Friday, 5 January 2018

Social care and the Tory protest letter

In September 2015, a letter of protest about proposed ‘cuts to frontline services’ arrived on the desk of Ian Hudspeth, a county Councillor.


It read in part: 'I was disappointed at the long list of suggestions floated in the briefing note to make significant cuts…. from elderly day centres, to libraries, to museums. 

This is in addition to the unwelcome and counter-productive proposals to close children’s centres across the country … work … could be done to generate savings in a more creative manner.’

The reply from the Councillor was clear: the council had no other options, having already fired middle managers (losing around 2,800 jobs), changed contracts, frozen pay or given under-inflation pay rises. Services had been merged and physical assets sold off, even though this was ‘neither legal, nor sustainable in the long term’.

Although the council was dealing with more older people needing more social support, more children in care and hospitals that were unable to discharge 159 people home because of funding gaps in social care, there was nowhere left to go.

While the protester claimed that the council’s spending had ‘increased in recent years’, the fact was, replied Hudspeth: ‘Our Revenue Support Grant has fallen by almost 50% in the first half of this decade from £122 million in 2011/12 to £62 million in 2015/16, and we expect it to approach zero by 2020.

Other funding streams have not kept pace with this, particularly in real terms.’ In addition: ‘… additional functions have been transferred to local authorities since 2009/10. Most notably Public Health as well as new burdens related to the Care Act 2014 and the Health and Social Care Act 2012. …

The Better Care Fund is not new money for the system, there has been £8 million in additional funding for Adult Social Care, but this has been at the expense of funding for NHS Services.’ The council was having to do more, much more, with less, including delivering public health services. Something had to give.

That something was frontline care.
The sender of the above letter was David Cameron, the prime minister who had overseen the financial cuts to local councils he was complaining about. 
Surreally, it seems he simply did not understand that they could not be absorbed without reducing the services available. Local authorities – which commission and pay for social services – have taken hits of 30% of budget in real terms in England and around 24% in Scotland between 2008 and 2015.
_____________________________________________________________
Excerpt above kindly reproduced from Margaret McCartney's book titled The State of Medicine: Keeping the Promise of the NHS






RELATED LINKS
What cuts to your local council should David Cameron be aware of?





Monday, 25 December 2017

NHS takeover in Lancashire begins as Virgin awarded huge contract



Not be long before we have private hospitals/clinics in Lancashire, run by the likes of privateers Virgin Care.

I see the Tory controlled Lancashire County Council (LCC) have awarded £104m to private company Virgin Care Ltd to run the county’s 0-19 Healthy Child Programme for the next five years?

Any idea why LCC chose billionaire privateer Branson over the NHS? All answers on a postcard....

I can't wait till the contract comes up for renewel, Branson's virgin 'Care' recently threw their toys out the pram and sued the NHS over a contract procurement process thus stripping the NHS of more assets.

But wait till you read the Case Study below!
Virgin Care avoid paying taxes and are snapping up NHS contracts now (even at a loss) knowing they will 'break even' and start to profit after the Sustainability Transformation Partnerships (STPs) begin to take shape as new 'Accountable Care Organisations' (ACOs). Estimates are as early as 2018/19.

__________________________________________

Virgin Care: A case study in how private corporations loot the UK’s National Health Service
By Ajanta Silva 23 December 2017


The Health Service Journal (HSJ) recently exposed a scandalous handout given to private healthcare company Virgin Care by a Clinical Commissioning Group (CCG) in the county of Surrey, England. This brings to light how private companies are plundering the National Health Service (NHS) with impunity like never before, with the blessing of central government.

The Health and Social Care Act 2012 replaced the secretary of state for health’s “duty to provide health care” with a “duty to arrange,” and provided the basis to create 211 Clinical Commissioning Groups, which are allowed to purchase care from any “qualified provider.”

The Surrey Downs Clinical Commissioning Group accidentally disclosed in its October public finance papers a backdoor payment of £328,000 to Virgin Care, owned by billionaire business mogul Richard Branson. This would not have come to public knowledge were it not for the mistake on CCG’s part.

The removal of the report from the Surrey Downs CCG website—after the HSJ made enquiries about the settlement—testifies to the ongoing conspiracy to keep the population in the dark about the scope of the influence of private companies. Surrey Downs CCG later stated that this “level of detail should not have been included in the report.”

In 2016, Virgin Care lost its bid to provide children’s health services across Surrey—a contract worth £82 million. It then sued NHS England, Surrey County Council and six CCGs in Surrey, arguing that there were “serious flaws in the procurement process.” Surrey Downs CCG handed over the payment as a part of their liability in an out of court settlement with the private company. The amount paid by the other parties to Virgin Care remains undisclosed, but some reports suggest that the private company could have received more than £2.5 million from the NHS.

This spring, it was reported that Virgin Care was [again] in dispute with East Staffordshire CCG over arrangements in the seven-year prime provider contract for frail, elderly patients, people with long-term conditions and intermediate care. In October, the HSJ reported that Virgin Care was demanding an extra £5 million from East Staffordshire CCG.

The anger felt by people nationwide against this daylight robbery is such that a petition, demanding Branson hand back the ill-gotten money to the struggling NHS, reached well over 100,000 signatures within few weeks.

Virgin Care, Virgin Care Services Ltd, Virgin Care Ltd, VH Community Services Ltd and Virgin Care Corporate Services Ltd are some of the subsidiaries of Virgin Healthcare Holdings Ltd based in the UK. Virgin Healthcare Holdings Ltd is a subsidiary of Virgin Group Holdings Ltd, belonging to Branson and his family.

To “legally” avoid taxes, Virgin Group Holdings Ltd is based in the British Virgin Islands tax haven. It “loans” Virgin Care the money to invest in the care industry in the UK. In return, Virgin Care transfers money to a mother company as loan repayments.

The NHS Support Federation pointed out “this type of corporate set-up has potential for reducing or eliminating the tax liabilities of operating companies; a company in the UK could always report a loss due to loan repayments to sister companies thereby never having to pay tax.”
Branson’s care companies have been reporting losses since 2012—the year that Virgin Care came to prominence for winning a lucrative £450 million NHS contract in Surrey.

This begs the question of why Virgin Care places ever more bids on NHS contracts if it supposedly loses money on them. Despite its reported losses and paying no tax, the company has been aggressively competing to win NHS contacts and exploiting opportunities opened up with the introduction of the Health and Social Care Act.

The Act laid the foundation for the acceleration of the privatisation of the NHS, which began through the backdoor during 13 years of Labour rule from 1997 to 2010. Under the Act, it is mandatory for CCGs to put services out to competitive tender if they can potentially be provided by organisations other than the NHS. *Knowing the private market takes a few years to overtake public services, Virgin buy contracts in early ready for the break even period which should be after ACO's are up and running.

Surrey is a small county in England with a population of just 1.1 million. With the population of the UK at around 60 million, the scale of the rich pickings available to the NHS nationally is vast. According to the NHS Support Federation, over the period of April 2013 to January 2016, £16 billion in NHS clinical contracts were awarded through the market and the private sector has won nearly £5.5 billion worth. The Federation point out that “in total around £30 billion worth of NHS contracts have gone before the market, although just over half this value has been awarded.”

Published accounts by the Department of Health demonstrate that NHS commissioners spent 7.7 percent of their budget on private sector providers in 2016/17.

Over the last five years, Virgin Care alone has won over £2 billion worth of NHS contracts to run NHS and local authority services ranging from primary care services—including GP services, walk-in centres and community-based NHS services—to adult social services. Virgin Care boasts of having 400 services across the country and treating more than one million people a year. Last year, it won a £700 million contract to run health and social care services in Bath and North Somerset. This was the first NHS contract under which adult social care was privatised.

The latest is the £104 million contract that Lancashire County Council gave to Virgin Care to run the county’s 0-19 Healthy Child Programme for the next five years. Virgin Care was chosen as the preferred provider over the Lancashire Care NHS Foundation Trust, which currently provides these services before its contract expires in March next year. Trusting their political paymasters in government to create endless opportunities to make inroads into the public provision of health care, this year Virgin Care started their own independent clinics that function entirely separately from NHS or Local Authority services. Patients have to pay for appointments to see health care professionals in these clinics.

Virgin Care is not alone in this plunder. Capita, HCA, Circle, Serco, Care UK, Interserve, The Practice, Inhealth and Alliance Boots are among the private operators providing NHS services ranging from direct patient care, elective surgeries, laboratory services, pharmaceuticals, cleaning and maintenance, logistical services and supplies to primary care.

Government intentional underfunding of local NHS services enables corporate takeover bids 

The NHS, which has seen the lowest ever funding increase in its entire history and billions of funding cuts imposed as “efficiency savings” over the last seven years, is not placed on a level playing field when it is compelled to bid against the private sector for the contracts.

NHS trusts are saddled with massive deficits and are burdened by the crippling impact of the Private Finance Initiative (PFI). Under PFI—massively expanded under the 1997-2010 Labour governments of Blair and Brown—private companies were able to build and maintain hospitals and reap enormous profits, payable to them for decades hence.

The combined deficit of NHS trusts stood at £770 million in the last financial year. Over the last six years, private firms have made a record £831 million pre-tax profit from PFI contracts, which otherwise would  have been spent on patient care.

When NHS trusts win contracts and deliver care they are forced to make savings and reinvest in patient care, while private companies winning contracts are allowed to make profits and transfer them to tax havens without difficulty, as revealed in the case of Virgin Care.

Numerous reports have exposed how private health companies, including Virgin Care, jeopardise patient care and safety in order to make profits. Some of the practices include replacing trained staff with untrained staff, stopping care packages on which vulnerable patients depend, persuading staff to take home sexual health testing kits to use on friends and family to help make the numbers up, and forcing patients to attend extra appointments to boost profits.

source: http://www.wsws.org/en/articles/2017/12/23/nhsc-d23.html

Links/references
Virgin Care Ltd - NHS for Sale
http://www.nhsforsale.info/private-providers/virgin.html

Tuesday, 19 December 2017

NHS Nurses forced to take out loans after Tories scrap burseries

DEBT - FROM CRADLE TO GRAVE

On the 17th July this year [2017], new nursing, midwifery and other health students such as occupational therapists and physiotherapists had their NHS bursaries stopped. Nurses no longer receive NHS bursaries to cover their tuition fees. Instead, they will have to apply for student loans.

The Tories claim ending the bursaries will free up about £800m a year to create additional nursing roles by 2020. But removing the NHS bursary simply deepens the nursing recruitment crisis.

40,000 nursing posts are currently unfilled, and ending the Nurse bursary scheme will stop students from working class and mature backgrounds applying to train. Nursing students already face very different challenges from students studying other disciplines.


TORY WORK ETHIC - WORK FOR NOTHING

For example, trainee Nurses have little time to do paid work to cover their living costs at university as they are required to undertake unpaid clinical placements during non-term time.  More than 20 charities, medical and professional bodies and trade unions have called ending the bursary an “untested gamble”.

MORE AUSTERITY LIES

The NHS Bursary Scheme was previously funded by Health Education England (HEE), which itself is funded by the government - i.e. by you and me as taxpayers.


THE OLD 'UNAFORDABLE' CHESTNUT

The number of nurse training places available each year was limited to how much they could afford to fund. The Tories claim this number wasn’t enough to supply the quantity of nurses needed and the number couldn’t be increased because of 'constraints on government spending'. The Department of Health (DoH) state this is "a result of ongoing government policy to reduce the national budget deficit" [National debt] - but this is contrary to the Tory manifesto of ring-fencing NHS spending.

WE WANT TO BUT......

The Tories claim they wanted to increase the number of places available, but were unable to do so with the money available. So rather than requesting more money be made available to recruit more nurses, they STOPPED the bursary: thereby turning it into a debt (loan).


LOANS AND DEBT is a SYSTEM THAT ENSLAVES

Starting out life with student debt only adds to the burden of stress. Now add to the mix a mortgage and perhaps a car on finance, and "every employer would love to employ someone with such high debts because they won't cause any trouble" (Tony Benn 2008 Question Time TV panel show - see link below).



LINKS/REFERENCES
https://www.theguardian.com/society/2017/jul/31/as-the-nhs-bursary-ends-would-you-still-train-to-be-a-nurse-or-midwife-today

Monday, 20 November 2017

Chorley A&E must not go the same way as Burnley


At the October health scrutiny meeting  I note there were no 'matters arising' from the previous health scrutiny meeting held in September. Why aren't councillors raising questions about the STPs and querying why we're still waiting for doctors to re-open Chorley & South Ribble A&E full time?

The Lancashire Teaching hospital NHS trust didn't attend Octobers health scrutiny meeting since apparently NHS Improvement had a very important meeting with them. I think we can all guess what that was all about - all queries on a postcard to the LTHT trust since they don't allow the public to speak at their meetings. I wonder what's to hide?

Watching the 'webcast' (link below) for October's Health scrutiny meeting I couldn't help but notice the North West Ambulance Service (NWAS) representative mention the 999 call-centre advisors are occasionally obliged to remain on the phone and this was taking up valuable time. The thought occurred the reason for this is because many A&E's/Hospitals are running over-capacity resulting in ambulance crews being unable to get back on the road and attend other incidents? It's not rocket science is it?

Handover breaches are a 'clear indication' of a failed system

The figures for last year show a huge increase in serious Ambulance handover breaches (> 60mins) when Chorley A&E closed. Patients had to be taken to the Royal Preston hospital and any hospital nearby. Wigan saw a huge increase in patients arriving by Ambulance of almost 500% when Chorley & South Ribble hospital A&E shut it's doors in April 2016.
The ambulance handover times trebled and as the table above shows there was a huge increase in serious ambulance handover breaches resulting in patients lives' being put at risk.

To my horror however, the CCG had received instructions from NHS England and NHS Improvement not to penalise hospital trusts as they were going through a period of transition. *NWAS aren't penalised for waiting, the trust are supposed to pay but they've been told there's no recourse for breaching 4 hour and 12 hour targets. disgraceful!

And the problems of overcrowding at acute/A&E hospitals resulting in poor quality patient care haven't just 'gone away' either. In fact, they are getting much worse. Royal Blackburn Hospital (RBH) was on code 5 black alert over the weekend and today at RBH every single ambulance bay was full (image above) with some having to park.... on the CAR PARK!
Note here that Burnley's A&E was closed/downgraded in 2007 and moved to Blackburn resulting in one hospital in East Lancashire to cater for over 540,000 people. It's been crisis management ever since over at the Hospital in Blackburn, and patients as always pay the price for the politically motivated upheaval.
We're still waiting for a small number of mid-grade doctors to come to Chorley A&E and save the day and re-open services 24/7. Yet the longer this fiasco continues, the more suspicion arises that something else is planned for our A&E services.  Something so devious that even a hospital trust board avoiding a council health scrutiny meeting pales into insignificance in the overall scheme of things.

But we're not going away, we have a duty to ensure we keep what's rightfully ours in a 24 hour A&E service and that it remains in place for our children, and our children's children.

Finance is not the issue here, deception and betrayal of our NHS is...

LINKS



Webcast Health scrutiny committee Oct 31st 2017

Wednesday, 8 November 2017

THE REVOLVING DOOR & THE CROSS-PARTY WHITE PAPER


Are the NHS reform plans based on New Labour's' 2006 white paper? and what's a Labour peer doing heading up an STP scheme then praising Lancashire teaching hospitals NHS trust? Are all 3 main political parties in favour of a private-public NHS partnership? What the hell is going on?

The current boss of NHS England 'Simon Stevens' is a turncoat and entered government with New Labour (he was previously a Labour councillor for Brixton and former advisor to Labour PM TONY BLAIR).

Stevens was previously vice president for Unitedhealth, the largest private healthcare insurer in the U.S.A. He will sell his soul for fame and fortune and has U.S Accountable Care Organisations (ACOs') ready for privatisation in England as his goal. The reason he is head of NHS England is because NHS England were set up by the real privateer (the previous health secretary) 'Jeremy Hunt' with no input from the NHS or those who use it.
It appears Stevens has simply expanded on New Labours 'Our Health Our Care Our Say' white paper from 2006 and added American style ACOs into the integrated part of the Sustainability & Transformation Partnership (STP).
STP = Straight To Pocket (private sector pocket)
*Labour's 2006 white paper is said to be the blue print for the 'five year forward view' which in turn is the blueprint document for all STPs. So not only has Stevens expanded on Labour's 2006 white paper, but he's handed it over to the Tories and it appears to be supported by Labour Peer Lord Pat Carter. 

The Labour Peer Lord Carter, like Tony Blair, seems to be just another Tory in disguise. Carter (real name Patrick Robert Carter) is heading up the Slash Trash & Privatise care home scheme, he visited Lancashire county council in late July along with the Lancashire Teaching hospital trust who closed the A&E department 24/7 at Chorley & South Ribble Hospital in April 2016. So what's a Labour peer doing promoting the STP privatisation plans? 

  • New Labour's 'Tony Blair' appointed Carter as a Labour peer in 2004.
  • Lord Carter co-founded private nursing home company 'Westminster Health Care' in 1985 with Martin Bradford. He's been lobbying for the private care-home sector to take on more patients from over-stretched NHS hospitals ever since Simon Stevens revealed the STP plans for England.
  • Carter was also previously president of Mckesson enterprise ltd international operations group (business portfolio holder), Mckesson specialise in orthopedic imaging/consultancy private sector work.
  • In 1985, Lord Carter founded Westminster Health Care which he built into a leading health care provider and subsequently sold in 1999. Carter is now a private investor and director of public and private companies in the fields of insurance, healthcare and information technology.
Previously many Labour politicians have made full use of the 'revolving door' between industry and government. Alan Milburn and Patricia Hewitt are among the ten previous health ministers who have taken lucrative consultancies with private health care companies.

More links below...

Is this the blueprint for the STPs five year forward view?
New Labour's 2006 white paper 'Our Health Our Care Our Say': a new direction for community services

Lord Carter visits Lancashire Teaching Hospitals July 201
7

Lobbying for transparency

Co-operation & Competition panel for NHS funded services

Are STPs based on New Labour's white paper from 2006?
http://mavericksunite.blogspot.co.uk/2017/04/are-stps-based-on-new-labours-white.html

Chorley A&E closure, super-hospitals, & NHS Privatisation
http://mavericksunite.blogspot.co.uk/2016/08/chorley-closure-super-hospitals-and-nhs.html


Wednesday, 1 November 2017

STPs demand Hospital service closures in Chorley & Preston


In early 2015 Lancashire Teaching Hospitals NHS trust were granted planning permission to build a multi-storey carpark at Royal Preston Hospital.

But shortly after came the general election along with news that the NHS was to undergo yet another top-down reorganisation based on privatisation plans known as a 'five year forward view' [5YFV]. The chief executive of NHS England appointed to roll-out these plans was no other than 'Simon Stevens', ex vice president of UnitedHealth, the largest private healthcare provider in the united states.

This drew suspicion from NHS campaigners: that NHS privatisation in England was on the cards and the 5YFV was a template for the introduction of American-style healthcare. The suspicion was made worse when it was discovered the man who appointed Stevens in post was no other than the health secretary 'Jeremy Hunt', an MP  renown for his political parties position on wishing to privatise the long-serving publicly provided NHS.

Under these regional plans, called Sustainability & Transformation Plans or 'STPs', health providers in Lancashire were to merge with those in South Cumbria to share resources and aid roll-out of the transformation from a 'National' healthcare system to a localised U.S. based healthcare system now known as an 'Accountable Care Organisation' (ACO) sometimes referred to as an Accountable Care System (ACS).

*The Tories Health & social care act (H&SCA) that came into effect in 2013 handed National responsibility for healthcare provision down to localised private GP-led groups called 'clinical commissioning groups or CCGs for short. The 'National' element had been removed from the NHS leaving NHS services wide-open to commercial ventures, including take-over of the more lucrative hospital services, that under STP plans, were to be relocated from hospitals into private-public partnership community clinics operated by the ACO.

CARE CLOSER TO HOME = FEWER HOSPITAL SERVICES

One idea in the STPs was to close many hospital services and move them into what the plans call 'multi-specialty community provider clinics, or MCP clinics for short. The H&SCA allowed 'Any Qualified Provider' (AQP) to bid on, and win NHS contracts. CCGs soon set to work tendering out NHS contracts and over in Chorley hospital (and Preston hospital) urgent care centre services were handed over to a private provider for an apparently meager sum, leaving one Preston doctor to question if the services could be provided on such a small budget (the advice was £44m for a 5 year contract but the contract went for £30m allegedly).
The latest proposal from the STP Solutions Design Team are to close 80% of outpatients services at Chorley & Preston hospitals and move them into the community under the 'care closer to home' scheme.
footprint
With less and less money going into the NHS it was soon realised other NHS services were becoming unstable, none more so than A&E and other acute services.

Lancashire Teaching Hospitals NHS Trust (LTHT) who run hospitals in Chorley and Preston were told to drop the multi-storey car park plans for Preston Hospital since it was anticipated the transformation of the NHS would result in many fewer hospital attendances. The five year forward view had divided England into 44 'footprint' areas with each allocated a 'sustainability & transformation plan [STP] of its own'. The STP plans were bad news for the NHS, but good news for the private healthcare sector who in 2013 had been given statutory rights to bid on ANY NHS service contract (under the Tories 2012 Health & social care act).

Having shelved the multi-storey car park plan, the Lancashire hospital trust reported: "Since then we have been working on a new plan to improve how we provide and organise our hospital services so that we can ..remain viable for the future.  Major building work, including the multi-storey, has been put on hold whilst the transformation programme [STP] is progressing to make sure we don’t make any significant investments before our future plan is finalised".

Yet things appeared to be going wrong for those rolling out the STPs. The local plans for Chorley & South Ribble were questioned by the borough council resulting in a unanimous vote that Chorley council write to the health secretary and that the STP be ceased and remodelled so that it  "seeks to protect health and social care services, ensure they retain their local identity and strengthen local democratic accountability".

I don't recall any reply from Jeremy Hunt to the council's tabled motion on the issue but that's not surprising given Hunt's track record of ignorance.

So where are we up to at present with the STPs?

Since their inception via the 5YFV, without any indication to the public, STPs have mutated into 'Sustainability & Transformation Partnerships' instructed to form Accountable Care Organisations (ACOs).

These ACOs attempt to prevent ill-health by 'demand managing' (rationing) medications and treatment. They use a 'capitated payment' system and are financially driven to ensure an end of year surplus is passed backed to shareholders in the ACO. The ACO are a spin-off of the failed Obamacare and introduce a two-tier healthcare system into England. They will see the demise of the NHS if implemented nation wide.

The first ACO for Lancashire & South Cumbria is being trialled over in the Fylde, and if all goes well, they are proposed to be rolled out in Chorley, South Ribble, Preston and beyond.

So there we have it, we need not worry about car parking at hospitals soon, because there won't be hospitals left (with the exception of a trauma/A&E centre in the middle of beyond).

We won't need to worry about hospital car parking, since we'll all have a private clinic on the street corner run by Circle, Virgin, or Care UK Ltd.  The NHS will be a thing of the past and we'll all be making co-payments under the local ACO insurers for surgery or that medicine that is no longer on prescription.

Or we can stand up and say NO!

We are no longer under any doubt as to the intentions of the STPs and the two-tier privatised system they represent. We can no longer sit on the fence claiming we are in the dark about these sordid plans.
As campaigners to retain publicly provided health services we inform others and gain their support.

After all, we all know what happens to people who stay in the middle of the road, they get run over.[Nye Bevan]



 LINKS

Multi-storey car park plans for Preston Hospital halted

Chorley council return STP plans for remodelling

Monday, 23 October 2017

NHS Privatisation, where's the scrutiny?

Lancashire's Health scrutiny committee need to stop being hoodwinked and properly scrutinise STPs before it's too late. It's time to start asking questions, no decision about us without us.

At the previous Lancashire Health scrutiny committee on the 19th September, councillors were given a presentation by the 'Healthier Lancashire and South Cumbria - STP Team*' on 'progress' made since the Next Steps on the NHS Five Year Forward View published in March 2017 including the Sustainability Transformation Partnership (STP) for Lancashire and South Cumbria.

Councillors were informed that a 'board' called "the STP Board" had been established but this board was not a statutory body but merely consisted of several organisations such as the hospital trust, GP federation, mental healthcare trust, social services, clinical commissioning groups voluntary and private sector.

All these existing organisations are to be merged into a single partnership organisation. The merged healthcare bodies form an organisation imported from the U.S.A called an 'Accountable Care System' (aka Accountable Care Organisation or 'ACO' in the United states).

Ironically, the boss of NHS England 'Simon Stevens' is ex vice-president of UnitedHealth Group, the largest private healthcare insurer in the United States. Steven's now wants to bring the U.S. multinational private healthcare market to the U.K. with UnitedHealth group taking a slice of the NHS cake...

Among the companies taking on NHS work were privately owned businesses such as VirginCare and Care UK as well as stock market listed multinationals including UnitedHealth Group, Acadia Healthcare, Circle, Capita and Interserve.

Councillors at the health scrutiny meeting on the 19th were told these organisations on the STP board had no statutory mandate but that each organisation had signed up to it and volunteered to agree to work together to forward the NHS England STP plans. The STP board deals with the STP target finances and approves the transformation plans (its own plans). Yet the STP board has no accountability and is merely 'acting out' roles that are neither democratic, lawful, nor representative of the people who pay for the services they provide as individual organisations.
The STP board is in effect a QUANGO set up by NHS England in an attempt to bypass local democracy and enforce a private-public accountable care system (ACS) upon the peoples without their consent.
Those who've followed the disgraceful overruling by this government of the county objections to fracking know only too well the strategy here.

The 2012 Health & Social Care Act handed most of the NHS budget over to private GP practice commissioning groups (CCGs) handsomely rewarding those GPs with business acumen to start the NHS privatisation process in motion. Since its inception in April 2013, CCGs have tendered over a third of NHS services to the private sector, and are rationing more medicines and hospital surgery treatment every week.

Forming 'Accountable Care Systems' will only legitimise and expand on the existing rationing of healthcare treatment and services (what an ACS calls 'demand management' ) and fragment what's left of our public healthcare system into a two-tier private-public partnership accountable only to it's shareholders - the collection of healthcare organisations mentioned above.

Health Insurers & Accountable Care Systems (ACS)

In effect, CCGs will act as micro-insurers in the ACS with the prime incentive for the whole organisation to ensure an end-of-year surplus (profit) is made. To do this it uses a fixed capitated budget and 'demand management' to ration and withhold medicines and treatment.

Or as stopthestps.org puts it...

ACOs/STPs don’t explain that this mean-spirited restriction of treatments and patient numbers is based on an American health insurance system variously called  managed care, health maintenance organisations or accountable care organisations. An Accountable Care Organisation (or System now also called in 2017) is accountable to the health insurance company that holds the budgets for treatments available to the population that is covered by the ACO . This is usually around 50K people - compare this with the 2k-6K population that is usually registered with a UK GP surgery. Don't be fooled by the word 'accountable' in this contect. It means counting money not BEING accountable to the public.

The health insurance company specifies what treatments are available (managed care) and which patients can access them (the ones who are cheapest to treat and who offer the best chance of financial recovery), as well as setting the overall annual population budget that the ACO has to stick to.

If the ACO comes in under budget it can keep what it hasn’t spent so there is incentive there to restrict treatment in order to maximise profit. The spin from NHS England is that this incentivises efficiency. The reality is it leads to cherry picking patients and restrictions and denial of care.  This is called ‘demand management.’ STPs and ACOs are ALL ABOUT 'Demand Management'.

By imposing managed care pathways - ie telling doctors what treatments they can provide and how to provide them -  Accountable Care Organisations de-professionalise doctors and other health workers and destroy the individual patient- health worker relationship.This is clearly not the NHS as a publicly owned, funded and run comprehensive health service, or as an empathetic, person-centred health service...


stopthestps.org is correct, here in Chorley & South Ribble we're already seeing CCGs telling doctors which medicines and treatments they should or shouldn't provide. Only last week Clinical Commissioning groups in Chorley and Preston introduced draconian policies that stopped certain surgical surgery such as some hernia operations leaving many to suffer.

All Councillors need to be aware, this is what STP leaders and other 'boards' who meet in secret haven't told you. It's happening in front of your very eyes, with very few councillors and members of the public aware of the sheer scale of NHS healthcare privatisation that's coming.


Let this be a warning. One by one you will see larger private clinics (called Hubs) being built/established in Preston and Chorley/South Ribble to house services that have been moved from hospitals. Gradually, the likes of Virgin care who already have the Musculo-Skeletal (MSK) contract, will takeover more of the lucrative NHS services thus destabalising the remaining NHS services.

For Chorley, South Ribble, and Preston, the STP solution designs team have already stated they wish to see almost ALL outpatient hospital services CLOSED and moved into a community setting - thus paving the way for more private contractors to take over NHS services.

Emergency care cannot survive without these services and Chorley District Hospital will become nothing more than a shadow of its former self; re-labelled as a 'community hospital' (private providers already have a specially built building at the hospital and hold a 7 year urgent care contract in the bargain).

The threat of the closure of both Preston and Chorley hospitals is still hanging over us, that's why week in and week out we stand outside Chorley & South Ribble hospital. Shortage of mid-grade staff or not, questions need to be asked about what these unelected 'STP boards' are really up to.

There is no money to roll-out these plans, there is a serious lack of staff, and there is no evidence that the plans will work in practice. So what are we waiting for? If STPs were planning applications they'd be thrown out of county hall.

I suggest the same treatment is given to STPs, or we'll be heading back to the dark ages where only those who can afford to pay get treated. Think on, be prepared, ask the questions. I guarantee you will not get any straight honest answers. Stop the STPs before it's too late....

Next Health Scrutiny Committee
Tuesday, 31st October, 2017 10.30 am
Venue: Cabinet Room 'C' - The Duke of Lancaster Room, County Hall, Preston



Agenda page here: http://council.lancashire.gov.uk/ieListDocuments.aspx?CId=182&MId=6793&Ver=4

Links..

http://www.stopthestps.org.uk/stp-effects-2/4593295687


*Healthier Lancashire and South Cumbria (STP Team):  Dr Amanda Doyle OBE, GP and STP Lead; Neil Greaves, Communications and Engagement Manager Gary Raphael, Finance Director; and From Morecambe Bay CCG:  Andrew Bennett, Chief Officer