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.“

The Government’s Plans To Privatise The NHS: The Voice Of Anti-Capitalism In Guildford Investigates

“The unions should no longer criticise from the sidelines but recall their membership in special conferences and discuss how to mobilise to defend every single hospital and NHS unit, and make sure this Health Bill cannot be implemented”. 

Or go down to the summary

The publication of the Health and Social Care Bill last month heralds dramatic changes for the NHS, which will affect the way public health and social care are provided in the UK. Those changes alone will have huge impact, but it is the formation of an NHS Commissioning Board, and GP commissioning consortia, that will once and for all remove the word “national” from the health service in England. The result, due to come into force in 2013, will be the catastrophic break up of the NHS.

Out go strategic health authorities and 152 primary care trusts and in come several hundred general practitioner consortiums, responsible for commissioning £80bn of NHS care from “any willing provider.” This means Privatisation!

Putting general practitioners (GPs) in charge of commissioning health services for their patients is similar, in some respects, to the fundholding experiment in the 1990s. The principle then was that GPs controlled the budgets to buy the specialist care their patients needed. Fundholding took years to implement, but evidence on short-term or long-term benefits for patients is lacking. In the current Bill, health outcomes, including prevention of premature death, will be the responsibility of the NHS Commissioning Board, which has been asked to publish a business plan and annual reports on progress. That business plan is urgently needed to allow transparent appraisal of how the Board plans to monitor patients’ outcomes.

The UK coalition Government has now been in power for about 8 months. Neither the Conservatives nor the Liberal Democrats included the formation of an NHS Commissioning Board, or GPs’ commissioning consortia, in their health manifestos. There was no mention of their health plans in either of the parties pledges and the plans were not mentioned in the coalition agreement. However, less than eight weeks after the election, an outline emerged in the white paper “Equity and excellence: liberating the NHS.

The speed of the introduction of the Health and Social Care Bill is surprising, especially given the absence of relevant detail in the health manifestos. The Conservatives promised, if elected, to scrap “politically motivated targets that have no clinical justification” and called themselves the “party of the NHS” — a commitment that seems particularly hollow now.

The NHS was unsurprisingly absent from the 2010 election campaign because satisfaction levels with the NHS were at an all time high, and for most of the electorate the NHS was a non-issue. In the words of Simon Stevens, president of global health at United Health Group, a company that stands to benefit from the reforms,“The inconvenient truth is that on most indicators the English NHS is probably performing better than ever.”

The House of Commons Health Committee’s report, “Commissioning 2011” points out that the proposed changes are to be implemented at the same time as annual efficiency savings of 4% over four years. The report says,“The scale of changes is without precedent in NHS history; and there is no known example of such a feat being achieved by any other healthcare system in the world. ”To pull off either of these challenges would therefore be breathtaking; to believe that you could manage both of them at once is deluded. Since its establishment in July, 1948, the aim of the NHS has been to offer a comprehensive service to improve health and prevent illness. Health care for all, for free, has been the common ethos and philosophy throughout the NHS. On July 3, 1948, in an editorial entitled “Our Service”, The Lancet commented: “Now that everyone is entitled to full medical care, the doctor can provide that care without thinking of his own profit or his patient’s loss, and can allocate his efforts more according to medical priority. The money barrier has of course protected him against people who do not really require help, but it has also separated him from people who really do.”

Now, GPs will return to the market place and will decide what care they can afford to provide for their patients, and who will be the provider. The emphasis will move from clinical need (GPs’ forte) back to cost (not what GPs were trained to evaluate). The ethos will become that of the individual providers, and will differ accordingly throughout England, replacing the philosophy of a genuinely national health service.  As it stands, the UK Government’s new Bill spells the end of the NHS.

Moving to consortiums will incur the costs of transition in addition to their recurring costs. On the basis of past National Audit Office data, the government has put the cost of the NHS reorganisation at £2-3bn. The white paper’s key financial pledge was to reduce the NHS’s management costs by more than 45%. GP consortiums would replace primary care trusts, which have administrative costs of over a billion pounds a year (for a population of 51 million) The potential consortiums have learnt that their running costs will be capped at between £25 and £35 per head of population which equals around 1.5billion a year (based on a £30 cap). So where’s the saving?

The government’s recent “bonfire of the quangos” provides an instructive example of how a rush job doesn’t necessarily guarantee the best outcome. Earlier this month, the parliamentary select committee on public administration criticised the axing of 192 public bodies and the merging of 118 more as poorly managed. It also said that the government’s NHS plans would not deliver significant cost savings or better accountability—two of the government’s key aims. The committee’s chairman said that,“The whole process was rushed and poorly handled and should have been thought through a lot more.”

Rationalising a few hundred arm’s length bodies hardly compares with turning the NHS upside down, yet the proposed timescale for the health reforms is dizzying. The bill promises that all general practices will be part of consortiums by April 2012, yet it took six years for 56% of general practices to become fundholders after the introduction of the internal market.

The health secretary has made much of these changes being evolutionary rather than revolutionary. People “woefully overestimate the scale of the change,” he said. After all, practice based commissioning, choice of provider, an NHS price list, and foundation trusts already exist. But a week later came the revelation that hospitals would be allowed to undercut the NHS tariff to increase their business. Health economists queued up to say what a terrible idea this was, citing evidence that it would lead to a race to the bottom on price, which would threaten quality. Taken with the opening up of NHS contracts to European competition law, it was the last piece of evidence needed to convince critics that the government was unleashing a storm of creative destruction onto the NHS, with the imperative: compete or die.

Regardless of the true motivation behind the governments plans, such radical reorganisations always adversely affect service performance. They are a huge distraction from the real mission of the NHS, “to deliver and improve the quality of healthcare” that can absorb a massive amount of managerial and clinical time.

With an estimated one billion pounds of redundancy money in their pockets, many of those made redundant in the reorganisation and “efficiency savings” of the NHS are likely to be employed by the new GP consortiums in much their same roles. It raises the question: if GP commissioning turns out to be simply primary care trust commissioning done by GPs, aren’t there less disruptive routes to this destination?

Meanwhile, government cuts haven’t gone away. Although the impact assessment of the new bill calculates that savings will have covered the costs of transition by 2012-13, the reorganisation will not have made any savings to contribute to the £15-£20bn efficiency savings the government requires from the NHS by 2014-15.

 East Sussex GPs Oppose Consotia
A recent survey of East Sussex GPs, conducted by the BMA found that more than 70 per cent of them fear patient care will suffer when changes to the NHS are given the go-ahead. The vast majority of GPs surveyed slammed government plans to put GP consortia in charge of health care. Just 7.7 per cent of respondents were convinced that GP consortia will be up to the task.

Although 58 per cent of the GPs believe too much money is wasted on bureaucracy in the NHS, just one in ten GPs approved government proposals to hand purchasing power to GPs. Under government plans, GP consortia will replace the East Sussex Downs and Weald Primary Care Trust by 2013 and will be responsible for buying 80 per cent of health services.

Dr Michael von Fraunhofer, of the Eastbourne consortium steering committee, said local consortia could be hamstrung with more than £30 million in debt from the outgoing PCT. He warned: ‘This will cripple patient care and the blame will fall on GPs unfairly. No matter how good, dynamic or inventive we are, we will be making massive cuts in choice and services just to stay afloat.’
Private Health Care Company, Care UK 
Meanwhile, private health firm, Care UK has won a £53m prison hospitals contract, despite an NHS bid offering a better service. The company has won the contract to run health services at eight jails in north east England, with its cheaper, lower quality bid. About 200 nurses’ jobs and pay could be under threat. Glenn Turp, of the Royal College of Nursing, said he was worried about infection control as Care UK ‘had no plans in place’.

An NHS executive who lost the contract, Les Morgan, sent an angry email to the Health Commissioning Unit which decides who should run healthcare at the eight jails. Morgan wrote: ‘Our bid was judged better on quality, delivery and risk. ‘We are keen to understand the large difference in scoring on price.’ Care UK’s then boss John Nash and wife Caroline donated £200,000 to the Tories before the general election, including £21,000 to Health Secretary Andrew Lansley’s private office.

BMA Discusses Strike Action
BMA boss, Dr Hajioff said, The British Medical Association will put ‘absolutely everything’ on the table including strike action when members determine their response to the government’s NHS Health and Social Care Bill. His comments come as health unions are planning further protests against plans by Barts and The London NHS Trust to cut 635 posts to save £56m over two years. This includes the loss of 250 nursing jobs and a 100 beds.

Similar plans are taking place all over Britain. The Royal Surrey in Guildford has already seen 400 redundancies and the loss of beds. BMA Council member Anna Athow said in a recent interview: “‘The Health Bill aims to accelerate the plans of the last government to physically close and destroy hospitals and make their staff redundant on a massive scale, in order to privatise the NHS”.

She continued; “The unions should no longer criticise from the sidelines but recall their membership in special conferences and discuss how to mobilise to defend every single hospital and NHS unit, and make sure this Health Bill cannot be implemented”. “The recalled Special Representative Meeting of the BMA on March 15 should discuss all options in this campaign. Hospitals must be occupied by local staff and campaigners in Councils of Action to stop them closing.’

In Summary   
1. Andrew Lansley’s Health and Social Care Bill will encourage ’any willing provider’ to cherry pick profitable slices of NHS services. It’s the biggest-ever privatisation of health care anywhere in the world,

 2. The Bill will turn the NHS into a free market, cost billions to implement, and be far more unequal in its provision of services than the current system.

 3. GP consortia, with their budgets squeezed to create £20 billion of savings will have to restrict access to hospital care.

 4. GP consortia will have to employ private management consultants, who are the only people to have welcomed Lansley’s plans.

5. Patients will be even less informed as existing public bodies are replaced by local GP consortia, that function in secret sessions, and a remote national NHS Commissioning Board.

6. Health care services are to be privatised, with EU competition laws forcing GPs to put any service out to tender.

7. All limits on the money Foundation Trusts hospitals can earn from private medicine are to be scrapped. Hospitals will then prioritise attracting wealthy private patients.

8. Price competition is to be introduced in clinical services, despite warnings that this will undermine the quality of care.

9. The limited ’scrutiny’ proposals are a fraud: GP consortia and the Commissioning Board will take their decisions in secret, and are not even obliged to go through the motions of consultation.

10. The Bill is opposed by the health unions and the TUC, the majority of GPs, and virtually every organisation of health professionals, including the Royal College of GPs and the BMA.

That’s why Lansley must be stopped. It’s time for urgent political action to Kill Lansley’s Bill.
Read: “Kill Lansley’s Bill 10 good reasons” from the PCS Union. 

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Ministers plan huge sell-off of Britain’s forests (Reported By Guildford Against Fees And Cuts)

Ministers are planning a massive sell-off of Britain’s Government-owned forests as they seek to save billions of pounds to help cut the deficit, Patrick Hennessy writes in the Sunday Telegraph.

Caroline Spelman, the Environment Secretary, is expected to announce plans within days to dispose of about half of the 748,000 hectares of woodland overseen by the Forestry Commission by 2020. The controversial decision will pave the way for a huge expansion in the number of Centre Parcs-style holiday villages, golf courses, adventure sites and commercial logging operations throughout Britain as land is sold to private companies.

Legislation which currently governs the treatment of “ancient forests” such as the Forest of Dean and Sherwood Forest is likely to be changed giving private firms the right to cut down trees. Laws governing Britain’s forests were included in the Magna Carta of 1215, and some date back even earlier.

Conservation groups last night called on ministers to ensure that the public could still enjoy the landscape after the disposal, which will see some woodland areas given to community groups or charitable organisations. However, large amounts of forests will be sold as the Department for the Environment Food and Rural Affairs (Defra) seeks to make massive budget savings as demanded in last week’s Spending Review.

Whitehall sources said about a third of the land to be disposed of would be transferred to other ownership before the end of the period covered by the Spending Review, between 2011 and 2015, with the rest expected to go by 2020. A source close to the department said: “We are looking to energise our forests by bringing in fresh ideas and investment, and by putting conservation in the hands of local communities.”

 Unions vowed to fight the planned sell-off. Defra was one of the worst-hit Whitehall departments under the Spending Review, with Ms Spelman losing around 30 per cent of her current £2.9 billion annual budget by 2015.

The Forestry Commission, whose estate was valued in the 1990s at £2.5 billion, was a quango which was initially thought to be facing the axe as ministers drew up a list of arms-length bodies to be culled.  However, when the final list was published earlier this month it was officially earmarked: “Retain and substantially reform – details of reform will be set out by Defra later in the autumn as part of the Government’s strategic approach to forestry in England.”

A spokesman for the National Trust said: “Potentially this is an opportunity. It would depend on which 50 per cent of land they sold off, if it is valuable in terms of nature, conservation and landscape, or of high commercial value in terms of logging. “We will take a fairly pragmatic approach and look at each sale on a case by case basis, making sure the land goes to the appropriate organisations for the right sites, making sure the public can continue to enjoy the land.”

Mark Avery, conservation director for the Royal Society for the Protection of Birds (RSPB) said: “You can understand why this Government would think ‘why does the state need to be in charge of growing trees’, because there are lots of people who make a living from growing trees. But the Forestry Commission does more than just grow trees. A lot of the work is about looking after nature and landscapes.”

“We would be quite relaxed about the idea of some sales, but would be unrelaxed if the wrong bits were up for sale like the New Forest, Forest of Dean or Sherwood Forest, which are incredibly valuable for wildlife and shouldn’t be sold off.  We would look very carefully at what was planned. It would be possible to sell 50 per cent if it was done in the right way.”

A Defra spokesman said: “Details of the Government’s strategic approach to forestry will be set out later in the autumn. We will ensure our forests continue to play a full role in our efforts to combat climate change, protect the environment and enhance biodiversity, provide green space for access and recreation, alongside seeking opportunities to support modernisation and growth in the forestry sector.”

Allan MacKenzie, secretary of the Forestry Commission Trade Unions, said: “We will oppose any land sale. Once we’ve sold it, it never comes back. Once it is sold restrictions are placed on the land which means the public don’t get the same access to the land and facilities that are provided by the public forest estate. The current system means a vast amount of people can enjoy forests and feel ownership of them. It is an integral part of society.”

In 1992 John Major’s Conservative government – also looking to save money in a recession – drew up plans to privatise the Forestry Commission’s giant estate, which ranges from huge conifer plantations to small neighbourhood woodlands. John Gummer, then the Agriculture Minister, wrote to cabinet colleagues saying that he ‘wanted to raise money and get the forest estate out of the private sector’. Mr Major backed the sell- off which, it was hoped, would raise £1 billion. However it was later abandoned following a study by a group of senior civil servants, amid widespread public opposition.

Much forest is already being cut down. A Facebook environmentalist informs me. For example 6 out of 20 sq miles of Ashdown Forest near Forest Row, Sussex, because the EU designated it as heath land. And all over Britain, small areas of forest have been cut down. In St Albans for example- two years ago a naturally seeded oak forest was cut down because an EU directive said it was grassland. Those in the immediate vicinity were informed two days before that Fairview Homes, the owner would be clearing scrub!!! Up to 35 year old oaks were turned to sawdust.  They didn’t even make use of the wood.

SUAC says: the only way to stop this and all the government cuts is to destroy the coalition and bring down the government. Climbing up trees or individual protests may make us feel better, but will never be effective. 100,000 people brought down Thatcher in the 90’s. So we need mass action. That means all environmentalists, anarchists and socialists joining with the Trade Union movement and coming together in a Coalition Of Resistance. 200,000 people on the streets of London should do it -with the help of strike action. Is this possible?…Absolutely. France is regularly putting 300,000 on the streets of Paris – So yes we can do it here. We’ve no choice. Find your local anti-cuts group and join the Coalition Of Resistance.
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