Is the NHS really safe in Tory hands?

First topic message reminder :

Here is a news item from North Yorkshire which never made it onto the national headlines

A York-based practice has written to its patients offering them a range of minor treatments privately, claiming they are not funded by the local NHS.

Doctors' leaders said this could be the start of a worrying trend due to the squeeze on finances and NHS overhaul.

The letter, seen by the BBC, said local health chiefs had stopped funding a range of services, but added they could still have them done privately at a number of clinics, including one owned by the practice.

These included removing skin tags from £56.30 to treating benign tumours for £243.20.

Dr Richard Vautrey, of the British Medical Association, added: "The dire finances of many trusts means that many more NHS treatments are likely to become unavailable in the future".

I think it's because they understand the uses of power (and of course how to abuse it)

Family doctors are increasingly having to fight to obtain NHS treatment for their patients, according to an investigation by GP magazine.

This story is carried in todays Northern Echo and shows what most people allready know, that waiting times and waiting lists are on the rise, and that people wanting routine operations like knee replacement, cataract removal or hip replacement are either been refused or told to come back when the situation gets worse.

Many professionals in the NHS believe that the government has a hidden agenda, a secret policy of driving people into private healthcare, and to be honest it realy does look that way.

The secret plan is to shrink the NHS by forcing desperate people to use private healthcare, thereby shrinking the NHS, the government hopes to change peoples perception of the NHS by slowly turning it into a service of "last resort" if you realy cannot afford private.

As for vthe post by tittf

I dont have a problem with the private sector been used by health authorities where there is a long waiting list of certain procedures, or if a particular hospital is short of particular consultants, surgeons or specialists.

When this happened under the last government, there was a very clear dividing line between the NHS and the private sector, even though each sector regularly used the other.

The difference now however, is that the private sector, or as you so rightly put it "profit-driven health firms" are actualy going to be taking over large chunks of the NHS, they will be taking over hospitals, the de-nationalization of the NATIONAL health service commences next April.

The dissmantling of the NHS will be to Cameron what the Poll Tax was to Thatcher

By a remarkable coincidence, BUPA announce that they are reducing the amount which they are prepared to pay for some (not all) procedures. Certain Surgeons, described as too expensive, have been removed from BUPA's "approved list".

I wonder if Dave will use PMQ's to get his side chanting his favorite 'Up' word, like 'Employment Up' when he spouts his long list....

Hospital trolley waiting time....'UP'.........

Meanwhile, back in A & E ....

A number of hospitals in the north of England have removed hand gel from public areas because some patients and visitors are drinking it for its alcoholic content.

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Saw that - a picture really is as good as a thousand words, isn't it?
Just hope the electorate understand the message

See original at [You must be registered and logged in to see this link.] for links.

Eoin Clarke’s excellent blog recently highlighted the fact that the Conservatives had recently changed their official website because their claims to have increased spending in every year of this Parliament so far had been shown to be untrue by an official report by Andrew Dilnot, Dilnot, the Chair of the UK Statistics Authority, had rebuked the government for misusing statistics and making its false claim on NHS spending.

The Tories responded, at least on their party website. Instead of claiming to have increased spending ‘in each of the last 2 years’, it now claims that they increased it ‘since 2010-11′, a subtle but important difference.

Today, I’ve been watching Shadow Health Secretary Andy Burnham using today’s debate on NHS Funding to try to get his opposite number, Jeremy Hunt, to admit on the record that his and his colleagues’ previous claims – to Parliament, a very serious matter – to have increased spending every year were false. It’s been pathetic, laughable and infuriating in roughly equal measure to watch Hunt weasel his way around the issue in an attempt to ridicule Burnham and Labour for daring to raise the issue, by making all kinds of statements about efficiency, overall increases and – even though it completely contradicts the rest of his dodging – that Dilnot reports that NHS spending is unchanged in real terms. Anything but actually answer the accusation and admit that the Tories gave Parliament false information by claiming an ‘increase in each year’, just like the website.

Burnham also pointed out that several Conservative MPs needed to rush to change their websites because they were still making the claim that the Tories had increased spending every year, even though Dilnot's report said emphatically, at least a week ago:

expenditure on the NHS in real terms was lower in 2011-12 than it was in 2009-10

Well, perhaps those MPs will do just that, and try to pretend it never happened, following the lead of their Health Secretary. But to make sure they can’t eradicate their lie completely, I’ve decided to record their names and statements here. The Tories like a bit of ‘naming and shaming’, after all.

The MPs mentioned by Andy Burnham today were ‘the members for’ Mid Derbyshire (Pauline Latham), South West Beds (Andrew Selous), North Herefordshire (Bill Wiggin), Hendon (Matthew Offord) and Sleaford & North Hykeham (Stephen Phillips).

Here are the statements from their websites, followed by a screenshot from each:

Pauline Latham MP

The Government is increasing spending on the NHS in real terms in every year of this Parliament.

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Andrew Selous MP

We have protected spending on the NHS to guarantee real-terms increases in each year of this Parliament.

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Bill Wiggin MP

We are increasing resources to the NHS. Even when we are taking very tough spending decisions, we are increasing spending in real terms

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Matthew Offord MP

Even though the Government is having to take very tough spending decisions, we are increasing spending on the NHS in real terms

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Stephen Phillips MP

We will guarantee that health spending increases in real terms in each year of the Parliament

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So, there you have it. Tory MPs lying to their constituents and the nation about our country’s most-treasured institution and their party’s actions, even after their party HQ amended its false claims (just barely). I’d be amazed if these five were the only ones, so if you hear of others, please let me know.

It’s no wonder, though, that they behave in this way and treat us and even their own supporters as contemptible idiots – it seems to be deeply-embedded in Tory DNA, and they’re following the example set by those at the top of their party, from Cameron, Osborne and Hunt downwards. These attitudes, and the lies they lead to, are killing people as the sick and disabled are targeted and deprived, and they are costing the jobs and hope of millions of others.

There’s only one possible sane reaction to this and all the other Tory crimes and misdeeds: consign them to electoral oblivion at the first opportunity. The sooner it comes, the better.

Politicians telling lies? I think I'll have to go and lie down for a bit, sky.

It used to be rare they'd be quite so blatant and persistent, even when they've been spanked for it and the truth is clearly on view. Not any more, under this lot.

The latest news is that NHS Doctors and Surgeons will be required to work at weekends.

THAT will be pretty to watch. Will their patients be flown to the ski slopes?http://www.telegraph.co.uk/health/healthnews/9748905/Learn-from-Tesco-to-work-seven-days-a-week-doctors-told.html#

The original of this post contains a number of links to sources. Since I published it a couple of hours ago, it's already received about 300 readers, which is at the high end of traffic for my site, so it seems to have touched a nerve (as it should, but not all the posts I think should do so!). You can see the original with links at [You must be registered and logged in to see this link.]

There was a very interesting little passage on the BBC’s ‘Sunday Politics’ show yesterday. Chaired by Andrew Neil, the show’s ‘Head to Head’ segment featured Mehdi Hasan, political editor of the UK Huffington Post in a debate on welfare spending with Tory MP and Health Select Committee member Chris Skidmore.

The debate wasn’t on health but, as is often the way with these things, it was touched on in an aside that was even more revealing than the debate on the main topic.

That Chris Skidmore should be arguing for cuts and caps to the welfare state is unsurprising. He is a member of the Free Enterprise Group and co-authored ‘Britannia Unchained’, a ludicrous book that lies freely about the facts in order to smear British workers that “[o]nce they enter the workplace, the British are among the worst idlers in the world. We work among the lowest hours, we retire early and our productivity is poor‘.” Britons actually work the longest hours in Europe, retire later than people in most other European countries, especially as retirement age rises to 68, and have the fewest national holidays and the lowest statutory leave in the European Union. I wrote an article on this poor excuse for a book back in August. in case you want to read more on it.

But the most interesting passage in the discussion was when they started to talk about universal welfare benefits – the idea that some benefits are available to everyone, regardless of income. Skidmore was arguing for more means-testing (assessing people’s income and only paying the benefit if it’s below a certain threshold), and Hasan responded that means-testing actually costs more while helping fewer people. But for anyone who, like me, is passionate about the NHS, the conversation took a very interesting turn. Here it is, with just a couple of omissions for brevity that don’t affect the meaning of what’s said:

Hasan: Means-testing benefits lowers the rate of uptake, it’s much more complex bureaucratically, it costs more to actually administer means-testing benefits than universal benefits, and it leads to higher rates of fraud.

Skidmore: In the longer term, with an ageing population, it will not cost more. It is not fair..for an MP on a final-salary pension of £65k to be claiming a winter fuel allowance or receiving a free TV licence. I don’t believe that’s fair, do you?

H: On that basis, you shouldn’t get free healthcare. We have a universal welfare state..

S (interjecting): Yes, exactly.

Skidmore then backtracks, denying Hasan’s accusation that the Conservatives want to introduce a US-style healthcare model and repeating the Tories spurious claim – for which they had already been reprimanded by the head of the UK statistics authority – that they have increased NHS spending.

But the truth had already slipped out. Hearing the unexpected, hypothetical supposition that we shouldn’t get free healthcare if other benefits need to be means-tested, Skidmore’s instinctive response is:

Yes, exactly.

They say the truth will out. No matter how hard the Tories try to pose as being pro-NHS and on the side of the ‘strivers’, the longer these malignant people are in power, the more often the truth slips out – just like last week with David Cameron’s freudian ‘We are making more money for the rich“.

We need to make sure people hear when it happens.

Too much negativity - and a bit more problem-solving please.

It was GB's fault before and now it's Cameron's but we voted and we got what we voted for, more or less.

How would or should Labour address the debt problem and the Euro problem and the middle east? It all stems from alliances and allegiances. No-one can go it alone and there are some devious characters that are way ahead of the majority, leading in what seems like a good direction, yet without an openly declared outcome in view.

Syria's WMD's are making the headlines now - and I have more confidence that these exist, and more concern about the seeding of unrest across the region and the risk that they may fall into unscrupulous hands. Diplomacy is an edgy game with huge risks.

Where moves have been made to disadvantage groups of people, we see that they are the ones without a voice, without a government lobby group, who aren't organised, because government has always been answerable to law.

Therefore the law needs to be made accountable for decisions by government. And lobbyists need to be well-informed.

Me - I know nuthing...

methought wrote:Too much negativity - and a bit more problem-solving please.

It was GB's fault before and now it's Cameron's but we voted and we got what we voted for, more or less.

How would or should Labour address the debt problem and the Euro problem and the middle east? It all stems from alliances and allegiances. No-one can go it alone and there are some devious characters that are way ahead of the majority, leading in what seems like a good direction, yet without an openly declared outcome in view.

Syria's WMD's are making the headlines now - and I have more confidence that these exist, and more concern about the seeding of unrest across the region and the risk that they may fall into unscrupulous hands. Diplomacy is an edgy game with huge risks.

Where moves have been made to disadvantage groups of people, we see that they are the ones without a voice, without a government lobby group, who aren't organised, because government has always been answerable to law.

Therefore the law needs to be made accountable for decisions by government. And lobbyists need to be well-informed.

Me - I know nuthing...

The debt problem is largely a construct rather than a reality - I've blogged extensively about it. See past the construct to the reality and there is no money shortage. It's just concentrated in the wrong places, and there are ways to change that. I've written on my blog, and here, about a straightforward way to achieve a minimum wage or better and moderate executive salaries, for example.

As for the problems in the Middle East, I've spent a lot of time there - including Syria right up to the conflict, and Lebanon at various times. The problems there may well be beyond the ability of anyone in the UK to solve - any party in power could only do its best, advocate impartially (UK governments have tended to over-favour Israel - perhaps it's guilt).

The Euro crisis is, likewise, not all it's made out to be. International organisations such as the IMF and World Bank are primarily staffed by Friedmanites, and have a demonstrable track record of exaggerating and even manufacturing 'crises' for ideological ends. Again, you can read about some of the incidents in detail on my blog. In case you want to bother, it's at skwalker1964.wordpress.com

This is what happens when health is for profit:-

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" (UK governments have tended to over-favour Israel - perhaps it's guilt)."

UK governments have also tended to avoid disagreement with USA Policy, ever since 1956.

Thatcher would have liked to privatise the NHS, but feared Civil commotion. What made Cameron decide that he could get away with it?

Mind you, out-of -hours GP services have been contracted out for several years now, and I think most people realised it wasn't a good solution.
But GP's already seem to work long hours, and I suppose they wanted theirweekends free.

Here's another to add to the liars list:

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And a hypocrite, but I'll be writing about that later.

Tory supporters have always elected to be treated privately, and although it was their own choice resented having to "pay twice" for the NHS through taxation. Accordingly they are quite happy to see the service fall by the wayside. Dog in a manger style.

In times gone by, only wealthy men could afford to be an MP so the Nation got what it paid for, a cosy Gentlemen's Club at Westminster where they passed Laws to suit themselves.

Now they are paid "expenses" but it's not easy to say whether anything else has changed.

oftenwrong wrote:" (UK governments have tended to over-favour Israel - perhaps it's guilt)."

UK governments have also tended to avoid disagreement with USA Policy, ever since 1956.

Indeed.

Perhaps the only way to a really fair society would be to abolish all private health care and all private education - everyone access the same services, freee at the point of delivery, and then we'll see just what resources we, as a country, have to devote to those services.
No-one would be able to be in ignorance of the way other parts of society live, and so politicians making laws which disadvantage certain parts of society would be seen for exactly what they are.

The medical profession demanded the right to ride two horses at the same time in their original negotiations with Nye Bevan prior to the 1948 Welfare legislation. At the time he was quoted as saying, "I stuffed their mouths with gold."

Which is what makes it fascinating to watch the present administration attempting to bring the Doctors to heel and work a seven-day week. Shall we eventually see strike-breakers brought in to enforce the Government's will?

Shall we eventually see strike-breakers brought in to enforce the Government's will?

I wonder how many doctors that armed forces have to put on standby?????

2012: how the NHS became privatised and the impact that has had

Extracts from an article by Alex Nunns:-

2012 will go down as a cataclysmic date in the history of the English health service. It was the year when the virus of privatisation finally gained control of the cell nucleus of the NHS and began its destruction in earnest.

If you listen to the politicians you wouldn’t know it. According to David Cameron “we will not be selling off the NHS". If you believe Nick Clegg “there will be no privatisation". They have been able to get away with this deception because the transformation they unleashed is messy. It is happening everywhere, but not uniformly. It is hidden by its very scale and spread.

But take a step back and the patterns are unmistakable. The controversial Health and Social Care Act passed in March 2012 ended the English National Health Service in all but name by abolishing the 60-year duty on the government to provide comprehensive healthcare for all. In its place is not so much a new structure as a process with its own dynamic - that of a snowball tumbling down a hillside.

For the full article:-
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Nick Clegg's NHS guarantee, January 2010

We’ll protect NHS frontline services
Labour is cutting frontline services.
Many Conservatives want to sell off the NHS.
Only Nick Clegg and the Liberal Democrats will protect the vital
services we all rely on. Nick Clegg said, “Every vote for the Liberal Democrats is a vote to keep our NHS safe.

“We will cut waste and make sure that frontline services are maintained and improved for people everywhere.”

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TREASURY STOLE FROM NHS IN 2011/12 15X TOTAL ‘CRISIS HOSPITAL’ DEFICIT

I published a post this morning about Treasury minister Sajid Javid’s lies, on his website, to his constituents about NHS spending. In spite of a rebuke from the UK Statistics Authority over the falsity of Tory claims to have increased NHS spending ‘in each year of this Parliament’, Javid (along with at least 4 other Tory MPS and Health Secretary Jeremy Hunt), persists in this claim, blatantly lying to the British people and to Parliament.

I also touched on his hypocrisy in inviting Daniel Poulter, another liar, on the record, to one of his own party’s MPs about plans to cut a local hospital, to come and visit the Alexandra (‘Alex’) hospital in Bromsgrove to talk about the importance of local hospitals to local communities.

But that wasn’t the limit of his hypocrisy, and I promised to provide more detail as to why it is utterly disingenuous of Javid – who is Economic Secretary to the Treasury – to try to convince his constituents that he is fighting for their cherished local hospital.

According to reports, the NHS outside London ran in surplus by £45m, while across the greater London area overall it ran at a deficit of £95m – including £65m at South London Healthcare Trust which is supposedly in a financial crisis so irretrievable that it has led to the Trust being put into administration. Media reports abound of the supposed ‘crisis’ of ‘unsustainable’ NHS Trusts, usually accompanied by mention of the possibility of inviting private companies to take over these ‘struggling’ hospitals.

The problem is that most members of the public don’t know any better than to believe what they read in the papers and hear in the news. And the problem with these reports are that they are – to put it moderately – completely misleading.

Speaking of the ‘Nicholson Challenge’, the Dept of Health’s official website still says that the £20 billion savings to be achieved by 2015 will be (not may be) ‘reinvested in frontline care’:

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According to the Audit Commission report to the Commons Health Select Committee (CHSC), which I’ve managed to obtain even though written evidence is not freely available to the public:

PCTs, SHAs and NHS trusts reported a combined underspend and surplus of £1.6 billion in 2011/12. NHS foundation trusts (FTs) recorded a surplus of £0.4 billion, giving a total surplus of £2 billion

That’s right – the NHS amassed a surplus of £2 billion in a single financial year. That’s 15 times more than it would take to wipe out the entire deficit of NHS hospitals in the London area, even if you don’t offset the £45bn positive balance built up by hospitals across the rest of the country as a whole.

According to the Dept of Health, these savings should be reinvested in front-line NHS services. But it’s not happening.

And here’s where Javid’s hypocrisy – like that of his party – goes so high up the scale that it blows the top off.

Javid is a senior Treasury minister.

Among other written evidence to the CHSC that I’ve obtained is a reference to a statement by HM Treasury that £1.4 billion of the surplus had been ‘clawed back’ by the Treasury “to help fund the freeze in council tax, major infrastructure projects and other key areas of public spending not related to health“.

This is echoed in the very revealing email by an NHS Finance Director, which I published a few months ago. Discussing the drive to push down the pay of NHS workers to achieve the Nicholson Challenge, this FD wrote:

The question which is the really difficult one is the belief that if pay is cut or frozen but with other related cuts, will the Treasury say thank you very much and steal the savings leaving the NHS in just as bad a situation as it is currently facing, and probably worse. This is the biggest issue. No one trusts the Treasury and we have already seen it steal carry forward money built up to help the NHS over the years ahead.

‘We have already seen it steal..money built up to help the NHS over the years ahead.’ Exactly what the Treasury has now confirmed (using the euphemistic ‘clawed back’) it has done.

The £1.4 billion stolen from the NHS by the Treasury in a single financial year would be enough to completely wipe out the deficits of struggling hospitals – with enough left over to ensure that the Alex in Bromsgrove, Kettering General Hospital and others like them can continue to provide crucial, life-saving services to their local people, and to pay the salaries of the 7,000 nurses who have lost their jobs under this wolf-in-scrubs government (around £140m, assuming an average of £20k per year), with plenty to spare.

The NHS – as the NHA party recently pointed out (although they appear to have taken the article down temporarily for an update) – is a single entity. The debts of one hospital do not have to be treated in isolation, and there is no reason whatsoever why the government cannot use surpluses in one area to cancel deficits in another, avoiding any need for ‘special measures’ or administration. If it chooses to.

That it doesn’t do so is an ideological and strategic choice, aimed at making the NHS appear unsustainable, so that the government can claim it is ‘forced’ to find ‘solutions’ to the problem-that-isn’t-really.

But instead, despite all the government’s ludicrous claims to be protecting the NHS and even increasing spending, the cash is syphoned away – stolen by Osborne, Javid and their department.

The examples of this government’s mendacity and hypocrisy are almost too many to count, and they multiply faster than rabbits. But statements and posturing about the NHS provide among the clearest examples of the utter hypocrisy of the party that promised it would ‘cut the deficit, not the NHS‘.

There are no words strong enough or vivid enough to describe the jaw-dropping disingenuousness of Sajid Javid – senior minister of Her Majesty’s Treasury – in claiming to be fighting for the survival of his constituents’ local hospital when enough surplus money was there all along to put its future beyond doubt.

But even his startling insincerity pales into nothingness compared to that of his party as a whole, as it continues to claim it can be trusted with the NHS even as it bleeds our national treasure dry with complete disregard for the wishes and welfare of patients, health-workers and the public at large.

If their lips are moving, they’re lying – especially if they’re talking about the NHS.

The above will not come as a total surprise to Motorists. In 1934 the government of the day introduced the Road Fund Licence (Tax Disc) which has escalated regularly in cost ever since.

Very little of the revenue raised has ever been spent on Road-building or maintenance, as the majority has always gone straight into the Consolidated General Fund.

In order for money raised for a specific purpose to be used exclusively for that purpose, it must be "Hypothecated". Government legal-draughtsmen try to avoid doing that.

Only this bunch of thieves could in the same breath decline all responsibility for maintaining a health service and nick the proceeds of National Health Insurance.

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What I’m about to write about isn’t a secret. It’s on the parliamentary record, and the occasional web or print news article has touched on it. But, as far as it possibly can, the government keeps it very much under the radar. So it may well be, esteemed visitor to this blog, that you’ve never heard about it.

If you’re a regular (esteemed) visitor, you’ll know that I’ve written frequently about the NHS and I’ve written at length about the government’s attacks, current and future, on it. I don’t work in the NHS, but I do recognise the enormous importance to our society of healthcare ‘free at the point of need’ and the doctors, nurses and other staff who provide it. I also recognise that it’s a prime target for the Tories’ state-stripping ideology.

In the course of my research for various articles over the past couple of weeks, I’ve been reading through some of the written evidence submitted to the Commons Health Select Committee on NHS funding. It’s in the course of this research that what I’m going to tell you now really came to my own attention, and I keep a close eye on NHS-related developments, so it’s entirely understandable if you weren’t aware of it until now.

I’ve written recently about the readiness of Tory MPs, including Health Secretary Jeremy Hunt and treasury minister Sajid Javid, to lie in Parliament or to the electorate via their websites, about NHS funding. I’ve also noted how my prediction that Hunt’s next attack on the NHS would be based on prioritising funding on (wealthy) areas with more elderly people has unfortunately started to be fulfilled, and how the Treasury is quietly stealing (they call it ‘clawing back’) a massive amount of money that the NHS has saved, and which the government had promised to reinvest in frontline health services:

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If you’re a regular reader, excuse me repeating all these points, but I try to consider first-time readers and the importance of context for properly understanding what this government is up to.

Hunt’s and the Treasury’s measures are aimed at eroding the performance of, and therefore public affection for, the NHS in order to prepare it and us for the break-up and sale of our health service to private interests on the (carefully-created) grounds that the NHS needs to be ‘saved’, and that it’s all for our good. And they do it, by design, in ways which give them ‘plausible deniability’ – that allow them to say ‘the NHS is safe in our hands’ and ‘we’re protecting NHS spending’.

The extent of the Treasury’s clawback in the last full financial year was at least £1.4 billion – 15 times more than the total deficit of all the NHS’ financially-struggling hospitals – even if you don’t offset the surplus that the remaining hospitals generated against it. The NHS does not have a financial problem, and no hospital has to be allowed to struggle and fail. There is plenty of surplus to cover the debts of a few, to pay the salaries of each of the 7,000 nurses that have lost their jobs under this government, and still to have most of it left over. The government chooses to treat each hospital trust in isolation and make it swim, or sink.

But that’s not the limit of the government’s back-door robbery. The same amount again – in fact more – is being quietly bled off by the Dept of Heath (DH) to very partially mitigate the effects of swingeing cuts in another area.

In evidence presented to the select committee the DH itself, as well as various other bodies, advised that funding of around £1 billion a year is taken from NHS funding and allocated to local authorities to spend on social care. Here’s a table, from the evidence presented by the Local Government Association and the Association of Directors of Adult Social Services, showing the details:

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As you can see from the table header, this money is supposed to be spent on measures which will support social care and benefit health. The DH’s own report underlines this:

The new funding will further support and promote more joint working between health and social care. This will enable local areas to transform their services and to deliver better integrated care that saves money across the two systems.

But this isn’t happening at all. The NHS Confederation – hardly a defender of true NHS principles – gave evidence that says the money is merely being used to ‘paper over the cracks’ caused by cuts to local government funding. They’ve even written a book with the title of ‘Papering over the cracks: the impact of social care funding on the NHS’.

The RCN, meanwhile, noted that local authorities do not even have to spend the money on social care at all:

since social care funding is not ring-fenced there was no guarantee that this allocation would be spent on social care, particularly in light of the pressures of local authorities’ budgets

But the government isn’t content with stealing just £1 billion from NHS funds. In its evidence, the DH advised that it will be taking:

a further £300 million over and above the funding set out at the Spending Review for the period 2013–15. The new funding
will further support and promote more joint working between health and social care. This will enable local areas to transform their services and to deliver better integrated care that saves money across the two systems.

Again, these funds are supposed to save the NHS – and us – money, but as both the NHS Confederation and the RCN pointed out, this just isn’t happening.

So, we’re up to £1.3 billion so far – almost as much as the Treasury euphemistically ‘clawed back’. But the government isn’t finished yet.

In spite of the theft – let’s be kind and call it a ‘re-direction’ – of funds that should be providing treatment for sick people to offset massive budget cuts imposed on local government, the cuts are so massive that local authorities are still being forced to make huge cuts in spending on social care, even after they’ve made every possible cut in less essential services. The Association of Directors of Adult Social Services (ADASS) reported that – in spite of the £1bn ‘windfall’ from NHS funds:

£1.89 billion has already been taken out of adult social care budgets over the last two years

The pressures caused by these massive budget cuts in social services have resulted in a phenomenon of ‘delayed discharges”, where patients who do not really need hospital treatment are left in hospital beds because local authorities either can’t find a care place for them, or else are using delaying tactics to eke out their budgets by shifting the cost of caring for these stranded people onto their local NHS. The NHS confederation told the select committee:

delayed transfers of care already cost the NHS £545,000 per day (approximately £200 million per year

However, they are almost certainly dramatically underestimating the cost, as they based their assessment on a costing provided by the DH, which has a vested interest in downplaying the figure to keep the spotlight off the issues that the government’s cuts to services are creating. The NHS currently treats some 3 million patients per week, from a budget of £104 billion, or £2 billion per week. £2bn divided by 3 million comes to £667 per patient, per day.

It’s a very rough measure, but it gives an indication of the what it costs to treat people in hospital. According to the the Kings Fund, on any given day there are around 4,000 patients unnecessarily in hospital because of delayed discharges caused by lack of social care provision. £667 x 4,000 comes to a daily cost to the NHS of almost £2.7 million, or £973 million a year.

The NHSC’s estimate of £545,000 per day, divided among these 4,000 patients, would mean a cost of only £136 a day, which seems unrealistically low. There are, of course, fixed costs that don’t vary with the number of patients, so the real figure will be somewhere in the middle, but in any event it’s a vast cost that is little appreciated outside the healthcare system – and the government is quite happy for it to be that way – and that includes ignoring the effects on waiting times for those who do need treatment, who consequently suffer longer and unnecessarily.

But for the sake of argument, let’s use the Confederation’s figure of £200 million a year, so no one can say I’m exaggerating. Put that together with the £1bn taken every year from NHS funding to shore up social services that are falling apart because of cuts in other areas. Then add the extra £300 million the government has added to the ‘social care drain’.

That makes a figure of £1.5 billion per year that is being covertly slipped out of the NHS, on top of the sum of at least £1.4 billion ‘clawed back’ by the Treasury. The £1.5bn is supposedly to integrate the two care systems so that they operate more efficiently – but the evidence given to the committee indicates that this integration is:

unlikely to produce major cost savings or improvements in patient experience outside of a small group of conditions

Instead, this money is being taken away from front-line care for patients who need it, in order to inadequately ‘paper over the cracks’ – cracks that can only widen following Eric Pickles’ announcement this week in Parliament of further cuts to local government funding of 3-8% (although he factors this down to an average of 1.7% and calls this a ‘bargain’!). If he stays true to form, the higher cuts will fall on poorer areas because they will never vote Tory anyway, so that their effect on already-wobbling services will be catastrophic.

These twin moves of Treasury theft and quiet transfer of funds to partially offset massive spending cuts in local government and therefore in social care are a massive con designed to allow the government to claim (though according to the UK Statistics Authority it’s untrue even then) that it is ‘protecting’ and even increasing NHS funding, when the reality is that significant percentages of the NHS’ funds never make it through to benefit patients or provide the staff and care that they need.

It’s absolutely essential that the public starts to understand what’s going on. So spread the word and let’s counteract the propaganda and expose the con-trick.

Bobby, the key attribute of being in charge is that your Party are, well, IN CHARGE.

I think that our Parliamentary system of elected delegates is well past it's best before date now that everybody has instant communicatoin through the internet.

All I see instant communication is, a means to get their lies out even quicker.

The Exciting New Tory NHS

[You must be registered and logged in to see this image.](telegraph.co.uk)

" Wonderful news, Mr Plebb - you've won the draw for the bedpan this week..."

bobby wrote:But you'll have to wait till tomorrow for your cup of tea.

No - that's for it to be emptied!

Private NHS providers in line for corporation tax exemption.

Private companies providing NHS services could be exempt from paying corporation tax on their profits under proposals being considered by a government-commissioned review of competition in the health service, the Guardian has learned.

Monitor, the NHS's economic regulator, argues that as public sector hospitals do not pay corporation tax and VAT on supplies, whereas private firms do, the result is an "unfair playing field" in healthcare. The regulator was asked to look at the issues as part of a review into NHS competition, and will report to the health secretary, Jeremy Hunt, later this month.

Hunt's predecessor, Andrew Lansley, produced analysis which said "the majority of the quantifiable distortions work in favour of NHS organisations; tax, capital and pensions distortions result in a private sector acute provider facing costs about £14 higher for every £100 of cost relative to an NHS acute provide".

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The other big difference is Private= for Profit V State = Not for Profit......

Original including links is at: [You must be registered and logged in to see this link.]

Restricted McKinsey paper portrays grim future for health service

A set of restricted-circulation papers prepared by private health consultants McKinsey in 2010 for the NHS in Northern Ireland includes measures that depict a grim future for the NHS’ founding principle of healthcare ‘free at the point of need’. The measures offer a glimpse into the way that government and private consultants see the future of our NHS in Northern Ireland – and, most likely, in the rest of the UK.

The documents are marked

This document is solely for the use of personnel in the Health and Social Care Board and Public Health Agency of Northern Ireland. No part of it may be circulated, quoted, or reproduced for distribution outside the HSCB or PHA without prior written approval.

However, they are stored on a publicly-accessible area of Northern Ireland’s Department of Health, Social Services and Public Safety (DHSSPS) website, and are therefore in the public domain – perhaps either through oversight or hubris.

The documents can be accessed by entering a specific page address, or by doing a site search for ‘McKinsey’ – but no links to them appear to be available on any of the site index pages. It seems likely, therefore, that they were stored on the site for ease of access by remote personnel in the expectation – ill-founded, as it turns out, that no one else would notice their presence.

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The documents are extensive, and heavy going in many parts. However, some sections are very clear. The first, under a heading that says:

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begins with a preliminary paragraph warning that the measures about to be suggested would

challenge the principle that the NHS is free at the point of delivery

but that the report’s content

suggests that such options may need to be considered.

So, what are these measures that will challenge the founding principle of the NHS that treatment should be free at the point of need, but that McKinsey’s report suggests are necessary? The first may not seem so bad to those of us who live in England:

We could generate revenue through co-payment by the service user, an opportunity estimated to be worth £0.1 billion -£0.3 billion p.a. by 2014/15.

– Bringing co-payment protocols into line with the rest of the UK could be worth ~£50-80 million by 2014/15.

Co-payment means requiring the patient (‘service user’ in the more commercial jargon) to pay part of the cost of treatment, such as prescription charges or dental treatment tariffs. Since people in England already have to pay such costs, it might not seem unreasonable to impose the same regime in Northern Ireland. However, McKinsey don’t stop there:

In addition to this, other co-payments such as are used in other European countries – or beyond that – could potentially be introduced, if there was need and will. For example, people could pay for attending A&E (as in Republic of Ireland); for access to primary care (as in Germany); for inpatient stays (as in France).

The introduction of any of these measures would do far more than challenge ‘free at the point of use’ as an NHS principle – any one of them would mean its immediate end, and a massive burden on people at their most vulnerable moments.

A careful reading of the figures indicated by the report show that the underlying intent is to implement the wider range of ‘co-payments’, and not just to bring Northern Ireland into line with the system in England.

The report indicates that merely bringing NI into line with England would save between £50m and £80m. But the introduction to the section outlines an ‘opportunity’ of £100-300 million per year. The aim is clearly to save the higher amount – which would mean the complete destruction of the founding principle – and a massive theft of an entitlement which we rightly regard as an essential element of British life.

McKinsey’s recommendations go further still. The report outlines the ‘opportunities’ for reductions in staffing numbers as follows:

• a reduction in the number of consultants by 234

• a reduction in non-clinical staff of 4,300

• 12,600 fewer staff overall (clincal and non-clinical) compared to previously-expected 2015 requirements

Not only does the report recommend reducing staff numbers, but advises a saving of £100m per year by 2014/15 by freezing staff pay.

The grim news isn’t finished yet. The report outlines some of the likely results of having to achieve ‘further savings’ – which will certainly be required as government continues to squeeze funding:

If further reductions in funding were to prove necessary, beyond the identified improvements in productivity and quality, and the changes to income and staff costs described above, then..We would need to restrict access to services and treatments, for example by:

- Enforcing tougher eligibility criteria for treatments, e.g., hip replacements only for the over 80s, social care packages only for the acutely-ill, asking people who need it to buy their own equipment
- Introducing means-testing, i.e., making people pay for care if they can afford to
- Denying treatments that are high cost per Quality-Adjusted Life Year (QALY), e.g., high-cost end of life treatments such as chemotherapy
- Reducing funding of services seen as ‘non-core’, e.g., voluntary and community groups – which currently substitute and/or prevent need for statutory care.

Such actions would ..involve further bed closures and workforce reductions, of ~150 beds and ~1,200 staff per £0.1 billion further reduction in 2014/15 funding.

And, just in case we still need ‘icing on the cake’, the report recommends (but doesn’t quantify, that I can see), the closure of whole hospital sites and of large parts of others.

It’s no surprise that the NHS in Northern Ireland didn’t want these papers in general circulation – and quite a slip to put them into the public domain.

We should be thankful that they did slip. This report gives a frank view of the future of our NHS under this coalition government that robs the poor to enrich the wealthy, and which admits in private, no matter what the public pronouncements say, that the Tories’ long-term aim is not just to privatise the NHS but to eradicate all public services.

This particular document may only pertain expressly to Northern Ireland, but without question the cost-cutting, staff-cutting, service-cutting measures it recommends reveal the nightmare vision that this Tory-led government has for the NHS – one of the greatest achievements of our society.

It has to be resisted, its progress stopped – and the damage reversed by the next Labour government, no matter what it takes.

The 1200 deaths due to poor care happened in 2006 at a pure NHS hospital (Staffordshire).
Germany lets private companies run their service on behalf of the state as does France. It seems to work for them.