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More than 140 top doctors attack government record on NHS

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Letter from senior health professionals says coalition has left NHS in weakest position ever and calls on people to use votes to reinstate service

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David Cameron during a visit to Frimley Park hospital. Photograph: Getty Images

Sarah Boseley Health editor

Tuesday 7 April 2015 18.41 EDT Last modified on Wednesday 8 April 2015 05.24 EDT

Leading doctors in the NHS have accused the coalition government of a catalogue of broken promises, funding cuts and destructive legislation which has left the health service weaker than ever before.

In a letter to the Guardian, more than 140 senior doctors pass a damning judgment on the government’s stewardship of the NHS, which they say is under pressure because of unnecessary market-oriented changes.

Letter: More than 100 senior health professionals write in a personal capacity outlining their view of how the NHS in England has fared under the coalition
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“As medical and public health professionals our primary concern is for all patients. We invite voters to consider carefully how the NHS has fared over the last five years, and to use their vote to ensure that the NHS in England is reinstated,” they write.

The signatories to the letter include Dr Clare Gerada, former chair of the Royal College of General Practitioners; Prof John Ashton, retired director of public health; epidemiologist Prof Michael Coleman; Simon Capewell, professor of public health at the University of Liverpool; Trisha Greenhalgh, professor of primary care at Oxford; Martin McKee, professor of European public health, and Raymond Tallis, emeritus professor of geriatric medicine at the University of Manchester.

The letter, which the doctors have written in a private capacity, challenges the government on its NHS record and deplores the current pressures facing the health service.

Entering the last election, David Cameron assured voters that the NHS was safe in Conservative hands. The doctors, however, say the NHS “is withering away and if things carry on as they are then in future people will be denied care they once had under the NHS and have to pay more for health services. Privatisation not only threatens coordinated services but also jeopardises training of our future healthcare providers and medical research, particularly that of public health.”

Just a week ago, 100 senior business leaders wrote to the Telegraph, claiming a Labour government would “threaten jobs and deter investment” in the UK. The NHS is a potentially difficult issue for the Tories and a strong suit for Labour.

Earlier on Tuesday, the health secretary, Jeremy Hunt, said he would meet the funding challenge thrown down by the NHS chief executive, Simon Stevens, last year. Stevens said in October that the health service faced a funding gap of £30bn by 2020, of which £22bn could be met through efficiency savings.

Hunt told BBC Radio 4’s World at One programme: “We will give whatever they need. It might be more than £8bn, it might be less.”

Within hours of Hunt’s pledge, an earlier draft of the doctors’ letter was leaked to the Daily Telegraph, which claimed that Labour had orchestrated it. Julian Smith, the Tory candidate defending Skipton and Ripon, told the paper: “This Labour stitch-up is another desperate attempt to weaponise the NHS. The truth is that only today Andy Burnham said he didn’t support the NHS’s own funding plan. Under this government, we’ve got more doctors, more nurses and more patients being seen than ever before.”

But Gerada, who organised the letter, denied that the Labour party was responsible. “It has not been orchestrated by Labour, it has been put together by me and a few other medical leaders,” she told the Telegraph. “I’m not doing this from a party political point of view. My views on the health service and the Health and Social Care Act go back and are well known. This letter was drafted by me and some others.

“I am a Labour party member now, but I’m not an activist in the Labour party. This is a view of many doctors who have serious concerns about the state of the NHS as it is now.”

A Labour spokesperson said: “It’s little surprise that doctors have written this letter – they are deeply concerned about the direction of the NHS under David Cameron and the consequences for patients of another five years of Tory government. The NHS needs Labour’s better plan for 20,000 more nurses and 8,000 more GPs, paid for with a £2.5bn a year time to care fund, and guaranteed GP appointments within 48 hours.”

Zara Aziz: I accept that we can’t fund everything, but there is a lack of consistency in which treatments are rationed and service provision varies across the country
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The letter attacks Andrew Lansley’s NHS shakeup, which was passed by parliament in 2012 as the Health and Social Care Act. It is “already leading to the rapid and unwanted expansion of the role of commercial companies in the NHS. Lansley’s Act is denationalising healthcare because the abolition of the duty to provide a NHS throughout England, abdicates government responsibility for universal services to ad hoc bodies (such as clinical commissioning groups) and competitive markets controlled by private sector-dominated quangos,” the doctors write.

The squeeze is hitting patients, they continue: “People may be unaware that under the coalition, dozens of accident and emergency departments and maternity units have been closed or earmarked for closure or downgrading. In addition, 51 NHS walk-in centres have been closed or downgraded in this time, and more than 60 ambulance stations have shut and more than 100 general practices are at risk of closure.”

Thousands of NHS beds have closed since 2010, they say, while mental health and primary care are in disarray and public health has been “wrenched” out of the NHS and is now the responsibility of local authorities.

The way forward is clear, the doctors say. “Abolish all the damaging sections of the Health and Social Care Act 2012 that fragment care and drive the NHS towards a market-driven, ‘out-for-tender’ mentality where care is provided by the lowest bidder. Reversing this costly and inefficient market bureaucracy alone will save significant sums. Above all, the duty on the secretary of state to provide a health service throughout England must be reinstated – it still exists in Scotland and Wales.”

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Why are GPs being told to hand billions-worth of NHS decisions to private health firms and their lobbyists?
Tamasin Cave 3 May 2015

https://www.opendemocracy.net/tamasin-cave/why-are-gps-being-told-to-hand-decisions-to-private-health-firms-and-their-lobbyists

Whilst all eyes have been on the election, the government has quietly shifted into stage two of NHS privatisation, generating huge potential conflicts of interest.

‘The whole point of our NHS reforms,’ David Cameron said, is ‘to put the power in the hands of local doctors, so that they make decisions based on what is good for their local area.’

But now new information has emerged in the run-up to the election, showing just how far from the truth this claim is.

Yes, most of the NHS budget was handed to GPs. But they are now handing it over to private firms. It’s phase two of the privatisation project. It is private firms who will determine how and where the NHS budget will be spent (through a process known in NHS speak as commissioning).

Everything from deciding which hospitals stay open, which services are still available on the NHS, and who provides these services, the NHS or the private sector.

As the Observer reveals this morning, the list of approved suppliers bidding for this work – the planning and buying of care – has just quietly been released.

The list is dominated by management consultancies, outsourcing giant, Capita, and US health insurer, UnitedHealth, the previous employer of NHS CEO, Simon Stevens.

Last year, Spinwatch uncovered how UnitedHealth’s lobbyist, Chris Exeter, chaired a discreet forum, the Commissioning Support Industry Group, giving these firms regular privileged access to senior NHS officials overseeing the creation of this new market in ‘commissioning services’.

Capita was another member of the group, as were KPMG, PwC, EY (formerly Ernst & Young) and McKinsey.

There are nine consortia set up to ‘supply’ local health purchasing decisions. UnitedHealth, Capita, KPMG and PwC are now approved suppliers to two thirds of them. McKinsey and EY are suppliers to half of them.

These companies (and others) will supply GP commissioners with key services that have until now been done by the NHS for the NHS: planning services; managing relationships and contracts with healthcare providers, like hospitals; and crucially deciding what the NHS will look like in the future – what NHS England calls ‘transformation and service redesign’.

GP groups will be forced to re-procure a lot of these services by April 2016 (apparently in order to comply with EU procurement law). It is thought that, consequently, between £3-5billion of services will be bought through these consortia.

The privatisation of commissioning hands the private sector more power, more influence and potentially a lot more of the NHS budget.

It also presents potentially huge conflicts of interest, with private companies like United Health bidding to take charge of local health budgets at the same time as it is increasingly looking to provide the healthcare those budgets pay for.

UnitedHealth, for example, is bidding for the biggest privatisation in NHS history, Staffordshire’s £1.2bn contract to run cancer and end-of-life care. Are rules in place to prevent any conflicts of interest?

The approved list of suppliers also includes a number of commercial lobbying firms working for private healthcare clients seeking to make money out of the NHS.

Take commercial lobbying agency Hanover, which is part of a consortia led by UnitedHealth. Hanover’s head of health is lobbyist Andrew Harrison, a former aide to Labour’s privatising health secretary, Alan Milburn and an ex-colleague of the man currently holding the NHS purse-strings, Simon Stevens.

Hanover has been UnitedHealth’s lobbying agency for years. Another recent client is HCA, the huge private hospital operator that had to pay $1.7bn in US fraud settlements in 2003. HCA has a few ‘joint ventures’ with the NHS, but wants more. Hanover also bends ministerial ears on behalf of the US pharmaceutical lobby group, the American Pharmaceutical Group. Another long-standing client is Alliance Medical, which paid ‘cash-for-access’ Tory MP Malcolm Rifkind to sit on its board and recently won an £80 million contract to run cancer scans across England (despite a rival NHS group claiming their bid was £7 million cheaper).

Hanover, which as an approved supplier is now in line to provide “communications services” to local health bosses, already serves a number of NHS bodies. It provides the NHS Cancer Screening Programmes with ‘reputation management’, and advises on ‘managing relationships with key stakeholders’, for example.

Hanover aren’t the only commercial lobbyists on the list faced with potential conflicts of interests.

Engine is in another of the private sector consortia, MBED. Engine is actually a group of communications companies, which includes lobbying agency MHP. The firm has long been a favorite of healthcare companies. Until recently, their star turn was Bill Morgan, who was Andrew Lansley’s right-hand man.

MHP’s roster of clients contains all the big names in pharmaceuticals, and some drug-funded health charities. Since 1999, Engine has also worked for Bupa, including providing the private health company with ‘business consultancy’ and support for its e-Health programmes (using computers to both collect health data and provide healthcare and monitoring).

Global business consultants FTI Consulting are a part of half of the consortia that GP local health bosses will now be encouraged to use.

FTI claims to have years of experience creating campaigns to ‘protect clients’ political and policy interests’. Who they lobby for in the UK isn’t known, but in the US clients include the lobby group for the private health insurance industry, America’s Health Insurance Plans; the Biotechnology Industry Organisation; and the health insurer AXA. In Brussels, FTI stands up for private health insurer, Prudential; lots of pharmaceutical companies, plus the European Association for Biotech industries.

Then there’s EY, formerly Ernst & Young, another global consultancy firm that is poised to help direct how and where the NHS spends its money. EY are – you guessed it – lobbyists for private health companies. EY has just registered Prudential as a client on the UK’s new register of lobbyists. The Pru is also a US lobbying client, as are Zurich and AIG; Pfizer; and every NHS-leader’s favorite US healthcare firm, Kaiser Permanente.

PwC, which is a supplier to most of the consortia, has registered itself on the UK’s register of lobbyists, meaning it lobbies ministers on behalf of (as yet un-named) clients. PwC is looking to increase its position in what it sees as the UK’s growing, commercial market in healthcare. ‘The health industry in the UK offers strong opportunities for growth in the wider economy and for PwC,’ said chair of PwC’s advisory board, former health secretary, Alan Milburn.

McKinsey, a supplier to five of the groups on offer to GPs, earns most of its revenue from advising corporations: health insurers, private hospital groups, pharmaceutical companies, tech interests and investors. Emails show that it was sharing its thinking on the implications of the Coalition’s NHS reforms ‘with clients’. Who they are, and what McKinsey does for them, though, is confidential. McKinsey also appears to act as a bridge between the public and private sectors. More documents show the consultants connecting London’s health officials with one of Germany’s largest private hospital chains to discuss ‘potential opportunities’ to take over public hospitals in the capital. McKinsey also advised them how to minimise public resistance to the privatisation of hospitals: start ‘from a mindset [of] one at a time’.

Then there’s KPMG, a supplier of services to six of the nine approved groups. Official spending data shows how much work has already been sent KPMG’s way by the NHS-led consortia. From September 2013 to March 2014, it picked up £3.5m from them. One group on the list, the Arden & Greater East Midlands Commissioning Support Unit (GEM) paid KPMG over a quarter of a million pounds a month in the first six months of 2014 for services, including work on a £500k ‘enhanced analytics’ project, and supporting ‘specialised commissioning’.

KPMG has itself subcontracted some of this work to UnitedHealth (via another unnamed company), according to a Freedom of Information release. There is no contract between GEM and UnitedHealth.

At the same time, KPMG is engaged with the private healthcare sector. Addressing a conference of healthcare companies and investors in New York in 2010, Mark Britnell, head of KPMG’s UK health division, spoke of the private sector opportunities presented by the UK’s health reforms: "The NHS will be shown no mercy and the best time to take advantage of this will be in the next couple of years," he advised the attending companies.

Britnell was speaking a year into his job at KPMG, which he joined from the Department of Health where he was director general in charge of commissioning. Britnell was the architect of what we see today: the privatisation of commissioning.

Back in 2010, the BBC reported the Coalition’s reforms of the NHS as 'handing funding powers to GPs'.

Let’s hope they also report that the power is now passing to profit-seeking corporations.

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Medical union to seek legal advice on treatment of young doctors amid fear NHS is breaching Human Rights Act

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http://www.independent.co.uk/life-style/health-and-families/health-news/medical-union-to-seek-legal-advice-on-treatment-of-young-doctors-amid-fear-nhs-is-breaching-human-rights-act-10255657.html

Edited by Steven Gaal
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£22bn NHS cuts and ‘staff burnout’ could halt Tory reforms – health trust

http://rinf.com/alt-news/latest-news/22bn-nhs-cuts-and-staff-burnout-could-halt-tory-reforms-health-trust/

Plans to move the National Health Service (NHS) to a seven-day service could be hampered by increased pressure on staff, coupled with £22 billion worth of further cuts, a report has warned.

The report from healthcare think tank The Nuffield Trust comes as Health Secretary Jeremy Hunt announced a clamp down on excessive NHS spending on agency staff.

The Nuffield Trust said Tory plans to cut spending and increase operating hours of the NHS could create staff burnout which “could hamper progress at a time of immense pressure on the NHS.”

The report calls for an overhaul of the current top-down organizational structure, saying the “narrow”goals are forcing distorted hospital priorities.

Nuffield Trust CEO Nigel Edwards said: “The NHS needs to hit very ambitious efficiency targets, at the same time as fundamentally changing the way care is delivered and moving to a seven-day service. That can only be done if it has the right staff in the right places. Yet there are not enough staff to fill gaps in key areas, and we are seeing clear signs of stress and disengagement.

“Already, the health service has been thrown off course by the massive bill for agency staffing because it can’t get enough permanent nurses to join hospital trusts. Solving these problems doesn’t just mean pledging more doctors and nurses. We need to use those we have more intelligently, so that they’re more ready to deal with the growing number of older people with very complicated health issues.”

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Read more: £22bn NHS cuts and ‘staff burnout’ could halt Tory reforms – health trust — RT UK

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Child Hood Abuse Survivor Faces Jail NHS DRUG INDUCED PSYCOSIS

The horrors of prescribed medication in the UK for Joanne Peacher NHS Nightmare

The horrors of prescribed medication in the UK – how Police lock up people who allege they are raped by nuns and priests without investigating those allegations – even when they are made aware that prescribed medication is causing these survivors of satanic ritual abuse to hear voices which tell them what to do – https://butlincat.wordpress.com/…/joanne-peacher-in-need-o…/

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Calling the immediate release of all people in prisons and mental health institutions with drug induced symptoms without insight or intent to cause loss, injury or harm such as Joanne Peacher wife of Andy Peacher of http://freedomtalkradio.co.uk/

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Edited by Steven Gaal
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