Scottish Referendum

Privatisation of the NHS in England.

Privatisation of the NHS in England.

First you bring the Doctors to Heel. Then you bypass them through the widespread use of private healthcare contracting using large conglomerates with their place of business registered off shore, Bahamas, Switzerland etc. This ensures profits are maximised but the UK taxpayer is well and truly ripped off, and we talking big money. Over ten years around £1trillion profit.

The undernoted information provides evidence of the privatisation. Be assured where the NHS in England goes the NHS in Scotland will surely follow, by fair means or foul. There is so much at stake for Scotland. A, “no” vote in the September referendum will bring the changes to Scotland. A, “Yes” vote will free Scotland from the clutches of Westminster. Vote not for your father. Vote for your children.

GPs across England face being fined if they don’t make use of a new e-referral system that is due to be launched by the end of this year, according to plans being developed by NHS England. The e-referral system, which has been modeled off popular flight-booking websites, is central to Health Secretary Jeremy Hunt’s plans to create a paperless NHS by 2018. It is hoped that if this target is met it could deliver the government savings of £4.4 billion a year.

According to specialist health publication Pulse, NHS England has set its sights on getting 100 percent of practices using the new system by 2017 and that it is considering penalties for Gps that don’t use it to make referrals. Speaking to MPs on the Public Accounts Committee this week, chief executive of NHS England, Sir David Nicholson, said that they were looking at an “incentive stroke penalty system” to maximise uptake.

The system will allow ‘anyone to anyone’ referrals, with GPs able to refer to any NHS service and diagnostics. It will also be designed for mobile and patients will be able to book follow-up appointments via the system. Sir David told MPs: “GPs, of all our clinicians across the NHS, are probably the most technically advanced. They’ve got more digital systems than almost anybody. So it’s not that they’re frightened, they just don’t like the way the system works and it affects their patients they think they don’t want different ways, and we’ve been unable to persuade them of that.

“But I think we’re getting to the point here, where we’ve heard from e-referrals implementation, is that we want to get a system where we can make it a mandatory system as we go forward.” He added: “The question we’ve got to ask is, in a sense – to get as wide a support for it as we can – and then: What is the incentive stroke penalty system we want to put in place to ensure that it actually works?”

By March 2015 everyone in the UK should be able to get online access to their health records held by their GP, according to Jeremy Hunt, and there should be a clear plan in place to enable secure linking of these electronic health and care records wherever they are held. The NHS Commissioning Board will be leading the implementation and it has set a clear expectation that hospitals should plan to make information digitally and securely available by 2014/15.

Scottish Referendum

Alternative Providers of Medical Services (APMS) contracts To be Offered Exclusively to Private Healthcare Providers

All new GP, Alternative Providers of Medical Services (APMS) contracts To be offered exclusively to Private Healthcare providers

NHS Contract Terminology

1. Personal Medical Services contracts (PMS)
Contracts are agreed between NHS England and GP practices, together with funding arrangements. In England, approximately 40 per cent of GP practices are on PMS contracts.

2. General Medical Services (GMS)
practice-based contract rewards practices for essential services, as well as additional services that practices can choose to offer.

3. Alternative Providers of Medical Services (APMS)
Under APMS, PCTs are able to contract for primary medical services with commercial providers, voluntary sector providers, mutual sector providers, social enterprises, public service bodies, GMS and PMS practices (through a separate APMS contract) and NHS Trusts and NHS Foundation Trusts.

Contracting Policy

Exclusive All new GP contracts will be opened up to bids from the private sector by NHS England in a move that GP leaders have warn marks the ‘death-knell’ of traditional life-long general practice. As a tide of practices face closure, because of competition law they will replaced with time-limited, (usually 5 year) APMS contracts instead. The move has taken GP leaders by surprise, with the GPC seeking urgent legal advice about the move. Some have warned it will lead to the privatisation of the NHS with surgeries replaced with ‘short-term, profit making ventures’.

Click to access apms-standard-contract-june14.pdf

The foregoing changes are now well under way in England. High street pharmacies will be increasingly offering a range of services previously the remit of GP’s. Computerised private patient records will be made available to contractors. GP service provision will be dismantled over a period of 5-10 years in favour of large Private Healthcare providers. The Scottish government recently restated that healthcare provision in Scotland will not be subject to such abuse, which favours profiteering by large private healthcare contractors. But in the event of a, “No” vote the English NHS model in all respects will be imposed, (by stealth) on Scotland. Scot’s who wish to retain the existing Scottish NHS should vote, “Yes” in the referendum.

A few views from senior NHS medical staff

An NHS England spokesperson said: ‘Under the GMS regulations there is scope to enter into a temporary contract but this is AT CLEAR ODDS WITH PROCUREMENT LAW and the 2013 regulations so best practice would dictate that this should not be used when APMS effectively does the same job and does not come with the same risks attached. “GMS can still be entered into upon reversion from PMS and the new form of PMS contract may be entered into by way of renegotiation (ie variation) but in respect of procurements, yes they should all be on APMS.”

GP leaders are warning that, with practices under increasing workload and financial pressure, strict tender requirements could exclude smaller practices from primary care and drive the invasion of private providers and they are advising practices to seek alternatives to contract termination, for example by merging, when partners reach retirement in order to avoid losing, “invaluable” GMS and PMS contracts.

GPC chair Dr Chaand Nagpaul said he was surprised to hear about the national policy that would, “spell the death knell of the whole ethos of long-term, continuity of care in the way general practice operates”. He said the GPC was seeking urgent legal advice on whether NHS England was correct in asserting that APMS contracts were the only way to satisfy international procurement law. He added: “It’s extremely unfortunate, and highly ill-advised that area teams should be undermining secure, long-term sustained provision of general practice through APMS contracts. There is nothing to stop an area team choosing to use a PMS or GMS as a contract, on the grounds that it offers a local population the best mechanism for the provision of general practice services.”

Dr Tony Grewal, Medical Director at Londonwide LMCs said they were worried about the moves in the capital that would replace family doctors with, “short-term, profit making ventures that went against the ethos of primary care”. He added: “APMS is only for five years, potentially renewable, which means that you cannot invest time, you can’t invest in the long term. It’s designed for people to go in, to make a profit, and to go out again. Which is not, in my opinion, what general practice is about.” “What it means is, over a reasonably short period of time, given the rate at which practices are closing at the moment, you are going to have significant proportions of general practice services in London, being run by the commercials or big conglomerates.”

Dr David Jenner, GP contract lead at the NHS Alliance and a GP in Cullompton, Devon, warned that the move would mean that independent GPs would struggle to compete with larger healthcare corporations. He said, “Often minimum requirements of IT, quality, financial backing, in practice can make it difficult for small providers to effectively compete”. “It can be a very inefficient way of procuring a service of limited value. There is also the danger of providers bidding low to win the contract and then being unable to meet the terms of it.”

BMA Council member and Lewisham GP Dr Louise Irvine said, “I’m worried about that becoming the new model of care, we’ve already seen new models of private companies bidding for these APMS contracts, some of them have been successful and it’s hard for ordinary practices to bid against them.” She added, “It’s very much part of a trend, it’s part of this big push to privatise, to commercialise and bring in private, for profit companies to run more and more, not just primary care, but community and secondary hospital care.”

Scottish Referendum

The NHS England Health Reform Act and the Involvement of USA Management Consultancy McKinsey & Company

The NHS England Health Reform Act and the Involvement of USA Management Consultancy McKinsey & Company

In June 2011, the head of NHS regulator, “Monitor”, recently armed with a massively expanded remit, including regulating health service contracts potentially worth many billions, flew business class to New York, where he stayed at a five-star hotel and attended a lavish banquet, all paid for by McKinsey and Company, the international management consultants. A government employee he may not have broken the law in the strict sense. But as a former McKinsey executive, he should have known he was displaying questionable judgment – because of, “Monitor’s” role, implementing Health Secretary, Andrew Lansley’s controversial Health and Social Care Bill, together with McKinsey and its clients .

Many of the Bill’s proposals were drawn up by McKinsey and included in the legislation wholesale. One document says the firm routinely used its privileged access to ‘share information’ with its corporate clients – which include the world’s biggest private hospital firms – who are now set to bid for health service work. McKinsey’s involvement in the Bill is so great that its executives attend the meetings of the ‘Extraordinary NHS Management Board’ convened to implement it. Sometimes McKinsey even hosts these meetings at its UK headquarters in Jermyn Street, Central London.

The company is already benefiting from contracts worth undisclosed millions with GPs arising from the Bill. It has earned at least £13.8million from Government health policy since the Coalition took office – and the Bill opens up most of the current £106 billion NHS budget to the private sector, with much of it likely to go to McKinsey clients. More information here;–Companys-role-Andrew-Lansleys-proposals.html#ixzz1mA8EAyJy

As sure as night follows day, Scotland will be next for the chopping block unless the September Referendum returns a, “Yes” vote. The world’s money men are after rich financial pickings, after they have cleaned up NHS England. Their beady eye’s are on Scotland.

Scottish Referendum

NHS Privatisation

The National Health Service in England is being dismantled in favour of private sector healthcare provision. £80 Billion is to be handed over to 40 commissioning bodies, providing massive profits for a few major private healthcare providers. Contracts are being drawn up, in secret, for implementation at the earliest opportunity, which unfortunately for the Health Service in England is now. David Cameron, (Prime Minister) is firmly set on continuing with the changes despite ever growing public dissent. There has been little argucontractualment from the Labour Party.

The process, (now nearing the implementation stage) was first conceived by the government of Tony Blair. The Commons Public Accounts Committee, (CPAC) reported that the Health Service in England spent £600?million on consultants, including McKinsey, in, (2005-06). A few of his ministers involved;

1. Mark Britnell; Director-General for Commissioning and System Management for the National Health Service (NHS) in England (2007–2009) is now a partner and Head of Healthcare, Europe & UK for advisory firm KPMG.

2. Lord Warner, Labour Health Secretary, (2005-2006), is involved with the huge equity firm APAX, which also owns healthcare interests.

3. Simon Stevens; Former Chief Health Adviser, (to Tony Blair) is now the executive vice-president of United Healthcare. The company is well advanced in contractural agreements with NHS civil servants.

4. Alan Milburn; Labour Health Secretary, (1999-2003), is retained by Alliance Medical owners a number of healthcare providers.

5. Cherie Blair; (Wife of Tony) is a founding partner of, “Mee Healthcare”. Reports indicate the company is recruiting financial backers gathering £100 Million.

It is evident, in the future, (contrary to assurances by the Con/Dem government) that GP’s will not be the driving force of the Health Service in England. The 40 Commissioning Teams will run the show, awarding large contracts to approved Healthcare providers, namely, BUPA, AXA, KPMG, McKinsey and others.

So there it is. Loadsa money for the already mega-rich, (including those listed above) asset stripping the National Health Service in England, (the wee Welshman must be turning in his grave). A, “No” vote will bring about the same fate for the Health Service in Scotland as is planned for England. Scotland will only be spared if we vote, “Yes” in the referendum.

Scottish Referendum

The Sick are in Trouble

A letter, supported by 95% of Doctors in England, signed off by a leader of the BMA has this week been sent to Mr Cameron warning that the sick, frail and elderly are being failed by Westminster. The rarely used somewhat politically incorrect intervention by the medical profession advises an urgent need for a major change in direction transferring control of Health and Social Welfare away from private healthcare back to the control of the Nation. A summary of the letter;

The crisis in health and welfare support services is directly attributable to Westminster’s, (Health & Social Services Act) embracing and implementing a programme of rapid ill conceived transfers of services to the private sector. It is estimated in excess of £11Billion and 35,000 staff, (from frontline services) has been given over to private healthcare which has not delivered. This systematic break-up of the National Health Service and welfare support, (under-funded by around £30 Billion) is becoming dangerously fragmented. Rationing of and removal of some treatments is being ordered by non-medical managers all to the detriment of patient care. Very soon changes will be, “bedded in” and virtually impossible to reverse effectively providing citizens with very limited healthcare and Welfare support.

Clearly, where applicable the foregoing applies to the Health Service in England, but Welfare Support is only partially devolved to Scotland and, (at the time of writing) our citizens are suffering the brunt of changes in these systems, (controlled by Ian Duncan Smith).

In the event of a, “no” vote in the Referendum coupled with the, (increasingly likely) return of a Conservative Government in 2015, there is every probability that changes in the National Health Service in England will be transferred, (for early implementation) to Scotland. This will be achieved through a major reduction in the Scottish, “Block Grant” significantly lowering Healthcare finance availability forcing the Scottish Government to adopt the same Healthcare profile as that available in England.

A, “Yes” vote in the Referendum will allow Scotland’s citizens to decide their own future in terms of Healthcare and Social Welfare support. I am confident we will turn away from the disastrous systems envisaged by Westminster.

Scottish Referendum

NHS England Privatisation

NHS England Privatisation, (The Latest Wheeze)

Health Secretary Jeremy Hunt is to introduce a, new class of doctor called, “Physician Associate”. Their training will be complete after 2 years as opposed to the present 7 years and they will attract salaries around £40,000.

The, “Physician Associate” will be allowed to perform a wide range of jobs currently the remit of fully qualified doctors, including diagnosis and treatment.

My previous posts 11311 & 11385 provided information giving warning of the rolling privatisation of the NHS in England. “Bringing the doctors to heel” is crucial to a successful introduction of Private Healthcare Corporations who need to make a, “profit” from their contracts. Both objectives are achieved by the measures indicated. New medics will be flying in from all over the world.

The British Medical Association, (BMA) have expressed concern that mis-diagnosis will become rife leading to more work on the part of more qualified doctors. User body, “Patient Consern” see that the measure is a fantastic way to save money at increased risk to patients.

The process has started. Private Healthcare providers are already moving forward with their recruitment plans, both in the UK and worldwide.

A, “Yes” vote in the referendum will alllow Scot’s to decide the future direction and organisation of healthcare service provision in Scotland. A, “No” vote will place the sick and elderly at the mercy of the prvatisation measures so well advanced in England.