Labour U-turn on bill to reinstate public NHS

The Labour party have pulled the plug on support for the parliamentary bill that gave the NHS the only chance it had of being fully reinstated back into public ownership.

The NHS Restoration Bill, sponsored by Labour MP Elaine Smith was due to be heard on the 11th July in the house of commons.

But on Wednesday afternoon the Wolverhampton Labour MP posted a statement on her social media page saying the bill had been withdrawn and that she's "now received clarification from the Health Policy team as to where the resistance to the Bill came from".

It's unknown at this time why the Labour party have come up against resistance to the bill since a motion at a Labour conference last September fully supported the bill in its entirety.

Smith continued "In view of this [resistance] I want to reassure supporters of the Bill that the main thrust of its content will be maintained; we are going to try and work through and resolve the issues; meetings are being arranged for next week - and I expect to be invited to take part in them".

A broken commitment?

Although the NHS bill was important in itself, it's the principles behind the bill that drove Labour's NHS health policy culminating in the Labour party committing to the bill at last September's Labour party conference.

The composite 8 motion was agreed on September 25, 2017 at the Labour party conference and in part reads:

"Conference recognises that reversing this process demands more than amending the 2012 Health & Social Care Act and calls for our next manifesto to include existing Party policy to restore our fully-funded, comprehensive, universal, publicly-provided and owned NHS without user charges, as per the NHS Bill (2016-17)".

The speakers at the conference included shadow chancellor John McDonnell, shadow health secretary Jonathon Ashworth and Professor Allyson Pollock, co-author of the NHS Reinstatement Bill, which has for so long acted as a beacon for campaigners against NHS privatisation.

Support it, yes we do, wait no we don't or ...

Labour have always supported the NHS bill and approved MP's sponsor it many times since its initial reading around 2015. The second reading of the bill however attracted only 15 Labour MPs to its debate in parliament - about 94% of all Labour MPs didn't bother to turn up to support the NHS reinstatement bill.

The Campaign for the NHS Bill is provided by Public Matters, a not for profit company. Along with other groups such as Keep Our NHS Public [KONP] Public matters provided a statement on social media which caused an uproar in the NHS campaigning fraternity.

Fake News?

The public outcry must have reached Labour's HQ as after a short while Labour's Shadow health & social care secretary Jon Ashworth posted a long article saying previous reports about the NHS bill veto were 'fake news'.

If in doubt- call it 'Fake News'

The labelling of the article by public matters as fake news appears to have infuriated Public Matters who replied ...

We are extremely concerned and surprised to see Jon Ashworth, Shadow Secretary of State for Health, label the statement on the withdrawal of the NHS Bill as ‘fake news’ on his Facebook page.

We put the statement out on behalf of the reinstatement bill group. It was approved by Eleanor Smith MP who was going to present the bill.  The statement we issued did not attack either Jon Ashworth or Jeremy Corbyn on these issues. It simply expressed concern that the bill should not have been allowed to have its reading. That was specific and not fake. The issue of why that happened has not been addressed.

"We will continue to provide evidence based information on privatisation and political manoeuvres around these issues. Labour could have issued a simple apology and said they got it wrong on this occasion (or given a polite explanation of why they did not feel it was appropriate at this time).

Disappointing that they sought to cast doubt on us and the Bill Group instead.

full statement from public matters here...

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So have Labour now detracted from their commitment to support, sponsor or promote the NHS reinstatement bill?

Nobody has actually said why the Labour health team pulled the plug on such an important bill and where the 'resistance' to the bill, which is basically Labour's own composite 8 motion, came from?

Have Labour reneged on their commitment to the NHS bill and hence their own policies?

The cross-party bill, whilst not supported by the Tories, was a huge boost for campaigners and Labour supporters alike. Supporting the bill was crucial to gaining cross-party support, as well as support from NHS campaigners who spend hundreds of hours fighting to save the NHS from further privatisation.

Who or what is resisting the bill ?

This could be the straw that broke the back of the NHS. The very party who created the NHS, may have handed it over the wolves in Blue and their corporate buddies... keep campaigning, the NHS is bigger than elusive politics....
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Statement from Eleanor Smith, MP for Wolverhampton South West..

Public Matters group report shock news of NHS bill's withdrawal

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Related Links

MPs have let down the public on the NHS bill [from 2016]

Labour Has Committed To Renationalise Our NHS

Labour's full composite motion pledging to support the NHS bill

Labour MPs that support the NHS Bill

Labour party conference (including videos)

Converting the draft NHS Reinstatement Bill 2015 into Law [socialist health]

Commissioning in Lincolnshire - Selling off the NHS

Dividing the NHS in two. U.S. style 'Accountable Care' models, and the link between Lincolnshire and multi-national health corporations...

The Health & Social Care [HSC] Act 2012 created GP-led Clinical Commissioning Groups (CCGs).

Section 75 3(a) of the Act imposes requirements relating to competitive tendering for the provision of NHS services to 'any qualified provider'. CCGs feel they are open to legal challenge if they do not tender NHS contracts under the HSC Act.

What are the doctors playing at?

GPs do not have the collective skills to carry out the complex procurement process of putting services out to tender. Instead, they use Commissioning Support Units such as Optum, the UK subsidiary of United Health of America, to perform this function.

United Health are the single largest private Health insurer in the United States. The head of NHS England [NHSE] Simon Stevens [shown above] was previously vice president of United Health working on Medicare and other projects such as expanding the private health care business across Europe. Stevens published his 'five year forward view' [FYFV] document just after the general election in 2015.

Sustainability & Transformation plans [STPs] based on the FYFV document were developed in 44 'footprint' areas of  England. The FYFV 'vision' brings together Steven's work as vice-president of European division of United health and introduces profit-making American style health care schemes here in England. In particular a variant of the U.S. Obamacare which is part state funded but mostly private insurance-plan based. Here's a clip from Optum's Annual review 2015/16 ..


Lincolnshire Commissioning Support Programme & United Health
Following a rigorous procurement process throughout 2015, Optum received accreditation as an approved supplier to provide Commissioning Support Services under the NHS England Lead Provider Framework (LPF).

In October 2015 Optum was successful in winning the first tender under the LPF to provide the ‘Endto-End’ Commissioning Support Services to South Lincolnshire and South West Lincolnshire CCGs (whilst also providing a subset of services to Lincolnshire East CCG) for an initial three year period
from February 1st 2016.

Following a successful handover and mobilisation period, the Optum Team is now focused on delivering the new service offerings. source: Optum Commissioning Annual Review 2015/16

To expand the health care market in Lincolnshire and beyond, Optum do not initially need to provide services, only influence and control the strategy that delivers them. This furthers the process to gradually enable them to be part of what are called Accountable Care Systems. These are the ultimate goals for Stevens, and the end game for the NHS.

Accountable Care Systems (ACS) were previously titled Accountable Care Organisations (ACOs), but NHS England thought the name had connotations  that were too close with American private health care so the name was changed to Accountable Care Systems. Ultimately they are the same entity.  If it looks like a duck, swims like a duck, and quacks like a duck, then it probably is a duck, an Accountable Care Duck. *The only substantial difference between the ACS and ACO are the number of 'partners' signed up to the accountable care scheme. To add to the confusion, other titles used are Integrated Partnerships, Accountable Care Partnerships etc.

No matter what they are called, Stevens and NHS England has said over time they are all to become ACOs (March 2017 NHSE).

An ACO is a network or 'partnership' of GP federations, hospital trusts, care trusts, social & community care and mental health care providers that share financial and medical responsibility for providing coordinated care to patients in the hope of limiting unnecessary spending. A fictitious ACO is shown below depicting a typical 10 year contract to providers who may then sub-contract out any services.

Over in the states ACOs have sprouted up as ways to reduce the national deficit, Medicare became a prime target. With baby boomers entering retirement age, the costs of caring for elderly and disabled Americans are expected to soar.

One of the main ways the ACOs seek to reduce health care costs is by encouraging doctors, hospitals and other health care providers to form ACS/ACO networks that coordinate patient care and become eligible for financial bonuses when they deliver that care more efficiently. In many cases the efficiency is sought by withholding treatment and rationing medicines, they call this demand management.

The fewer patients they treat, the more money the government save, and the more bonuses the ACO partners receive from the government. 

Providers make more money by attempting to keep their patients healthy and in particular out of a hospital setting. *This is where the market for private providers expands since this is used to justify transferring public NHS services from hospitals into communities and straight into the private sector.

ACOs are profit-oriented systems that rely heavily on two major factors: Managing demand, and capitated payments. This is where problems lay for the NHS in England.

CCGs are already managing demand by rationing medicines and treatment. But there are more perverse incentives when ACOs are actually established. Competition between ACOs rises between the private sector who will step up their share of the market to cater for more and more patients who can't or won't wait to access medical treatment and services that have been rationed or where patients have been 'denied care' by the ACO.


England is heading towards a 'two-tier' health system

Health insurance plans then become a viable option, and as with dentistry in England, we will have taken a retrograde step into a two-tier system where those who can pay will pay, and those who can't will only have access to a rump healthcare system similar to Medicare and Medicaid in the U.S.
*In the U.S. Medicaid is for under 65's, Medicare plans are for over 65's.

While ACOs are touted as a way to help fix an inefficient payment system that rewards more, not better, care, some economists warn they could lead to greater consolidation in the health care industry, which would allow some providers to charge more if they’re the only game in town. [1] 

ACOs may include private providers as 'partners'. In fact they are encouraged to do this (as it reduces competition and thus increases profits for the ACO).

Providers make more money and recieve more bonuses if they can prove to the health department they are keeping their patients healthy. The main concern is 'how' they do this since the payment system with these ACS/ACOs is based on a limited amount allocated per patient (capitated) rather than per treatment.
Capitated Payments don't account for fluctuations in populations or patients who use cross boundary services. Each ACO could end up competing with each other giving rise to the commercial sector taking on a whole ACO ten-year contract (see image above with the fictitious Kaiser Virgin Ltd).

NHS England are using the term 'integration' to sell ACOs to the public. This is a misnomer.

The term integration has its origins in the USA care pathway where paying paitients make their own decisions on which physician (e.g. dr, Nurse, specialist, surgeon or consultant) they should go to first. This led to confusion as patient records were fragmented across different providers. This is completely different to the NHS where the patient is guided by primary and secondary care professionals.

In terms of the NHS, Stevens and NHSE are using the 'integration' vernacular to justify formation of partnerships that would also incorporate the social care budget.

Sustainability & Transformation Plans changed title to Sustainability & Transformation Partnerships. Some footprint regions were trialling NHSE vanguard care models so changed their STP titles to either Integrated Care Partnerships (ICP), or Accountable Care Partnerships (ACP). They are all based on the same FYFV document are are just various prototypes of an ACO.

There is a fear that merging (integrating) social care which is means-tested, will also result in some NHS services and treatments also becoming 'means tested'. In fact, this is a major component of Universal Credit, but more on that later....

Links

[1] https://khn.org/news/aco-accountable-care-organization-faq/


[2] Optum Commissioning Annual Review 2015/15 [PDF]

No room at the dentists inn - unless you pay

We already have a reduced A&E service at Chorley hospital. Rationing of healthcare seems to be flavour of the day, including dentistry! 

{My Story}
Today I had a look online to check the availability of NHS dentists in the local area. My spouse and I called in a local dentist & asked if we might register as  NHS patients. What happened next was shocking....

"we're not accepting any new NHS customers, only private", said the receptionist. I noted the word 'customer' then looked round noting the large waiting room was empty. So I said "but the place is empty, are you saying there are places available but only to private patients?"

The receptionist replied "yes, but there are reasonable plans available for example £55.00 for a first 45 minute consultation with any further payments made monthly".

The pre-rehearsed line about financial costs seemed to roll off the receptionists tongue as if by rote. 

I noted the receptionist shifting in the chair as if anticipating what I was about to say. Rather than debate the blatant discrimination of turning away those NHS 'customers' who can't afford to pay (twice) I simply said...

"We do pay. We pay into a collective system for dentistry called the National Health Service. It's a system where everyone supports each other in times of need. It's a system that does not discriminate or turn people away who, for whatever reason, cannot afford to pay".

"If I was to pay privately, I'd be going against the principles of a universal healthcare system I love. I'd be pushing out other NHS 'patients' resulting in this dentist treating only those who can pay privately. It would no longer be 'taking on NHS customers".

So as you can see folks, I had no means to pay as a private 'customer', and for this reason only, I was refused treatment and shown the door.

When we got home I decided to look again at the website of the dentist I'd just visited. But this time a little closer, and one sentence stood out highlighting the hypocracy of my experience. The sentence was...

"our practice caters for all"

Ironically, the dentist is called {My Dentist} on Dole Lane, Chorley.

The  {My Dentist} website then shows a list of NHS treatments and costs, with a band 3 crown costing the NHS 'customer' £256.50.

Our NHS is the best, safest and most affordable healthcare system in the advanced world. Yet slowly but surely it is being eroded and converted into a private payment system where those who can pay will, and those who can't are either shown the door, asked to setup a payment plan, or go without.

Related Links

Half of NHS dental practices are not accepting new adult NHS patients

Healthwatch CumbriaShire and the fading patient voice

Healthwatch contract mergers, is this the end of the patient voice?

As of the 1st May 2018, the Healthwatch Lancashire contract will be delivered by the Cumbria-based People First Independent Advocacy PLC.

Ironically, Healthwatch Lancashire, the so-called 'public voice' for Health & Social Care in Lancashire, have just been appointed a new chief executive 'David Blacklock' who was previously the chief executive of the very same...People First Independent Advocacy based in Cumbria.

One imagines this is some sort of transformation or integration of contracts and all those other buzz words used these days. But the appointment to the Lancashire Healthwatch of the Cumbria based advocacy company boss doesn't appear to be just 'coincidence'?

Company house also shows the new C.E. for HW Lancashire was also appointed as the People First Independent Advocacy company secretary last July (2017).  [1]

The Cumbria-based advocacy service which includes other business elements now has the contract for what happens with the peoples voice on health care services in Lancashire.

Over the years, the local opinions and voices of local people has gradually been distanced with several mergers of patient forums into larger unaccountable organisations.

Here's an extract from the book NHS for Sale: Myths, Lies & Deception.....

The patient voice was strongest when represented by Community Health Councils (CHCs). CHCs could and did visit and report on local NHS services, organise local campaigns and hold NHS bureaucrats to account. They were abolished by Alan Milburn in 2003, and replaced by a succession of weak bodies culminating in Healthwatch, established by the Health & Social Care Act. 

Real patient voice has become politically inconvenient as more NHS ‘reforms’ have been pushed through against the wishes of the public.

The proliferation of local NHS campaigns and action groups is an indication of the fact that many people feel that legitimate avenues of enquiry and complaint have been closed to them, leaving little option but to take to the streets in order to be heard.

Public bodies such as Healthwatch Lancashire have come under fire as playing little or no role in defending any of the threatened hospitals and services, and which few people even know exist. 

The People’s Inquiry concluded that Healthwatch in its current form is unlikely to deliver an effective voice for local communities, and recommended that they be wound up, with new bodies established that should be separated from the CQC and modelled on the old CHCs. 

They should link up with local community organisations, pensioners groups and other community organisations, and be given the statutory powers to inspect hospital and community services, to object to changes which lack public acceptance, and to force a decision on contested changes from the Secretary of State. 

The invisibility and impotence of Healthwatch is rivalled by many of the Health & Wellbeing Boards (HWBs), which were also established under the HSC Act. However HWBs are not NHS bodies, but controlled locally by councils with social service responsibilities. The unusual flexibility of the phrasing of the Act gives council extensive discretion on how public and outward-going the HWBs should be. 

There is the possibility to make them campaigning platforms, or a way to hold local health managers to account. But so far not one council has taken the chance to co-opt campaigners, community leaders and advocates of patient groups, and create HWBs as a vibrant, proactive public forum for scrutiny of local NHS commissioners or providers. 

The London People’s inquiry again recommended a substantial change, calling on councils to ‘make underachieving and narrow Health & Wellbeing Boards into genuine platforms for the planning and scrutiny of public health, health and social care in each borough’. 

It suggested that one way forward might even be to merge HWBs with Healthwatch, to create a single, clear and authoritative, democratic voice for local people that will monitor and scrutinise local health and social care services and plans for future developments, but also champion patient complaints.

Meanwhile, Healthwatch Lancashire has remained publicly silent on all the cuts, privatisation, integration and NHS devolution that's going on at the moment, and remains so far below the radar that very few people have ever heard of our `independent consumer champion in health and social care'...

Healthwatch should be independent of all health care providers so it can scrutinise them if it needs to? This could now be a bit tricky. The contract is now held by a PLC which opens all sorts of commercial opportunities, including with local authorities.

Instead of scrutinising proposed NHS reforms campaigners call Slash, Trash and Privatise plans (STPs), Healthwatch Lancashire appear to be promoting them. Hosting several public events involving STP leaders over the last 12 months.

With Cumbria now holding the contract for peoples voices in Lancashire, it's only a matter of time before we have a single contract for Healthwatch England, whereupon all campaigners of patient voice may as well pack up their bags and emigrate...


https://healthwatchlancashire.co.uk/news/healthwatch-lancashire-welcomes-a-new-chief-executive/


https://beta.companieshouse.gov.uk/company/05438407/filing-history

first NHS judicial review on ACOs - highlights

Chorley NHS campaigners with others in Leeds

Campaign group '999 Call for the NHS' were in Leeds High Court on 24th April for the hearing of the Judicial Review of NHS England’s contentious Accountable Care Organisation (ACO) contract. The challenge was that the contract’s introduction of a new payment mechanism is unlawful under current NHS and social care legislation and national tariff rules.

A message from 38 degrees

Thanks to everyone who signed the petition to stop the dismantling of the NHS and thank you if you made it to Leeds for the first Judicial Review on Tuesday 24th April [2018].

If you couldn't get there, here are a few highlights.

This Judicial Review marked the first of the legal challenges to the change from a National Health Service, to a Neighbourhood Health Service, (Simon Stevens' words I'm told), where the possibilities for postcode lotteries are magnified hugely and £22bn is being cut from the funding that would otherwise have been allocated by the Treasury by 2020.

Campaign groups from Chorley, Darlington, Dewsbury, Grantham, Huddersfield, Leeds,  Manchester, Slaithwaite,  Stafford, and Oxford, to name but a few, plus concerned individuals, gathered outside the court for the rally and some went into court afterwards. We were all lifted in spirits by the wonderful choir.

The Slaithwaite story was of a success, showing that together we CAN make a difference.

There were more contributions than we can include here and thank you to all who sent stories and messages of support which were read out at the start.

Other stories are in the links...a speaker from where 999 Call for the NHS started, in Darlington, a Consultant from Leeds, and the struggle in Oxford.

Now we wait for the ruling. Find out more about the day in court here.

And please share with this link http://bit.ly/999JRreport

And also share the petition...https://you.38degrees.org.uk/petitions/stop-the-plans-to-dismantle-our-nhs

This is a huge challenge but together we ARE making a difference. We must fight for the NHS as a comprehensive service for all. Nobody will do it for us.

Checkout the facebook page.

Thanks for your part in this. We couldn't do it without you.

Christine
38 degrees

Nottingham NHS sell off to private Circle

Over at Nottingham’s so called ‘health economy’ there's another struggle going on out of National public view.

The Clinical Commissioning Group (CCG) have contracted a private provider to run The Circle Nottingham Treatment Centre which employs over 150 experienced consultants and performs diagnostics and treats cancer as well as other illnesses.

The new STP arrangements everywhere in England, renamed Integrated Care Organisations and Systems are having to make cuts and Nottingham is no different. So now the CCG wants to procure the contract for less money.

It is on the cards that the private, for-profit company, most famous for handing back the contract for Hinchingbrook Hospital and owned by Toscafund , will sue the CCG.

How can that be fair? What are the odds they’ll win?

This is hot on the heels of the undisclosed sum awarded out of court to Virgin when it challenged NHS England 6 CCGs and the Council, in the Surrey ‘health economy’.

The odds are seemingly, not stacked in NHS hospitals favour, because they are doing more work than they are being paid for. The harsh ‘control totals’ ie permitted spending amount, do not provide enough money to do the job, so they can’t save or ‘increase efficiency’ . Then they are penalised, for not hitting A&E targets for example and previously promised 'Transformation' money withdrawn.

The relentless move to close hospitals goes on. We’ve just found out about South Tyneside’s Save our Hospital campaign, which needs help on crowdjustice.

As Jeremy Hunt says, he wants to re-direct NHS services by suspending tariffs .

It doesn’t really matter what the name is, the plan is the same. STP Integrated Care Systems will mean ‘managed care’ ie less care, fewer services, fewer medics.

We are fighting this with every bit of our strength because it is ideologically driven and completely unnecessary! Stay updated by clicking to recieve updates. You can unsubscribe later.

A final tribute?

At the same time as all the hospitals which haven't yet been closed, were full and some patients were experiencing third world conditions, the Department of Health organised an award ceremony. Secretary of State for Health Jeremy Hunt got one for 'services to patient safety.'

You couldn't make it up!

HELP STOP THE ROT! Click the link and support below...
Article from 38degrees "STOP the New Plans to Dismantle Our NHS"

NHS Campaigners demand A&E reopen after two years of protesting

Chorley & South Ribble NHS campaigners marched through Chorley town centre today to mark two years since the A&E at Chorley was closed.

A BIG THANK YOU TO GRUPO SAMBAFRIQ
Protesters today accompanied by a Samba drum band marched all the way from Chorley & South Ribble district hospital to Chorley town centre.

The demonstration, fronted by the samba drum band 'Sambafriq' comes only a few weeks after protesters marked the 100th week of protests since the A&E was closed in April 2016.

Sambafriq band Chorley town centre

The previous demonstration on March the 10th marked the 100th week of protests since the A&E closed. It also coincided with the anniversary of a rally back in March 1975, when hundreds of people marched to call for a 24/7 casualty service for the district.

Then (1975 B&W) and Now

The demo in March drew bikers from all over the county who came out in force to support A&E campaigners who created a chain of supporters from Preston Road to Euxton Lane entrances.

Rivington Barn Bikers and others from surrounding area

The A&E department was closed in April 2016 with the hospital trust board blaming a shortage of staff but was reopened in January 2017 part-time (8am-8pm) after pressure from campaigners, the local MP and councillors.

Fired by a sense of injustice, campaigners have since gathered outside the hospital on Euxton Lane every Saturday morning from 10am to 11am  to campaign against the closure of the A&E unit.

But campaigners are as adamant as ever to get the A&E reinstated full-time and have vowed to 'remain on the gate' at the hospital until the A&E is reinstated full-time.

Volunteers Needed -  Can You Help?

Our Chorley & South Ribble NHS campaign organisers are currently looking for volunteers to help out with organising events and other activities.

You don't need any special skills, just the will and determination to help out where you can. If you want to help out feel free to join our facebook forum (link below) and leave a message. Alternatively use the Contact form above top left of this page.


Protect Chorley Hospital from Cuts & Privatisation

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