Tag: NHS England

The systematic destruction of the NHS

By Daniel Margrain

Dr Bob Gill who has worked for the NHS for 24 years, and is currently seeking crowdfunding for his documentary filmThe Great NHS Heist, was interviewed as part of a short video presentation produced by the UK journalist co-operative, Real Media.

In the interview, Dr Gill discusses how the move towards privatizing the NHS has been an agenda-driven project continued over many years by successive Conservative and Labour governments’.

Over the course of the twelve minute talk, Dr Gill highlights some of the issues the NHS faces. These are the key 23 assertions he makes in the presentation:

  • The intention of successive governments’ has been to transform a publicly-funded free at the point of delivery healthcare system into something that is driven by the need for profit.
  • The privatization agenda has been a well-planned long-term project.
  • Successive governments’ have understood NHS privatization is not in the public interest and thus they have devised alternative narratives in order to deceive the public.
  • A key component of this deception has been the deliberate cultivation of a ‘scapegoating’ culture in which the elderly, immigrants, overweight etc are blamed for government under-investment in the NHS.
  • This lack of investment is portrayed in the media as NHS Trust ‘overspending’.
  • The hospital network has been deliberately saddled with toxic loans.
  • In legal terms, the 2012 Health and Social Care Act abolished the NHS.
  • The result was the emergence of a Quango headed by NHS England’s Simon Stevens who has the day-to-day power of managing the service.
  • In 2014 Steven’s introduced a five year ‘Sustainability and Transformation’ Plan (STP).
  • The STP will move the NHS closer to the private US insurance system through a process of re-structuring, dismantling, integration, means-testing and merging of existing NHS services.
  • Both the NHS workforce and the general public are largely unaware of these plans which have been made deliberately complex and drawn-out over many years.
  • This drawn-out complexity is yet another part of the plan to deceive the general public and NHS staff alike.
  • NHS reforms are reported in the media in a positive way. This is despite the fact that the said reforms will result in the destruction of the service.
  • The British Medical Association (BMA) is largely complicit in the privatization agenda.
  • Jeremy Hunt, whose powers are limited, is being used by the media as a distraction.
  • Simon Stevens, who has the real power, has been deliberately set-up by the media as a ‘saviour’ for the NHS, whereas Hunt is portrayed as the ‘bad guy’.
  • Simon Stevens ambition for the NHS is to hand it over to his former colleagues at United Health in the U.S and the U.S insurance industry.
  • Stevens is “the most dangerous public servant in the country.”
  • The NHS is subject to competition law and is under constant threat from internationally negotiated trade deals.
  • The service is geared-up to work against the interests of the patient.
  • The NHS is heading in a direction in which doctors will be incentivized to deny patient care.
  • The introduction of the principle of private insurance will result in a more expensive system with worse outcomes.
  • The plan to fully privatize the NHS is “endemically fraudulent”.

Dr Gill alludes that the deliberate asset-stripping of the NHS ranks as one of the greatest crimes inflicted on the British people. The jewel in Britain’s crown is being whittled away in front of the public’s eyes.

All the while the Conservative government has convinced large swaths of the public that Simon Stevens is the saviour of the service when in truth he is its principal destroyer. Like a TV illusionist, the government is involved in an incredible sleight of hand – some may say, collective hypnosis – of the British people.

The Health Secretary, Jeremy Hunt, is essentially a public relations figure for the government and the corporations it represents. Where the blows of both NHS workers and the public alike would arguably be better targeted is towards NHS England boss, Simon Stevens, whose power to be able to shape the future direction of the NHS far exceeds that of Hunt.

Although it’s highly encouraging that an estimated 250,000 people attended one of the biggest national demonstrations against NHS cuts in London in March last year, it is somewhat perplexing to this writer why Labour’s Jeremy Corbyn in his otherwise excellent post-demo speech, failed to mention the nefarious role played by Stevens which is crucial to the entire NHS debate.

How is it possible for activists and campaigners to get anywhere near the bulls eye with their arrows when the correct target hasn’t even been identified by the leader of the opposition?

Please make a small donation

If you’ve enjoyed reading this or another posting, please consider making a donation, no matter how small. I don’t make any money from my work, and I’m not funded. You can help continue my research and write independently.… Thanks!


Donate Button with Credit Cards

Moving full steam ahead towards the disastrous U.S healthcare model?

By Daniel Margrain

Image result for NHS is breaking, pics

The shocking indifference shown by Theresa May towards the plight of stroke victims in the NHS and the systems ongoing crisis in which patients have been photographed sleeping on a hospital floor, is indicative of a public service that the UK government is determined to break. As Dr Bob Gill cogently argued, the Tories are deliberately under-funding the NHS to erode public confidence in order to manufacture consent for privatisation. The governments aim is to reconfigure the service from a free at the point of use healthcare system, towards a fee-paying US model.

In their 2017 election manifesto, the Conservative government said they would increase NHS spending by at least £8 billion in real terms until 2022. But King’s Fund, Nuffield Trust and Health Foundation figures show that NHS spending per person is set to fall by 0.3% in 2018/19 compared to the year before. Research undertaken by the former, indicates that UK funding for the health service is falling by international standards.

The think tanks have argued that even based on the government’s current spending plans, there is likely to be a spending gap of over £20 billion by 2022/23. They have also said that the NHS will need an extra £4 billion next year alone “to stop patient care deteriorating”. In 2013, NHS England said it faced a funding gap of £30 billion by the end of the decade, even if government spending kept up in line with inflation.

Under-funding has inevitably impacted on staffing levels. The shortage of nurses within the NHS has reached dangerous levels in 90 per cent of UK hospitals, and the amount of doctors per capita is the second lowest among eleven European countries.

On six out of nine measures of varying sorts, the UK did worse than any other advanced country in the world. Under the Tories, the erosion of the principle of a free at the point of delivery service is undermining what Sir Michael Marmont refers to  as “the optimal allocation of resources.”

However, despite all the problems the government has thrown at the NHS, the UK is still ranked a relatively respectable 10th in the world in terms of efficiency compared to the U.S ranking of 44. The latter reflects the fact that the marketization of health care in the United States is long established.

Given the figures, one might reasonably ask why the UK government appears to be insistent on dismantling something that, despite its faults, essentially works for the mass of the population, by subsequently restructuring it in the image of a system that doesn’t? The answer to this rhetorical question is, of course, that the said restructuring is intended to maximize profits for the few.

Shortly after president Trump’s inauguration this time last year, UK Health Secretary, Jeremy Hunt made a fleeting visit to the U.S. It was rumored that Hunt took this opportunity to discuss with US financiers moves to carve up the NHS in order to bring it closer to the US insurance-based model.

The U.S model the UK is moving towards

The requirement of the US Affordable Care Act (which was signed into law in March 2010 but in reality is unaffordable for large swaths of the US population), is that people are forced to buy private health care insurance if they fail to qualify for public health programmes – namely Medicare and Medicaid. However, the insurers have created plans that restrict the number of doctors in hospitals.

These “ultra narrow networks” have resulted in the reduction of at least 70% of health facilities within communities throughout the U.S, thereby restricting access to care for people with serious health problems. This means that increasingly Americans are paying higher premiums but are not getting sufficient access to services they need. They are, therefore, having to find money upfront, largely because their insurance policies do not provide adequate cover for their injuries or illnesses.

So America is still seeing high rates of people who are either delaying, avoiding getting access to the care they need, or are being confronted with medical debts. Research shows that tax-funded expenditures account for 64.3 percent of US health spending, with public spending exceeding total spending in most countries with universal care. Yet, 33 million people in the US do not have access to health insurance cover.

The delivery of a NHS-style healthcare system in the U.S is hamstrung by the narrow commercial interests of the corporations who lobby Congress. The conflicting interests that a succession of American presidents face relates to the close relationship they have to members of Congress who need to get reelected. If Congress speak out against the interests who are funding their campaigns, they’re not going to get that funding.

Dysfunctional

Tiny efforts to try and patch together what is clearly a dysfunctional U.S healthcare system is further undermined by the Heritage Foundation. This conservative Think Tank came up with the model of forcing people to buy private insurance and to use public tax dollars to subsidize the purchase of this insurance. In other words, as a result of a process of publicly funded corporate welfare, billions of funds are shifted into the hands of private insurance companies.

America’s healthcare costs are the highest per capita of any country in the world with some of the worst outcomes. Attempts to reform the US system are undermined by the insurance companies whose only function is to be middlemen between the patients and the health professionals.

The U.S government’s treatment of healthcare as a commodity instead of a public good is out of sync with the rest of the developed world and illustrates the extent to which, more broadly, the giant corporations have usurped democracy in the United States.

Currently, the U.S is the only industrialized nation on the planet that has used a market-based model for healthcare. Alarmingly, whether the British public want to admit it or not, this is the direction of travel both the Tories and NHS England, under Simon Stevens, are taking the system of healthcare provision in the UK.

If you’ve enjoyed reading this or another posting, please consider making a donation, no matter how small. I don’t make any money from my work, and I’m not funded. You can help continue my research and write independently.… Thanks!


Donate Button with Credit Cards

How the establishment have engineered the NHS crisis

By Daniel Margrain​

A century or so ago, the Russian Marxist Nicolai Bukharin understood that the growth of international corporations and their close association with national states was symptomatic of how both aspects hollow out the parliamentary system. It is now widely recognized that the power of private lobbying money draws power upwards into the executive and non-elected parts of the state dominated by corporations. Consequently this leads to a reduction in democratic accountability and public transparency.

Internal markets, market testing, contracting out, privatization, encouraging private pensions and all the rest, are mechanisms that are intended to depoliticise the process of social provision, so making it easier to refuse it to those deemed not to deserve it on the one hand, and to clamp down on the workers in the welfare sector on the other. This ethos became established in the late 1980s under Margaret Thatcher during her third term in office.

Removing the foundations of the welfare state

Following the advice of the then chief executive of Sainsbury’s, Sir Roy Griffiths in 1987, the Thatcher government set about removing the foundations upon which the welfare state had been built. Camouflaged in the language of ‘public-private partnerships’, Tony Blair’s New Labour took this one stage further as a result of his envisaging the state as the purchaser rather than direct provider of services. Whole entities within the public sector have increasingly been outsourced, health and social care services privatized and competition and the business ethos introduced into public services in the form of managerialism and New Public Management.

Thus, within residential care, patients have been recast as customers. The aim is to ensure the domination of the market by a small number of very powerful multinational corporations whose primary concern is not the welfare of the residents in care homes which they own or patients in hospitals but with maximizing profits.

The carving up of the NHS opens up one of the worlds biggest investment opportunities. Indeed, its exploitation by private interests is proceeding at a pace. This is hardly surprising given the 2014 revelation that 70 MPs have financial links to private healthcare firms while hundreds of private healthcare corporations have donated to Tory coffers.

There exists a symbiotic relationship between privatization and what Noam Chomsky refers to as a policy strategy of “defunding”. In line with Chomsky’s notion, the aim over the last three decades has been to shrink the NHS and bring it to the point of collapse as the basis for then claiming the only solution is more privatization. In Orwellian terms, health under-funding is portrayed in the media as “unprecedented levels of overspending by hospitals and NHS trusts.” 

Health and Social Care Act

The 2012 Health and Social Care Act removes the duty on the Secretary of State for Health to provide a comprehensive health service and requires that up to 49 percent of services can be tendered out to “any qualified provider.” As early as 2013, between a quarter and a half of all community services were run by Virgin Care. Three years later, the corporation had won £700m worth of NHS and social service contracts.

The retreating by the state from the principle of universal health care provision, free at the point of delivery, can be pin-pointed to 1988 when Tory politician, Oliver Letwin, wrote a ‘blueprint’ document called ‘Britain’s Biggest Enterprise’ where he set out the stages governments’ would have to go through to achieve a US model of health care without the public noticing. The New Labour government under Tony Blair adopted Letwin’s principles. But prior to the 1997 General Election, Blair had to disguise the strategy by using dissembling language in order to get elected.

Once in power, Blair took several steps towards privatization. For example, he broke up the hospital network into foundation trusts which are essentially separate business entities. He also deliberately saddled hospitals with Private Finance Initiative (PFI) liabilities which involved the government borrowing £11 billion from private banks and financiers in order to justify the sale and breakdown of the NHS further down the line.

This culminated with the New Labour government introducing in 2009 what was termed the “unsustainable provider regime” which is a fake bankruptcy framework to justify closing hospitals. The £11 billion of PFI public money borrowed from the banks and injected into the NHS is, in the words of ‘Save Our NHS’ activist Dr Bob Gill, intended to “set up the infrastructure for the whole scale hand-over of our NHS to American corporations.”

Simon Stevens

Arguably, the most influential individual currently working in the NHS is former Labour councillor, Simon Stevens, chief executive of NHS England. After having served under the Blair government, Stevens went on to work for the US private health care provider, United Health, where he campaigned against Obama Care prior to campaigning for the Transatlantic Trade and Investment Partnership (TTIP) to be included within the UK health care remit. Those encouraged by the election of Jeremy Corbyn are still waiting to hear something from the shadow health team about this troubling development.

Controversially, Stevens introduced NHS England’s ‘Sustainability and Transformation Plans’ which form part of the annual HHS Planning Guidance. ‘Sustainability and transformation’ is Orwellian-speak for the move towards the total reorganization of the NHS predicated on more privatizations and cuts.

Two years ago this month, Dr Bob Gill attended a meeting to get some insight into what the position of the then Shadow Secretary of State for Health, Heidi Alexander, was in relation to the direction NHS England was moving in under Stevens. What he heard were narratives that fitted into the ongoing privatization agenda. According to Gill, Alexander expressed support for Simon Stevens, despite his appalling track record. There is no indication that neither the Labour leader, nor current Shadow Health minister, Jon Ashworth, intend to take Stevens to task.

This is extremely worrying given that Stevens appears to be less committed to ethics and patient care, and more concerned with perpetuating the notion that medicine is a profit-based ‘conveyor belt’ service. Could it be the case that Corbyn has underestimated the extent to which the corrupting influence of corporations and the power of lobbying money have hollowed out the parliamentary system as outlined by Bukharin a century ago?

If you’ve enjoyed reading this or another posting, please consider making a donation, no matter how small. I don’t make any money from my work, and I’m not funded. You can help continue my research and write independently.… Thanks!


Donate Button with Credit Cards