References

NHS Under Siege John Lister, Jacky Davis via KONP, Merlin BRILLIANT!!!

How to Dismantle the NHS in 10 Easy Steps (best 2nd Edition)Youssef el-Gingihy Amazon

The Plot Against the NHS Colin Leys and Stewart Player Amazon

NHS for Sale Jacky Davis, John Lister, David Wrigley Amazon

NHS SOS Jacky Davis & Raymond Tallis Amazon

NHS PLC Allyson M Pollock Amazon

Private Eye and "MD"

The Guardian and Polly Toynbee, The Morning Star et al.

Called to Account, Margaret Hodge

All sources Copyright acknowledged and respected, with thanks.

Humpty Dumpty: "When I use a word, it means exactly what I want it to mean...

The 2021 Act uses "flexibility" 56 times-so government can interpret bland words the way they want... BEWARE!

The Health (not National) Health and Social Care bill 2021 Professor Allyson Pollock

Ten years ago, Andrew Lansley’s health and social care bill to reorganise the NHS in England faced enormous opposition. The current health and care bill, which has its second reading in the House of Lords today, has received far less attention. But it is no less significant. The new bill will continue the dismantling of the NHS, this time by adopting more features from the US health system. For anyone who cares about the NHS, this should set off alarm bells.

The proposals mean that for the first time since 1948, parliament will not determine to whom NHS services must be provided. The bill removes the requirement for emergency services to be provided for everybody present in an area. No explanation has been given for getting rid of it.

Over the past three decades the funding, planning and provision of health services have become disconnected from each other and from people living in local areas. The bill takes this further. It gives a single budget pot to 42 new integrated care boards (ICBs) to commission most health services-not all, not comprehensive...

These won’t serve all people living in a local area, but a “group of people” who can be drawn from anywhere in England. The group will be allocated to the ICB under rules made by NHS England, without parliamentary process.

Each ICB will have “core responsibility” for its group of people. This new concept closely resembles the US definition of a health maintenance organisation (HMO). In the US, contrary to popular perception, the government funds most healthcare, much of it through private health companies such as HMOs and other “managed care organisations”. These are responsible only for providing limited free services to a group of people who enrol as their “members”, not a local population. They provide a core or basic package of care paid for under a health plan. Additional services are paid for through more insurance or user charges.

US private health companies such as Centene (Operose) and UnitedHealth (Optum Health) offer publicly funded health plans in the US, and already operate in the UK's NHS. After a takeover earlier this year, Centene became one of the largest primary care providers in England, with 58 practices and more than 500,000 patients. Within weeks of the deal, Samantha Jones, the CEO of Centene in the UK, had resigned and was appointed Boris Johnson’s health adviser. UnitedHealth has received a range of NHS contracts for more than a decade, and in 2019 Optum was one of two companies awarded a four-year prescribing support contract up to £100m. The chief executive of NHS England was until recently Simon Stevens, the former vice-president of UnitedHealth. Stevens became a peer this year, and the bill is his brainchild.

After a weasel-worded amendment from the government, which failed to rule out private companies sitting on the ICBs or their committees, the new bill will still allow these multinationals, together with private health insurance companies such as Bupa and Spire, to join the ICBs. These ICBs will decide how the budget should be distributed.

Still, despite the focus on ICBs, much of the real power and decision-making will lie with four groups that already exist but are not mentioned in the bill: provider collaboratives, place-based partnerships, primary care networks, and companies accredited to the Health System Support Framework. Provider collaboratives are groups of public and private providers that NHS England has said will be responsible for designing services. ICBs will be able to delegate their functions to them. The bill also proposes that commissioning contracts can include “discretions … in relation to anything to be provided under” the contracts. In practice this will allow providers to decide what, where and how services will be provided. So much for our so-called rights under the NHS constitution.

More than 40 collaboratives are listed on the NHS England website, including several private companies such as Cygnet, Priory and Elysium. There are echoes here again of the US. In the byzantine US healthcare system, private insurance companies sell health plans to individuals, some of whom may be eligible for public funding. The private insurance companies enter contracts with a limited number of providers to buy services for their plan members, known as “provider networks”. An ICB will be able to operate similarly, with similar effects, for its group of people. The Northern Care Alliance is already reported to be doing this. In effect, this leaves the principle of a universal and comprehensive NHS in tatters.

And let’s not forget the many private companies already accredited to the health system support framework, including Atos, Capita, Operose, Deloitte, Ernst & Young, McKinsey, PWC, Serco and Optum. The bill says nothing about these, but they will be providing population health management, digital and other support services. In other words, the private sector will be present at every level of the health service.

This isn’t a plan for social care in England – it’s a recipe for disaster
Polly Toynbee

Read more
These changes and more build on three decades of incremental chipping away by successive governments at the founding principles of the NHS as a universal and comprehensive service based on public funding, accountability and ownership. In the wake of the pandemic, the public is being softened up to expect fewer NHS-funded services and to be pushed into paying for them. Already, the NHS-partnered patient access website for GP appointments, repeat prescriptions and “discovering local health services” is reportedly offering mostly private healthcare with lists of tests and treatments to be paid for.

This bill will help ease the way for more private funding and provision of health services. MPs and local authorities will have little influence over the decisions of ICBs, as ICBs will not be established to meet the needs of the local population. Provider collaboratives will be even freer to make their own decisions. Yet the handing over of power to non-statutory groups has received less scrutiny than one would expect from MPs in the Commons. The spin that ICBs will deliver “integration and innovation” has been swallowed by too many.

This bill cannot be defeated by MPs, and it is highly unlikely it will be defeated in the Lords. The government’s Commons majority is too large and there are too many MPs and peers with interests in the private health sector. But there’s still time for the public to realise what’s happening. Anyone who believes that health services must be publicly funded and provided should oppose this bill.

Allyson Pollock is clinical professor of public health at Newcastle University and author of NHS plc: the Privatisation of Our Health Care; Peter Roderick is a principal research associate at the Population Health Sciences Institute, Newcastle University

Letter to Boris and Javid

Boris Johnson
House of Commons
London SW1A 0AA

CC Sajid Javid
House of Commons
London
SW1A 0AA
Sir!
It seems you, as newly appointed SoS for Health, have concerns about the 2021 Health and Social Care Act.
Rightly so-because you personally would be responsible for destroying the NHS…
The Health and Social Care Act 2021
After Brexit-where people voted simply to LEAVE the EU-no agreement, no deal, no new Treaty, the government have embarked on a “strategy” (!) of shrinking the state, privatising everything… reducing taxes (!!!)
Totally unvoted for…
They were warned that the NHS workers should be given UK citizenship, (as Treasury had capped medic and nursing training places, and government had decided that importing foreign doctors, nurses and midwives was cheaper), fruit pickers, abattoir workers be given 6 month visa, HGV drivers given rollover 12 month visas-as UK workers were unwilling to take on such foul jobs.
Take Tescos-they outsourced transport to Stobarts-a private firm, whose duty is to make profit for shareholders. They provoke a strike, fire workers, reduce their wages, and cause shortages.
Privatising everything benefits their rich pals-but causes huge problems if there is not competent government oversight….
The one single thing that humanises the UK above everything else is Bevan’s NHS.
Everybody in it has the NHS vocation, the NHS ethos: you have destroyed this.
The Tories hate the NHS, have this weird belief that
-privatisation saves money-it does not
-provides better treatment-it does not
-gives choice-it does not
Private Finance Initiative should be banned under the Geneva Convention: it is pure evil.
To pay the horrendous interest, over 30-60 years, and the hospital still belongs to the hedge funds-out of revenues, means the hospital is smaller, has fewer beds, fewer staff, and can go bankrupt-or forced to merge, close.
The main evil from Lansley was to remove responsibility from the S o S to provide a comprehensive NHS. This was passed to CCG’s who could
-refuse treatment to patients not on a GP list,
-could refuse to commission certain treatments-like second hearing aid, hips, cataracts etc
This would be even worse with the 2021 Act of Folly.
For Chrissakes, DO NOT ALLOW THIS ACT of FOLLY TO PROCEED.
David Owens’ “Restore the NHS” Act should be passed first-then mad Borisses omnishambles government should genuinely like the NHS, not destroy it with US style Accountable Care Organisations-already being forced on Londoners in preparation for US style insurance.

Oil-Rich visitors, the upper middle classes, rose-tinted MPs-who get preferential treatment-will always obtain good medical treatment.
For the rest of us, the right’s wish to “shrink the state, reduce taxes and reduce services" always leave the poorer at great disadvantage.
The NHS should reduce waste-pay off PFI’s, stop the costly purchaser/provider, stop Clinical Commissioning groups reducing services, and commit the Sec for Health to providing Health Services for everybody-including basic dentistry…
Just as Lansley was a clever “razzle dazzle ‘em” crafty way to privatise, the unfathomable Health and Care bill 2021 is pure evil and should never be enacted.
Integrated Care Organisations are purely to allow US for profit organisations to take over contracts for huge swathes of the country, (like Operose in London), reduce beds, staff, services for greater profit for their shareholders-not for a real enhanced National Health Service.
The Health (note-NOT The National Health Service) and Social Care Act
The Tories have already taken a wrecking ball to the State and the NHS, Social care.
This Act, probably drawn up by corporate lawyers, has intentionally been made so long and so complex, intending to bamboozle MPs, who will be bullied by the Whips and their agents, and coerced by promises of promotion, to pass it.
It is time for the Public, and MP’s to wake up and smell the coffee…
Cute phrases like “Integrated care” are a mask for private (US) firms to run hospitals, soon, immediately after the next election, provide only those services they want, cut unprofitable services, at greater profit,
by sacking surgeons, junior doctors, nurses, cutting beds, prescribing more and more profitable tests and operations, refusing patients deemed too expensive.
John Penrose's Operose takeover of London boroughs is a prelude to private insurance pools: already suitable patients being selected for insurance, operations sorted by profitability, not need.
This is not scare mongering-it has already happened with Lansley and “any qualified provider”
The priority is to train more UK doctors, nurses and midwives (a GP needs eleven years to train), using more Advanced Nurse practitioners, until government and treasury wake up and remove the secret cap on medic places...
If staff on the frontline do not enjoy their vocation, they may resign, take early retirement, reduce their hours, move to a country that appreciates them or change career-many are doing so!
NHS Trust staff dare not speak out-fear of reprisals if they do not sing the Marketisers hymn...
This Act of Folly must not go ahead-fewer managers, less threats, more understanding from mega shambles governments!!!
With Private Finance Initiatives-the Hospital is smaller, has less staff, less beds, less spendable cash-and after thirty years of horrifying interest payments, now does not even belong to the public!!!

YOU HAVE A BIG PROBLEM WITH RETENTION OF NURSES, DOCTORS, AND MIDWIVES!

DO NOT ALIENATE THEM FURTHER!!!

YOU BELIEVE YOU CAN FORCE THIS THROUGH WITH YOUR BIG MAJORITY!
YOU WILL HAVE NO MAJORITY SOON!

The UK’s NHS provides a standard of care for everyone, from Lords, MPs, to rough sleepers, at no charge, and is one of the least costly.

British Private hospitals are very expensive
No UK private hospital group, corporation insurer or provider can provide a full range of services from A&E, emergency Intensive care and all major medical and surgical specialities.

Many insurers have a top limit cap: not all treatments a patient needs will be paid for.
It is no use finding out your chosen insurer (of many) will not pay for your necessary treatment.
Bupa and other patients still rely on the NHS for intensive care, accidents, strokes, heart attacks etc
In emergency, patient is stabilised then moved to NHS ICU
My son works in Boston USA-he and his wife and family are covered by totally comprehensive insurance, pregnancy, dental and periodontal procedures, (including computer-milled crowns at $700 a pop!) with pre-existing conditions covered. It costs $21,000 each year. BUPA say they cannot provide similar such insurance.

How much would similar insurance cost when the Tories dismantle the NHS in favour of individual insurance, please?
The NHS is far too important to be organised by politicians-especially Tories and ministers who have their fingers in private pies.
Ministers swap into new positions regularly there should be at least a few GPs, epidemiologists and virologists forming long term policy-not wonks like Redwood and Letwin, devoted abolishers…
Every doctor I have spoken to say once you get politicians involved…
How can you tell when politicians are lying? … You can see their lips move.

Finally, give a thought to our hard working, caring, vocational, GPs, who advocate for their patients.

Always denigrated by the government and media, (when they want to impose new contracts and terms), criticised for high (gross, not net ) incomes, they work long hours on paperwork, QoC assessments, correspondence, seeing ever higher numbers of patients, shortened time slots, with burnout, high stress, worried about misdiagnosing, and now, wisely, reduce patients crowding into a small waiting room to reduce Covid . A dead GP, killed by Covid, helps noone.
Without proper PPE, (FFP3 masks) they regularly saw patients face to face when required, used video and phone consultations to triage patients.
It takes ELEVAN YEARS to train to be a GP; government increasingly sidelines them, even though they carry out skilled, accurate diagnoses and gatekeepers to other specialists.

All they want is enough time to diagnose, treat or refer, and access to sufficient diagnostic tests and services-such as radiography, blood tests and pathology (more test tubes please)
Referral Management centres suggest cheaper treatments, (decided by the GP in best interests of the patient), send the referral back to the GP to start again…
Foundation Trusts start waiting lists to get on the waiting lists to massage their figures…

Contradictions and Consequences
Mid Staffordshire became a Foundation Trust, and PFI made it cut beds, doctors, nurses, midwives. Care became bad, and they then hired more staff and got into severe financial difficulties…
Many trusts fired staff, then had to rehire expensive agency nurses.

CCGs urge doctors to refer fewer cases, then Hunt criticised and said refer all cases...

Clinical commissioning groups are run by the “Big Four” accountancy management firms: people from private for profit firms bidding for private firms to do NHS work: a clear scope for fat cats… controlled by tight cash budgets from NHS England

The Treasury secretly capped both nursing and medic training. They qualify with a debt of £60,000. I qualified with no debt-before the government messed up the system. Halving tuition fees, removing the cap should have been done years ago-but the government decided it was cheaper to steal foreign staff, rather than train their own.
Due to many training hospitals being closed, even our local hospitals are accrediting doctors.
The government forced through the 2012 Health and Social Care Lansley Act,
and Boris and his willing useful idiots, canon fodder, will force through the present 2021 Health (NOT the National Health) Act of Folly by every means-fair or foul: this really is the last nail in the coffin for our NHS.

The British Dental and Medical Associations dismally failed to support the grassroots medics, in failing to oppose the 1990 contract for NHS Dentists, the 2012 Act, Lansley’s Monster, and now the 2021 Act of Folly, and showed complete cowardice in the face of the enemy.
Remember-our GPs are acting in the best interests of patients and the NHS despite the government and politicians.
Some GP practices are outsourced to private profiteers-like Virgin
Occasionally, the original GPs leave, replaced by Marketisers, the company resigns and a couple of thousand patients are turfed out on the streets.
We are indeed very lucky in Welton.

Social care
Most social care (in the community-to coin a phrase) is given by totally unpaid devoted family, (care by the community), stopping work, and often needing care themselves-a huge source of unrecognised, unpaid labour.
The 1946 NHS Act was separate from
the 1948 National Assistance Act-provided for those “requiring care and attention” by local authorities-the frail, and means tested, subject to a statutory charge
a distinction between those who were “sick” “, and those “in need of care and attention”
Care and attention was then divided into a range of chronic sicknesses which could then be charged for

Bevan meant an Assistance Act to care for people in their own homes, needing domestic help
but currently, care home patients need very considerable health care needs
Government then relied of voluntary sector-Cheshire Homes, Salvation Army
Local authorities under the NHS Act were given power to develop these-not provide them directly
In 1960s local authorities given power to provide…
Thatcher reduced funding, then private firms started building or opening Care homes, their budget coming from open-ended Social security funds
Major corporate providers-with huge, massive lobbying powers rushed in
1990 Health and Social community care Act required local authorities to fund private firms care homes. A sell-off/giveaway of LA Homes ensued-a £ each...
Local authority cuts meant they had to charge for domiciliary care

From 1994, LAs made patients sell their homes-
In 2001 Tony Blair chose not to introduce free personal care
They funded “nursing care”, not “personal care

Labour made “intermediate care” -to be charged for

Private corporations have to make a profit: some sold out to housing, golf courses…
Powerful lobbying rejected staffing standards and qualifications
rejected staffing numbers
rejected building spec, room sizes and
said to patients families “Accept or remove”
Some simply turfed patients out…

Where is your wonder plan, Boris???
Bevan’s architects, in a bankrupt post war UK, accepted fault lines in his new NHS: he intended the state to charge rent for hotel-style care homes
Margaret Thatcher coined “Community Care” to sneak through long term care of the elderly, previously financed by the NHS to local council social services departments, where it remains, under means tested charges
As a result, each year thousands have to sell their homes to pay for care that was once free.
Most domiciliary care and home help has been privatised
Government funding cuts mean higher and higher charges

Cash strapped local authorities farmed off care homes to the private sector, at giveaway prices bricks and land, care paid for from social security budgets
These private providers had a guaranteed income from the state
Later, differentiated between health care and social care
Care homes are private enterprises, and introduce new charges, raise existing charges
There are, of course, excellent care homes-St Johns example-and some quite evil…

The Lansley 2012 and 2021 Health and Social Care Acts

Simon Stevens was appointed by the government as head of the NHS.
He was employed by Optum UK- a front company of United Healthcare-the US largest healthcare insurance company.
A former member of the Labour party, Lambeth councillor, senior executive of United Health Care-a for profit managed health care group: appointed Chief Executive of NHS England by Cameron, May, Johnson
He is accused being the key figure behind NHS privatisation and marketisation-“2014 Sustainability and Transformation Plan”, moving closer to the US insurance system by restructuring, dismantling, integration, means testing and merging, and opening up the NHS to marketisation and privatisation by profiteering companies..
He was advisor to Frank Dobson, Alan Milburn, to No 10 Policy Unit to Tony Blair

Optum is NHS Englands National Partner for Data and Analytics to promote Integrated Care Systems into the UK-importing the worst aspects of the US system, where families regularly go bankrupt if their insurance does not cover them.
This makes ICS’s open to private corporations exploitation.

Most have no problem with private medical or dental care, in private hospitals or clinics-where talented caring surgeons give exemplary care.

The problem is where private, usually US corporations bid for NHS contracts… (Contricks???)
They loss lead, they cherry pick, cream skim, make a profit by excluding expensive patients, make profit for their shareholders by reducing costs, sacking staff, reducing wages and salaries, taking a big slice for their CEOs, Directors at every layer, treating only profitable patients.

They poach real NHS staff at harsher contract; take over Independent Treatment Centres, run Foundation Trust hospitals and GP practices.
The four big accountancy consultancy firms run CCGs at horrendous cost.
The real NHS treats difficult cases, covers indemnity.

Boris could compensate for all the cock-ups by abolishing the Lansley 2012 and present 2021 Health and Social Care Acts.

Stephen Sanford (long term Tory voter!)

Essential questions

Should the Minister for Health and Social Care keep the DUTY to provide comprehansive care?

Should the NHS and Social Care be an independent Trust? This was Letwin and Redwoodfs view, adopted by Margaret. The politicians would never again be blamed for failures.

Should private Health Care and Social Care have an entirely seperate Minister

Keep Our NHS Public a group devoted to saving a PUBLICALLY FUNDED NHS and Social Care

Problems caused by a parliamentary system

It is very easy for a government, with strong orders to comply by the Whips, to vote for the government, to pass bad legislation.
If a matter is made so complex, full of bamboozle, and MPs are not voting independently, with their conscience, for sensible strategy… bad Acts are passed

Lansleys 2012 Monster Act is the worst ever legislation. There have been far too many reorganisations of the NHS, each delaying progress and costing billions, each to “correct” previous reorganisations.
The basic requirement is to like and value the NHS-for poorer citizens, and vunerable, who, unlike MPs, Lords, middle classes-are unable to afford private treatment or get preferential care.

The second is to get better health and social care under a public system, for the same money.
-Stop purchaser provider (but government want to keep this-to allow private health insurers to buy care from the real NHS...)
-Stop PFI-leads to fewer staff, fewer beds, evilly high interest over twenty five years, and the hospital still belongs to the hedge funds...

We need the layers of command simplifying, minimising:
1-Treasury and S of S for NHS Health and Social care, in an overall duty to provide comprehensive health care.
2-Strategic health authority, planning, collecting data on manpower, outcomes, costs
3-Regional health authorities, supervising hospitals- with Medical and dental, ophthalmic executive councils.

NO MORE!
-No privateers competing for highest salaries, profits for shareholders
-Fewer seven-hundred-thousand -pound managers, installed to promote Marketisation…

The electorate only have the choice of three main parties-now two, and usually choose the best option of a least incompetent, bigoted, right or left leaning party.
In some USA elections, voters also vote on education, schools, health, roads etc.
The UK electorate have never been allowed to vote to keep the NHS/social care, or dismantle the NHS/social care

A new tax starting at age 40 would appeal to many if it increased doctors, nurses, midwives, social care workers and gave dignified good care for our older citizens
or limiting contribution to 20% of your house
The UK needs to train more UK doctors, nurses, midwives, doctors (GPs take ELEVAN years to train); the profiteers do not train GPs or surgeons. With the best hospital being closed by PFI, fewer hospitals can accredit new GPs
and remove the secret Treasury cap on numbers, halve medic fees,

The US-UK trade deal must not allow the US to take over our NHS, nor include drug supply-but it will…
EU competition law requires anyone to bid for public services-and cannot be re “publicced” afterwards…

I cannot understand why both Tory and Labour do not see the obvious:

The S of S for Health and Social Care should have the duty to provide a comprehensive NHS and Social Care
-with proper funding-not HS2, huge road building, roundabouts etc, furlough for pubs etc
-the 2012 Lansley Monster Act should be repealed
-and the present 2021 Heal;th and Social Care Act of Folly should be aborted.

Boris and Javid will get their Act through if everybody puts their heads in the sand...

It is very easy for a government, with strong orders to comply by the Whips, promising advancement or punishment, to vote for the government, to pass bad legislation.
If a matter is made so complex, full of bamboozle, and MPs are not voting independently, with their conscience, for sensible strategy… bad Acts are passed.
Lansleys 2012 Monster Act is the worst ever legislation. There have been far too many reorganisations of the NHS, each delaying progress and costing billions, each to “correct” previous reorganisations.
The basic requirement is to like and valuethe NHS-for poorer citizens, and vunerable, who, unlike MPs, Lords, middle classes-are unable to afford private treatment or get preferential care.
The second is to get better health and social care under a public system, for the same money.

-Stop purchaser provider
-Stop PFI-fewer staff, fewer beds, evilly high interest over twenty five years, and the hospital still belongs to the hedge funds...
We need the layers of command simplifying, minimising:
1-Treasury and S of S for NHS Health and Social care, in an overall duty to provide comprehensive health care.
2-Strategic health authority, planning, collecting data on manpower, outcomes, costs
3-Regional health authorities, supervising hospitals- with Medical and dental, ophthalmic executive councils.

-the S of S for Health and Social Care should have the duty to provide a comprehensive NHS and Social Care
-with proper funding-not HS2, roundabouts etc
-the 2012 Lansley Monster Act should be repealed
-and the present 2021 Health and Social Care Act of Folly should be aborted.

Boris and Javid will get their Act through if everybody puts their heads in the sand...

Privateers take over GP surgeries

What does the US want? Everything!!!

Manifestoes and broken promises
Once upon a time, perhaps 1830, political parties wrote manifestos which bore some resemblance to their true intentions.

-With Blair, he instantly reneged on his promises not to reorganise the NHS (“get bad news over early-they will have forgotten in four years”)
-Portillo admitted “we would have lost if we admitted our intentions”
-Lansley was forbidden to talk about his proposed reforms,
-Cameron said “no top down reorganisation”-and then let Lansley out of his cage… and forced through Lansley Monster Act-because no one was awake...

Never trust any manifesto…
-The S of S for Health should have the duty to provide a comprehensive NHS and Social Care

-repeal Lansley

-abort this present 2021 Act of Folly

abolish purchaser/provider

-abolish PFI

https://healthcampaignstogether.com/flip/NB13/NewsBulletin-13.html

https://lowdownnhs.info/news/sos-nhs-fighting-to-rebuild-and-expand-nhs-capacity/

https://lowdownnhs.info/news/sos-nhs-fighting-to-rebuild-and-expand-nhs-capacity/

From Dr David Owen

Thank you for your email.

It is basically fraudulent to use the term NHS which bears no relationship to the NHS Act which Bevan steered through Parliament. A day which my father, a GP,, hailed as a ‘day of freedom’ the end of individual health insurance and the stopping of charging to see patients. He knew having operated in the pre Second World War health lottery and he voted Labour in 1945 in the belief that they would transform it, which they did.

Sadly, the turning away from NHS principles began under Blair’s Labour governments in the 2001 legislation followed by further legislation in 2006. It then took another few turns of the screw from the coalition government’s 2012 legislation driven through ideologically by Lansley and his implementer, Simon Stevens.

A body called the Medical Practice Committee functioned very well when I was Minister of Health from 1974-76. It was abolished by the Blair government in 2001 because it had done well and has since been followed by a dire and predictable turn of events with large disparities in the much larger numbers of patients per GP in deprived areas compared with more prosperous areas. The Conservative government are now being recommended by the Social Market Foundation to restore this. Everywhere you see in the NHS this pattern has been followed as a side effect of abandoning important structures developed by the real NHS and abandoned by the pseudo NHS.

The Conservative Government is no more to blame than Labour. The suffocating consensus in the Lords aided and abetted by so many people who have been sucked into NHS jobs or committees which support the slow ending of the structural values of the real NHS; not least in the prevention of ill health.

Realistically nothing radical will be done in the Lords or Commons to arrest the destruction of the NHS. I tried hard to stop this happening in strongly opposing the 2012 legislation which I considered 'fatally flawed'. I cannot bear to watch it happen again and is the reason why I will take no part in the debates on the upcoming legislation.

Yours sincerely
David Owen

Private Eye Dr Phil Hammond
I directly challenged Andrew Lansley on Question Time about the folly of his reforms 10 years ago, have repeatedly written how damaging they were in the Eye and wrote about the dangers of the new health act in February (Eye 1541) They restore a huge amount of power to the health secretary with very little accountability, so are very dependent on the wisdom of the health secretary (be it Hancock or Javid).

I don’t think much has changed since I wrote the below. Javid and the government can pretty much do what they like with the NHS and an 80 seat majority.

THESE reforms have been coming since the Tories realised their Health and Social Care Act 2012 was a disaster, but they needed pandemic cover to ditch it. Health secretary at the time Andrew Lansley was repeatedly warned (eg by MD on Question Time) that feeding the NHS even more to the market would splinter it and patients would fall through the cracks between hospitals, GP practices, community services, social care and public health services. Ten years of austerity hardly helped.

Before the pandemic, NHS waiting lists and health and care staff vacancies were at an all-time high, scandals and whistleblowers were still being suppressed, and no one seemed to be accountable or in charge. There were specific warnings in 2011 that fragmentation of public health services would make us poorly prepared for a pandemic (Eye 1529), and here we are. So there is a clear rationale for the right reform.

THE best part of the proposals is that “the NHS should be free to make decisions on how it organises itself without the involvement of the Competition and Markets Authority”. Instead, the proposed reform reinstates power to the health secretary, which makes sense for a tax-funded service. But it makes it all the more important to install a wise, compassionate, scientifically literate leader, or we could end up with another Lansley, beavering away on an immensely complicated, cunning plan that doesn’t work.

Hancock’s new powers and capacity to meddle with the NHS would be considerable. He could replace NHS CEO Simon Stevens with Dido Harding. He could continue to buy goods and services (pandemic or otherwise) from his friends and contacts. He could sell our data. He could push more money into pet projects even if they had no evidence base or NICE approval. He could get rid of NICE, the Care Quality Commission or even NHS England itself, possibly without primary legislation. And he could offer Serco, Sitel, Capita and a horde of management consultants a share of the tax pickings. Just as the Covid Act has allowed the government to make almost any emergency resource allocation decision without scrutiny or tender, Hancock will pick up this baton.

Stevens’s big idea behind the reforms is to join up the NHS, public health services and social care into regional integrated care systems by statute, which hopefully will mean these vast chunks of care will stay public and can’t be outsourced. Whether they will be transparent and accountable, help pandemic recovery, resolve urgent problems with staffing, social care and health inequalities, and deliver the myriad lefty promises Johnson made to get elected (Eye 1512), we shall see. Stevens is due to stand down soon. The competence of his replacement is crucial. And a lot depends on Hancock. Has his pandemic performance earned him the right to more power?

Useful Web links (copy into browser, paste and go)

https://www.nhsforsale.info/private-providers/the-practice-group-ltd-new/
https://www.nhsforsale.info/outsourcing/trading-the-nhs-what-does-us-want-on-the-table/
https://healthcampaignstogether.com/flip/NB13/NewsBulletin-13.html
https://lowdownnhs.info/news/sos-nhs-fighting-to-rebuild-and-expand-nhs-capacity/
https://lowdownnhs.info/comment/privatisation-commercial-secrecy-is-not-in-the-public-interest/

History of deception and strategy

Margaret Thatcher and Ken Clark outsourced catering in the 1980’s, cleaning and laundry -separating out the unions, providing worse services…
Under John Major, most NHS bodies were made into Trusts
Margaret Thatcher and Ken Clark created the internal market, purchaser/provider, which raised admin costs from 5% in mid-1970s to 14% in 2003. The Tories will never reverse this-it is required to allow private insurers to buy treatments like A&E, trauma, from the NHS providers.

The 2012 H & Social Care Act could push up costs to 30%-similar to the US
Tim Evans, negotiated the concordat for the private sector: “the NHS will be a kitemark attached to institutions in a system of purely private providers”-given them sweeteners-12% above the NHS tariff, indemnity… but worse treatment, simpler cases only, cherry-picking...
Nick Seddon, Cameron's health adviser openly called for the end of the NHS as we know it-and promoted the idea of an insurance-based system; was previously head of communications at Circle
The TTIP EU-US trade agreement opens up the NHS to international competition.. Once privatised, cannot be bought back into public ownership...
The EU competition law gives “a right to provide”, allowing foreign companies to force the opening up of public services… and “harmonisation”
in 1988 a conference of Conservative politicians, NHS senior managers, think tank advisors set out a seven step plan to alter the NHS

In 1988 the pro-market Centre for Policy studies published
“Britain biggest Enterprise” by the dastardly duo Oliver Letwin and John Redwood (both heading NM Rothschild bank international privatisation unit at the time. Letwin: plans for massive cuts in public spending
Letwin: the NHS will not exist within five years of a Conservative government
-goals for the NHS-establishing it as a Trust independent of government (Maggie's wish...)
-extending charging,
-personal health budgets, top up with insurance
-transition of this sort is fraught with difficulties
-foolhardy to move so far in one leap

-Might it not, rather, be possible to work slowly from the present system towards a national insurance scheme?
-One could begin with, for example, the establishment of the NHS as an independent Trust,
with increased ventures between the NHS and the private sector;
-move on next to the use of “credits” to meet standard charges set by central NHS funding administration for independently managed hospitals or districts;
-and only at the last stage create a national health scheme separate from the tax system”

Do not let profiteers siphon off NHS surgeons from the real NHS
There are 18,000 surgeons in England-to train each one costs about £400,000

Cameron and Lansley lied, used cherry-picked statistics to imply the NHS produced poor outcomes.
They declared the NHS unsustainable (after Blair-it was very good, inexpensive…)
We cannot carry on like this…
There is no alternative…
to soften up the electorate.

Portillo admitted they kept quiet before the election-they could not win if they disclosed their true plans. Lansley was forbidden to blab…

All campaigners can do is recognise the superb efforts of all workers in the NHS-surgeons, doctors, GPs, nurses, midwives-who work like Trojans to look after the patient, in the true NHS ethos-despite governments constant reorganisations to correct the failed previous reorganisations., denigrating them and refusing a decent payrise after five years of reduced salaries…

If certain critics are wealthy enough to self pay, or have private insurance, and fail to recognise that we will all and every one require the NHS at some point-when we have a stroke, childbirth, get knocked down by a bus-then see how much the private sector helps you...

Who can we ask about NHS Health?

Me:Hello! Is that Savid Javid?

SJ:It is: how did you get my top secret number?

I need a new hip-I’m in absolute agony. Ive been waiting ten months…
You have got through to the wrong man-I have no duty to provide treatment under the NHS-that was thrown away in 2012-The Lansley “Monster” Act. I have no function other than taking complaints and flak for the government-that's why Hancock engineered his own exit-very crafty...

Who should I contact?

The Clinical Commissioning Group!

Can you give me their phone number?

No! It’s secret! They might have one pro-government greedy GP on it, and many Marketisers, -but they are controlled by top secret NHS England, who are controlled by the top secret Treasury

Who are they run by?

That is secret! McKinsey, PWC, Ernst and Young

What treatment services do they have to provide?

Only ambulance (very stretched-not enough paramedics or ambulances), and Out of hours (privateer profiteer firms…), long waits for an ambulance, long wait because we under fund
A & E...

Why aren't there enough doctors and nurses, midwives?

We steal them from the EU and all over the world-its cheaper than training our own! We should have offered NHS workers citizenship. Many have left the UK in disgust.

Why are there not enough GPs

Because we do not respect or appreciate them, always denigrate them, overload them with services we never provide in the Social Care realm!

Why are there not enough carers?

They are shamefully underpaid by the private profiteer firms. They can earn more in supermarkets.

We are employing sixty new managers at £120,000 plus salaries.

Why do you not

-collect unpaid taxes?

-collect tax haven unpaid taxes

-stop corporations shifting money abroad, pretending they are struggling

-abolish Purchaser/provider? So we can allow the privateers to buy from NHS Hospitals (Sorry, the Hedge Funds’s hospital…)

-pay off the evil PPI schemes which reduce beds, doctors, nurses, midwives and the size of hospitals, and enrich the hedge funds?

How can I get my hip done?

Go private or do without. Goodbye-and don’t ring me again...

https://keepournhspublic.com/wp-content/uploads/2021/07/Health-Bill_statement_FINAL.pdf final

When politicians describe more “care in the community”, (famously Cameron) they fail to setup resources to provide it. They want the Sally Army, your daughter, the family… and the additional workload is heaped on to GPs
Dr John Harris-Hall, on retiring, said “The increasing demand and workload pressure are leading to low morale and stress, causing many GPs like myself to leave the profession. I am sad to retire early, but I feel there is no other choice. Enough is enough”
When Hancock urged GPs to return-many said “Not **% likely…”
Young qualified doctors, hearing from their older colleagues are unlikely to become a GP.

Not only does Treasury secretly cap training places for medics, but the rate of leaving beats the rate of joining…
Profiteering private (US) corporation do not train.

Profiteers taking GP supply contracts
United Health Europe (recently rebranded as Optum) bid to run three GP practices, won on “value for money”, against the GPs “offering superior services”.
Centene's CEO salary $27 million!!!

They sold the contract to The Practice plc-the UKs largest operator of privatised NHS GP practices.
Camden Primary Care Trust thought it had contractual safeguards to stop subcontracting

In 2012 patients at 142 Camden Road saw in the paper it was about to close. Practice plc said “because loss-making, unsustainable.”
Now run by locums, 4700 patients were thrown out
In Kent, Concordia Health pulled out of a contract to run a practice. Now staffed by locums (all the original GPs left), patients dumped
several other examples

The parliamentary Labour party

Corbyn, McDonnell signed the NHS Reinstatement bill
-to repeal the HSCA-reverse privatisation and marketisation
-resolve the question of PPI
-restore a properly funded and owned healthcare scheme

-exactly what you would vote for in a socialist government

A majority of the PLP not supportive, wedded to deregulated free markets and public-private partnerships
Shadow SoS Health Heidi Alexander blocked the NHS Reinstatement bill-the PLP abstained

After Brexit vote, Labour MPs intent on toppling Corbyn

An NHS Think Tank was proposed-the Guardian smeared this advisory panel-showed the Guardian indifferent to a public NHS because they detested Corbyn and McDonnell…

2016 Healthcare Conference-hosted by United Healthcare UK arm, Optum (Centene!)
Alexander
Lansley
Paul Corrigan (Blair’s advisor)

Owen Smith tried to portray himself as NHS champion but was actually working for Pfizer, American biotech company Amgen
And supported “choice”-direct private payments, easier access to private care
Supported PFI...

There seems no body, think tank or politician who absolutely believes in the creal NHS! They all want their fingers in the pie of increased competition for shareholder profits.
To have an NHS Commission? A commission could be stuffed with profiteers, bent on health insurance

Thatcher wished for an NHS Trust separate from government-so she could not be blamed..
A commission could recommend charging and and insurance…Through its acquisition strategy The Practice Group (TPG) grew substantially until eventually acquired by Centene Corporation. In the main, TPG did not have a policy of ownership or partnerships for GPs, but employed salaried GPs at its practices, and this has continued since its acquisition by Centene. Of the problems that have been reported in the media, a major component was the excessive use of locums because the company has been unable to find permanent salaried GPs with potential for a reduction in quality of care for patients.

Centene Operose TPG

In June 2012 TPG relinquished a contract to run the Brandon Street surgery (also known as Belgrave Health Centre) in Leicester. TPG had failed to recruit permanent GPs for the surgery and a succession of locums was used. Patient complaints noted difficulties in getting through on the phone and making appointments, rude staff, and the use of locums which meant medical history had to be gone over again and again in the limited appointment time allowed. TPG took over the running of this surgery and three others in Leicester in 2010 for five years under a £5 million contract.

In April 2012 TPG closed its Camden Road surgery in London, which it had bought from United Health, when its lease ran out. There was an outcry from patients who had been given very little notice of the decision. Both United Health and TPG were accused of running down the surgery and there was considerable use of locums. The closure triggered a public enquiry by Camden Council. Neither UnitedHealth nor TPG produced any evidence at the public enquiry. The process by which The Practice acquired United Health’s surgeries was severely criticised by the enquiry, which noted that a loophole in APMS contracts needed to be closed. A third scrutiny committee meeting to discuss the closure of the surgery had to be abandoned when both United Health and The Practice, refused to attend

In 2011 The Practice was given notice to terminate its contract for the St James medical practice in Handsworth, Birmingham, in December 2011. The Practice Plc noted that “The type of contract we have is a ten-year fixed term and the PCT have the option to terminate at the mid-point which they have chosen to do. This coincides with the unexpected termination of our lease by Vitality which means we will have no premises to practice from after December 31.” The Vitality Partnership is a GP partnership across five practices in Birmingham.

There was further controversy in January 2016 when TPG announced its intention to terminate its contract for five surgeries in Brighton and Hove following a funding dispute. This left the future care of 11,400 people in doubt. Patients have since been dispersed to other practices and only one practice, the one serving the homeless community, has been recommissioned.

How to privatise
The classic ways to privatise a public service are well annunciatiated-Letwin and Redwood “How to Privatise the world”
- denigrate, underfund, brief against, saying how inefficient it is; prevent the public servants from their vocation by regulations, reorganisations…
-“There is no alternative..”

YES THERE IS
-stop purchaser/provider (saves 20-30% of existing budget)
-stop PFI- leads to less staff, smaller hospitals, fewer beds, mothball whole floors…
-fund the NHS and Social care properly
-stop private profiteers taking huge salaries at every level

-you would also initiate several distractions: I do not believe this government is clever enough…
They provide distractions through sheer ineptitude and stupidity..

The dead cat strategy-
If you are losing a political argument-throw a dead cat onto the table... Everybody stops talking about your argument, starts talking about how horrible the dead cat is...

The privateers should be completely separate from the NHS, with their own Secretary of Satate for Private Health and Social Care (in the US privateers have a saturated market, insurance has hit a limit: multinational profiteers corporations-like the avaricious Centene-want to open the bonanza oyster of the NHS budget...

and in the UK private hospitals cannot make a profit, love their balance sheet being swelled by the NHS leassing bed space-which is barely used...
and are taken over by Centene- CEO salary $27 million…)

Private nursing homes are owned by huge complex financial structures, based in overseas tax havens, avoiding tax, paying huge interest out of funds for patient care.

Individual health budgets are a stupid idea- used to ration funding… How on earth do I know best choices for my care? When it is spent, top it up with insurance…

Scotland, Wales, NI and Scotland still escape the Boris experiment, still have an equitable public services

Now Boris wants to be able to reject any law made (he does that already…!)

The Lowdown Dec 8 2021

Keep on Fighting

Now Tory MPs have rubber stamped a deeply flawed Health and Care Bill with no opposition amendments passed and minimal changes conceded by ministers, the focus for opposition to it will shift to the House of Lords.

The fight over the controversial issues is important, both to expose as widely as possible (and warn a wider public and the NHS staff) what new problems are coming down the line, and to make it absolutely clear that each and every negative consequence that flows from the Bill is down to ministers and the Tory MPs that vote it through, and nobody else.

According to a document leaked to the HSJ, it appears that NHS England is concerned that the tight schedule to launch Integrated Care Boards by April next year, when legislation may not have been finalised until late February or March could force a delayed launch of the new system.

The last-minute addition into the Bill of the controversial proposals to introduce an unfair system to “cap” social care spending for the wealthy, offering little if any benefit to those on low incomes dependent on local authority funding, or with smaller assets and lower-priced housing, could yet be a factor in holding up progress.

But even if this happens, and as a result some amendments are carried in the Lords and even accepted by the Commons, at the end of the process a government with a majority of 80 will get the core elements of its Bill through.

Campaigning lessons

So whatever is passed we will have to find ways to fight on to repair and restore our battered NHS – just as we had to do back in 1991 as John Major’s government broke the NHS into an “internal market” of purchasers and providers, and in 2012 after Andrew Lansley’s wide-ranging and fundamental Health and Social Care Act was forced through by the Tories, propped up only by the spineless LibDems.

That legislation set out to entrench privatisation and outsourcing, a competitive market system in which local commissioning groups were forced to put an ever-growing range of clinical services out to competitive tender. Lansley’s fundamentalist neoliberal supporters gleefully hailed it as the start of the “denationalisation” of the NHS. Happily they were subsequently disappointed.

The 2012 Act replaced Primary Health Trusts as local commissioning bodies with 207 newly-created Clinical Commissioning Groups, in theory ‘led by GPs’: it also scrapped Strategic Health Authorities, and with them any coordination or planning.

It ended the direct accountability of the Secretary of State for the promotion and provision of health services in England, which was transferred to an ‘arm’s length’ body, NHS England – although in practice Health Secretaries have continued to behave as if they were still in charge.

It gave foundation trusts new “freedom” to make up to half of their income from private patients and other work outside the NHS, scrapping previous tighter restrictions.

But in practice, vigorous resistance to the Bill by campaigners was followed by increased local scrutiny and exposure of every move by CCGs, every contract they signed, and every company seeking or winning contracts. That, coupled with frequent private sector failures and continued public opposition to privatising NHS services, helped to limit how far the key Lansley plans could be fully rolled out.

An initial flurry of contracting led to an increase in numbers of private contracts, especially relatively low value community health contracts: the number and total value of contracts did increase, but the share of NHS spending on for-profit providers plateaued in 2015 and has even fallen slightly. Only by including the whole of spending on GP services can the total spent on non-NHS providers prior to Covid reach 26%: without the GPs it comes to 18.5%.

Clearly this level of spending on private provision of mental health, elective care and contracted services is way too high, and the NHS could more efficiently deliver better coordinated services if the contracts were brought in house along with the necessary investment.

But years after Lansley the vast majority of NHS services – and the whole of emergency health care services – are still delivered by NHS providers, with private companies unwilling to touch most of this work for fear of eroding their profit margins.

Since 2014, just over a year after the Act came fully in to force, NHS England’s focus shifted from competition, markets and the private sector, to ‘systems’ and coordination between providers and commissioners, reducing fragmentation. Now there is no visible lobby seeking to uphold and continue with the legislation the Tories fought so hard for in 2011-12.

Instead we saw the abortive drive in 2016-17 to reorganise England’s NHS into just 44 “Sustainability and Transformation Plans”; then mergers of CCGs, coupled with pilot projects establishing so-called “Integrated Care Systems” from 2018; and the Long Term Plan in 2019.

The Plan was linked to a campaign by NHS England for new legislation, to remove sections of the Lansley Act requiring competitive tendering, and to give legal powers to 42 ‘Integrated Care Systems.’

Partial progress on outsourcing

The new Bill does end some tendering, but pulls up well short of abolishing outsourcing and privatisation, or making the NHS the default provider, as proposed by the unions. It only abolishes competitive tendering for clinical services (of which only an estimated 2 percent have been going through with tender processes anyway), and does not roll back any existing contracts. An amendment reinserting regulations to limit the danger of a new round of shameless crony contracts has been rejected.

Numerous controversial proposals were added to the Bill by former health secretary Matt Hancock, extending and adding new powers of the Secretary of State on a wide range of issues, including intervention in local hospital closures and reconfiguration of services.

The Bill scraps the legal right in the Care Act (suspended last year during the Covid peak) for vulnerable patients to have their needs fully assessed before they are discharged from hospital, posing real dangers of patients being left stranded at home by inadequate social care, community and primary care services.

Ministers have responded to criticism that the Bill is a ‘corporate takeover bill’ by tabling an amendment to prohibit anyone “involved with the private sector or otherwise” from taking a seat on an Integrated Care Board if this could be “reasonably regarded as undermining the independence of the health service”. But an amendment to similarly keep private-sector representation out of all ICB decision-making bodies has been rejected, and an amendment to exclude GP employees of private corporations from ICB GP seats also failed.

With just 42 ICBs as “local” bodies, some spanning large areas and populations as large as 3 million, and no explicit requirement to establish more local “place based” structures, England’s NHS will be less locally accountable and less open to scrutiny than it has been since the early 1970s.

Amendments calling for ICB chairs, who will have considerable powers, to be elected on similar lines to police and crime commissioners were brushed aside. Instead chairs will be imposed top-down by NHS England, and accountable only upwards, not downwards to local communities: they can be removed only with agreement of the Secretary of State.

The Bill reorganises the NHS – but it does not fundamentally change the system established in 2012. It does not “sell off” the NHS, although services will still be contracted out, not least where capital investment is required to develop new centres or services. Private hospitals and contractors do not seek to own, but feed off and profit from the NHS.

Any increased role of the private sector or major outsourcing of contracts once the Bill becomes law is almost certain to be closely watched and scrutinised – with just 42 ICSs to keep track of, and a horde of campaigners in each, alert to the slightest whiff of cronyism or privatisation and ready to sound the alarm.

The fight goes on, to the Lords – and beyond.

But the bill is far from the only, or even the biggest problem faced by the NHS. A wider fight also has to be waged on the ground in every part of the NHS, where 12 years of cash starvation coupled with Covid has brought services to an unprecedented crisis in which the main enemy is not the private sector but the lack of public investment and NHS provision.

There’s still a lot of NHS to defend – and far too much to lose if we don’t.

Never let a good crisis go to Waste (Churchill, Blair etc)

Brexit lack of clear sharp exit WTO rules, hgv shortage, doctors, nurses, midwives shortage after Brexit (novisas), energy cap is crazy, Covid-a great distraction, enabling HSCA to be squeezed through...

Suggestion to 38 degrees
Sirs/Mesdames! URGENT!
Can I suggest 38 degrees email every member asking them to duplicate and post this purple message.
In times of Boris’s difficulties, it might just be an inexpensive way to tip their Act into the brink!

CENTENE, a US health corporation expanding throughout the NHS, has been repeatedly fined in its native United States for medical and financial failures.

Missouri-based Centene is enthusiastic about Britain, which it says is one of its two overseas locations. It is so keen it is buying key British companies and key British personnel.

Centene is very big in the United States — it is the 42nd-biggest firm in the US, according to the Fortune 500 list of US firms.

Centene is bigger than Pepsi and Disney and almost as big as Boeing.

It has grown by becoming a big supplier in the marketplace of the US’s primitive public healthcare systems, Medicare, Medicaid and the Affordable Care Act (ACA).

Medicare provides state-funded healthcare for the old, Medicaid does the same for the very poor, while the ACA tries to keep down private health insurance costs for the rest.

Centene specialises in “managed care,” the US term for keeping down healthcare costs for insurers and public programmes by trying to ration services, promote cheaper treatments and use incentives to keep people out of hospital.

Centene might already be a huge US corporation, but it is very interested in buying into Britain.

Through mergers and buyouts Centene made a big expansion in running GP practices earlier this year — its main British subsidiary, called Operose took control of 58 GP practices, covering half a million patients, leading to protests reported by the Morning Star.

That’s just part of Centene’s British expansion. Last January Centene bought “significant control” of British private health firm Circle.

Firms must notify Companies House about who owns and controls them — Circle Health registered that Centene’s ownership had jumped to somewhere between 25 per cent and 50 per cent of the firm.

At the same time, Circle took over another British private hospital firm, BMI Healthcare.

The Circle-BMI takeover creates a big network of private hospitals, part-owned by Centene, all of which do NHS operations under privatisation schemes.

Centene is also a growing player in NHS integrated care systems. These are regional boards supposed to improve health by integrating NHS and social care.

Integrated care systems are part of Health Secretary Matt Hancock’s NHS Long Term Plan.

2019’s Tory election manifesto promised to enshrine this plan in law, so integrated care systems are a manifesto commitment.

Integrating NHS and social care is a political prize sought by many, but critics say integrated care systems are also a route to rationing and privatisation — the systems will substitute regional agreements for national standards of care and place private companies in powerful positions in the integrated care system boards.

Centene UK is one such firm. In 2018 Centene hired Samantha Jones, formerly an NHS England director in charge of integration of health and social care, as the chief executive of its British subsidiary Operose.

Centene also in 2017 won a contract to help deliver Nottingham’s sustainability and transformation plan, a precursor of its integrated care system.

Centene hired Jones to help with its privatisation plans. Then in March Boris Johnson hired the same Samantha Jones as one of his “special advisers” on health.

This signals that Johnson wants to push more NHS work to private contractors, and that Centene is in a key position to get those contracts.

Centene has other good reasons to expect more work from NHS “integration.”

Its Spanish subsidiary runs what is often quoted as a model for integration. Centene owns Spanish health firm Ribera Salud (“Riverside Health”), which was given an overarching contract to run integrated health and care in Alzira, Valencia.

Supporters say the “Alzira model” shows how health and care can be integrated, but opponents view it as a privatisation scheme, where a corporation was given one “outputs-based” contract covering a whole region.

Centene is well placed to pick up more British NHS privatisation work, but judging by its US record, this could be bad news.

Last January healthcare officials in Iowa announced they were withholding $44 million (£31.6m) in payments from the Centene subsidiary that runs the state’s Medicaid scheme.

Iowa switched from a publicly run Medicaid scheme to one administered by private firms including Centene, but officials had to withhold payments because they say Centene is not paying the doctors and hospitals who actually carry out treatment on time.

When Iowa gave Centene the privatised Medicaid contract in 2018, the main newspaper in the state, the Des Moines Register — Des Moines is the prettily named state capital city of Iowa — investigated the firm and found Centene subsidiaries faced “a host of fines.”

The Des Moines Register totalled up $23.6m (£17m) in fines since 2013. Centene was fined for not providing enough doctors.

It was fined $1.5m (£1.2m) in Washington State in 2017 and it also settled a lawsuit with Kentucky with a $7.5m (£5.4m) payment in 2016, for pulling out of an unprofitable Medicaid programme before the contract was up.

Centene also paid $4.5m (£3.2m) in 2016 to settle a court case brought by nurses who said the firm had wrongly refused to pay them overtime.

As the Morning Star revealed earlier this month, in March Ohio sued Centene for what its attorney general called “an elaborate scheme to maximise company profits at the expense of the Ohio Department of Medicaid and the state of Ohio.”

Attorney general Dave Yost said: “Corporate greed has led Centene and its wholly owned subsidiaries to fleece taxpayers out of millions.

“This conspiracy to obtain Medicaid payments through deceptive means stops now.”

He said the firm was making money by misrepresenting costs, resulting in “millions of dollars of overpayments” by the state.

Centene denies the charges, but if this is what Centene does in its native US, we might big problems as it expands in Britain.

Private Eye: Tony Abbott Part of Free Trade Group Wanting to Sell NHS to Americans
This fortnight’s Private Eye for 11th -24th September has a very ominous story about new Brexit adviser’s Tony Abbott’s attitude to this country’s single greatest institution, the NHS. He’s part of a free trade group run by the extreme right-wing Tory MP, Daniel ‘Lyin’ King’ Hannan, which wants to privatise the NHS. The article ‘Rough Traders’ runs

Britain’s controversial new trade adviser Tony Abbott, ex-Australian PM, is also on the advisory board of a right-wing British “free trade” group that wants to open the NHS to US competition in a future trade deal.

Abbott, appointed to the government’s new Board of Trade last week, joined the Initiative for Free Trade, a think tank set up by keen Brexiteer and former Tory MEP Daniel Hannan, in 2017. International trade scretary Liz Truss has co-opted Hannan on to her new Board of Trade alongside Abbott, making clear the official sympathy for Hannan’s think tank (whose launch in 2017 was graced by a certain Boris Johnson, then foreign secretary).

So what kind of Brexit does these two gung-ho free marketeers now advising the government actually want? In September 2018, their Initiative for Free Trade jointly published an “Ideal US-Uk Free Trade Agreement” with the Cato Institute, a right-wing US think tank. Its proposed deal “should open all government procurement markets to goods and services providers” from either country; and it said explicitly: “Health services are an area where both sides would benefit from openness to foreign competition” – meaning the NHS, its hospitals and drug purchasing should be fully open to US firms. It accepted the NHS was a political hot potato – “We recognise any changes to existing regulations will be extremely controversial” – and so suggested a stealthy approach whereby “the initial focus should be on other fields such as education or legal services” before health, so “negotiators can test the waters and see what is possible”.

The paper from Abbott and Hannan’s think tank also said the UK should get ready to eat US chlorinated chicken and hormone enhanced beef; and any deal should avoid “restrictions based on scientifically unsubstantiated public health and safety concerns”. And provisions on workers’ rights and environmental protections? Yes: any deal should avoid these too.

Much of the objections to Abbott’s appointment have concentrated on his own personal failings – his racism, sexism and homophobia. He comes across as personally obnoxious, the living embodiment of Barry Humphries’ character, Sir Les Patterson, the Australian cultural attache. More serious is his sheer incompetence. He was in office for two years before his own party gave him the heave-ho, and then lost his safe seat to an independent.

But this is what really scares me. He and his buddy Hannan really do want to sell off the NHS. Hannan’s been promoting this for a very long time, so it’s no surprise from this direction. They’re going to do it by stealth, which also comes as no surprise, as that’s what they’ve been doing for the past forty years or so. And the Americans have been very heavily involved in all this. Johnson and the Tories have already included the NHS in their talks with the Americans, and one their best to kept it secret. They’re trying to pass further legislation to keep the negotiations as a whole under wraps, so we can’t see that this is what they’re doing.

And to cap it all, they’re determined to feed us chlorinated chicken, hormone injected beef, and wreck the environment and further degrade workers’ rights. Because this is what free trade American capitalism is all about – feeding people dodgy food, wrecking the planet and making sure there are no penalties for workers’ sick or injured at work.

Get Abbott out of the Brexit negotiations. Get private industry out of my NHS. And get the Tories out of office!

37 NHS GP practices have been sold to a private US health company - here's what it means
By Sarah Wilson
Friday, 19th March 2021, 3:31 pm
Updated
Friday, 19th March 2021, 3:31 pm

During the 2019 election campaign, Boris Johnson ruled out the NHS being 'on the table' in deals with the US (Photo: Shutterstock)
During the 2019 election campaign, Boris Johnson ruled out the NHS being 'on the table' in deals with the US (Photo: Shutterstock)
An American health insurance company has taken over 37 GP practices in London, sparking fears the NHS is being sold by stealth.

Private Eye magazine reported this week that Operose Health, the UK subsidiary of US health insurance giant Centene Corporation, took over the 37 GP practices this week, adding to the 22 primary care services the company already runs in the UK. The firm now has full control of the NHS-funded contracts to run the London surgeries.

Boris Johnson denied US firms would take on NHS contracts
During the 2019 election campaign, former Labour leader Jeremy Corbyn claimed in a debate that he had seen internal documents showing Boris Johnson had signalled willingness to allow US healthcare companies greater access to the NHS.

Johnson repeatedly denied that the NHS would be "on the table" in any deals between the UK and the US, however.

GP practices have traditionally been owned privately by GPs themselves.

Many political leaders and members of the public have expressed concern that sales to private companies will lead to poorer service while opening the door to further privatisation of public NHS services - something Conservative leaders have previously ruled out.

Profit-driven services could also disadvantage local people, with GPs paid by local CCGs for the number of patients they have registered with the practice.

Under a profit-driven model, GPs may thus seek younger and fitter patients who won't need to use their services as often in order to make more money. This could, in turn, disadvantage older patients living in the area.

'Failed' Test and Trace system was outsourced
The Government has already faced criticisms throughout the pandemic for outsourcing services to private companies, including the Covid-19 Test and Trace system.

The Serco-run Test and Trace system, for example, has faced wide criticisms for its inefficiency and failure to contact a sufficient number of coronavirus contacts.

Costing £37 billion of public money, recent polling discovered 60 per cent of the UK public believe the system to have been a failure.

Education and Child Protection Social Services

It is essential to have enough older experienced, probing police officers and child protection officers who have the power to examine, interview the child at reported risk without pre warning, and repeatedly...

Re Save Our NHS

The problem is, that despite KONP etc, the average man on the bus is still totally unaware of the 2012 and 2021 significance- keen NHS “students” do know, but only a big ad in the papers, a FB campaign, or a big name (I asked Rod Stewart and Elton John!!!) will have any effect on mad Boris…

He wants to be known as Churchill, even wants to ignore the laws of the land and courts! A campaign on FB urging remembering him as the NHS destroyer might get the 2012 Act repealed and 2021 Act aborted… Everybody post on Facebook and Twitter 'til it beaks!!!

The Tories know they can totally ignore campaigns, their MPs do not even reply to letters.

Steve Sanford

My village website www.welton-village.org.uk is not seen even by dozens… but has all the info in Explainers and resources

Whistleblowers should have protection from bullying and carreer regicide...

Private Eye's MD covers regular cases where a whistleblowing medic has been ostracised, often on full pay for years, but demoted, punished as a troublemaker, unable to continue his/her career, as a result of exposing and reporting problems.

Staff in the NHS dare not speak out against problems for fear of being sacked, demoted, not promoted, unable to ever get another job.

Margaret Hodge, past Chair of the Public Accounts Committee, in her excellent book, Called to Account, details the case of a barrister from Nigeria who joined HMRC, postgrad, sent detailed evidence as a whistleblower.
Exploiting powers under the Regulation of Investigatory Powers Act 200 (intended for terrorism), HMRC gained access to his locked desk, hacked his hard drive, all his emails, texts, phone calls, even his wife s phone calls
they kept him off work for a long time
when returned, made his life so intolerable he decided to quit, later his marriage broke down
HMRC refused to give assurances they would never employ RIBA powers against whistleblowers-refused