KONP Updates

Thursday 5th March 2015

Charities should be preferred NHS providers, says Andy Burnham.

Charities could get 10-year contracts to help deliver NHS services if Labour wins the general election, the shadow health secretary, Andy Burnham, has told voluntary sector leaders. Not-for-profit care organisations would be given “a form of preferred provider” status under legislation that a Labour government would introduce to replace parts of the coalition’s 2012 Health and Social Care Act. The move would recognise their contribution to strengthening communities. The announcement came as Burnham sought to allay fears in the voluntary sector that his plan to restore NHS trusts’ preferred provider status for delivery of health services would hit charities as well as private companies.
Winsford Guardian

NHS campaigners rally on streets against privatisation.

Protestors in Winsford joined thousands around the UK in taking to the streets to help gather support to protect the NHS from privatisation. Around 170 people signed the ‘Save our NHS’ petition in Winsford. The petition asks each MP candidate to commit to protecting the NHS from privatization and to keep it out of the Transatlantic Trade and Investment Partnership (TTIP) trade deal with the US. The day of action, coordinated by campaign group 38 Degrees, was held across England with more than 10,000 people taking part.
Health Service Journal

Monitor could be asked to examine £350m contract.

A decision by NHS England to hand more than half of the country’s PET-CT imaging services to one company could be the subject of a formal complaint to market regulator Monitor, HSJ has learned.

Left Food Forward

The NHS has never been in more danger.

Kailash Chand OBE writes: In 2010 David Cameron’s coalition government betrayed pre-election promises to protect the NHS. Instead they imposed savage spending cuts and pushed through ‘reforms’ which put at risk the health of the entire population. The Health and Social Care Act 2012 has been described as so ‘complex, confusing and bureaucratic’ that the organisation of the NHS ‘is not fit for purpose’ as a result. The NHS is now at the brink of extinction. The public has been misled about the objectives and consequences of the 2012 Health and Social Care Act. But the coalition’s repeated denials of NHS privatisation do not stand up to scrutiny. The 2012 Act has not just repealed society’s contract with the health service, it has put the NHS on the chopping block, ready to be sold in pieces to private corporations. The Health and Social Care Act raised the cap hospitals could generate from private income to 49 per cent from an average of around two per cent. Privatisation is an ideological luxury which wastes money and destabilises the NHS. It has no purpose other than diverting money to shareholders and enriching a privileged few. We all know people should always come before profit, but the current government thinks otherwise. In the past year, £9 billion worth of our NHS has been put up for sale, while thousands of jobs have been axed, including over 4000 senior nurses. Half of our 600 ambulance stations are earmarked for closure. 50 of the 230 NHS walk-in centres have been closed and 66 A& E and maternity units have been shut or downgraded. The coalition’s policies and privatisation mean the NHS as we know it will be gone in as little as five years if no one speaks up. The NHS will just be a logo; reduced from being the main provider of health services in England with one of the biggest workforces in the world, to a US-style insurance scheme, divorced from the delivery of care. Fewer treatments will be available as cuts start to bite. The ‘new’ NHS is now more fragmented than ever before. It has no primacy over provision, and money is squandered over lost causes such as procurement of contracts and fighting competition from within. There has been a proliferation of small and large providers in the NHS in the last two or three years and the other winners in this revolutionary reform are management consultants. The proliferation of private service providers spells serious problems for the future. For while the public sector seeks to maximise quality and coverage of services, the private sector aims to provide services in order to maximise profits. John Major attempted to suffocate the NHS by bringing in the internal market. David Cameron is fulfilling the dream of the ‘Tory right’ to privatise health care lock-stock and barrel.

Hunt To Supress the Rose Report


Toby Helm Observer political editor

Saturday 7 March 2015 21.16 GMT Last modified on Sunday 8 March 2015 00.09 GMT

Health secretary Jeremy Hunt faces allegations of a politically motivated cover-up after the Tory head of the health select committee said his department’s refusal to publish a damning report on NHS management before the general election was not acceptable.

Sarah Wollaston, a former GP who took over the chairmanship of the committee last year, said it was not reasonable or right that a report by former Marks & Spencer boss and Tory peer Stuart Rose, which was commissioned by Hunt a year ago and completed in December, was being kept from the public.

Senior government officials have made it known that Rose’s report is strongly critical of management systems in the NHS – findings that are potentially damaging for the Tories before an election in which the NHS is centre stage.

There are also suggestions that the report implies that the government’s own NHS reforms, steered through by Hunt’s predecessor Andrew Lansley, may have made matters worse.

Rose, who is said to be angry that the report has been put on the back burner until after the election, was unavailable for comment.

The Department of Health said it did not have a date for publication of the Rose report because its remit had suddenly been widened. “The remit of the Rose review has been expanded so that it takes into account the NHS’s own five-year forward view, which was published after Lord Rose’s work had begun. This means that further work is required before the final report is published.”

Wollaston told the Observer that reports which had been commissioned by government and paid for by taxpayers should be made available at the earliest opportunity on matters of such clear public interest.

“There is far too much of this going on, with uncomfortable information being withheld,” Wollaston said. “Just as with the Chilcot report into the Iraq war, it is not right that reports paid for out of public money are not made available to the public on such vital issues as soon as possible, particularly ahead of a general election.”

She said she was expressing her personal views, as she had not had a chance to discuss the issue with her committee. But she added that she would have liked to have been able to draw on the findings of the Rose report in an investigation of public expenditure in the NHS that is now being finalised by the select committee.

Rose, who is now chairman of the online retailer Ocado, was asked in February last year by Hunt to assess how NHS hospitals could keep “the very best leaders to help transform the culture in underperforming hospitals”.

But in a story that he has not denied, the Financial Times said recently that the peer had been dismayed by what he found and regarded the overall standard of management to be “totally shocking”.

Last night shadow health secretary Andy Burnham said: “Jeremy Hunt likes to claim that he stands for openness and transparency but this looks for all the world like a politically motivated cover-up in advance of the general election.

“If he wants to dispel or dismiss this suspicion, he must make arrangements to publish this report without delay.”

Rose would not be alone in thinking that the Lansley reforms made the management of the NHS less effective and more bureaucratic. A recent report by independent thinktank the King’s Fund said the Lansley overhaul left structures so “complex, confusing and bureaucratic” that the organisation of the service “is not fit for purpose”.

It also said the changes wasted the time of NHS bosses, who were “distracted as they were required to re-arrange the deckchairs rather than navigate safely past the iceberg” of growing demand at a time of acute financial pressure.

It also said the reforms led to a loss of talented senior NHS leaders by creating an array of new organisations, each responsible for areas such as hospitals or public health, meaning that no one was in overall charge and that there was a leadership vacuum.
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A heartfelt thank you to the NHS | openDemocracy

e-affirming experiences don’t come much more convincingly than cancer. In June Mr Tim Duncan, with his steady gaze and infinite blue eyes, told me that I had cancer of the ovaries, bowel and possibly liver. I had gone to see my GP, a few weeks before, thinking that I was intolerant to wheat (feeling bloated is apparently a common symptom; ladies be warned). I can’t imagine what it is like having to tell people the news that they may not see their children grow up and alarmingly, these days, telling it regularly. I write to thank Mr Duncan for his gentle patience as my world crashed before me, and to sing from the roof tops praise for the NHS, with its incredible staff who have looked after me and my family through these five months.

I was admitted to Norfolk and Norwich hospital where I underwent an 11-hour operation performed by surely the most handsome team of surgeons (all the nurses agree), and after a short stay in the high-dependency unit I arrived at the wonderful Cley ward for 20 days. I can’t begin to explain my thanks and gratitude to the staff of Cley. My condition was at times frightening and harrowing, but I was cared for with such expertise and vigilance that I have to share my experience and rejoice in the knowledge that their support has meant that I am now walking in my favourite woods again.

It amazes me that I am alive. I fully intend to remain so. Most women in the world do not have access to this level of expertise. Even in the US, on my income, my insurance probably would not have covered the operation and I don’t have a house to re-mortgage or funds to cover this unexpected disease. The x-rays, scans, medication, food, cleaning staff, porters that have been given to me because I’m British leave me speechless. We all know someone who has had a baby, broken an arm or has been seriously ill. Do we consider enough how lucky we are to see our GP for free? ”

I really want to say thank you for the kind way my decrepit body was washed; how, in the middle of the night when I felt overwhelmed, a nurse stopped what she was doing and held my hand; the cake covered in Smarties the catering staff brought me for my birthday; the smiles and jokes with the staff to pass the long days; and Mr Burbos (one of the handsome consultant surgeons) who has been so generous with his time and care. Thank you. I will be supporting the strikes to get better pay for nurses. They are intelligent, helpful, kind people, not money-grabbers. If they say their pay is unfair, I believe them.

About the author

Gael Mosesson is a musician and songwriter, performing original music to diverse audiences, and an outdoor educator at Ringsfield Hall in Suffolk, helping people reconnect with nature. She has three beautifully crazy teenagers and is in love with Magnus.


Staffing and compassion

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via A heartfelt thank you to the NHS | openDemocracy.

Will MPs vote to right some of the NHS wrongs?

A private member’s bill that proposes undoing the worst excesses of Andrew Lansley’s unpopular NHS reforms has caught a mood
Former health secretary Andrew Lansley. If the bill to repeal his reforms went through it would be ‘a parliamentary mea culpa of historic proportions’. Photograph: Stefan Wermuth/Reuters
This week the same MPs who voted Andrew Lansley’s unpopular Health and Social Care Act through parliament, despite the warnings that it would distract, weaken and potentially even wreck the NHS, have a chance to undo at least some of the damage that both Westminster and the NHS’s equivalents of the dogs in the street know it has done. On Friday they will debate and vote on Labour MP Clive Efford’s National Health Service (amended duties and powers) bill, a private member’s bill which will receive its second reading.
Among what Efford regards as the many ill-advised, reckless or self-evidently negative changes the 2012 Act involved, he has one key target – the huge expansion in competition it brought to the NHS, with a concomitant expansion in the privatisation of clinical services previously provided by the NHS.
“The bill wouldn’t repeal the entire Health and Social Care Act. But it cuts the heart out of it. It would repeal some of the worst elements of it that impose market forces on the NHS,” explains the MP for Eltham in south-east London, who is better known as the shadow sports minister. For example, it would replace the health sector regulator Monitor’s duty to promote tendering with an obligation to promote integration of services.
Its 14 clauses would also repeal “section 75”, the clause in Lansley’s legacy that enforces the compulsory tendering of all NHS contracts, which came into force last year. It removes the ability of hospitals to earn 49% of their income from private patients. New figures last weekend showed that such income has risen 10% overall since 2010 with, for example, the specialist Royal Brompton and Harefield trust growing its revenue from that source from £24.3m in 2010-11 to £33.6m in 2013-14.
It would also exempt the NHS from the EU-US trade treaty, currently being negotiated in secret, known as the Transatlantic Trade and Investment Partnership (TTIP), which could open up NHS services to competition permanently, including from US healthcare firms. The coalition’s refusal to seek such an opt-out would be trumped by the new law specifying that TTIP does not affect the NHS. And it would restore the health secretary’s responsibility for the NHS, something Lansley watered down. Crucially, says Efford, his bill would reassert parliament’s sovereignty over the NHS.
The Royal College of Nursing, a persistent critic of Lansley’s “unnecessary and chaotic reorganisation”, has welcomed the bill as an opportunity to undo the damage. Lord Owen, the ex-Labour health secretary who tried to pilot two similar bills through last year, praises its “imaginative and constructive proposals”. The British Medical Association is broadly supportive, though worried that an over-powerful health secretary could introduce even more political interference in the NHS.
If it became law – few private member’s bills ever do – Efford’s bill would amount to a parliamentary mea culpa of historic proportions. If the coalition had made meaningful rather than cosmetic changes to Lansley’s law at the time, Efford’s effort would not be needed. But the admission by an unnamed cabinet minister last month that the act was this government’s greatest folly (quoted on the front page of the Times) and the fact that 44% of the public think the NHS is under threat from private health companies suggests Efford’s bill has caught a mood.
Efford says: “There will be plenty of Labour MPs in the Commons on Friday [a day MPs are usually in their constituences rather than Westminster] and I’ve got no indication that there’s a whipping operation to stop it, so the government has accepted that it can’t win the vote”.
Are any coalition MPs who backed Lansley’s bill likely to now back Efford’s? “Not so far. I suspect that they are all too embarrassed that they supported this incredibly unpopular piece of legislation that people want repealed,” he says.

You Can Build Aircraft But Can You Treat Patients?

From the Independent

Doctors have expressed dismay at reports that an international arms firm is considering a bid for a £1bn NHS contract to run GP support services in England.

American defence giant Lockheed Martin was one of a number of private companies represented at a recent meeting hosted by NHS England, for those interested in taking over the contract, which largely involves administrative functions.

G4S, whose handling of security at the London 2012 Olympics drew widespread criticism, also attended the meeting, as did KPMG and the US law firm DLA Piper. No potential NHS bidders attended, according to the Health Service Journal (HSJ).

The contract, which is likely to be awarded early next year, is one of the biggest ever put out to tender by the NHS.

Leading London GP Dr Louise Irvine told The Independent that it was “shocking” that an arms firm could be awarded such a major NHS contract, and warned that the company could profit from money “taken from front line care”.

“[It is] just as shocking that no NHS organisation was allowed to bid to provide these services, which are mainly back office support for General Practice,” said Dr Irvine, who is standing the general election for the National Health Action Party. “NHS administration systems, with years of experience, are being displaced by organisations that have little or no experience in providing these services.”

Dr Mark Porter, chair of the British Medical Association, said that the tender was “another worrying example of creeping privatisation in the NHS”.

Dr Mark Porter, head of the BMA Dr Mark Porter, head of the BMA (Justin Sutcliffe)
“How can it be in any way sensible to have a system in place which prevents NHS organisations providing some NHS support functions?” he said. “Doctors have repeatedly raised serious concerns over the continued emphasis on competition over integration, its failure to improve patient care, and the millions wasted on lawyers as commissioners struggle with the significant challenges that competitive tendering has introduced.”

As well as developing military hardware including the F-35 fighter plane, Lockheed Martin already provides IT services to several public sector organisations, and has worked with NHS providers before.

A Lockheed Martin UK spokesperson said: “Our UK workforce already delivers IT systems which protect and enhance our national industry, critical infrastructure and justice systems, enable NATS to navigate more than two million commercial flights safely across UK skies each year and ensure Royal Mail can reliably deliver more than fifty million items to our homes and office each day. We continue to explore further opportunities in the public sector.”

The 10-year contract is understood to be worth more than the current cost of running the services, which currently employ 1,600 people. Bidders have been told they will have to close some offices and invest in new technology, and should expect to bear some redundancy costs, the HSJ reported.

NHS England said it was too early in the contract tender process to comment.

The Myth of Intgegrated Care

Commission of inquiry says politicians have fallen for myth that integrating health and social care services is best way forward
Denis Campbell, health correspondent
The Guardian, Wednesday 19 November 2014

The NHS is expected to face a £30bn gap in its finances by 2020. Photograph: Graeme Robertson/Getty Images

Plans by the Westminster parties and the NHS leadership to safeguard the health service’s future constitute “magical thinking” that will not ensure its survival, a group of experts has said.
In a strongly worded critique, a commission of inquiry claims that both the coalition’s and Labour’s policies are not based on evidence and will not help the NHS to close the £30bn gap in its finances that is expected to open up by 2020.
Politicians of all parties have fallen for a myth that integrating health and social care services and moving many medical services out of hospitals represent the best way of keeping the NHS sustainable, they say.
The experts also accuse Simon Stevens, the chief executive of NHS England, of making a “heroic assumption” in pledging that the service will save £22bn a year by 2020 through extra efficiency after an overhaul of how patients receive care.
They claim that none of the three main parties’ recently announced NHS funding plans will prove sufficient and that all will leave a funding gap.
The findings constitute a stark challenge to the broad consensus about the best way to help the NHS withstand rising demand for healthcare while it also deals with an ongoing financial squeeze. They come from a year-long inquiry by the commission on hospital care for frail older people, set up by the Health Service Journal, which is widely read among senior NHS managers.
The group is chaired by Dame Julie Moore, the chief executive of University Hospitals Birmingham NHS foundation trust. The health secretary, Jeremy Hunt, has described the widely admired Moore as one of the NHS’s outstanding leaders.
Her co-authors include Prof John Appleby, chief economist of the King’s Fund health thinktank, and Prof David Oliver, a government health adviser, specialist in older people’s care and president of the British Geriatric Society.
Their report says: “There is a myth that providing more and better care for frail older people in the community, increasing integration between health and social care services and pooling health and social care budgets will lead to significant, cashable financial savings in the acute hospital sector and across health economies. The commission found no evidence that these assumptions are true.”
It urges political parties and NHS leaders to “avoid wishful thinking that improving intermediate and community care, while perhaps the right thing to do, will automatically mean we can disinvest significantly in hospitals.”
The government is pressing ahead with its Better Care Fund, which from next April will move £1.9bn from hospitals’ £40bn budget into schemes in the community intended to keep patients, especially frail older people and the 15 million patients with long-term conditions, healthier at home.
Labour plans to go further, if elected, by fully integrating health and social care services to provide “whole-person care”, with the same twin aims of better looking after patients and saving money.
But the commission decries both. “Improving community care may postpone the need for hospital care, but it will make frail older people neither invincible nor immortal; mostly, they will simply need the care later,” the report says. The available evidence is at best inconsistent or negative about integration’s potential to save money, it adds.
Moore said the already variable and sometimes poor quality of care experienced by older patients could deteriorate if the NHS did not urgently rethink its planned direction of travel.
“As much as it suits us all to have one nice neat solution to the problem of our growing, ageing population – and the current policy has certainly become the accepted wisdom on the matter – the truth is that as a catch-all answer it is simply wishful thinking. Integrated community care is a good thing and we need more of it and innovative approaches, but this can never be a substitution for hospital care.”
The Royal College of Nursing said integration “cannot be relied upon as a quick-fix to the problems facing the health service”, and existing community services had recently been reduced.
An NHS England spokeswoman said: “It is critical that we get care right, not just because an ageing population is a challenge the NHS must face but the frail older people of today are the public who have paid for the NHS throughout their lives. Their contribution, hard work and belief have sustained the NHS. They should always feel it continues to offer the best for them.”
The Department of Health defended its drive to integrate services. “Moving the NHS from a system of cure to prevention is better for patients and better value for money,” it said.