CCG rationing policies are forerunner to private partnerships

Don't be fooled by Chorley & South Ribble CCGs policies on stopping medications. It's a forerunner to NHS privatisation for when they become partners in an STP private-partnership...

Let's clarify one or two things since there still appears to be some misconception about what's happening with Clinical Commissioning Groups (CCGs) and rationing of medicines and procedures.

Consider this: No GP writes out a prescription for 37p worth of paracetamol.
The mild pain killers are usually prescribed in bulk boxes of 100 and included with other items for patients with long-term conditions such as COPD, MS. fibromyalgia etc.

Also, when boxes of paracetamol are written on prescription they do not cost the NHS £8.60 (a box of 100 is around £1.67 and the practice claims back the difference). Patients who pay for paracetamol are unlikely to be written a prescription and the number of GPs who prescribe paracetamol is very small, with the exception as in bulk for chronic long term conditions where paracetamol is preferable to a stronger prescription only pain killer such as Tramadol.

SMOKE & MIRRORS

Let's not get sidelined here, the real reason for CCGs cutting back on medicines and services is to preserve their budget and enable them to make gains in other areas. Areas they deem more important such as perhaps paying their chairman an annual salary of over £130,000 [1]

It's penny pinching, and the reason behind the rationing of medicines and treatment is to 'familiarise' patients with 'paying for treatment and drugs'.
This is part of the overall strategy for Lancashire & South Cumbria 'Sustainability & Transformation Partnership' (STP) where all healthcare providers have been told to make 'efficiency savings' (i.e. make cuts).

This is so healthcare providers can access 'transformation funding' to enable the roll-out of American Style private public partnerships called 'Accountable Care Systems' (ACS).[2] .*Also known as Accountable Care Organisations (ACO).

Accountable Care Systems - Care managed by accountants
An Accountable Care System (ACS) relies heavily on reducing 'patient demand' on services such as hospital admissions and GP attendances along with rationing procedures such as hip and knee operations* and cutting back on entitlements for medication and treatment.

*Rationing paracetamol is only the start. For example, in January, three clinical commissioning groups (CCGs) in the West Midlands proposed reducing the number of people who qualify for hip replacements by 12%, and knee replacements by 19%. To qualify under the proposed rules, patients would need to have such severe levels of pain that they could not sleep or carry out daily tasks.

In the United States the health insurance industry call this 'demand management'. The NHS currently has a fixed tariff payment per treatment (payment by results) but with an Accountable Care System this changes to a fixed budget payment per person (capitated payment).

The incentive then becomes more financial and partners in the ACS will start to 'cherry pick' the most lucrative high-turnover procedures/treatment and introduce a more demanding rationing system.

Whilst people are arguing over who pays for a packet of paracetamol, the CCGs are working on policies to actually STOP you accessing NHS services in a timely manner and prioritising those who can pay for those services, i.e. the profitable element comes first. 

Those affected the most are the poor

Many poorer in society will go to the back of the queue and be classed as low priority by the ACS (they undertake a risk assessment and categorise all patient records registered with a GP Practice). In the U.S.A the scheme is called Medicaid and is a 'two-tier' system where those who can't afford healthcare are only entitled to certain services, and only then if they setup a healthcare plan with their providers [an ACS might call this a 'Personal Health Budget'].

Now factor in the 'welfare' element and the gradual reduction of benefits to the disabled and families on low income and we have a situation where many people become dependant on household incomes that are on the poverty line.

This means they may have to choose between paracetamol and a meal, just as we have now with foodbanks.

Mark my words, if the ACS systems are rolled out here in England you won't be arguing over a packet of paracetamol, you'll be fighting for access to life-saving treatment that was once free at the point of need on the NHS.

It's time to stop this madness before it goes any further.

Sustainability and Transformation Plans are now STP Partnerships and are turning into Accountable Care Systems. Local Authority Health Scrutiny Committees are nodding them through without any objections. Councillors don't seem to know what  Accountable Care Systems are or realise how they will dismantle our NHS.

STOP THE STPs
Speak to your councillor, write to your MP, join your local NHS campaign group. We must do everything we can to prevent our NHS becoming a thing of the past... Read more here from STOP THE STPS

[1] Annual Report CCG 2016/17
[2] Lancashire & South Cumbria STP page 9

RELATED LINKS
Chorley & South Ribble CCG plan to REMOVE THIRTY THREE more medicines and treatments in bid to save on spending...