute services which is impacting directly on the delivery of key access targets.

Sustainability & Transformation Plan (STP) related contracts have been brought forward and have now been signed off thus accelerating plans for privatisation before any public consultation periods start. NHS England are basically holding hospital trusts to ransom if the trusts don't meet financial targets by fixed dates.

This will inevitably result in trusts cutting corners resulting in poor quality patient care.

Today (29th April 2017), hundreds of campaigners turned out in Huddersfield to protest against the undemocratic way their hospital had been earmarked for closure. And they are not going to let it go when lives are at risk.

Our NHS campaign here in Chorley has a lot in common with Huddersfield's NHS hospital campaign, and today was the start of a united effort to emphasise just how important our NHS is to us and that services must remain local at all costs.

The NHS is always there when we need it. Now it needs us to prevent it from being sold-off to those who put profit before people. We must never let this happen...

The Biggest NHS Sell-Off Event Ever!

A 'business-case' for the NHS has now been set, and its the biggest NHS Sell-Off event Ever!

If anyone is in any doubt as to the sheer scale of the privatisation of our NHS, look no further than the Health+Care Conference announced for June.

The conference 28-29 June 2017 | ExCeL London, brings together all STP leads, health trust and CCG chief executives and other delegates from the private sector. The event organisers claim the event is" Europe's largest integrated health and social care event, building relationships between commissioners, providers and suppliers".

Their brochure states "IT’S THE ONLY PLATFORM FOR BUILDING RELATIONSHIPS BETWEEN COMMISSIONERS, PROVIDERS AND SUPPLIERS. IT’S ALSO THE LARGEST GATHERING OF STP LEADERS EVER ASSEMBLED. AND LET’S FACE IT, AS THEY’LL BE LOOKING FOR YOU AT HEALTH+CARE, CAN YOU AFFORD TO NOT SEE 5,500 CUSTOMERS YOU HAVEN’T MET YET.

The objective of the expo conference is to accelerate 'Transformation' of the NHS by introducing delegates to hundreds of private healthcare sector companies along with other STP leads.

To anyone wishing to retain a universal healthcare system, the Health+Care conference is a shameful collection of people openly betraying the principles of the NHS. Such events would have been taboo 20 years ago, but now the SALE OF OUR NHS is openly broadcast and in public. There's even a 'transformation' awards event for those who so far have managed to cut NHS services and transform them in line with private healthcare sector values.

It's a no holds barred event with Labour and Lib Dem politicians thrown in for good measure...

Here's a brief list of those hosting some of the events with many sessions openly 'sponsored' by private companies..

Opening and Welcome to Health+Care 2017
Chair: Dame Ruth Carnall,
Managing Partner, Carnall Farar Ltd

Cross-Party Debate: NHS and Social Care Funding - is it time to ask the public?
Jonathan Ashworth MP, Labour Shadow Secretary of State for Health

And another Labour Peer...
■ Delivering the £5bn operational productivity challenge
Patrick Carter, Lord Carter of Coles, founded Westminster Health Care Ltd in1985 which he built into a leading health care provider which he sold in 1999. The Labour peer is a private investor and director of public and private companies in the fields of insurance, healthcare and information technology.

Local Authority Trading Company - The benefits and opportunities and challenges
Alison Waller, Managing Director, Tricuro Limited

■ Improving quality with creative leadership
Chris Gage, Managing Director, Ladder to the Moon
Dr Al Mulley, Managing Director for Global HealthCare Delivery Science, The Dartmouth Institute

Dr Rupert Dunbar-Rees, Founder and CEO, Outcomes Based Healthcare [research company]

Antony Tiernan, Director of Engagement and Communication, New Care Models Programme – Five Year Forward View

James Sanderson, Director of Personalisation and Choice, NHS England

Sir Bruce Keogh, Medical Director, NHS England

Professor Matthew Cripps, National Director, NHS RightCare

Jacob West, National Care Model Lead – Acute Care Collaboration and Primary and Acute Care
Systems (PACS), New Care Models Programme

The Rt Hon Stephen Dorrell, Chair, NHS Confederation and former Secretary of State for Health

Matthew Swindells, National Director: Operations and Information, NHS England

GP Regulation: Professor Steve Field, Chief Inspector of General Practice, CQC

Challenges facing the NHS provider sector: Chris Hopson, Chief Executive, NHS Providers

Dominique Kent, Chief Operating Officer, The Good Care Group Ltd


The expo conference brags it has over 450 private and public exhibitors....

Are STPs based on New Labours white paper from 2006?

All STPs are based on a blueprint document titled 'the Five Year Forward View" (FYFV). But did you know the 'five year forward view' is based on an old Labour party white paper dating back to 2006? The title of the white paper? "Our Health Our Care Our Say"

In this article we'll look at the similarities and argue that if Gordon Brown had remained in office after the 2010 elections, the five year forward view may still have gone ahead.

Is it coincidence that Labour's plans in 2010 have been accelerated under the Tories?

Would Labour have gone ahead with their secret NHS plans?
New Labour had a long history of marketising the NHS and opening up NHS services to the private sector. Services such as diagnostics and elective surgery (Labour's concordat), Private Finance Initiatives (PFi) that still cripple many NHS hospitals budgets today, and will continue to do so unless something is done. So Tony Blair's NHS policies showed it's likely we would have seen something similar to STP's if Gordon Brown had remained in government.


Same Advisor: One of Tony Blair's health policy advisors was 'Simon Stevens'.

Stevens worked for over 10 years as vice president of UnitedHealth, the largest private healthcare insurer in the United States. Stevens was appointed by the Conservatives to be head of NHS England pushing through Sustainability & Transformation Plans (STPs).

Let's take a brief look at New Labour's 2006 the white paper and compare it with the FYFV..

Personal Health Budgets..

A.19 There is particular support for greater personalisation of services. Responses to Independence, Wellbeing and Choice widely welcomed extending the availability of direct payments and the introduction of individual budgets for people to stay as independent, active and in control of their own lives as their circumstances allow. There was also significant support for the wider use of self-assessment and more streamlined assessment processes, including the sharing of personal information between appropriate agencies to enable joined-up care.

Prevention, combining NHS budget with social care budget and means tested NHS services

"we provide services with an emphasis on preventing problems and ensure that social care and the NHS work on a shared agenda to help maintain the independence of individuals".
Social services are means tested resulting in patients paying for some or all of the services. Combining NHS services with social care services would result in an extension of means testing for NHS services. Effectively forcing patients to pay for services that were previously free at the point of need. See also : Helping people to look after their own health and well-being 31 and Shifting the system towards prevention.

January 2006 - Ministers unveil plan to move care away from hospitals and into community

A.21 ...an interest in new and innovative ways of providing hospital services, such as
diagnostic tests and routine surgery, in community settings*.

*A.21 decouples routine hospital services into community clinics allowing the private sector to take on more NHS workload. Exactly as stated in the FYFV

GP federations and more private sector investment in Primary care

3.11 In some places this will mean encouraging or allowing new providers, including social enterprises or commercial [private] companies, to offer services to registered patients alongside traditional general practice. *Paying to see a GP or funding a personal health plan with part -payments from the NHS.

Page 31- Alternative [private] Provider of Medical Services (APMS)

now implemented with CCGs (2013) under APMS contracts

Page 78 - virtual clinics and digital appointments

a large part of the FYFV is based on this.

Universal Credit
Yep, page 87

Interestingly, resources used when forming the white paper refer to some of the largest private healthcare insurers on the planet. For example page 162..

References:- Hospital bed utilisation in the NHS – Kaiser Permanente and the US Medicare programme: analysis of routine data. 2003

The  plot to Privatise our NHS can be seen from outer space.

The question now is who can we trust to save it?


LINKS

• Labour 2006 white paper: Our Health Our Care Our Say [PDF] 
• New head of NHS England to be Tony Blair's former health advisor

Who's hands is the NHS safe in?

The 2012 Health & Social Care (H&SC) Act removed the guarantee that any services in the future of our NHS will be publicly owned. The CCGs were setup as soon as the H&SC bill became an 'Act' (April 2013) and they immediately set about privatising NHS services by tendering, and awarding, contracts to private providers. 

The word used by Dr Gingihi in his book "how to dismantle the NHS in 10 easy steps" was 'decouple'. Once the low-risk, lucrative, high-turnover routine procedures were 'decoupled' from NHS hospitals they were rife for handing over to the private sector. 

It's essential that these services are retained in a hospital environment for several reasons, mainly for training public sector workers and ensuring unification and ease of pathways between departments in the same building. If they're decoupled, the fragmentation will result in a much faster corporate take-over.

We no longer have a publicly owned, democratically accountable NHS. There isn't a cat in hell's chance of the NHS surviving as a universal healthcare system at the rate its contracts (and thus services) are being sold-off by CCGs to the private sector. 

The mantra "we're living longer" is a smoke-screen since the figures used in the analysis for this is based on infant mortality. There is no austerity, but the Tories love to play this out making you think you owe something and must make a commitment and tighten your belt, when you don't. It is indeed a load of manure designed to deceive you into believing the NHS is unaffordable, when in fact it is.

The NHS’s financial squeeze, coupled with private firms’ ability to undercut NHS providers, plus the obligation imposed on CCGs by the coalition’s shakeup of the NHS in 2012, together mean that more and more CCGs feel obliged to sell-off more and more NHS contracts, despite concerns about the quality of service that may ensue. 

After all, the CCGs have been given a limited budget from NHS England. And we all know who's head of that body don't we? 

The one and only ex vice president of one of Americas largest private healthcare insurers, Simon Stevens. 

No, the NHS is unsafe for whichever political party he's working for. 

So the question is, who's hands is the NHS safe in?

LINKS/RESOURCES
How much are the Tories privatising the NHS?

Yes to rational prescribing, NO to rationing

Yes to rational prescribing,
NO to rationing

The following article is kindly reproduced from March 4th Health Campaigns Together Newsletter

NHS England has resurrected a long-running debate on the prescription of a variety of drugs which have been confusingly lumped together as ‘low value’ items.

In an extraordinary claim, it declares it will: “work with clinicians and clinical commissioning groups to develop guidelines initially around a set of 10 medicines which are ineffective, unnecessary, inappropriate for prescription on the NHS, or indeed unsafe, and that together cost the NHS £128m per year.”

Apart from implicitly dismissing the decisions of thousands of GPs, the most pertinent point here is the amount a desperate NHS hopes to save by excluding large numbers of people from access to free drugs and treatment.

An NHS that was genuinely committed, as it claims to be, to developing proactive health care that could prevent the onset of more serious conditions would be seeking ways of making prescriptions free for all, as they are in Wales, Scotland and Northern Ireland, rather than forcing the sick and elderly to pay new charges.

For the last 20 years NHS managers have been trying to eliminate procedures, and now “products of limited clinical value (POLCV), collectively branded as ‘the droplist’. There is no disagreement that
drugs that are ineffective should not be prescribed – or even produced, although drug companies make huge profits from selling them.

Do it yourself care

This also fits in with the current rhetoric of encouraging patients to “self care,” and of course many community pharmacists’ businesses depend on sales of over the counter medicines, many of which (such as cough mixtures) are less than effective, and cheaper in supermarkets.

However the policy lumps together cheap, effective drugs such paracetamol, with useless ones such as cough medicines, and potentially less safe ones such as coproximol, which has not been available over the counter since 2005 but is often prescribed.

The vast majority of prescriptions are dispensed free of charge – for over-60s, children and under 18s in full time education, for pregnant women till a year after birth, for those on benefits and low income, and a few chronic medical conditions.

Thus, while at £8.60 per item it makes no sense for those who pay for prescriptions to get paracetamol or other low cost drugs that way, the large majority who don’t now pay for key items such as paracetamol would be compelled to pay.

This heavily discriminates against the poor and chronic sick, who already eke out an existence on unacceptably low income, and for whom all extra costs are a burden. The knock-on impact is likely to
be more problems for GPs and prescribers, with the risk that they are tempted instead to prescribe stronger medicines, especially if patients begin to insist on prescription only meds when they see the doctor.

Stronger alternatives are more toxic and dearer. Some are also unsuitable for older people seeking pain relief for arthritis and other chronic conditions (such as opioids codeine tramadol etc.) and combinations, which can lead to common side effects including confusion, constipation and belly ache, breathing suppression and dependency.

Other types of stronger painkillers such as naproxen, diclofenac or ibuprofen also have common side effects including ulcers, dyspepsia, bowel bleeding, raised blood pressure and risk of heart and kidney problems. However among the products also lumped in with the NHS England hit list is prescription of gluten free food for those diagnosed with coeliac disease.

Gluten free food is expensive for those who need it, and gluten does long term damage if those who are intolerant consume it. Just because a lot of other people feel gluten doesn’t suit them does not give an excuse to remove free scrips from coeliacs.

Safe clinical care means not prescribing ineffective items – not removing effective ones.


Health Campaigns Together.com

Are we sharing our NHS, or giving it away? (part 1)

image courtesy of mirror.co.uk

One of the guiding principles of the NHS constitution is The NHS is committed to working jointly with other local authority services, other public sector organisations and a wide range of private and voluntary sector organisations to provide and deliver improvements in health and wellbeing.

However, re-directing more public NHS services and hence more NHS money to the private sector would inevitably lead to a reduction in services provided by the NHS and ultimately result in the NHS becoming unsustainable. This is the whole premise of the Tory plot to dismantle the NHS.

For the NHS to survive and continue to provide quality health services, there has to be a fine balance between how many services/contracts the NHS relinquished to the private sector, and how many it kept. Any of the same services that were provided by both the NHS and the private sector also needed to be tightly controlled with any outsourced services kept to a very minimum.

No doubt the private sector has its uses when the NHS became overloaded and patients needed to be treated faster to alleviate pressures in the NHS such as bed-blocking and reducing the elective demand. Until 2012, the amount of NHS services outsourced to the private sector were tightly controlled.

To denatioanlise the NHS, all the private sector needed was a sympathetic government that would allow them to take on NHS contracts on a more permanent basis.

But if the percentages allocated to the private sector went out of control, money circulating in the NHS would dwindle and again, the result would be a permanent handover of NHS services to private providers on a contractual basis. Knowing this, the Tories began to expand their plot to denationalise (privatise) the NHS.

In 2012 the Tory-led coalition government introduced the Health and Social Care (H&SC) Bill making substantial changes to the way the NHS in England was organised. The H&SC bill altered how much work the private sector could undertake.  The amount of private work for foundation trust hospitals were allowed to undertake went from 2% to 50% and the market for NHS services was thrown wide open by allowing 'any qualified provider' to take on NHS contractual services.

With seemingly little opposition from MPs to the H&SC Bill, and with over a thousand amendments, the H&SC bill became an act of parliament in April 2013. *The bill had a 'risk-register' attached to it but the MPs chose to vetoe it!

The Act abolished Primary Care Trusts and replaced them with GP-led Clinical Commissioning Groups (CCGs). These 'Groups' however actually consisted of strategists taking orders from NHS England and doing the day-to-day running of the CCG with GPs having minimal input such as signing off NHS contracts and making decisions on which medicines and treatments it should ration to its patients.

The Act admonished responsibility for the Secretary of State for Health to provide healthcare to the Nation of England and passed this on to CCGs.

The organisational structure of the NHS had changed vastly under the Act, and the chain of accountability broken leaving no overall responsibility or accountability if the public didn't like any top-down changes made, such as privatisation. Perfect for the Tory plot!

1. Sec. of State (Health)  - Jeremy Hunt only 'mandates' NHS England
2. NHS England instruct CCGs
3. CCGs bring the axe down on public services with no accountability

The Tory government along with NHS England receive a huge amount of lobbying from private healthcare providers. After ridding their shackles of their coalition partners (the Lib Dems) and being re-elected in 2015, the Tories set about implementing the clauses in the H&SC Act in the name of a document titled the 'Five Year Forward View'.

To help with their plot to privatise the NHS, the Conservative government recruited 'Simon Stevens', the ex vice-president of the U.S. private Healthcare company 'UnitedHealth'.

In summary, the Tories have now succeeded in getting 'two' successive terms of office: one in 2010 to change how the NHS works (H&SC Act), and the second in 2015 to implement those changes in the H&SC Act (via the 'Five Year Forward View') thus ensuring the NHS is transformed into a private 'healthcare insurance plan' system the same as that in the United States.


In my next BLOG post I'll expand further on the Five Year Forward View and dissect and expose it as being the most unachievable and most deceitful document ever to set foot in the public arena...