Update, 25/1/19: Rinse and Repeat: The sequel to the 5 Year Forward View
Update, 4/12/18: NHS Commissioning Support Units: the public sector beyond scrutiny
Update, 29/9/18: Brand NHS – Your Global Healthcare Provider
There is a simple rule to life. You cannot trust the Tories with the NHS.
And with the latest proposals for a ‘free trade’ deal with the US post Brexit from Dan Hannan and the Cato Institute, we should be worried.
The paper is edited by Tory MEP Daniel Hannan‘s think tank the Initiative for Free Trade (IFT) and authored by The Cato Institute which is a rightwing US ‘libertarian’ thinktank founded and funded by the fossil fuel barons and major political donors and manipulators, the Koch family.
They suggest that the NHS should be opened to foreign competition, there should be a bonfire of consumer and environmental regulations and best of all, freedom of movement between the two nations for workers.
This is the plan that Liam Fox & Co are currently negotiating with the Trump team through back channels:
The ground work is already being set as…”NHS England is consulting on the contract for a new model of health and social care provision that threatens the break-up of the NHS into units run by less accountable ‘Integrated Care Providers’ – or ‘ICPs’. Each of these ‘business units’ would control spend and rationing of healthcare for populations of up to 500,000. These huge contracts will be eminently open to the private sector to compete for.”
To understand what is currently going on, you need to know the history.
In typical Tory fashion, Jeremy Hunt actually tried to pass the NHS off as a Tory construction when he wrote for Conservative Home to mark the NHS’ 70th anniversary this July just gone.
“As we celebrate the 70th birthday today, some on the left will try to claim ownership of the NHS. They couldn’t be more wrong … It is a little known fact that the Health Minister who announced plans for the first universal healthcare system in 1944 was in fact the Conservative MP for Croydon North, Sir Henry Willink. His white paper, with cross-party support, proposed a new service to provide medical advice and treatment for everyone … All three parties had the establishment of the NHS in their 1945 manifestos. Of course Labour’s Nye Bevan deserves huge credit for making this promise a reality in 1948. But in its remarkable 70 year history the NHS has actually been under the stewardship of Conservatives for 16 years longer than under Labour.”
– Jeremy Hunt
So let’s put the record straight…
“The Labour Party had put forward proposals for a national hospital service before the first world war, and between the wars there was increasing interest in resolving problems. Several reports — commissioned by the government, produced by independent groups or the work of professional or hospital organisations — had laid out alternatives. In the 1930s whenever a new public service was envisaged, such as civil defence, it was considered as a potential function for local authorities. In the 1940s it became apparent that a health service run by them could be introduced only in the teeth of opposition from the medical profession. A PEP broadsheet, published in July 1942, anticipated Beveridge and called for a national health service. The Beveridge Report on future social insurance aimed for universal coverage, and named ‘five giants’ on the road to reconstruction: want, disease, ignorance, squalor and idleness. The depression in the 1920s and 1930s, the lack of systematic provision for health care at that time, the experience of communal action in war and the efficiency of the EMS all pointed to the need for a health service. The draft interim report of the BMA’s Medical Planning Commission in 1942, which called for the creation of a comprehensive service covering most people, made it easy for Beveridge to assume that one would be created for the whole nation.”
The Tories fought tooth and nail through Parliament on a three one whip against the creation of the NHS, voting against its creation 22 times warning it was “Hitlerian”.
They have wanted to abolish it ever since.
From as early as 1953, the UK Conservative government requested an inquiry into the cost of the NHS with a view to dismantling it.
“Margaret Thatcher secretly tried to press ahead with a politically toxic plan to dismantle the welfare state even after a “cabinet riot” and her famous declaration that the “NHS is safe with us”, newly released Treasury documents show.”
The current Tory blueprint for the privatisation of the NHS was developed in the 1980’s by Oliver Letwin and John Redwood.
In ‘Britain’s Biggest Enterprise’, Letwin and Redwood:
– calls the NHS “a bureaucratic monster that cannot be tamed”.
– says the NHS needs “radical reform” and “revolutionary ideas”.
– claims waiting lists were caused by the “system itself” rather than a lack of funds, and that spending more money would simply increase waiting lists. No, really.
They make these five recommendations:
1) Establishment of the NHS as an independent trust.
(Done, the NHS is now NHS England).
2) Increased use of joint ventures between the NHS and private sector.
(Done, the marketisation of the NHS was a key plank of the 2012 Health and Social Care Act).
3) Extending the principle of charging.
(Done, again the 2012 Act, so far charging has been extended to:
4) A system of ‘health credits’.
(Letwin explains these would be issued to a patient who could “spend” it in an NHS hospital or “he could choose instead to go to a private sector hospital”.)
5) A national health insurance scheme..
(Steps 4 & 5 are underway. Tory MP Christopher Chope of upskirting fame tried to bring before parliament a private members bill: ‘National Health Service (Co-Funding and Co-Payment)’, It would be the first step toward TOTAL PRIVATISATION of the NHS.
Which wasn’t the first time the Tories have tried in recent years;
“Imagine for a moment that you are the newly re-elected Conservative Prime Minister, and you want to launch an inquiry into whether the NHS should be paid for in future through user charges and insurance, not through tax.
But you’ve got a problem – you’ve just won an election without breathing a word that you were considering such a fundamental change to the funding of the NHS.
So how would you make such an announcement?
You can see in full: ‘Britain’s Biggest Enterprise’ by Oliver Letwin and John Redwood – Wednesday 26th October 1988
Here is Dr Youssef El-Gingihy with a breakdown:
This was followed up in 2005 by ‘DIRECT DEMOCRACY: An Agenda for a New Model Party’
“The problem with the NHS is not one of resources. Rather, it is that the system remains a centrally run, state monopoly, designed over half a century ago …
We should fund patients, either through the tax system or by way of universal insurance, to purchase health care from the provider of their choice …
“Our ambition should be to break down the barriers between private and public provision, in effect denationalising the provision of health care in Britain.”
– Jeremy Hunt
This attitude was on display from day one in Hunt’s role as Health Secretary, as demonstrated by his very first act being to intervene on behalf of Richard Branson to ensure his takeover of NHS Surrey.
And to add insult to injury…
“Richard Branson’s Virgin private health firm wins £2m in taxpayer cash after suing the NHS for ‘serious flaws’ when they lost a £82million contract to provide children’s medical services … Virgin Care won £1billion of NHS contracts in 2016/17 as £3.1billion of health services were privatised.”
Jeremy Hunt also being a man who takes massive cash donations from US Private Healthcare hedge funds. Now that’s not dodgy at all, is it?
A trend that his successor, Matt Hancock, has kept up in his acceptance of £32,000 from the chairman of the opaque lobby group, the Institute of Economic Affairs (IEA), who masquerade as a ‘charitable think-tank’ whose goal is to scrap the NHS. He also took £5,000 from the director of a private nursing firm which supplies agency workers to the health service.
So what exactly was the 2012 Health and Social Care Act?
“The Health and Social Care Act 2012 did 3 main things:
• removed the responsibility of the Secretary of State to secure comprehensive and universal healthcare provision. This means government can blame local decision makers (Clinical Commissioning Groups and NHS hospitals), and that these organisations will find it easier to start to withdraw care from patients and/or start charging for it.
• lifted the cap on private patient income from Foundation Trusts3 , 4 (and laid down a legal requirement for all NHS Trusts to become Foundation Trusts), so that they can earn up to half their income from patients who can afford to pay (meaning those of us who can’t, will be increasingly pushed to the back of the queue).
• replaced the old bureaucracy with a new, more complicated one (at a cost of £3bn), in particular replacing Primary Care Trusts with Clinical Commissioning Groups (CCGs). CCGs have less responsibility to treat all patients intheir areas. They have a few doctors on the board (this is why the Act was presented as ‘giving power to doctors’, even though most doctors are not involved and want to spend their time being doctors, not contract administrators).
Just before the Act went fully ‘live’ in April 2012, a regulation (under Section 75) was inserted doing one more, crucial thing:
• requiring all commissioning decisions to be open to competition from private providers, unless there is only ‘one capable provider’ (something that is very hard to prove, particularly when there is continual talk of the need to ‘do things differently’).”
Here is Dr Allyson Pollock breaking down the devastating effects of the2012 health and Social Care Act:
This was Letwin and Redwood’s wet dream.
“The Health and Social Care bill has opened up the NHS to further privatisation, with threats from free market campaign groups with links to government wanting its total abolition.
As the bill was being debated and voted on in the House of Lords and Commons, MPs and Lords who had financial interest in companies involved in private healthcare companies, were able to vote on the bill.
This flaw has allowed the corporate takeover of our parliamentary system, and the passing of a bill that will hand over public resources into the hands of private companies our so-called public servants have vested interests in.
This page is a quote page of some of those 141 Lords and multiple MPs who have links to private healthcare. There will be more added and please use this resource, now and come election time.”
Which lead to £1.5 billion leaving the NHS and going into the pockets of just 15 private companies linked to 23 Tory MPs and Lords, who were all able to vote for the Health and Social Care Act.
Since the introduction of the 2012 Health and Social Care Act, privatisation has gone into overdrive, with the likes of;
“In the wake of the Health and Social Care Act 2012, the percentage of NHS outsourcing to the private sector has doubled from four per cent in 2009-10 to eight per cent in 2015-16. While foundation trusts – particularly world famous names such as The Royal Marsden and Great Ormond Street Hospital – have taken advantage of new rules allowing them to make up to half their income from private patients. In other words, a two-tier system is already in place.”
“Health trusts have been accused of taking a first step towards privatisation by transferring the employment of support staff to new subsidiary companies.
At least three NHS foundation trusts in Yorkshire, the West Country and northern England have set up firms with the intention of taking thousands of workers off the NHS’s books.
It means that a staff member whose employment is transferred to the new companies will no longer be an NHS employee, even if they have been guaranteed their current working conditions.”
“An analysis by the Health Foundation think tank found that £900m of the money promised before the 2015 general election was spent on buying care from independent and other non-NHS “providers” – compared with £800m spent on the same treatments from NHS trusts”
“Jeremy Hunt’s claims that the NHS is not for sale lay in tatters last night after he signed the largest privatisation deal in history. The Health Secretary, who has repeatedly denied health services are being siphoned off to private firms under this Government, faced furious reactions as the £780million deal was revealed.”
“Government quietly privatises the NHS’s in-house agency staff provider”
While at the same time…
“NHS spending on agency staff increased by £400 million last financial year, despite an attempted crackdown. English providers spent an estimated £3.7 billion on locum doctors, nurses and other staff in 2015-16.”
Also at a time when…”NHS spends £215,000 A DAY on private ambulances because of paramedic shortage,” which equates to £235m over three years.
“Sir Richard Branson’s health firm, Virgin Care, has won a £700m contract to deliver 200 types of NHS and social care services to more than 200,000 people in Bath and north-east Somerset.”
“July 2016 saw the very quiet publication of two key documents charting the route to the privatisation of the NHS in England. Firstly, from NHS England, came Strengthening Financial Performance and Accountability in 2016-17. This is the latest set of instructions on the implementation of NHS chief executive Simon Stevens’s Five Year Forward View(5YFV).”
“Over the last year private firms have won £3.5bn worth of new clinical contracts – an increase of 500% on the previous year, our research shows. Two years on from the Health and Social Care Act we now have clear evidence that NHS privatisation is accelerating.”
“The Tories have been carving up the NHS and giving away the pieces to their donors Circle Health, which is 29.2% owned by a hedge fund run by major Tory party donor Paul Ruddock has been handed over £1.3 billion in NHS contracts. Other Tory party donors with major investments in Circle Health include Martyn Arbib, Crispin Odey and Michael Platt.
Care UK has received over £100 million in NHS contracts. Their chairman is John Nash who has made £247,250 worth of donations to the Tory party. Aside from his company picking up huge NHS contract as a result of Tory party legislation, he has also been handed a seat in the unelected House of Lords.”
“The list below (you can see that list here), which is by no means totally complete, highlights the various interests in healthcare. They are of varying significance with some persons being the sole owners of companies, chairman, directors, advisers, consultants, shares, you name it. What this list should do is act as a catalyst to reform. Many of those on the list are attached to companies that have financially gained from the changes made possible by the new Health Act, which in turn was made possible by their vote.”
Tory MP works for firm targeting huge health service deal:
“They did not believe they could win an election if they told you what they were going to do because people are so wedded to the NHS.”
– Michael Portillo
Here are 100 ways the Conservatives have failed the NHS, complete with comprehensive supporting evidence.
According to the Institute for Fiscal Studies, NHS spending under the Conservatives since 2010 has grown 68% SLOWER that the NHS’s average spending settlement since 1955.
No British government has invested less additional cash in real terms in our NHS than the post-2010 Conservative-led government.
“Analysis from the House of Commons library shows that the NHS will suffer £2.7bn in new cuts over the course of this Parliamentary term due to a shocking government miscalculation which underestimated the pension costs of all public sector workers by as much as £4bn a year.”
Matt Hancock is just as committed to the destruction and dismantlement of the NHS and social care as his predecessor. Hancock is a prize fool if there ever was one…
“The Advertising Standards Authority (ASA) has told the private health firm Babylon Health not to advertise its GP at Hand service, which has been endorsed by the health secretary, until it corrects factual errors used in its promotion.
It criticised Babylon for not making clear in the adverts that patients signing up to GP at Hand first had to deregister from their existing family doctor, a move that GP leaders warned would prove damaging.
The ASA’s ruling raises questions for Matt Hancock, the health and social care secretary, who has explicitly backed the service, despite fears in the NHS that its expansion will destabilise traditional GP services.”
I would say that Hancock hasn’t got off to a very good start…
“In the latest quarterly report of NHS Improvement (NHSI), the combined forecast deficit of NHS trusts stands at a staggering £519 million. NHSI is responsible for overseeing foundation trusts and NHS trusts, as well as “independent providers” operating within the NHS. This figure has been deemed “unaffordable” by NHSI. Trusts across England were already at a total deficit of £814 million at the close of June, roughly £80 million worse than the same time last year.”
…but then that would imply that he was in the role to help the service. As we can clearly see, that is not the Tories plan…
That’s the standard technique of privatization: defund, make sure things don’t work, people get angry, you hand it over to private capital.
– Noam Chomsky
Of course it would be remiss of me to exclude the New Labour contribution, the legacy that is PFI. Although originally a John Mayjor’s Conservative initiative, it was Tony Blair and New Labour that really accelerated the process and created a massive black hole that sucks money from the NHS at an unprecedented rate;
“The NHS has been warned of “crippling” cost pressures from its PFI contracts over the next decade, when aggregate repayments on the deals will reach their peak …
Analysis by the Centre for Health and the Public Interest found the annual “unitary payments” on private finance initiative contracts held by all government departments peaked at around £10.5bn in 2017-18.
But unitary payments due on NHS contracts will continue rising over the next 10 years, from £2.2bn in 2019-20 to their peak of £2.7bn in 2029-30.”
And it was under Tony Blair that the costly and wasteful exercise of the Major governments “internal market” was expanded further through the imposition of private surgical provision into the NHS.
“The NHS is disappearing before our very eyes. If we are not vigilant, one of the greatest organisations in the world will not exist anymore…and letting it go will be our fault.”
– Jo Brand