Dennis Benson

Posts Tagged ‘NHS privatisation’

Today’s headlines about the collapse of NHS Accident & Emergency departments are, to say the least, worrying. Patients who arrive at hospital needing emergency treatment are increasingly having to spend the night in units designed for people undergoing heart surgery or having broken limbs plastered because A & E units are now under massive pressure, and have neither the beds nor staff to cope. According to the Daily Torygraph patients are being housed in cupboards, but we can probably discount anything quite as extreme as that.

Probably more factual is the widely quoted report from Karen Webb, the east of England regional director of the Royal College of Nursing. She reports that “patients are being scatterd around hospitals like confetti”, because A & E staff have nowhere else to put them. Growing numbers are being left in corridors and areas used during daytime hours. The result is that doctors have to form what they call “safari teams” to track them down.

Dr Clifford Mann, an A & E consultant in Somerset, said yestetday that; “The pressures on emergency departments are unprecedented. They have been building steadily but have now come to a tipping point where the number of incidents of concern have started to significantly take off. There are now examples of patients who need to be resuscitated because they have collapsed whilst waiting attention”.

Incredibly the Department of Health claims that local GPs are already leading great work to prevent patients having to go to A & E. The exact opposite is the case. In many parts of the country the waiting times to see a GP are now such that patients are going to their nearest hospital.

None of this is any surprise to we allotment codgers. From time to time we suffer minor injuries and, over the years, have used our local A & E to good effect. Now we dread having to go and, when we do, spend many an hour watching harrassed staff skidding around like Keyhole Kate. The service is in meltdown.

All this has drawn attention on the day the Lords takes a last look at the Health and Social Care Act 2012. This provides a legally enforceable basis for opening up the NHS to competition, contrary to minister’s stated objctives of allowing commissioners to decide if and when it should be used. Once again, and for the last time, the Lib Dems will support the move.

Many of the peers who vote have commercial interests in private healthcare providers, and have doubtless noted health minister Earl Howe’s remarks that private providers now have “huge opportunities”.

Expect to see many of the routine, and more profitable, services transferred from NHS hospitals. The result will be yet more cuts to clinical staff. A & E units will be hit hard given that they receive funding of £75 per patient irrespective of condition and treatment required. If they lose the ‘easy’ cases, their funding will collapse and the serious cases will be dependent on lower-cost junior doctors.

Deep down every family rests content in the knowledge that should a crisis occur an ambulance and skilled clinicians stand ready on a 24/7 basis. Those days are about to end and everyone of us should be extremely concerned.

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THOUGHT FOR TODAY;  “These are the actions of people who intend to turn the NHS into a kitemark for private profiteers!”…Geoff Barr

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A beautiful morning! Apparently the monsoons are on their way back, but right now all is well in our little sunlit world. The spell of decent weather has enabled us to make progress with our new pond, and some of the hen-runs have been re-roofed. To be honest our problem is that many of the tasks we undertake are way beyond our skills levels, most of us were supposedly professional people before our retirements, we now realise that learning a trade such as joinery or  plumbing would have stood us in better stead.

But at least we don’t all fall into the health-risk categories which regularly find themselves on the front page of the Daily Torygraph. Today it is the obese that provide the target for the, presumably, slimline hacks who pour forth their venom. In reality it is not the overweight that the disciples of our dear leader wish to shame, it is the NHS. Despite enjoying millions of pounds of taxpayer’s money our health service has failed to deal with obesity – what better reason could there be for privatisation?

We can of course reasonably ignore the heaps of cash argument for, in reality, the coalition has imposed cuts of £20 billion at a time when the number of patients is rocketing. That leaves the contention that the NHS is, in some mysterious way, culpable in the matter of body weight. It does all the obvious things such as brochures and TV ads, but the simple fact is that many people now live in circumstances so dour that they care not. And even if they did, they lack the income to buy other than the cheapest food.

It is unlikely that many of them read the Torygraph so why is so much trouble taken to offer sermons? The real agenda is of course to counter the growing wave of anger as people realise at last that privatisation of the NHS is underway. The service, already torn apart by top-down reorganisation on a grand scale, will soon be fragmented and treatment determined by profit margins. If you doubt that flick back a few days to our piece about the tragic death of baby Axel and the response from a reader who laments the destruction of our family doctor service!

But there are still a few days left in which the refreshed Lib Dems can do what they should have done long since. They nodded thrugh the Conservative Health and Social Care Act, perhaps little realising that the statutary regulations attached to it place an absolute obligation on the new Commissioning bodies to put every service out to tender. If they fail to do this they will be in breach of EU competition rules.

Over the weekend the medical royal colleges finally woke up and erupted. At the same time the protest group 38Degrees launched a national petition, which has already attracted hundreds of thousands of signatures. Sensing a last minute threat our dear leader ordered health minister Lord Hunt on to our TV screens. We will not privatise, he declared. Any such action will be down to the GP-lead commissioners. It was a lie, they have no alternative.

Suddenly the Lib Dems have a spring in their step and yesterday they demanded a promise to withdraw all the relevant clauses before the end of this week. President Tim Farron said that it is “critically important we make sure there is no privatisation of the NHS”. If his party now acts as he promises the disaster will be throttled at birth. Yes there will still be a shambolic disorganisation aimed at commercialisation, but it wouldn’t actually happen.

Always assuming that Clegg doesn’t yet again roll-over, the Liberal Democrats will this week demand a withdrawal of the relevant clauses. If not, an emergency motion will be tabled and the party will line up with Labour to defeat the Lansley/Hunt plan. It should be an interesting few days, not least because Farron yesterday said “we can collect 25 to 30 Tory seats in an election”!

Suddenly there is a ray of hope, not just for the NHS but for the coalition. The Lib Dems have made a mess of things so far, mistaking coalition for subservience. Eastleigh seems to have brought them to their senses.

None of which suggest that all is necessarily well with the NHS. But  bringing in incompetent profiteers only serve to make things worse.

Who knows, this could be an historic week, one in which both the Liberal Democrats and the NHS win a stay of execution!

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THOUGHT FOR TODAY : “Hospitals are like convents. You leave the world behind and take vows of poverty, chastity and obedience!”…..Steven Wright 

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Ever the fantasist, Harry disturbed our concentration on the chickens this morning when he outlined his cunning plan. At present Waitrose supply Columbian Black Tail eggs to government departments. He suggests we put in a bid to take over the service. Government advisers would then fail to check the numbers and award the contract to Scruffy Codgers Ltd. Waitrose would threaten court action, the advisers would realise they had cocked-up big time and we would receive bounteous compensation for costs we didn’t incur in the first place. Harry was subsequently calmed down by a well-aimed bucket of water.

Joking apart, it has to be said that when it comes to incompetence this government woiuld take some beating. The Transport Secretary, Patrick McLoughlin, appeared on Newsnight yesterday and explained that, once the department learned of the impending judicial review it had to check its numbers carefully. It occured to us plebs that maybe they should have done that earlier. As it is there is likely to be a bill of around £100,000 by way of compensation, not to mention the effects on passenger services of a long period of uncertainty.

Attacks on governments usually centre on ideology. With this one the rows are focussed on implementation. The train franchise fiasco is but the latest in a succession of them. Today we learn that the next act is about to hit the stage. Lansley’s reforms have pulverised the health service and the hapless Jeremy Hunt, fresh from his less than glorious handling of the Murdoch affair, is racing around cancelling bits of the plan not considered to be vote-winners. But it is too late for him to cry halt on the biggest act of privatisation in NHS history.

This week 398 contracts are to be signed. Some 37 private healthcare companies are bidding for a wide range of services including musculoskelal, hearing and physchology. In many cases those bidding have already failed to deliver the standard required after earlier successful trial bids. A perfect example was provided in Cornwall where Serco was awarded the out-of-hours service. It has been shown to have falsified data to cover inadequate night-time cover.

The biggest worry of all is the fact that one national service could be provided by a large number of different companies, each focussed solely on their patch. Postcode medicine is not to be yearned for. And how have the costings been arrived at given that cross-boundary cooperation will be essential. And how can bids be compared given that different suppliers have based their numbers on differing levels of clinical expertise?

In the hospitals themselves the NHS Foundation Trusts are being pressed to increase the number of ‘private’ beds up to 50%. How has this been costed, how will it effect those who cannot afford private insurance?

Dr Clare Gerada, chair of the council of the Royal College of GPs, said yesterday that as a result of all this the NHS is “in distress – and so are we”. This, she added, is “the mother of all top-down reorganisations”.

The Labour Party is in no position to criticise. Under Blair it made numerous attempts to outsource outpatient services, and when the outcry became overwhelming, paid out millions to companies such as Netcare to cover the costs of bidding and, in some instances, of actually acquiring buildings.

But someone needs to blow a whistle. In the north-west the bus company Arriva is taking over ambulance services, and Parkwood Healthcare is taking over patient advocacy groups. In each and every case there is need for detailed cost studies, the effect on the NHS should be carefully calculated.

Many believe that profit targets and patient interests will prove a deadly combination. But the coalition is hell-bent on privatisation, and the enabling act is now law thanks to the Lib Dems. But huge unanswered questions remain about the supposed financial benefits. Costing specialities such as surgery is a notoriously difficult task. How can it be that the private sector, which will employ surgeons at NHS pay levels and has to make profit for its shareholders, is claiming to be able to undercut NHS costs? 

Based on the government’s record the probability is that our whole health service is being put in jeopardy for the sake of savings proposed by private companies using logic and numbers which have not been carefully scrutinised.

The government insists that every bid has been checked out to the umpteenth degree. That is exactly what Justine Greening and Patrick McLoughlin said when Richard Branson launched his attack! 

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A sunny morning usually lifts spirits on the allotments, but not today. Our group of chicken-keepers includes several former NHS employees, a retired GP and yours truly, a former chairman of a Foundation Trust. Even the brilliant performance by David Weir in the Paralympics could not lift our spirits for the news that Jeremy Hunt, of all people, has taken over the role of Health Minister has appalled us.

The removal of Andrew Lansley was inevitable. His so-called reforms have created chaos and the imposition of £20 billion of cuts – efficiency savings in Lansley-talk - at a time when demand is rocketing have combined to send the service into crisis. In pursuit of the introduction of the private sector, Lansley came up with the wheeze of transferring commissioning to GPs. Before waiting to establish whether they would, or could, take on the burden he closed down the existing commissioners, the Primary Care Trusts, and handed out many a £100,000 in redundancy payments.

The GPs subsequently made clear that they could not undertake what would have been not only been a system guaranteed to create postcode medicine, but also one to open up conflicts of interest. The result is national adverts for expert commissioners at salaries of, er, £100,000. Those applying are those made redundant just months ago. Right now chaos reigns, different areas are cutting different services, cancer networks are being scrapped, key services are being obliged to employ senior clinicians on an on-call basis. And the private sector is setting about its ambition to cherry-pick.

So a change was desperately needed. The situation is crying out for an honest, experienced leader capable of restoring relationships with the medical profession and, with it, establishing the real short-term priorities. Restoration of waiting time targets would be a good start, recognition that using profit as a key criteria in medicine is dangerous a close second. But instead the service that means so much to so many gets Jeremy Hunt!

Regular readers will need no reminder of the part that Hunt played in the Murdoch affair. His department provided a constant stream of inside information to News Corp during their bid for BSkyB. Hunt sacked his adviser, Adam Smith, and claimed to have no knowlege of the clear impropriety. He was subsequently found to have held secret meetings with members of the Murdoch clan. Only the phone-hacking scandal prevented eventual emasculation of the BBC.  

As Lord Leveson may well confirm honesty does not come easily to Jeremy Hunt. But what of his commitment to the NHS? Some years ago he was a co-author in a book calling for the privatisation of the NHS. More recently he attempted to exclude scenes celebrating the work of NHS nurses from Danny Boyle’s much-praised Olympic opening ceremony. He does not support the service’s core values and disliked the implication of approval.

Above all Hunt believes in competition based on bottom line profit. Even he was forced to concede that his G4S fiasco had given him “food for thought”. No such doubts about the NHS, he genuinely believes that setting NHS and private health providers at each other’s throats will improve patient care. It may do for those able to buy private health insurance, for the rest of us it will spell disaster.

Like mad Boris we believe that the cabinet reshuffle is driven by political expediency. In the case of Jeremy Hunt it is a case of send for the millionaire spin-doctor. Because we regard the NHS as vital we wish him well. But we suspect that our dear leader has just made his greatest mistake.

If by the time of the next election people are waiting months for treatment, and the ever reducing number of nurses are cleaning the toilets, it will take more than the unswerving support of Nick Clegg to save him!

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If you care about the NHS do go to the 38 DEGREES website to sign the warning to Jeremy Hunt! Total already approaching 100,000 and full-page press ads planned.

Some of this morning’s columnists seem surprised by the inept performance of Nick Buckles, head of G4S, when he appeared before a select committee yesterday. He came across as someone who couldn’t organise a pig-out in a pie shop, like Manuel knew nothing, and babbled about the need to protect his comapny’s reputation. But we codgers were not remotely surprised. What did they expect – someone like the head of Tesco? Mr Buckles pockets the best part of million each year and made clear that he intends to hang on to the £57 million management fee for ‘running’ the Olympics security. So hostile was the reception to Mr Buckles, and his false tan and silly mullet hairdo, that one almost felt sorry or him were it not for the fact that he became a multimillionaire by paying peanuts to people who can’t get any other kind of work. Yet he is not the real villain of this shambolic affair.

That dubious honour belongs to politicians. Both the Blair administration and this one have become obsessed with the need to “learn from the private sector”. Had they been talking about retail giants such as Tesco it would have made sense. Yes, they too are driven by profit but they have to win it in the face of fierce competition. But giving monopolistic contracts to fly-by-night  profiteers is another matter altogether.

Yesterday former Thatcher minister William Waldegrave warned Conservatives in The Times “never to make the mistake of falling in love with free enterprise”, adding that “people who believe private companies are always more efficient than the public service have never worked in real private enterprise”. How right he is. Any concern facing no competition and the chance to make a fortune will always opt for low-paid staff and maximum prices.

The amount awarded to G4S for this latest fiasco would have paid for 1500 police officers for two years. The decision to take the responsibility away from the police was crass. And there have been plenty of warning signals. The company is already under investigation after a prisoner was found collapsed in a police custody suite it was managing. A crucial record had been falsified, claiming the vulerable prisoner had been visited every 30 mintes as ordered by a police doctor. A CCTV recording has shown that no visits were made.

The incident happened at Swansea and police there have referred to “failings by G4S detention officers”. Officers? Untrained people grateful for a minimum wage rarely merit such a title. How can it possibly make sense for routines in police stations to be contracted out to companies such as this?

Companies such as G4S have made fortunes by wooing gullible ministers. Even better they have recruited them. The New Labour Home Secretary, now Lord Reid, walked out of government to become a G4S director. Doubtless he proved a good buy, given his contacts. G4S have already taken over prisons and key police control rooms. And G4S are not alone. Other similar money-making racketeers are landing contracts to run NHS services, part of the loopy Lansley’s privatisation agenda.

There are many examples of the damage this is doing to patient care. One such is the awarding of the GP out-of-hours service for Cornwall to Serco. An investigation by the Care Quality Commission, which was alerted by whistleblowers, has condemned the company for not providing enough staff, lack of proper training, falsifying records, lack of monitoring and few doctors. And Lansley has ruled that every NHS commissioner must identify at least three NHS services to be put out for tender!

In both Germany and France there has been a major reversal of the policy of contracting out essential public services, even water is back in public ownership. Now some of our politicians are beginning to sense that we are on the wrong track. MPs such as Maria Eagle and Jon Trickett have started to float the case for even rail services to be returned to public ownership. That may be a bridge too far, but many fervent privatisers are starting to question how running such services as security and health on a basis of profit first-and-last can possibly be right.

During the recent drought in southern England one leading politican actually cottoned on to the fact that the privatised water company had sold off 25 reservoirs while rewarding shareholders with £5 billion in dividends. They were just doing their job which is primarily to make profit. Water provision? No competition, no worries! 

I never thought I would live to say this, but every member of the present governmnet would be well advise to listen to William Waldegrave!

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QUOTE OF THE DAY:   ” Blair is a pariah for a good reason. He colluded in an act of abundant wickedness, and untold hundreds of thousands died and millions more suffered. In lionising the fallen leader and in their wide-eyed admiration for his admitted genius for tactical manoeuvring David Cameron and George Osborne show that power to them is fundamentally a game..one of multi-dimensional chess perhaps, but just a game for all that”…..Matthew Norman (Independent)

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