American health chief appointed to NHS England 'transformation' board

Simon Stevens, head of NHS England and ex president of U.S. private health insurance firm United Health, has just hired the chief executive of a leading American healthcare organisation to help Americanise the NHS.

Tim Ferris MD – chief executive of the Massachusetts General Physicians Organisation and formerly the senior vice president of Population Health Management at Partners Healthcare in Boston, USA. Ferris was said to be running an Accountable Care Organisation (ACO). NHS England want the same ACO setup here in the English NHS but renamed them Integrated care Systems. So they've hired Dr Ferris to help roll out American style health plans called ACOs.

Also on board and newly appointed is Lord Ari Darzi of new Labour Tony Blair fame. In the 2000's, under Blair's 'centralisation' plans, Darzi recommended closure of over 132 A&Es in England.

Lordy Lordy! Who's working for the Tories?

Also steering the private ship is Lord Patrick Carter. The Labour peer undertook a review in 2016 for previous Conservative health secretary Jeremy Hunt.

Lord Carter of coles looked at healthcare systems abroad, including the United States, to see how savings (cuts) made in the U.S. private healthcare sector could be introduced into the English NHS. His review is currently cutting whole swathes of pathology labs across England, readying to replace them with private sector equivalents some say.

Welcoming them all on board the NHS England private parties only gravy train is no other than Dido Harding, so expect the train crash soon!

As mentioned previously in an article from the Physicians for a National Health Program (PNHP)...

The Americanisation of the NHS is not something waiting for us in a post-Brexit future. It is already in full swing. Since 2017 Integrated Care Systems (ICSs) have been taking over the purchasing as well as the provision of NHS services in England, deciding who gets which services, which are free and which – as with the dentist and prescriptions – we have to pay for.

Known in the US as Accountable Care Organisations (ACOs), ICSs are partnerships between hospitals, clinicians and private sector providers designed – and incentivised – to limit and reduce public healthcare costs, and in particular to lessen the demand on hospitals.

Health Maintenance Organisations (HMOs), the forerunners of ACOs, were pioneered by the US health insurance provider Kaiser Permanente in 1953. President Nixon’s adviser John Ehrlichman explained to his boss the basic concept before the passage of the 1973 HMO Act: ‘The less care they give them the more money they make.’ In May 2016 Jeremy Hunt, then health minister, admitted at a Commons Health Committee hearing that Kaiser was a model for his planned NHS reforms.

When a trial of ACOs was announced in the UK in 2017, it caused an outcry from campaigners and NHS England quickly rebranded them ICSs. But the Kaiser model isn’t new to healthcare policy in the UK: it has been the inspiration for the long and discreet process of the dismantling and reformation of the NHS since the 1980s. source Physicians for a National Health Program (PNHP)

Related Links

NHS England chief appoints leading American ACO figurehead

Americanisation of the NHS, it's happening right here and now

Americanising the NHS, a price comparison

Merger planned for pathology services

 

*Original article below from The Lowdown Issue 24 May 12 2020

Unite has uncovered plans being progressed “under the radar” in Lancashire and

South Cumbria, to drive through the merger of four NHS hospital laboratories

serving a population of 500,000 people (Blackburn, Blackpool, Lancaster and

Preston) into a single hub in Lancaster, and fuse pathology services into “one single hosted organisation” covering Lancashire and South Cumbria.

Stab in the back

Unite’s regional officer Keith Hutson said: “NHS bosses are using the pandemic

to reintroduce this flawed plan under the radar which will increase the times for

processing samples. Our members who have given their all during this crisis feel the deliberate lack of consultation is a stab in the back.

“We are going to involve the region’s MPs in this campaign, including The Speaker Sir Lindsay Hoyle, MP for Chorley, as, in the long-term, we fear

that any super lab could be ripe for being sold off to a profithungry healthcare company.

Unite’s challenge is in response to a May 6 letter to staff from the Managing

Director of Lancashire and South Cumbria Pathology Collaborative, Mark Hindle,

which after going through the motions of thanking staff for all their “hard work

and service” goes on to focus on the “day job”: “as we start to see hospitals

trying to get back to normal service myself and colleagues are still working to develop the Outline Business Case (OBC), that the Board will use to help them determine our future direction. … we have a large capital allocation available to us to provide new buildings for our services as we move forward once the Business Case is agreed.”

It appears that the Business Case will put forward three possible models:

•  A hub and spoke model (generally referred to as hub at Lancaster and small local laboratories (ESLs) to undertake urgent and work required at the hospital sites)
• A distributed hub where disciplines are co-located within existing estate supported by ESLs at hospital sites
• A do minimum option

Only option

But the next paragraph makes it clear that only one option is really being proposed

as the way forward: “The other main topic of conversation from the Board was how we bring our Pathology services in Lancashire and South Cumbria together into one hosted organisation in the future.”

Unite points out that merger plans for a super lab at Lancaster, covering the

areas of five NHS trusts, were rejected last year – because it would make the service too remote from local GPs and hospitals, and increase processing times from the current 24 to-48 hours.

Merger plans for a super lab at Lancaster, covering the areas of five NHS trusts, were rejected last year – because it would make the service too remote 

consultation on Integrated Care Providers farcical

Ask a silly question …

A response from Health Campaigns Together on the farcical NHS England consultation on "Integrated Care Providers" (concluded October 2018)

After wading through 32 pages of turgid and duplicitous prose, would-be respondents to the NHS England consultation on Integrated Care Providers (ICP) are, as usual with NHS consultations, channelled into answering a line of questions which make it difficult to encompass the objections many would have to the proposals.

We will offer some suggested answers and lines of argument for people wanting to respond to the official questions: but we also make clear that the NHS England approach is not the way to conduct a serious consultation on this issue.

There is no opening for any wider comments on the context in which ICPs are being proposed, or the misleading and inconsistent way in which “integration” is repeatedly used by various NHS bodies to imply various meanings, none of which is related to the everyday use of the word.

The starting point for this partial and dishonest approach to integration is the deliberate disintegration of the NHS brought about by the 2012 Health & Social Care Act, which nobody was allowed a chance to vote upon, and which clearly at no point enjoyed any popular support.

For most campaigners, health workers and informed members of the public the fundamental response is “we wouldn’t have started from here”.

Yet there is no question that allows a respondent press NHS England to support the call for legislation to sweep away the fragmentation, competition and contracting culture that are entrenched by the 2012 Act, or to argue in favour of REAL integration in place of the version offered in the consultation.

No question asks if people are satisfied with the consultation document’s evasions on future consultation and engagement with public and NHS staff. Some of the questions that are raised appear to be simply missing the point, while others deter answers by asking for a level of detail that few members of the public, and indeed few campaigners will feel confident to offer.

Since past experience suggests NHS bodies only take serious note of responses to questions that say what they wanted to hear in the first place, there seems little reason for campaigners and activists to feel bound by the constraints of answering all or indeed any of the questions posed in the document.

Instead the best use of the consultation document and the foreshortened consultation period seems to be

• to use the shortcomings and double speak of the document to publicly question the real intentions of NHS England,

• to press for meetings to be called by local councils to explain to local people what role if any they have played in drawing up and implementing plans for ICPs/ACOs,

• and to seek to prepare a largely unwitting public of the potential impact of a further loss of local accountability in health care.

• Local board meetings of trusts and CCGs should be pressed to hold public sessions answering questions on local proposals and in areas where vanguard schemes have received and spent a total of £389m in additional funding from NHS England to facilitate “new models of care” campaigners must demand a full account of how much has been received, where it has been spent and what there is to show for it.

• The link also needs to be made to the parallel NHS England consultation on restricting access to lists of elective treatment which began on July 4.

The reality is that just as ‘Sustainability & Transformation Plans’ have proved to be neither sustainable not transforming – or even workable plans, and Accountable Care Organisations turned out to be neither accountable nor caring, “Integrated Care Providers” in an age of brutal austerity offer people neither integration nor any guarantee of provision.

The lingering threat of privatisation – of the provision of certain services, or the involvement of private finance to plug growing gaps as budgets lag behind demand for care – and the explicit threat raised by NHS England of reducing access to a growing range of elective services creating a new post-code lottery and even more gaps in care mean that we cannot afford to ignore any reduction in the limited level of accountability we have over NHS providers and commissioners.

Integrated Care in an NHS without capital or revenue to expand and improve services, and in the context of cash-strapped and restricted levels of social care delivered by near-bankrupt councils, does not by any means necessarily mean an American takeover: but it will certainly not live up to the surreal promises made in the consultation document.

As campaigners, our best response is to reject this spurious offer of integration – and fight on for the real thing.

Above article kindly reproduced from Health Campaigns Together

the issue of a full time A&E in Chorley must take priority

 

It was touted in July that Chorley and South Ribble Hospital's emergency department (A&E) could reopen in September after its temporary closure during the coronavirus.

Last week however the planned reopening of Chorley and South Ribble A&E next week will not now happen – because we are told (again) that not enough staff have been secured to operate the facility.

It's also been reported that all 3 local MPs in Central Lancashire are pleading with the health secretary Matthew Hancock to shift gear and get Chorley A&E re-opened after it was closed during the viral pandemic.

But do all 3 Members of Parliament hold enough authority to get the job done and do what their electorate wants and re-open Chorley A&E full time?

Always the bone of contention is the hospital trusts case of staff shortages for re-opening the A&E. The objective however, under the CCGs plans are to permanently close Chorley A&E, build a new trauma centre, and move the profitable services out of Chorley hospital into private clinics under their ineptly titled program "Our Health Our Care". 

In October last year Matt Hancock went on a tour of health services in Lancashire. The trust and CCGs claim this gave them the opportunity to state their case to replace Chorley A&E with a new build in central Lancashire and at the same time to "secure written commitment around central policy intent". 

In other words to tie down the health sec. to commit to the NHS 10-year plan or STPs as we knew them.

The Scrutiny team at county hall however revealed some rather large flows, much of which are workforce issues, availability of alternative services and funding which the hospital trust/CCGs don't yet have. 

To close beds/A&E the CCGs and Trust must PROVE alternative service provision is in place and that it can be 'sustained' over a long period. 

None of these are achievable and never have been, which is why scrutiny at county hall queried not only why there's been no A&E staff recruited at the Chorley hospital, but also where do the hospital trust intend putting the outpatient services they've earmarked for closure in the Our Health Our Care program? 

The issues are echoed by not just scrutiny councillors either, consultants and other clinicians stated in the scrutiny report..

"Clinicians displayed concern that primary care is not currently in a place to accept significant re-profiling of activity away from the acute system and that networks are in their infancy"

"The New Build option was not prioritised highest because a number of the clinical delegates questioned whether or not this would work with whole system redesign and the lag time involved in developing a new build was plainly not compatible with the current timelines around OHOC". source: appendix 4 Enhanced clinical scrutiny

The Tories in government have stated many times they want to fragment the NHS and convert it into a paying insurance type system. Indirectly this is what the current NHS 10-year plan is all about - introducing the American accountable care system of health insurance....

  Here's what former prime minister John Major had to say on the issue of Johnson and others wishing to privatise the NHS..

John Major stated "Gove had wanted to privatise the NHS, Boris Johnson wished to charge people for health services and Duncan Smith advocated moving to a social insurance system".

To ensure fragmentation of the NHS it's crucial that the more lucrative profitable low-risk outpatient services are MOVED out of a hospital setting into a community setting where it's much easier to bind to an alternative private provider contract under a different payment system (currently the American model of accountable care).

It's likely there is suspicion the whole affair is being dragged out until funding for the 2024/25 new build unit is made available - but until then the clinical commissioning groups have plans to restrict more surgery and ban more medicines along with handing MORE NHS contracts over to to private providers.

The issue of a full time A&E in Chorley A&E must take priority and we must not be sidelined by other issues. Let's keep talking about it and keep our beloved hospital services on OUR agenda and protected from the ravages of profiteering capitalism.

_________________________________________________________

Why not leave a comment below or join one of the save Chorley hospital from privatisation facebook pages [search facebook with keywords "save chorley hospital"].

Was dividing Chorley A&E a marketing ploy gone wrong

Marketing plans to fragment A&E departments continue.

In 2017, Warrington & Halton hospital trust board setup a detailed marketing plan for people who opted to pay privately [PDF]  for surgical operations that were previously banned by commissioners (Clinical Commissioning Groups).

The marketing plan was relaunched in 2018 where it was revealed the trust had actually established the pay private scheme five years earlier in 2013, immediately after the 2012 Health & Social care act came into effect.

[1] Other 'changes' to how the NHS functions also came into effect such as 'fragmenting' A&E departments into two parts (emergent & urgent) then selling off the 'urgent care' contract to the private sector later.

Can anyone think of where [1] above has already happened?  I'm sure you can, just think local..

In their marketing material, the trust said they were "prepared to rebut ‘privatisation’ messaging via interest groups and media". 

It didn't work, and a clear message was sent from the public that all treatment under the NHS must remain universal and this is merely for those what had the ability to pay - and potentially jump any queues.

NHS patients were being charged as much as £8,500 for operations at the Warrington hospital trust, sparking outrage and claims "privatisation is already here".

Patients raised concerns over the cost of surgeries under the My Choice programme at NHS Warrington and Halton Hospitals Trust.

Since the introduction of the H&SC act in 2013, commissioning groups, also setup under the act, began to ration and ban NHS medicines and treatment, a list of which can be viewed here.

Barbaric and 'immoral'

One NHS campaigner said "So no knee/hip replacements for those that genuinely need them? No D&C (dilation and curettage) for those unfortunate to miscarry? Barbaric."

Another patient wrote on social media "Several of the operations I've had are listed including a knee arthroscopy I had a few years ago when I couldn't work for months."

She wrote that she was "horrified" to see treatment for heavy menstrual bleeding on the list, describing the whole move as "immoral"

The trust claim the self-pay scheme provided convenient access for patients, which many patients rightly translated as paying to jump the queue.

Since the outcry the trust have suspended the scheme. 

However, clinical commissioning groups (CCGs) continue to ration and ban medicines and treatment so be very vigilant and join an NHS campaign group near you.

Links/Related

NHS hospital stops plan to charge patients almost £20k for operations after outcry

History shows closing Chorley A&E results in worse outcomes, not better

History shows closing Chorley A&E results in worse outcomes, not better

When opposing closures by CCG and LTHTr don't look too closely at their reasons for closing Chorley District Hospital (CDH) A&E but look at historical data as reasons for RETAINING CDH A&E, and even 'expanding' these services.

The evidence for opening CDH A&E full time is compounding; as closing it permanently would result in worst outcomes for patients due to many factors including:

Overlcrowding at surrounding A&E hospitals - this includes Wigan WWL as their Chief exec has already stated the WWL could not manage additional patients in 2016/17 when CDH A&E was closed.

Perhaps the most compelling evidence to keep A&E services in Chorley is what's called' ambulance handover breaches'.

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

Paramedics are left waiting to handover their patients to a hospital A&E department. If that department is overcrowded and does not have enough beds then the handover times shoot up. The result is seriously ill patients waiting in corridors or backs of ambulance and thus fewer ambulances on the road.

When Chorley A&E closed in 2016 Ambulances began queuing up at Preston hospital so couldn't  get back on the road to reach emergencies. Subsequently it emerged in Jan 2018 a local man died of a suspected heart attack after waiting over 90 minutes for an ambulance to arrive.

If they close Chorley A&E, this could become commonplace, particularly as the Ambulance service comes under more pressure.

Now how much evidence do you want?

Well, let's have a quick look at another disaster that happened over at Blackburn hospital when it started taking patients when their Trust closed Burnley hospital A&E.

Let's do a comparison of ambulance handover breaches.

The figures for 2015/2016 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.

Now take a look at the table where it shows the Royal Blackburn [hospital] where they shut Burnley A&E taking patients to Blackburn.

The increase in handover and serious handover breaches at the Blackburn hospital is HUGE going from 191 handover breaches in Apr 2015 to 366 breaches a year later in May 2016.

Is this what we want for Chorley & South Ribble hospital?

and Remember, before Burnley A&E was closed the hospital trust claimed the Royal Blackburn hospital could accommodate patients from the Burnley area - including Burnley, Rossendale, Pendle and many other towns.

So how can that be deemed 'better outcomes' for patients as we're led to believe?

When it comes to the crunch, and public consultation arises, those wishing to close Chorley A&E need to prove alternative provision is already in place in the community and that any bed closures can accommodate patients elsewhere. They also need to prove there will be no overcrowding at surrounding hospitals pushing their resources and placing patients at risk.

I say it can't be done, and along with my fellow NHS campaigners intend to continue to fight tooth and nail to KEEP and EXPAND our life-saving services at Chorley & South Ribble hospital.

private health expert runs the NHS, why?

CCGs, clinical commissioning groups (established in 2012 to hand the bulk of
the NHS budget to private providers), have stopped providing funding for many medicines & surgical operations under their clinical policies.

The CCGs sent a list of medicines they'd banned to all GP practices but failed to recommend GPs CHECK TO SEE WHICH PATIENT IS EXEMPT from paying for the medicines. This led to doctors practices applying a blanket ban with the result being hundreds of patients ringing in asking where their repeat prescriptions were?

In their rush to save money due to government underfunding, the CCGs claimed they now had limited resources so must ban or restrict access to certain hospital operations and even rationed and banned some basic primary care surgical procedures unless the patient met certain 'criteria'.

One 'criteria' now for gaining access to NHS medicines includes 'financial viability'. 

This 'criteria' is straight from the American health insurance market, something the head of NHS England is all too familiar with.

After all, the man running NHS England (NHSE) is no other than Simon Stevens, the ex vice-president of global operations Europe at UnitedHealth, the largest private health insurer in the USA.

Stevens took over as CEO of NHSE in 2014 where he almost immediately invited the head of Americas state funded 'medicaid' over to England for a quick chit chat about how to run Accountable Care Organisations over here in England.

Earlier this week the UK Conservative government voted not to protect the NHS from trade deals with the USA and other countries.

The 2019 Conservative manifesto claims they would protect the NHS from trade deals, yet the very same MPs who pledged to protect the NHS went and betrayed it.

Here's the list of all the MPs who voted AGAINST protecting the NHS in post Brexit trade deal.

Giving multi-national companies access to NHS contracts is no different from a traitor selling off the crown jewels..

More..

Simon Stevens CV [PDF] can be downloaded here

Simon Stevens: NHS chief executive with a private past

---

Join the campaign to save Chorley A&E NOW!

For more on how to get involved visit the campaign group facebook page:

Protect Chorley & South Ribble Hospital Campaign