Introducing Self Pay from Care UK / NHS (with GPs as the ‘middlemen’?)

The Privatisation and Monetisation of the NHS is not happening with a big bang, but it is already happening, surreptitiously and with no public debate or mandate. It is happening.

Take a look at this leaflet to GPs in the Southampton area.  Note the joint Care UK / NHS logo.

Here is a copy of Care UK’s standard Self Pay leaflet.  Looks like Care UK are positioning to cash in on reductions in the NHS service and hope to use GPs as the ‘middle man’. The Southampton leaflet seems intended to muddy the distinction between private and NHS, presumably so that patients will get used to paying for NHS services. This will smooth the transistion to Care UK’s standard Self Pay services  Apparently the prices on these leaflets are standard private care prices not NHS prices which are lower.

Here is a link to the Southampton Care UK / NHS websites:
http://www.southamptontreatmentcentre.nhs.uk/

Care UK in joint deal with NHS  FT March 2013 (“The move underscores the growing commercialisation of the state-funded health service.”)

Corporate Watch: Care UK  (Corporate Watch)

FISHIEST OUTSOURCING FIRMS: Care UK  (False Economy)

“If there’s just one thing that Care UK knows how to do – and there is – it’s take money from the state. I would make a bigger deal of the fact that 96 per cent of Care UK’s revenue comes from the NHS. That’s the kind of solid base that any company would envy – taxpayers’ money, minimal risk, easy profits.” Alex Nunns: Going private? What happened when a private health company offered an NHS campaigner a job   New Statesman July 2012

Wiltshire CCG seeking legal advice over ‘Care UK’ contract for Wiltshire’s new NHS 111 phone service  (Reason and Reality March 21st 2013)

By 2015, new NHS charges will be knocking at the door  Guardian Nicholas Timmins Guardian.co.uk, Wednesday 17 April 2013

 

Lobbying: “The Next Big Scandal” (and its influence on NHS privatisation)

This is my latest letter to our local MP, John Glen, regarding a promise made by David Cameron concerning the “next big scandal”.

 

Dear Mr Glen,

Before the last election Mr Cameron promised there would be no top down reorganisation or privatisation of the NHS. He also pointed out that ‘Lobbying’ would be the next big scandal and promised to do something about it.

Three years after the last election, I note that a disturbing number of contracts in the privatisation of the NHS (part of a massive top down reorganisation) have gone to companies that have been generous donors to individual MPs, government ministers or the Conservative party in general. I also note that a disturbing number of MPs and Lords, not just Tory, stand to gain financially from the outsourcing of NHS services.  It would seem then that Mr Cameron’s prediction is about to come true. I am sure that you want to avoid this as much as ordinary ‘hard-working ‘ citizens, whose tax payments will fund this scandal.

I am therefore keen to ensure that the government fulfils its commitment to create a statutory lobbying register. If it is not legislated for in the next parliamentary session, I am sure that you will be concerned that the government may miss its chance to implement this pledge, which was in the coalition agreement.

Please can you ask the minister in charge, Chloe Smith, to seek an assurance that the legislation for it will be announced in the Queen’s Speech?

Also, if you have not yet done so, please sign EDM: 222 Register of Lobbyists.

This, on its own, will not be sufficient to prevent the scandal but will be a small first step and will indicate that the government is serious about this particular promise.

Many thanks,

Colin Lawson.

NB: Abundant evidence to substantiate the conflicts of interest, lobbying and political donations that are a part of the NHS ‘reforms’ is in the public domain but I can provide details if you so wish.

Some evidence from 2012: Special Report –  Selling the NHS: how parliament and the healthcare industry got cosy

NHS is threatened by ‘legalised corruption’ March 2012

 Unhealthy influence: The rise of the NHS Partners Network  Social Investigations, March 2013

The Chair of the committee that advises on business appointments to departing senior civil servants is a director of a company that has won a contract related to the Health and Social Care Act in which he voted in favour.  Social Investigations, April 2013

Latest on Conflicts of Interest:
CCG head awards “£70,000 contract to a firm where he is medical director.” http://bit.ly/14BELbz 

BBC News – Conflicts of interest ‘rife’ among new GP commissioners

GPs need protection against conflicts of interest, say legal experts  Pulse, 4th April 2013

GP duty of candour undermined by ‘inappropriate’ gagging clauses in CCG constitutions  Pulse, 5th April 2013

And, in case anyone wasn’t paying attention:How the BBC betrayed the NHS: an exclusive report by ‘Open Democracy’ on two years of censorship and distortion

Healthcare trusts seek big increase in income from private patients, raising fears of two-tier service  Observer 6th April 2013

1,000 GPs gagged by CCGs from talking about local health services  D Telegraph 6 April 2013

More than 100 lobbying professionals still hold parliamentary passes: Senior managers at interest groups and businesses still have passes despite coalition promises to change perception of lobbying  10th April, Guardian

 

Wiltshire CCG seeking legal advice over ‘Care UK’ contract for Wiltshire’s new NHS 111 phone service

I have just read another interesting article from Toby Millet at ‘Marlborough News Online’ (read it here). (See also a BBC report here).

It seems that the out sourcing of the NHS 111 phone service in Wiltshire is not going too well. The launch is being delayed and the new Wiltshire Clinical Commissioning Group (CCG) is taking legal advice on the contract.

It appears that during tests on ‘out of hours calls’ during evenings and at weekends far too many calls were not answered within the required time limit and ambulances were called out for people who definitely did not need them – apparently in one case to someone with a sore throat.

The article gives full details of the problems but I would like to take a closer look at private health care provider, ‘Care UK’, who bought out the original winner of the 111 phone contract (another health care company called Harmoni).

‘Care UK’ is a British private health care provider well placed to take advantage of the outsourcing of the NHS under the new Health Care Bill. Its chairman, John Nash[6], made a donation[1][2] of £21,000 to the private office of Andrew Lansley when he was opposition spokes person for Health and who later became Secretary of State for Health. According to a Guardian report ‘Care UK’ has a reduced tax bill[3] by taking out loans through the Channel Islands and coming to special agreements with HMRC.

If the NHS were being outsourced, for the benefit of patients, to small or medium sized organisations or enterprises, embedded in the local community and with a stake in maintaining the principles of the NHS this might not be so worrying, but Care UK is one of a number of companies (Spire Healthcare, Care UK, Circle Health, Ramsay Health Care, General Healthcare, Virgin Care) that clearly see the NHS as a cash cow. These companies along with the likes of KPMG, McKinsey, Price Waterhouse[4] are positioned to drive through changes to our health care that will suit them and their share holders with little protection for the interests of the users. The “legalised corruption”[5] that is the “revolving door” where advisors and decision makers can move from these private companies into government and then back again with resulting huge conflicts of interest will mean that there will be little to prevent our health service becoming yet another conduit for transferring tax payers cash to multimillionaires and share holders.

[1]  “Andrew Lansley embroiled in ‘cash for influence’ row after accepting £21,000 donation from Care UK chairman John Nash”Mail Online. 15 January 2010. Retrieved 6 April 2011.

[2] “Andrew Lansley bankrolled by private healthcare provider”The Daily Telegraph. 14 January 2010. Retrieved 6 April 2011.

[3] “Firms poised to take advantage of NHS shake-up ‘avoid tax on their profits'”The Guardian. 17 March 2012. Retrieved 21 January 2013.

[4] NHS has been handed over to McKinsey, KPMG, Price Waterhouse.  Reason and Reality, 15th Jan 2013

[5] The NHS is threatened by legalised corruption  Reason and Reality, 4th march 2012

[6] The price tag for becoming an unelected government minister – seems like £300,000. “In 2013 it was announced that John Nash would become a schools minister.  He became a life peer as Baron Nash, of Ewelme in the County of Oxfordshire on 21 January 2013.  He and his wife have donated almost £300,000 to the Conservative party and according to the Telegraph, the appointment raises concern about a potential conflict of interest and appointment of donors though the Department for Education said he would not make business decisions whilst in office”. Source: http://en.wikipedia.org/wiki/John_Nash,_Baron_Nash  Wikipedia

UPDATENHS 111 implodes as GPC withdraws support for urgent care hotline  By Jaimie Kaffash, PULSE, 22 March 2013

Wiltshire’s new NHS111 telephone service delayed for a month  Tony Millett Marlborough News Online, 22 March 2013.

Patients are being put at risk due to catastrophic failings of the new NHS 111 non-emergency phone line, doctors have warned. Daily Telegraph, 28 Mar 2013.

More UPDATE: Delays, abandoned calls and an 11-hour wait for a call-back: Leaked document reveals the extent of NHS 111 performance issues  Pulse 12th April 2013

Chair of NHS Wiltshire PCT criticises government’s restructuring of the health service & expresses concern about the future of the new Wiltshire CCG

I have just come across a very interesting article in MarlboroughNewsOnline which is based on an interview they did with Tony Barron, the outgoing Chair of the NHS Wiltshire PCT.

NHS Wiltshire is being replaced by the new Wiltshire CCG (clinical commissioning group) which takes over the job of commissioning NHS services in Wiltshire. The article is well worth reading in full, but the gist of the article is that Tony Barron is very critical of the way the Government has handled the restructuring of the NHS and is clearly equally concerned about the future of the NHS.

Mr Barron, who has been through 11 restructurings of the NHS, describes the current process as equivalent to “throwing everything up in the air and still today, making up the rules and regulations for what we have to do by 31 March”. He tells of the government denigrating his staff but then expecting them to take responsibility for implementing the restructuring.

Of particular note was Mr Barron’s concerns for the future of the new CCG and the financial pressures on hard working GPs trying to manage million pound budgets on a few days work per week and, reading between the lines, subject to conflicts of interest. GPs are effectively running small businesses and may also have interests in the private companies that will be offering their services to the CCG.

We have already seen how Virgin Care achieved a potentially influential position on our CCG. This may have been allayed slightly, but it seems that there is still a risk of conflicts of interest. Doctors running GP surgeries, who are also setting up private businesses to cater for the monetisation of the NHS, will be subject to conflicts of interest both in their GP surgery and additional conflicts if they are also a member of the CCG.

Here is an article from the BMJ giving an account of their own research showing that more than a third of GPs on commissioning groups have conflicts of interest resulting from directorships or shares held in private companies.

References:

As NHS Wiltshire disappears its Chairman criticises government’s methods & worries about new risks”  by Tony Millett, Marlborough News Online, 12 March 2013. (Accessed 16th march 2013)

More than a third of GPs on commissioning groups have conflicts of interest, BMJ investigation shows”  BMJ (Published 14 March 2013)

See also:
Salisbury NHS Watch

and:
Health / NHS

More news about the Wiltshire CCG / PCT:
£200,000 health HQ revamp questioned Swindon Advertiser, Wednesday 20th March 2013
Revealed: big increase in costs of running NHS commissioning for Wiltshire   Tony Millett, Marlborough News Online, 08 February 2013

300 GPs end Virgin partnership over conflict of interest

Well here is interesting news (from The Guardian of Wed 24th Oct).  “More than 300 GPs  have ended their partnership with Richard Branson’s Virgin Care to provide healthcare services after criticism that the arrangements might see doctors personally profit from sending patients to clinics they part-own under the coalition’s health reforms.”   This is exactly the kind of conflict of interest that people have been warning about since the bill to privatise the NHS was passed back in the spring.

I assume (but cannot confirm) that this includes the 15 GP surgeries in Wiltshire that are partnered with Virgin Care. This is particularly important as the Chair of the new Wiltshire Clinical Commissioning Group is a senior GP from a Virgin Care ‘Partner’ Surgery.

So it looks like one small step in the fight against the rapidly increasing take over of the NHS by the vested interests of big business.

First Chair of new Wiltshire Clinical Commissioning Group is a senior GP from a Virgin Care ‘Partner’ Surgery

‘Virgin Care’ partners in Wiltshire

The NHS is threatened by legalised corruption

More evidence of the involvement of Virgin Health in our local NHS

The Joint Board for NHS Bath and North East Somerset (B&NES) and NHS Wiltshire Cluster PCT has two members who are Doctors in GP Practices that are in partnership with Virgin Care.

Dr Ian Orpen B&NES CCG Chair:  Member of Assura Minerva (part of Virgin Health – practice is a shareholder)  also GP Partner providing NHS services under PMS Contract

Dr Stephen Rowlands Medical Director NHW Wiltshire and Interim Wiltshire CCG Chair: Practice member of GP practice which is in an LLP with Assura Medical (part of Virgin Health)

Source: http://www.wiltshire.nhs.uk/Downloads/Board-Papers/Joint%20Board%20ROI%202012-2013.pdf

For further background see: ‘Virgin Care’ partners in Wiltshire

Conflict of interest fears in NHS shakeup plans (Bureau of Investigative Journalism, June 2011)

NHS staff in the South West who don’t agree to pay cut face sack

As already reported here NHS staff in the South West including Salisbury Hospital face a pay cut and worsening conditions of service. This comes  as a result of the government’s enthusiasm for regional pay and the foundation of a “Pay Cartel” consisting of 19 NHS organisations across the South West.  This of course comes on top of a pay freeze and increased pension contributions.  Employers claim this will help them make the £20 billion in “savings” over four years required by the government, but coincidentally it could help to smooth the privatisation of the NHS where providers like Virgin and Serco will make their profits by driving down pay and conditions.

See here for more details: NHS staff who don’t agree to pay cut face sack

Salisbury NHS Watch

Hospital trusts’ joint talks on rising wage bill stokes fears of NHS pay cuts (Marlborough News Online)

Salisbury NHS Watch – Update

Not much to report, but the following updates may be of interest:

Virgin Care to take over children’s health services in Devon: As reported here previously, we already have fifteen GP surgeries in Wiltshire  partnered to Richard Branson’s “Virgin Care” and a GP from one of those surgeries appointed as Chairman of the new Wiltshire Clinical Commissioning Group.  So it may be of interest that Virgin Care have been named preferred bidder in a £130m deal that will see the privatisation of children’s health services in Devon.  See here for details.  It seems like Serco and Virgin have privatisation of the NHS in the South pretty well sown up.

It is important to point out that concern about companies like Serco, A4E, G4S, and Virgin Care taking over the running of our public services is not part of some left wing ideological agenda.  If the NHS were out sourcing parts of its work to small or medium sized, home grown businesses or organisations that are part of our community and have a track record of providing a quality service for a responsible and reasonable rate of remuneration then there would be no need for concern. But, in reality our services are being taken over by large national and international corporations that do not have a promising track record – they are essentially in the business of making large profits by employing members of our own community (Cameron’s hard working families) on lower pay with poorer employment conditions while providing the minimum service they can get away with.  Remember that these organisations will be signed up on confidential contracts, protected by commercial confidentiality and will not be open to Freedom of Information requests – they will be pretty much unaccountable and if things go wrong it will be the remnants of the NHS plus tax payers money that will be left with the problem. (Breast implant scandal: 3,500 private clinic patients referred to NHS)

Senior staff could be moved out of the ‘Agenda for Change’ pay framework under proposals devised by NHS Employers. Unfortunately this article is behind a pay wall but I suspect that the article will confirm what we already know – that regional pay for NHS staff (i.e. lower pay for everyone except for those who work in wealthy high pay areas) will not apply to the senior managers.  Sounds like a good way to encourage loyalty and enthusiasm from the staff or is it just a way to smooth the transition to the lower pay of Serco and Virgin Care?

Salisbury NHS Watch

Are Salisbury Hospital Staff to have their Pay Cut by 15%?

In light of the government’s move towards regional pay* in the NHS  – apparently a  euphemism for channeling cash from poorer to wealthier areas of the country, there has been an interesting development locally.

Following the revelation of the formation of NHS “Pay Cartels” in the South West, a freedom of Information request has been submitted to Salisbury NHS Foundation Trust by a J. Stewart.

Here is the main focus of the request:

“Please confirm or deny that the proposal being considered includes the possibility that Salisbury NHS Foundation Trust Staff will be dismissed and offered revised terms and conditions of employment.

Please confirm or deny that the proposal being considered includes the possibility that Salisbury NHS Foundation Trust Staff will have their pay reduced by upto 15%, and or that staff will have their annual leave entitlement reduced, and or sickness pay entitlements will be reduced, and or no longer offering staff membership of the NHS Pension scheme.

Please also confirm whether all Trust Senior Management and Board members would be included in any proposed change in Terms and Conditions.”

The Trust has 20 days from 12th June to respond.

(* interestingly regional pay will not apply to top tiers of management – there’s a surprise)

Sources:

FOI Request:
http://www.whatdotheyknow.com/request/all_salisbury_hospital_staff_to#incoming-288418

RCN Response (pay cartels):
http://www.rcn.org.uk/newsevents/news/article/uk/health_unions_condemn_regional_pay_cartel

Health Unions response:
https://docs.google.com/document/pub?id=1OQtwhh1C_LlPSosnjKEIU9asWu2SGhyuHE-3jYfsHxI

NL Group blog:
http://www.nlgroup.co.uk/pay-cartel-criticised-by-health-unions/

Blog Post by Eoin Clarke:
http://eoin-clarke.blogspot.co.uk/2012/06/tory-war-on-wages-for-nhs-staff.html

Regional pay:
http://www.guardian.co.uk/politics/2012/apr/22/andrew-lansley-pay-nhs-staff

Salisbury NHS Watch

Salisbury Journal –  Possible pay cuts at Hosptial