The NHS – Rationing And The Two-Tier Health Service

The NHS – Rationing And The Two-Tier Health Service

NHS hospitals performing record numbers of private operations in ‘two-tier’ health service. Hard-up hospitals can now earn up to 50% of income from private work. Shock figures show their income from private patients rose 12% last year – with a further 10% rise forecast for the next 12 months. The Tories are creating a two-tier NHS – with those who pay gobbling up scarce resources.

A Freedom of Information request by Labour MP Gareth Thomas revealed English NHS hospitals earned £434million from private patients in 2012/13, up £47million in a year. And hospitals are forecasting they will earn even more this year (2013/14), raking in some £480million from private work.

Ealing Hospital in London, where the A&E department is under threat, increased the amount it got from their private patients by 250% in the last two years; while Great Ormond Street hospital saw a 58% rise, and Nottingham University Hospitals NHS Trust has budgeted for a 30% increase next year.

The MP who unearthed the figures, said: “Our hospitals are seeing a huge rise in the amount of money they receive from private patients. With yet more increases to come this year, it’s clear that under David Cameron a two-tier health service is emerging; pay privately and you’ll be seen quickly – don’t pay privately and join an increasingly long waiting list.”

He said there was growing evidence that patients are being forced to go private because they are being turned away from the NHS or spending so long on waiting lists. “Last year more than 52,000 patients in England were denied routine operations because of the financial pressures on the NHS. This included people waiting for common procedures such as cataract operations and varicose veins treatment”.

Meanwhile, one in five GPs who sits on a Clinical Commissioning Group (CCG) board has a financial stake in a provider which currently provides services to their own CCG, a Pulse investigation has found, potentially having a conflict of interest because they hold a financial stake in a private healthcare provider.

Figures released by NHS England for July revealed more than half a million patients are on hospital waiting lists in London alone. Dr Clive Peedell, co-leader of the National Health Action Party said: “lifting the cap on private treatments would see a further rise in waiting NHS lists”. “It is a reflection of the huge financial strain on hospitals. The only way to survive and stop from going bankrupt is to increase the number of private patients. We are heading to a two-tier system with consultants having to decide who takes priority: do they see private or NHS patients first”. “The knock on effect will be increased waiting lists as the NHS only has a limited capacity, and if they treat private patients that pushes other patients out of the system. David Cameron is privatising our NHS”.

Rationing
According to the NHS Support Federation: 70% of GP’s are unable to refer patients to the NHS for treatment at least once a month, while 66% of GP’s reported an increase of patients enquiring about private health care because their treatment was no longer available on the NHS. Meanwhile, increased health care rationing is being felt accross the country. 56% of CCGs have further reduced access to care this year according to the Telegraph.

The NHS Support Federation reports that: 39% of people with diabetes have been left unable to monitor their blood glucose levels because the test strips required are being rationed to save money. Self-monitoring of blood glucose levels is essential for many people with the condition. Failure to do so can lead to serious complications such as hypoglycaemia and ketoacidosis.

The Evening Standard reported last month that the number of operations cancelled at the last minute by London hospitals is at a new high, with more patients having to wait at least four weeks for their rescheduled surgery. Other treatments being increasingly rationed include cataract surgery and hip and knee replacements. GP’s are to be given thresholds to ration 28 common surgical procedures including knee replacements, cataract surgery and bariatric surgery under new guidance currently being developed by the Department of Health.

A recent report from the National Audit Office stated: Hospitals in certain areas have stopped offering elective treatments for smokers or people above a certain level of obesity, while in others cataract patients are being forced to wait until their eyesight deteriorates further before being allowed surgery. Rationing elective operations “essentially defers, rather than avoids, spending,” the report said.

A survey of NHS professionals has found that ‘efficiency savings’ are not working, staff morale is low and services are being cut. Almost half of those surveyed believe patient safety is being affected by the need to save £20 billion by 2015, while nine out of 10 say staff morale is being badly hit.

5 Things You Need To Know About The NHS Bill

1 The bill will cost at least £2 billion
Estimates of the cost of implementing the Health and Social Care Bill range from the government’s £1.3 billion to Labour’s £3.5 billion, but most independent analysts estimate at least £2 billion. The government claims the bill will save money in the long run but even the Conservative-led parliamentary health committee says this is unlikely unless standards of care are cut. £1 billion is being spent on redundancy for managers, only for many to be rehired as consultants.

2 The bill will create more bureaucracy
The NHS bill replaces three levels of management (Department of Health, Strategic Health Authorities, Primary Care Trusts) with seven (Department of Health, NHS Commissioning Board, Strategic Health Authority clusters, Commissioning Support Organisations, Clinical Commissioning Groups, Clinical Senates, HealthWatch), and creates two unaccountable super-quangos (Monitor and the NHS Board).

3 Waiting times will grow – unless you go private
The bill allows hospitals to fill up to half of their beds with private patients, and waters down guarantees on NHS waiting times. NHS patients will increasingly find themselves at the back of the queue, even for their own local hospital.

4 Care will depend on a postcode lottery
The bill will break up the NHS and create a postcode lottery on a scale not seen before. With no national standards, there will be widespread variation in the treatments available on the NHS. In some areas, people may have to go private to get services available for free elsewhere. Scotland and Wales, which are not covered by the bill, will continue to provide services denied to patients in England.

5 Private companies, not GPs, will be in control
The bill says GPs will plan and commission healthcare. But this complex role cannot be done on the side while providing the same level of care to patients. We expect pilots to have excellent flying skills – not to design and purchase their own planes. In fact leaked papers show the government expects private companies called Commissioning Support Organisations to take over this role. CSOs will decide how care is delivered but there will be no democratic control over them.

A Betrayal Of Trust: Watch this video to find out why we must stop Lansley’s bill

Further information on the Health and Social Reform Bill is available at Keep Our NHS Public www.keepournhspublic.com/index.php and Health Emergency: www.healthemergency.org.uk

PFI And The NHS – A Health Emergency

Report by Health Emergency, Published: 04/03/11
More and more NHS hospitals built at high cost with private finance in the last decade (under the controversial Private Finance Initiative) are already closing beds and axing clinical and other staff in a desperate bid to balance the books as NHS budgets face the biggest-ever squeeze.

And now cuts and closures of services are being combined with asset-stripping sales of land and property to bail out floundering Trust finances.

• The financially-strapped South London Healthcare Trust, which includes two financially-disastrous PFI hospital schemes (Bromley’s Princess Royal University Hospital and the Queen Elizabeth Hospital in Woolwich) has announced plans to flog off “spare“ land assets on several sites. This will virtually dismember what remains of the Queen Mary’s hospital in Sidcup, where A&E and maternity services have already been axed, despite pre-election promises that they would be kept open – killing any last faint hopes of restoring the lost services.
• In West London, the struggling West Middlesex Hospital Trust is planning to axe hundreds of nursing and admin jobs, and close more of the beds in the PFI-funded hospital, seeking to cut spending by 12% in two years.
• In North East London, the £239m Queen’s Hospital in Romford, part of Barking Havering & Redbridge Hospitals Trust, is running with a whole floor unused, while the Trust is still seeking ways to close most of the 18-year old King George’s Hospital in Ilford in order to stem its continued yearly deficits.
• Upwards of 100 beds in the most costly PFI development in the country, the £1 billion Bart’s & London Hospital (where each bed is costing £1m to build, and £5m over the lifetime of the contract) are also to be closed – before they are even built, leaving the Trust saddled with the escalating bill for building capacity it cannot afford to run.
• In Portsmouth too, a brand new £256m 1,200 bed QueenAlexandraHospital has announced 700 job losses and the closure of 100 costly beds in a battle to balance the books. The “unitary charge“ PFI bill, which rises each year, is £43m this year, making the total cost of the hospital and support services under PFI a staggering £1.6 billion.

Many other PFI hospitals are facing financial problems but have yet to announce cuts. But perhaps the financial nonsense of PFI is clearly underlined by the plight of the West Middlesex Hospital, which has already paid out £89m to the consortium which built the £60m hospital, but faces another 20 years or more of payments totalling more than £420m before the £515m contract is complete.

Commenting on the latest revelations, Health Emergency’s Information Director Dr John Lister said: “PFI means that hospitals face rising bills each year – regardless of their income: It also means that private sector profits are protected by legally binding contracts, taking an increased share of declining Trust budgets, while clinical services, patient care and the jobs of NHS staff are sacrificed – in an impossible battle to balance the books as the NHS faces real-terms cuts for the first time in a decade.

“Isn’t it significant that Andrew Lansley’s massive and controversial Health and Social Care Bill is seeking to break up almost every structure in our NHS, claiming to make the system more efficient, but leaving PFI intact, and instead opening even more ways for the private sector to rip off the taxpayer and undermine public services?

“The Tories appeared opportunistically critical of their own PFI policy when Labour was implementing it, but are now happy to see this growing haemorrhage of cash from the NHS.

“If ministers really wanted value for money in the NHS, they would scrap Lansley’s crazy Bill which hardly anyone – even GPs – supports, and which will cost £3 billion or more to implement, and focus instead on nationalising the PFI hospitals, many of which will be paying through the nose for a generation to come to banks that the taxpayer already effectively owns.“