Fait Accompli of the thoothless BMA

 

A news article released earlier this month from the BMA claims STPs are "more than a missed opportunity", indicating they agree with aspects of the plans and don't intend to oppose them.
 
The article (see link below), written by Peter Blackburn of the BMA news team states "We as an association have much we agree with STPs on,’ Dr Wannan - BMA"

If I recall the BMA were also resolutely against formation of a publicly owned NHS in the early days?

We have to make it very clear that ALL aspects or 'models of care' proposed in these STP plans work against the interests of a publicly owned universal healthcare system. 

We can't just 'pick and choose' one element of the STP over another. They are all designed to lead to combined budgets founded on the private health sectors favoured 'population-based' care.

The BMA news article highlights the threat of NHS privatisation, but as with the Junior Doctor contract, offers no meaningful solution.

STPs are seen by the BMA as a barrier that can't be overcome, the article continues.."While the plans may be doomed – it appears they are here to stay".

What exactly does this fait accompli sentence mean to you and I?

• Are the BMA saying the plans will be continued by the next government or we will end up with some hybrid system akin to the U.S. healthcare model where those fortunate can pay for their treatment, whilst others die waiting in a queue?

• Are they saying we have come to a stage where the process cannot be stopped and is irreversible or 'too expensive' to change back?
• Will the NHS have enough funds to buy-back the bulk of the contracts sold off by their buyers the Clinical Commissioning Groups?

One thing is for sure, here over at Chorley & South Ribble we don't do fait accompli, we don't intend sitting around on our elbows watching whilst our NHS is gradually sold off and stolen away from us.

We haven't stood outside our local hospital every single week for almost a year, just to be told we're not getting the services we are entitled to and fought so hard to keep in the past.

We are the ones who are 'here to stay', the doomed plans will be kicked into the long grass where they belong. I know it won't be easy, and it will take a lot of effort, so it's now over to you...

STPs - more than just an opportunity lost (BMA)

STPs are not 'plans' they are fanciful ideas

The STPs are behind schedule, lack any significant popular public support, and as they stand will not deliver the results they promise.

The incoherent and inconsistent series of 44 'STP' documents that have been published since the end of October 2016 have clearly fallen far short of NHS England chief executive Simon Stevens’ hopes a year ago.

Most offer no viable or sustainable plans for staffing or management of the ‘innovative’ proposals to divert services away from hospitals, resulting in the services proposed being unsustainable.

There’s virtually no capital available from NHS England to finance any serious transformation; in many of the STP documents the numbers simply don’t add up, and there is little or no evidence that some of their key proposals can work in practice. Many lack any financial detail, and almost none of them have any worked-through practical plan for implementation (1).

Even the CCGs and its providers have asked us, as campaigners, for advice on how best to get around the problems thrown at them without incurring the huge financial penalties and of course the wrath of the public.

STPs are not 'plans', they are fanciful ideas with no evidence-base and do not take into account all the risks associated with major healthcare transformation. They are effectively documents that toy with ideas that could and would result in lowering of patient care and even many many deaths.

NHS England have been trialling some of the STP models in areas around England called vanguard areas'. They avoid the words 'trial' and 'pilot schemes' since they attempt to fool the public into believing the vanguards have some evidence-base in place. They haven't.

They are being rolled out on a suck it and see basis, a series of trial and error schemes that could fail at any stage without any prior risk assessment or consideration for equality laws. As such there is no bail out if things go wrong, apart from the Private Healthcare Sector waiting in the wings to take over public services. This is what we are fighting against, people willing to play with our lives, and care little when things go wrong.

The proposed care pathways in the Five year forward view, the blueprint document STPs are based on, are not new. 

For example 'prevention'. We'd all like help and advice to prevent ourselves from becoming ill, but it needs to be voluntary, not forced;

we need a welfare system that's fair and does not force people into poverty and thus ill-health.

The prevention espoused in the STPs is 'forced prevention' due to the very nature of rationing medical treatment and withholding medicines from the poor and needy in our society.

Although there's been much secrecy around the STP and their hidden agenda, the overall objective is to de-couple the more lucrative routine hospital services and place them into community clinics to enable the private sector to share the profits. It really is that simple.

Anything else, such as Integrating some NHS services with social services and the use of telecare* in old folks homes are a smokescreen as these are not contentious, and if funded properly, are unnecessary in the first instance.
*a webcam in a care home relaying sound and images to a healthcare practitioner

When funded properly, local authority social services have no problem in alleviating hospital bed blocking since they've always found places for re-ablement and after care in the patients own home or care home.

All this nonsense about patients not knowing which services are where and not being properly signposted is just that, another smokescreen to allow the private healthcare sector into the NHS.

After all, Lord Carter, of the Carter Review fame mentioned in many STPs, owns a string of private residential care homes. If you're in any doubt about how the private sector are waiting to take over the integrated health & social care model look no further than those who influenced the Five year forward view, the blueprint document all STPs are based on.

Oh and by the way, Lord Carter is a Labour peer currently advising the boss of NHS England on STPs, who was previously a Labour Councillor and health policy advisor to Tony Blair.

Money is the root of all evil and the most evil have no allegiance, no conscience, and no soul.

Although this is quite a long post, I think I've just summed up all Tory MPs in the single sentence above. 

Resources/Links


(1) Centre for Health & the Public Interest

NHS boss is 'private lobbyist'

What? the boss of NHS England 'Simon Stevens' was a Labour Councillor in Brixton until 2002? And he went on to become the boss of a private healthcare insurer? What is he doing in charge of our NHS?

 

Simon Stevens has managed to ruin healthcare services across two continents and decimate the NHS 

in England.

Not content with playing his part in killing off the only chance Americans had of having a near NHS health service [Obamacare], Simon the NHS traitor 'Stevens' is back in the UK spreading ideas about how to dismantle 90% of the NHS using the American private health systems such as Health maintenance and 'population-based care' organisations.

So what the ruddy hell is he doing as boss of our NHS?

Who made Stevens the chief of the NHS ?

So here it is brought to you by the Gaztapo bandido, Simon Stevens' CV accompanied with more info on this dubious and celubrious and any other word to describe dodgy traitor... enjoy

CV for Simon Stevens

 

• How the new NHS Boss helped ruin Health services across two continents

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


Links

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

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.


Source(s)
http://qmr.kingsfund.org.uk/2016/21/overview

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]

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?

  
News article: Secretive NHS STP plans could see GP numbers in Hackney fall by a third