Lansley/McKinsey violent NHS shake-down/privatisaton

[Caz]

.

Located at 11 Strand London is the National Institute for Clinical Excellence (NICE), as well as the IRP (Independent Reconfiguration Panel) and the Council for Healthcare Regulatory Excellence.

11 Strand, London, lies within the boudaries of what we have described as the John Adam St Gang network (aka Committee of 300).

http://en.wikipedia.org/wiki/National_Institute_for_Health_and_Clinica l_Excellence

[Disco_Destroyer]

In just one week, your MP has to vote on massive changes to our NHS. But 38 Degrees members now have something our MPs don’t – thorough, independent legal advice about what these changes really mean.

Our expert legal advice is sobering. Despite the “listening exercise”, the government’s changes to the NHS plans could still pave the way for a shift towards a US-style health system, where private companies profit at the expense of patient care.

Liberal Democratic MPs like yours are being told by their bosses that the NHS is safe. If they read our evidence they’ll know they can't hide behind that spin. Together, we can arm them with the facts and put them under massive pressure to vote to save our NHS.

Click on the link to send our legal advice to your MP and make them realise they have to respond:
https://secure.38degrees.org.uk/email-your-lib-dem-mp

Our independent lawyers identified two major problems in the new legislation:

The Secretary of State’s legal duty to provide a health service will be scrapped. On top of that, a new “hands-off clause” removes the government's powers to oversee local consortia and guarantee the level of service wherever we live. We can expect increases in postcode lotteries – and less ways to hold the government to account if the service deteriorates.
The NHS will almost certainly be subject to UK and EU competition law and the reach of procurement rules will extend across all NHS commissioners. Private health companies will be able to take new NHS commissioning groups to court if they don’t win contracts. Scarce public money could be tied up in legal wrangles instead of hospital beds. Meanwhile, the legislation lifts the cap on NHS hospitals filling beds with private patients.
So who are MPs going to listen to when casting their vote – you, or lobbyists from private health companies? This is our NHS, and it’s up to us to defend it. Email your MP now:
https://secure.38degrees.org.uk/email-your-lib-dem-mp

It’s pretty extraordinary what we’ve managed to achieve together already. Nearly half a million of us have signed the petition to save the NHS. And after Andrew Lansley announced the last round of changes, thousands of 38 Degrees members immediately chipped in to get top independent legal advice on the new plans.

Barrister Rebecca Haynes found that the government's plans could pave the way for private healthcare companies and their lawyers to benefit most from changes, not patients. Another barrister, Stephen Cragg, found that we were right to be worried that Andrew Lansley was planning to remove his duty to provide our NHS.

This is the conclusion of a top legal team paid to have no other interest at heart but yours.

MPs vote in just seven days. Seven days to not only get the evidence, but be convinced there’s way too much public concern to ignore it. The good news is, with over 800,000 of us now armed with expert legal advice, we are just the people to speak up. Our message is clear: we have the facts, so politicians can’t hide behind spin. Let’s give MPs from all parties the mandate they need to think again and vote against these changes to the NHS.
https://secure.38degrees.org.uk/email-your-lib-dem-mp


Thanks,
Johnny, David, Cian, Becky, Hannah, Marie and the 38 Degrees team.


PS:
Thousands of us chipped in to pay for lawyers to get a clear understanding of Lansley’s new proposals. This shows what we can all do together to make a difference. Right now, we can use this evidence to tell our MPs to face down NHS changes in Parliament next Tuesday.
https://secure.38degrees.org.uk/email-your-lib-dem-mp

PPS:
If you think there has been a mistake and you don't have a Liberal Democrat MP, please click here:
https://secure.38degrees.org.uk/email-the-evidence

NOTES
You can view the full report from the legal team here:
https://secure.38degrees.org.uk/nhs-legal-advice

[Disco_Destroyer]

UPDATE: It’s starting to work – this morning’s papers are reporting that key government MPs will refuse to vote for the government’s dangerous NHS plans.

That’s great news – and it comes after tens of thousands of us emailed our MPs. But more pressure is needed. Can you forward the email below to all your contacts and ask them to email their MP as well?

The crunch vote is on Tuesday. Many MPs are still making their mind up. So please forward this email to all your friends and family today - let them know how quick and easy it is to email your MP and tell them to vote to save the NHS.


---
Tuesday's email:

Dear Aron,

In just one week, your MP has to vote on massive changes to our NHS. But 38 Degrees members now have something our MPs don’t – thorough, independent legal advice about what these changes really mean.

Our expert legal advice is sobering. Despite the “listening exercise”, the government’s changes to the NHS plans could still pave the way for a shift towards a US-style health system, where private companies profit at the expense of patient care.

MPs are being told by the government that the NHS is safe. If they read our evidence, they’ll know that the spin doesn’t stand up. We can put them under massive pressure to vote to save our NHS. So we need to work together to get the legal advice to our MPs right now!

Email your MP now:
https://secure.38degrees.org.uk/email-the-evidence

Our independent lawyers identified two major problems in the new legislation:

The Secretary of State’s legal duty to provide a health service will be scrapped. On top of that, a new “hands-off clause” removes the government's powers to oversee local consortia and guarantee the level of service wherever we live. We can expect increases in postcode lotteries – and less ways to hold the government to account if the service deteriorates.
The NHS will almost certainly be subject to UK and EU competition law and the reach of procurement rules will extend across all NHS commissioners. Private health companies will be able to take new NHS commissioning groups to court if they don’t win contracts. Scarce public money could be tied up in legal wrangles instead of hospital beds. Meanwhile, the legislation lifts the cap on NHS hospitals filling beds with private patients.
So who are MPs going to listen to when casting their vote – you, or lobbyists from private health companies? This is our NHS, and it’s up to us to defend it. Email your MP now:
https://secure.38degrees.org.uk/email-the-evidence

It’s pretty extraordinary what we’ve managed to achieve together already. Nearly half a million of us have signed the petition to save the NHS. And after Andrew Lansley announced the last round of changes, thousands of 38 Degrees members immediately chipped in to get top independent legal advice on the new plans.

Barrister Rebecca Haynes found that the government's plans could pave the way for private healthcare companies and their lawyers to benefit most from changes, not patients. Another barrister, Stephen Cragg, found that we were right to be worried that Andrew Lansley was planning to remove his duty to provide our NHS.

This is the conclusion of a top legal team paid to have no other interest at heart but yours.

MPs vote in just seven days. Seven days to not only get the evidence, but be convinced there’s way too much public concern to ignore it. The good news is, with over 800,000 of us now armed with expert legal advice, we are just the people to speak up. Let’s give MPs from all parties the mandate they need to think again and vote against these changes to the NHS.
https://secure.38degrees.org.uk/email-the-evidence


Thanks,

Johnny, David, Cian, Becky, Hannah, Marie and the 38 Degrees team.


PS:
Thousands of us chipped in to pay for lawyers to get a clear understanding of Lansley’s new proposals. This shows what we can all do together to make a difference. Right now, we can use this evidence to tell our MPs to face down NHS changes in Parliament next Tuesday.
https://secure.38degrees.org.uk/email-the-evidence

NOTES
You can view the full report from the legal team here:
https://secure.38degrees.org.uk/nhs-legal-advice

[TonyGosling]

Brilliant! Millions died for justice in WWII and that's what the NHS represents.

[Disco_Destroyer]

Dear Aron,

The evidence from our independent legal experts has rattled the government. They've gone into spin overdrive in response. We've just got hold of an internal letter that was sent to all Lib Dem MPs from health minister Paul Burstow, which is full of mistakes!

The 38 Degrees office team has pulled together a point-by-point response to the letter. It sets out for Lib Dems where the government's arguments are inaccurate or misleading, and why they need to listen to their voters and stand up for the NHS.

Let's make sure every MP sees a copy of this response as they weigh up how to vote. Email your MP a copy now:
https://secure.38degrees.org.uk/email-lib-dem-mp-nhs

The government clearly thinks we're having an impact - that's why they've felt pushed to lean on Lib Dem MPs to ignore us. But the document isn't very convincing [1]. If we work together now, we can make sure they see the holes in the government's arguments - and make them realise their voters have seen them too.

The document is pretty dodgy. For example it totally ducks the issue of EU competition law, trying to reassure MPs by saying "the Bill does not change EU competition law." That's irrelevant - our legal experts explain how the NHS plans make it much more likely existing EU competition law will apply to our health service, favouring private health companies.

Let's make sure MPs see the facts as they weigh up how to vote next week:
https://secure.38degrees.org.uk/email-lib-dem-mp-nhs

It's pretty amazing to see it confirmed in black and white that our campaign is causing such a stir at the heart of government. It's just the latest proof of what we can do when thousands of us work together to stand up for the things that matter. So now let's keep the pressure on our MPs and make them realise their voters won't be impressed if they swallow the spin!

Email your MP now:
https://secure.38degrees.org.uk/email-lib-dem-mp-nhs


Thanks for being involved,

Johnny, David, Cian, Becky, Hannah, Marie and the 38 Degrees team.


Notes:
[1] From the Guardian: http://www.guardian.co.uk/politics/2011/aug/31/lib-dem-rebellion-healt h-bill?CMP=twt_gu
[2] Liberal Democrat misconceptions and inaccuracies are listed and corrected here: https://secure.38degrees.org.uk/NHS-lib-dem-responses
[3] You can view the original report from the legal team here: https://secure.38degrees.org.uk/nhs-legal-advice

[TonyGosling]

Lying lying lying - anyone would diagnose Lansley as extremely sick himself?
http://www.spinwatch.org/blogs-mainmenu-29/tamasin-cave-mainmenu-107/5 452-nhs-reforms-plunged-into-fresh-turmoil

Shirley Williams plunges NHS reforms into fresh turmoil
Liberal Democrat peer in new battle over health and social care bill, while secret emails fuel privatisation fears for hospitals
http://www.guardian.co.uk/politics/2011/sep/03/shirley-williams-nhs-re forms-turmoil
Toby Helm, political editor - observer.co.uk - Saturday 3 September 2011

The future of the government's health reforms has been plunged into fresh doubt as the Liberal Democrat peer Shirley Williams raises new concerns, and secret emails reveal plans to hand over the running of up to 20 hospitals to overseas companies. The revelations come as MPs prepare to return to Westminster on Tuesday for what promises to be a crucial stage of the flagship health and social care bill.
Baroness Williams, one of the original leaders of a Lib Dem rebellion against health secretary Andrew Lansley's plans – who appeared to have been pacified after changes were made over the summer – said she had new doubts, having re-examined the proposals. "Despite the great efforts made by Nick Clegg and Paul Burstow [the Lib Dem health minister], I still have huge concerns about the bill. The battle is far from over," she said.
Writing in Sunday's Observer, Williams raises a series of issues that she says must be addressed. Chief among them is a legal doubt as to whether the secretary of state will any longer be bound to deliver "a comprehensive health service for the people of England, free at the point of need".
Some critics of Lansley believe the Tories are bent on a mission to privatise the NHS, gradually handing it to the private sector. They fear that moves to end the legal obligation on the secretary of state to deliver comprehensive services may be a deliberate part of the process.
Concerns that ministers want more private involvement will be strengthened by details of email exchanges involving senior health officials about handing the management of 10 to 20 NHS hospitals to international private companies. The emails, which were made public following a freedom of information request and were obtained by non-profit-making investigations company Spinwatch, show that officials have been planning since late last year to bring in international companies. This is despite repeated insistences by both David Cameron and Nick Clegg that there will be no privatisation of the NHS. On 16 May, Cameron said: "Let me make clear: there will be no privatisation." Clegg said: "Yes to reform of the NHS, but no to the privatisation of the NHS."
One of the emails released by the department shows that officials at the private sector firm McKinsey, which advises ministers, were in active discussion about bringing in overseas firms to take over up to 20 hospitals in return for contracts running into hundreds of millions of pounds. An email to Ian Dalton, head of provider development at the Department of Health, who is heavily involved in the reform programme, in November last year talks about "interest in new solution for 10-20 hospitals but starting from a mindset of one at a time with various political constraints".
The emails show that McKinsey is acting as a broker between the department and "international players" that are bidding to run the NHS. The documents even lay out some of the conditions required by "international hospital provider groups" for running NHS hospitals. "International players can do an initiative if 500 million revenue [is] on the table." They also need to have "a free hand on staff management". The NHS would be allowed to "keep real estate and pensions".
.......

[Disco_Destroyer]

Today's a big day for your MP and our NHS.

Nick Clegg has called emergency talks today at 5pm, because he's worried that Liberal Democrat MPs (including yours) are preparing to revolt and vote against the government's changes to our National Health Service. [1] People power is working.

The news is reporting that support for this bill “hangs in the balance” and many MPs “will not decide until the crucial meeting” if they’ll back Lansley’s plans. They might even push for the bill to be scrapped to protect our NHS. [2]

Imagine your MP sitting in their office today, worrying about the big meeting and the vote. Every two minutes their phone goes, and each time it’s a 38 Degrees member from their constituency, telling them to stand up for our precious NHS. That could tip the balance, and send a clear signal to the government that this bill is heading for the dustbin of history.

The 38 Degrees website makes it easy to call your MP. Enter your postcode, and you’ll get their number, as well as ideas about what to say when they answer the phone. Make the call now:
https://secure.38degrees.org.uk/phone-your-lib-dem-MP

We’re not alone in protecting our NHS. Last week, the British Medical Association - which represents tens of thousands of doctors working in the NHS - said Lansley’s plans should be abandoned or "significantly amended". [3]

Every day, more and more people are demanding that this dangerous bill is scrapped. Nick Clegg’s crunch talks are proof that the bill’s success or failure is hanging by a thread. Tell your MP to be one of the courageous ones who speaks out against these changes - call them now:
https://secure.38degrees.org.uk/phone-your-lib-dem-MP

There are now over 430,000 38 Degrees members standing strong to protect our NHS. Together we’ve paid for expert legal opinions to expose what the government’s really planning. We’ve handed in our petition to nearly 200 MPs and chipped in over £90,000 to sound the alarm with newspaper ads.

During the Save our Forests campaign, tens of thousands of us tipped the balance by picking up the phone and telling our MPs to stop the forest sell-off. Now, we need to do it again to save our NHS.

The 38 Degrees website makes it easy to find your MP’s name and number, and there are tips and talking points from other 38 Degrees members to help you out in case you’re not sure what to say. Just click on this link to get started:
https://secure.38degrees.org.uk/phone-your-lib-dem-MP


Thank you so much, for everything you’ve done so far to save our NHS,

Johnny, Cian, Hannah, Becky, David, Marie and the 38 Degrees team


PS: From your postcode it looks like your MP is a Liberal Democrat. If that's wrong, let us know here: https://secure.38degrees.org.uk/contact-us

NOTES
[1] http://www.telegraph.co.uk/health/healthnews/8739621/Liberal-Democrat- talks-to-decide-which-way-to-jump-on-NHS-reforms.html or http://www.bbc.co.uk/news/uk-politics-14778406
[2]http://www.telegraph.co.uk/health/healthnews/8739621/Liberal-Democr at-talks-to-decide-which-way-to-jump-on-NHS-reforms.html
[3] http://www.guardian.co.uk/society/2011/sep/01/bma-letter-mps-nhs-refor m

[TonyGosling]

great stuff in the Guardian letters page following Sunday's brilliant Observer leaked article

Orwellian language of NHS 'reform'
guardian.co.uk, Tuesday 6 September 2011 20.59 BST
http://www.guardian.co.uk/society/2011/sep/06/orwellian-language-of-nh s-reform

Following the "listening exercise" triggered by widespread opposition to the original health and social care bill, the amended version has now reached its report stage and third reading (Clegg calls for probing questions on NHS bill, 6 September). Although much was made of the Lib Dem "demand" for its return in revised form to the committee stage, the undignified rush with which this has happened has not instilled confidence that this is a bill which has been carefully thought through or whose key proposals have been seriously abandoned or modified. Indeed, it appears that few MPs who have expressed themselves satisfied that their original concerns have been addressed have actually read and/or understood the amended bill.

The central problem with the bill is not the varying degrees of bafflement, unpopularity or downright hostility which it has engendered. It is that it threatens to bring to an end the NHS as an effective and successful public service and instead converts it into a form of competitive market not dissimilar to that operating in the utilities sector, without providing any convincing evidence that such a move will improve health outcomes. We, and other academics, remain totally opposed to the use of market competition in health, on the grounds that it will not lead to better outcomes or improve the public's health.

We are confronted with a bill best described as risky, ill thought out, and lacking a robust evidence base. We therefore support those calling for the bill to be withdrawn. Legislation is often imperfect, but is rarely as deeply flawed and high-risk as this offering.

Dr Sally Ruane Health Policy Research Unit, De Montfort University
Professor Martin McKee Professor of European public health, London School of Hygiene and Tropical Medicine
Professor Ruth McDonald Professor of healthcare innovation and learning, University of Nottingham
Professor Gareth Williams Professor of Sociology, Cardiff University
Professor Russell Mannion Professor of health systems, Health Services Management Centre, Birmingham University
Dr Alex Scott-Samuel Clinical senior lecturer in public health, University of Liverpool
Professor Stephen Harrison Honorary professor of social policy, University of Manchester
Professor Ian Greener Professor in the school of applied social sciences, Durham University
Professor Justine Schneider Professor of mental health and social care, Nottingham University
Professor Michael Calnan Professor of medical sociology, University of Kent
Dr Marianna Fotaki Reader in health policy and organisation studies, Manchester Business School
Professor John Mohan Professor of social policy, University of Southampton
Professor Rod Sheaff Professor of health services research, University of Plymouth
Professor Alison Macfarlane Professor of perinatal health, City University London
Professor Jennie Popay Professor of sociology and public health, Lancaster University faculty of health and medicine
Professor Calum Paton Professor of public policy (health policy), Keele University
Professor Peter Alcock Professor of social policy and administration, University of Birmingham
Professor David Gordon Professor of social justice, Bristol University
Professor Bernard Harris Professor of the history of social policy, Southampton University


• The response to your report (German firm lined up to take over NHS hospitals, 5 September) will, rightly, focus on the determination of ministers to deny a privatisation agenda. However, at least as important is the suggestion that the the workshop at which these plans were secretly discussed was described as "how international hospital provider groups may help to tackle the performance improvement of UK hospitals".

"Performance" is one of those words that means what its speaker wants it to mean. In the case of Helios, you rightly report that its performance is based on "cutting staff or wage levels. Local politicians have accused it of being motivated more by revenues than by patient care."

Such an approach ignores evidence suggesting that the way healthcare staff are treated and managed directly impacts on the quality of care and the health outcomes they achieve. Throughput is not the same as outcome.
Roger Kline
East Barnet, Hertfordshire

• Day after day you refer to the proposed changes to the health service as "reforms". Why are you colluding in this Orwellian misuse of language? To reform a system is to implement needed change for the better by removing existing shortcomings. To describe the proposed changes as reforms is to accept the very premises that you so rightly criticise.

As the philosopher George Lakoff so eloquently explains in Don't Think of an Elephant, professional conservative wordsmiths manipulate our choice of words so as to frame the debate on their terms. But you are also professional wordsmiths, and your role is to expose these tactics, not collude in them.
Paul Braterman
Professor emeritus, University of North Texas

• You quote sources close to Nick Clegg as saying: "We expect MPs to vote with the government. Otherwise we won't last very long [in power]." Are we to conclude from this that the Lib Dem leadership is willing to allow a dangerous and damaging bill to pass into law just to hold on to power? If so, then what is the point of being in power anyway? Let's hope there are enough Lib Dems with principles to stand up to this nonsense.
Hugh Dunkerley
Brighton

• Dr Anthony Isaacs asks for publication of Lib Dem MPs' views on changes to our NHS (Letters, 3 September). Views from all parties' MPs are online at bit.ly/rtryDj – and make interesting reading, particularly the contradictory ones from Tories.
Ian Lowery
Watford, Hertfordshire

• The main reason for the health and social care bill is to keepthe Tories in power. Just as the 1980 Housing Act was mainly about privatising council housing in the belief that new houseowners were more likely to be grateful to the government and vote Tory, so by privatising the NHS the new private health providers will prove their gratitude to the government bylarge donations to the Tory party. This bill is little shortof authorised corruption, as is the 'free school' revolution (Emails reveal hidden price of free schools, 30 September). But then what else can we expect from a bunch of pals educated in the Seldon public school for character-building (Toby Young has a point, 3 September)?
Tom Oliphant
Craghead, County Durham

• Let us be absolutely clear. The health and social care bill, if enacted, will fulfil the Tory-led government's aim to fragment and undermine our National Health Service. The principal provisions of the bill will push poorly informed patients (the advice of GPs on patient "choice" is expressly forbidden) into the hands of private commercial providers, already hovering to scoop up fees diverted from NHS hospitals and clinics. In consequence these latter will be starved of funds and there will be closures.

We know of course that the process of "marketisation" was begun under the New Labour government. We, the undersigned members of the Anjou Lunch Club, now implore Ed Miliband to recognise that this should never have happened and was utterly hostile to the founding principles of the NHS. We call on him to stand up and to speak out against this iniquitous Bill.

The Liberal Democrats, after early signs of dissension, seem now to have gone suspiciously quiet. It is plainly up to the Labour Party as the proud begetters of our NHS to alert the country to this imminent peril, and to lead a massive public campaign to bring down the bill and to save the NHS from privatisation.
Ena Abrahams, Rodney Barker, Edward Brandon, John Croll, Sonia Gable, Dr Agnes Kaposi, Chris Kaufman, Bernard Marder QC, Sylvia Marder, George Mercer, Sylvia Mercer, David Offenbach,Dr EM Passes, Rev Canon Julian Reindorp, Michael Seifert, Pat Sinclair
Members of the Anjou Lunch Club

• One aspect of the NHS reforms that seems to have received very little discussion is the effect of the changes on the training of junior doctors. If much of the more straightforward work is hived off to private providers, where will all the patients who are willing for their conditions to be taught over to come from? Will we be left with a generation of doctors with limited clinical skills? The teaching hospitals will doubtless be protected but most juniors gain their experience and expertise in straightforward district units. Juniors often find it hard to find good teaching posts as it is, but if these units go to the wall there will not be the jobs for juniors to fill.
Dr J Heber
Bishop Sutton, Somerset

[Disco_Destroyer]

The end of the NHS as we know it
www.guardian.co.uk
Colin Leys: The heath bill is the final stage of a project that began 25 years ago to turn this vital public service over to the private sector

http://www.guardian.co.uk/commentisfree/2011/sep/08/nhs-health-bill-pr ivate-sector

What Wednesday's vote on the health and social care bill shows more clearly than anything is that many, if not most, of the political elite no longer care whether they are carrying out the wishes of the electorate, and barely pretend that we are any longer a democracy.

[Disco_Destroyer]

Nine months ago, 38 Degrees members voted for a clear top priority: saving the NHS from the dangerous plans being forced through by health minister Andrew Lansley.

This week, those plans moved one step closer to becoming law, with the bill passing through the House of Commons. But we helped make sure it was close - nearly half of English Lib Dem backbenchers defied the government and refused to back the plans. [1]

That was an amazing achievement, and it means we're now in a great position to persuade the House of Lords - where the plans haven't been voted on yet - to strike out threats to our health service.

It's nowhere near over yet. 38 Degrees members are determined to keep working together to protect our NHS. So please click on the link below to take a quick survey which will help plan our next steps:
https://secure.38degrees.org.uk/help-decide-the-plan

Lansley's plans can't become law unless the House of Lords votes them through. One influential member of the House of Lords, Shirley Williams, is already on the record after reading our legal advice saying, "I still have huge concerns about the bill. The battle is far from over." [2]

She's joined by the Chair of the Royal College of GPs, who said this week that the current plans could lead to "an increase in damaging competition, an increase in health inequalities, and massively increased costs." The Royal College of Nursing added: "this bill risks creating a new and expensive bureaucracy and fragmenting care." [3]

We need a plan to make sure each member of the House of Lords hears these arguments. That will persuade them to vote to save our NHS. Take two minutes to help decide the plan now:
https://secure.38degrees.org.uk/help-decide-the-plan

Members of the House of Lords don't have to worry so much about toeing the party line because they're there for life, regardless. Many of them aren't even members of a political party. If there's enough pressure the Lords can change the plans themselves, or even block them altogether. [4]

Whilst this campaign is nowhere near over, it's worth remembering how much we have already achieved. Over the summer, it looked like the government might spin their way out of trouble with a half-hearted "listening" exercise. But together we chipped in for a independent legal advice which revealed what we'd suspected: the NHS plans still threaten our NHS.

Together, we did an incredible job getting the word out through emails and on the phone. We made sure MPs heard that the government were just papering over cracks in the health bill. We made sure there was a fierce debate in Parliament: 38 Degrees was mentioned 13 times! [5] And we made the headlines, including the front page of The Observer last Sunday. [6]

Lansley expected his plans to become law months ago. Working together we have helped stop that. Now let's decide how we can work together to change the debate in the House of Lords.
https://secure.38degrees.org.uk/help-decide-the-plan


Thank you for being part of this,

Johnny, Marie, Becky, David, Cian, Hannah and the 38 Degrees team


PS:
Should we organise more expert legal briefings? Would you be prepared to "adopt a Lord" and send them emails explaining our concerns? Is there a Lord or a Baroness with a special connection to your local area we should know about? Help decide the plan: https://secure.38degrees.org.uk/help-decide-the-plan

NOTES

[1] 14 out of 30 backbench Lib Dem MPs representing English constituencies (the plans won't directly affect Scotland and Wales) voted against or abstained from voting on the government's plans, with additional MPs voting for or abstaining on key amendments: http://www.publications.parliament.uk/pa/cm201011/cmhansrd/cm110907/de btext/110907-0005.htm

[2] http://www.guardian.co.uk/politics/2011/sep/03/shirley-williams-nhs-re forms-turmoil

[3] http://www.rcn.org.uk/newsevents/press_releases/uk/rcn_responds_to_pri me_ministers_comments_at_pmqs
Also see: http://www.hsj.co.uk/news/acute-care/dh-in-talks-for-international-pla yers-to-take-on-struggling-hospitals/5034587.article

[4] In 2008 the Lords forced the government to abandon plans to allow police to hold some suspects without charge for 42 days, after massive public outcry and opposition to the plans: http://news.bbc.co.uk/1/hi/uk_politics/7666022.stm

[5] Not all the mentions of 38 Degrees were complimentary! Some MPs accused us (wrongly) of misrepresenting the facts. See here for some responses to the rather rude things said about us by Andrew Lansley and some of his allies: http://blog.38degrees.org.uk/2011/09/08/save-our-nhs-what-lansley-said -in-the-house-of-commons/
http://blog.38degrees.org.uk/2011/09/07/busting-the-nhs-myths/

[6] http://www.guardian.co.uk/politics/2011/sep/03/shirley-williams-nhs-re forms-turmoil

[Disco_Destroyer]

Soon the House of Lords starts voting on Andrew Lansley’s dangerous NHS plans. They have a choice - will they force the government to make changes to protect our NHS? Or will they wave through plans that threaten our health service?

It's not going to be easy. But some key members of the House of Lords are already saying they have big concerns about the government's NHS plans. [1] If we work together, we really could persuade enough of them to vote the right way.

Here's the plan to protect our NHS:
- contact every member of the House of Lords about the need to make changes to the NHS plans
- put the Lords face to face with experts who can explain in detail why these NHS plans are so dangerous

The Lords start voting in just 2 weeks time - we’re on a very tight deadline to get this started. If enough of us chip in to raise £20,000, we can get going right now.

Click on the link below to find out more and help make it happen:
https://secure.38degrees.org.uk/nhs-lords-donate

Thousands of 38 Degrees members voted to decide our plan for persuading the House of Lords to protect the NHS. [2] £20,000 will mean we can put that plan into action. It will mean we can:

1. Pay for our legal team and other experts to hold briefing sessions in the House of Lords

2. Build a brand new “email a Lord” web tool to make it easier to contact a member of the House of Lords with messages about the NHS

3. Post letters to all 788 members of the House of Lords, setting out the problems with the NHS bill

4. Get fresh advice from our legal experts quickly if the government announces new changes to its proposals

The Lords start voting in just two weeks. Chip in now, and we'll get started this weekend:
https://secure.38degrees.org.uk/nhs-lords-donate

38 Degrees doesn't get big corporate donations or government funding. We rely on thousands of us all just contributing what we can afford. We can make a little money go a long way because our strength comes from the number of us involved rather than the size of our bank balances - but we still need some cash to put the plans into action.

In July, thousands of 38 Degrees members donated to pay for independent legal advice on Lansley’s plans. Our lawyers’ scary findings made the front page of the Observer and were discussed in Parliament. With thousands of emails and phonecalls, we helped persuade key MPs to vote to protect the NHS.

If we keep working together we can persuade the House of Lords to stop Lansley's threat to our health service - and ensure our NHS is kept safe for future generations.

Please donate whatever you can afford now:
https://secure.38degrees.org.uk/nhs-lords-donate


Thanks for being involved,

Johnny, Cian, David, Hannah, Marie, Becky and the 38 Degrees team


PS: The average donation to 38 Degrees is £14.13 - some of us give £1, some give £100. Donate whatever you can afford here: https://secure.38degrees.org.uk/nhs-lords-donate

Notes:
[1] http://www.guardian.co.uk/commentisfree/2011/sep/04/nhs-health-bill-an drew-lansley
[2] Read more about the poll results here: http://blog.38degrees.org.uk/2011/09/26/the-results-are-in/

[Disco_Destroyer]

Block The Bridge, Block The Bill - QuikPix
Published: October 09, 2011 21:28 by Tim Dalinian Jones |
Share
http://london.indymedia.org/articles/10363
Tagged as: cuts demo2011 free_spaces social_struggles workers_struggles
Neighbourhoods: westminster

[Disco_Destroyer]

Which way will they vote? This Wednesday the House of Lords makes a choice. They could wave through the government’s dangerous NHS plans. Or they could insist on proper scrutiny and big changes to protect our health service.

The press say it's on a knife edge. It could come down to one or two votes. [1] Together we can help tip the balance. If we can prove that the public wants Lansley’s plans put under the microscope, we can convince wavering Lords and Baronesses to stand up to the government and vote the right way.

Thousands of us have written personally to Lords and Baronesses. We know our message is starting to get through. Now let’s show wavering Lords just how many of us want them to vote to protect our NHS - by building a huge, people powered petition.

The vote is on Wednesday afternoon, and we'll need to deliver the petition just before it starts. Please add your name now:
https://secure.38degrees.org.uk/message-to-lords

An influential Lord, David Owen, has announced he will call a vote to put Lansley's NHS plan under the microscope, by creating a special 'select committee'. [2] The committee would investigate key concerns of ours - like scrapping of the Secretary of State's "duty to provide" health services. We can win this vote! And if we do, it will be a massive boost to our chances of stopping dangerous changes to the NHS being forced through.

The government doesn’t want this to happen. They're doing all they can to pressure Lords to toe the line. [3] We can outweigh that pressure with people power. Let's prove to the Lords that the government doesn't speak for us. We never voted for this dangerous NHS plan and we can show our support for Lords’ efforts to stop it.

Please take 30 seconds to add your name to the urgent petition to the House of Lords:
https://secure.38degrees.org.uk/message-to-lords

There's a lot at stake here. We all rely on the NHS to look after us and to look after our loved ones. We know that if the government's plans go through unchanged, we could lose our health service forever. The House of Lords could be our best hope of protecting our health service for future generations.

Thousands of 38 Degrees members have sent personal emails to Lords and Baronesses, telling them why the NHS matters so much. Now let's back that up with big numbers. Let's build a huge petition to the Lords to show them how many of us support efforts to protect the health service.

https://secure.38degrees.org.uk/message-to-lords


Thanks for being involved,

Johnny, Marie, Cian, David, Becky, Hannah & the 38 Degrees team


P.S. Yesterday, Lord Owen told Channel 4 News "I believe that if this Bill is introduced, in ten years’ time the NHS will be unrecognisable. It’s a great sadness to me.". Let's get behind his motion to stop that happening- add your name to the emergency petition now: https://secure.38degrees.org.uk/message-to-lords


NOTES

[1] See for example:
http://www.dailymail.co.uk/news/article-2047210/Controversial-NHS-refo rms-killed-peers-days.html
http://www.guardian.co.uk/politics/2011/oct/08/lords-kill-off-nhs-refo rms

[2] Lord Owen isn’t the only Lord who’s written an amendment to put the bill under the microscope, or stop it completely. But Lord Owen’s amendment has the greatest chance of success. The full text of Lord Owen's amendment reads:

“And that a Select Committee shall be appointed to examine and make recommendations to the House on the issues raised by the 18th Report of the Constitution Committee, namely the Government's and Parliament's constitutional responsibilities with regard to the NHS, in particular to clarify (a) the extent to which the Secretary of State remains responsible and accountable for the comprehensive health service, and (b) individual Ministerial responsibility to Parliament, and to report on the extent to which legal accountability to the courts is fragmented; that this House requests that the services of Parliamentary Counsel be available to the Committee; and that the Committee shall report no later than 19 December 2011.”

[3] http://www.telegraph.co.uk/health/healthnews/8816585/Health-bill-could -be-diluted-further-to-win-Lords-vote.html

[Disco_Destroyer]

"This is certainly disappointing. But over the last few days the 38 Degrees petition had a real impact, bringing the concerns of the public into the chamber of the House of Lords. It is not over yet. The legislative process will take several more months. It won't be easy but there's still a chance we can secure changes."
Lord David Owen, proposer of the amendment for a special scrutiny committee

Dear Aron,

It was close, but we lost the vote. 262 Lords voted in favour of a special scrutiny committee for the dangerous NHS plans. 330 voted against. If just 35 more Lords had voted the right way, we would have won.

Over 150,000 of us signed the emergency petition, in just 24 hours. It was all over the news. [1] Many Lords and Baronesses mentioned us in their speeches as they pledged to vote the right way. Lord Hunt stood up to announce how many of us had signed the petition and said: "That is but one small reflection of widespread concern within the community about the NHS." [2]

All across the UK we were crossing our fingers - could this be our breakthrough moment? But it wasn’t our day. The government managed to twist just enough arms for their plans to move forward to the next stage.

It’s nowhere near over yet. Lansley's NHS plans still have to pass several more crucial stages in the House of Lords. There will be more crunch votes and more breakthrough opportunities in the next three months. [3] One 38 Degrees member, Yvonne, summed it up on the 38 Degrees Facebook page:

“We may have lost the battle, but we have not lost the war!”

Here's what some other 38 Degrees members have been saying since the news came in:

Anthony: “Keep the spirit up, everything is possible.”
Emily: "Let’s see if we can facilitate LOCAL protests (not just the big city ones)."
Ivy: "Please people, keep campaigning, we mustn't lose this jewel in our crown."
Ann: "It seems there were about 150+ peers who did not vote; I wonder why and maybe we could target these next time?"
Adam: “The best option is for us to continue campaigning. There may be more amendments during the committee stage and third reading.”
Julie: “We have lost two battles but NOT the war...we actually got a lot of support from the cross benchers and some lib dems re supporting the Owen amendments, so the ground work has been done.”

You can join the conversation with other 38 Degrees members, and share your thoughts on lessons we've learned for next time, on the 38 Degrees Facebook page, on Twitter, or on the website.

In September, thousands of us helped write a people powered plan to influence the House of Lords. [4] Then thousands of us donated the money needed to get it started. [5] Really, we've only just started putting that plan into action – and we're already only 35 Lords short of a big breakthrough.

We did not have that breakthrough this week. But we saw that our strategy can work and we still have time to do more. We can send more messages, sign more petitions, pay for more briefings from legal experts and organise more local campaign events. We can work together to come up with new ideas for people powered tactics. If we keep going, there's a real chance we can change an extra 35 Lords' minds before the final votes in a few months' time.

Some Lords, particularly Liberal Democrats, said they wouldn't vote in favour of a special scrutiny committee because it was unnecessary. They claimed it will be possible to address 38 Degrees members' concerns by following the standard House of Lords procedure. [6] Now, we're going to have to do all we can to make them keep their word on this – it certainly isn't the time to give up!

We've done an incredible amount to sound the alarm about the threats our NHS is facing, and highlight all the reasons why having a public health service is one of the things Britain should be most proud of. It's obviously a bit depressing that yesterday's vote went the wrong way. But the fight is nowhere near over.

Dr Clare Gerada, Chair of the Royal College of GPs, contacted the office after the vote with this message for all of us: "Members of 38 Degrees have played an important role in speaking up for our NHS and highlighting concerns. Today's vote is by no means the end of the story, keep going!"


So let's keep going,

David, Hannah, Becky, Marie, Johnny, Cian and the 38 Degrees team


PS: One of the really exciting things to happen this week was that over 30,000 more people joined the Save Our NHS campaign. There are now well over half a million people involved. The more of us there are, the more we can do together and the bigger the impact we can have. You can help the campaign grow even bigger by forwarding emails like this to all your friends and asking them to get involved.

PPS: Andrew Lansley was expecting his changes to have been finalised 6 months ago. And together we've already reined in some of the very worst bits of Lansley’s plans. Click here for a quick recap of some of the things we have done together so far to protect the NHS:
https://secure.38degrees.org.uk/nhs-recap


NOTES
[1] The 38 Degrees petition was mentioned by many broadcasters and newspapers including BBC, Sky News, The Telegraph and The Guardian. See: http://blog.38degrees.org.uk/2011/10/12/nhs-lords-cant-miss-the-media- buzz/
[2] In the debate, Lord Hunt said: “This morning, I and my colleagues received from 38 Degrees a petition containing over 135,000 signatures collected in a very short space of time asking this House to protect the NHS and to ensure that the Bill gets proper scrutiny. That is but one small reflection of widespread concern in the community and the NHS...The scale of concern and mistrust among the public and the NHS is greater than I have ever known it before. Only this House now stands between safeguarding the NHS and these confused and damaging proposals.” See: http://www.publications.parliament.uk/pa/ld201011/ldhansrd/text/111012 -0001.htm#11101261001800
[3] http://www.independent.co.uk/life-style/health-and-families/health-new s/battle-for-nhs-reform-in-lords-is-just-beginning-2369713.html
[4] http://blog.38degrees.org.uk/2011/09/26/the-results-are-in/
[5] http://blog.38degrees.org.uk/2011/09/27/save-the-nhs-can-you-chip-in/
 [6] For example Lord Avebury’s response to a 38 Degrees member: http://action.38degrees.org.uk/node/40197

[TonyGosling]

BBC Question Time tonight - London audience in uproar about Andrew Lansley's carve up - time to remember Tamasin Cave's brilliant analysis

Just see what Tamasin Cave at spinwatch has dug up

THE HEALTH INDUSTRY LOBBY TOUR
Take a tour of Lansley's private healthcare supporters
19 January, 2011. Plans to radically change the NHS will be presented to Parliament by Health Secretary Andrew Lansley.
http://www.spinwatch.org/blogs-mainmenu-29/tamasin-cave-mainmenu-107/5 417-take-a-tour-of-lansleys-private-healthcare-supporters


and reminds me of the NHS rap from MC NxtGen - pass it round once more on yr lists pls

Andrew Lansley Rap

Link

http://www.youtube.com/watch?v=Dl1jPqqTdNo

[Disco_Destroyer]

It’s a moment to seize. This Thursday at 2pm, 38 Degrees will meet with key Lib Dem members of the House of Lords. [1] They’ve asked us to bring along our independent legal experts to discuss the alarming impact the government's plans could have on the NHS.

But that’s not all we will bring to the meeting. We’ll hand them a copy of the Save Our NHS petition to make them realise how many of us expect them to act to protect our health service. It’s the numbers of us involved with the campaign that forces politicians to listen.

You're already involved in the Save Our NHS campaign, but according to the database it looks like you haven't signed the Save Our NHS petition. [2] 443,251 have already signed - can you add your name before Thursday's meeting?

https://secure.38degrees.org.uk/Save-our-NHS

Thursday's meeting could be crucial. If we can persuade senior Lib Dems to demand big changes to Andrew Lansley’s plans, we could stop some of the worst damage to our health service. [3] The legal experts we paid for together will set out the legal details. But what will really convince the politicians on Thursday is the huge tidal wave of public support.

Our job is to let the senior Lib Dems know this isn’t a technical issue to be left to lawyers alone. There are hundreds of thousands of us determined to protect the future of our NHS. We all rely on the NHS. We can show the Lib Dem Lords we’ll work together to defend it as long as it is under threat.

It’s the numbers in this campaign that make them sit up and listen. So let's present them with a petition bigger than they’ve ever seen. We’ve already got 445,00 signatures. Can you take it over half a million?
https://secure.38degrees.org.uk/Save-our-NHS

We had a disappointing result in the first round of voting in the House of Lords last week, when the government's plans scraped through to the next stage. [4] But a 38 Degrees member named Richard summed it up when he said, “It is not yet over and any opportunity that presents itself must be used to pressure and attack Lansley’s plan for the NHS.”

Suzie, another 38 Degrees member, added, “This is just another skirmish. We may have lost this one but now we need to re-group and go forward again!”

So many of us have already signed this petition, because we know the NHS is worth defending. Together generations of British people have built and maintained a health service that looks after all of us - rich or poor, whenever we need it. The NHS isn’t perfect, but it does an incredible job. We can't afford to let it be damaged or destroyed.

Please add your name to the Save Our NHS petition, before 2pm Thursday:
https://secure.38degrees.org.uk/Save-our-NHS


Thanks for being involved,

Johnny, Hannah, David, Becky, Marie, Cian and the 38 Degrees team


P.S. Let's show the senior Lib Dem Lords that there isn't just independent legal evidence behind our worries about increasing competition from private health companies or scrapping the Secretary of State's "duty to provide" health services. Please sign and press forward on this email and ask your friends and family to add their voice:
https://secure.38degrees.org.uk/Save-our-NHS

NOTES
[1] The meeting will be with Baroness Jolly (the Lib Dem health spokesperson in the Lords), Lord Marks QC (a leading Lib Dem legal expert) and their political adviser.
[2] The Save Our NHS petition was launched in March 2011, and is ongoing. It's not to be confused with the "Emergency NHS Petition" which was in support of Lord Owen's amendment in the House of Lords on 12th October which ended last week.
[3] The plans go into committee stage in the House of Lords, a chance for 'line by line examination' and detailed changes, next week: http://services.parliament.uk/bills/2010-11/healthandsocialcare.html/
 [4] You can read more about what happened last week, and 38 Degrees members' reactions to it, here: https://secure.38degrees.org.uk/nhs-lords-vote-result

[Disco_Destroyer]

Good news. Yesterday we moved a step closer to stopping one of the worst bits of Andrew Lansley's NHS plan. It looks like we are on track to stop the health minister being able to wash his hands of legal responsibility for our health service.

The Guardian reports today that the government had to make concessions in the House of Lords, "in order to stave off an embarrassing rebellion from Lib Dem peers". There will now be further negotiations. The final vote on this issue will be in January at the earliest. It is "unlikely that the Lib Dem rebels will back down". [1]

It's not over yet. Nowhere near. We will need to get our independent legal experts to look very carefully at whatever the government does next. But this is a breakthrough. And a great sign of hope that people power can influence the House of Lords.

We voted together to make it a priority to stop Andrew Lansley scrapping his "duty to provide" health services. And we worked together to decide on the tactics we use to stop this happening. Slowly but surely our people powered campaign to protect the NHS is working.

38 Degrees members paid together for the independent legal advice which first set out the risks of scrapping the Secretary of State's duties. Thousands of us signed the emergency petition last month. And thousands more of us emailed Lords and Baronesses in the past two weeks.

We have taken some nasty abuse from politicians for our efforts. Andrew Lansley stood up in Parliament to accuse us of producing "propaganda". [2] A number of Conservative MPs contacted 38 Degrees members in their area to say we were liars. One Lib Dem Lord branded us all a "mob". [3] But now the government has finally been forced to admit that we have a point.

This is a small breakthrough on a huge issue. There is so much more to do to protect our NHS. Over the next few weeks the NHS plan will continue through "committee stage" in the House of Lords. We will need to push for other improvements like scrapping the "hands off clause" and reining in competition.

Then we'll have even bigger decisions to make. As the Lords gear up for final votes in early 2012, we will need to vote again on what we do together next. Should we push for further changes to Lansley's plan? Should we decide that it's still so far beyond improving that we have to make a last ditch attempt to stop it altogether? And if Lansley's plans do go through, what can we do together next to prevent the worst effects?

So, lots more to do together soon to protect our NHS – but a glimmer of hope today. Let's keep working together!


Thanks for being involved,

David, Hannah, Johnny, Becky, Marie, Cian and the 38 Degrees team


PS: 38 Degrees members have been discussing today's news on Facebook. For example Russell says, “Winning the war is about fighting many battles...little victories, some losses...as long as we have a strong cause!” If you use Facebook you can join the conversation here: https://www.facebook.com/peoplepowerchange


Notes:
[1] Guardian: NHS bill clause put on hold to stave off revolt by Liberal Democrat peers http://www.guardian.co.uk/society/2011/nov/02/nhs-bill-clause-hold-lor ds
BBC: Peace breaks out in the Lords on the NHS Bill - for now http://www.bbc.co.uk/news/uk-politics-15563602
FT: Govt in a flap over health bill in the Lords http://blogs.ft.com/westminster/2011/11/govt-in-a-flap-over-health-bil l-in-the-lords/#axzz1ce2iJ1sR
Politics.co.uk: NHS reforms: How to buy time in the Lords http://www.politics.co.uk/blogs/2011/11/02/nhs-reforms-how-to-buy-time -in-the-lords
[2] You can read what he said, and the 38 Degrees response, here: http://blog.38degrees.org.uk/2011/09/08/save-our-nhs-what-lansley-said -in-the-house-of-commons/
[3] http://www.guardian.co.uk/commentisfree/2011/oct/20/38-degrees-lords-n hs-bill

[TonyGosling]

The firm that is hijacking the NHS: Investigation reveals extraordinary extent of international management consultant's role in Lansley's health reforms
- McKinsey & Company paid for NHS regulator staff to go to lavish events
- Many Health and Social Care Bill proposals drawn up by the company
- Document shows it has used access to share information with other clients
- McKinsey also worked closely with previous government and on disastrous Railtrack privatisation under John Major
http://www.mailonsunday.co.uk/news/article-2099940/NHS-health-reforms- Extent-McKinsey--Companys-role-Andrew-Lansleys-proposals.html

Dr Phil Hammond: 'Killing The Nation', Lansley & McKinsey Inject Poison Into NHS

McKinsey is already benefiting from contracts worth undisclosed millions with GPs arising from the Bill. It has earned at least £13.8 million 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.

AUDIO: Dr Phil Hammond Petrie Hoskins on Diabolical Health & Social Care Bill - mp3 6.9M
http://indymedia.org.uk/media/2012/02//492296.mp3

More Chaos theory
by Dr Phil Hammond - Jan2012
http://drphilhammond.com/blog/2012/01/26/private-eye/medicine-balls-pr ivate-eye-issue-1306/
When MD asked health secretary Andrew Lansley to reduce his unintelligible 358 page health bill to 140 characters or less, he wrote: ‘Putting patients and their doctors and nurses in charge, accountable for the results they achieve.’ Some staff were initially won over by the promise of liberation from political meddling, less bureaucracy and more control over how the money is spent. But while most now long to be liberated from Lansley, they’ve now realised there is no freedom if you’re shackled to an unelected economic regulator, Monitor, and an unelected National Commissioning Board. Worse still, the complexities of competition law and competitive tendering are likely to make the NHS more bureaucratic, not less. And it’s the economists who’ll be in charge, stupid.
http://indymedia.org.uk/en/2012/02/492295.html

[TonyGosling]

NHS fairness tsar urged to quit by doctors over 'conflict of interest' following £799,000 payment for U.S. private health giant
http://www.dailymail.co.uk/news/article-2109907/NHS-fairness-tsar-urge d-quit-doctors-conflict-following-799-000-payment-U-S-private-health-g iant.html

By David Rose

Last updated at 2:08 AM on 4th March 2012

Questions: Lord Carter, is facing questions after it emerged he has received large payments from a health service business

The head of the NHS regulator that is meant to ensure fairness when private-sector firms bid for public contracts is also the chairman of a huge company whose Health Service business is worth £80 million a year – and set to increase massively.

As the chairman of the NHS Co-operation and Competition Panel (CCP), Lord Carter of Coles is paid £57,000 for two days’ work each week. But his other role, as chairman of the UK branch of the American healthcare firm McKesson, is more generously rewarded. Last year it paid him £799,000.

Even this is not the end of Lord Carter’s private healthcare interests. He is chairman of the Bermuda-registered Primary Group Ltd, a private-equity investment company that owns big slices of other healthcare firms.

And he is an adviser to Warburg Pincus International Ltd, another investment fund with large health interests. His income from these sources is not publicly disclosed.

The CCP describes itself as ‘an independent, transparent and effective advisory body... committed to using fair and transparent processes’.

If the controversial Health And Social Care Bill, now making its way through the House of Lords, becomes law, it will be merged with another NHS body, Monitor.

However, a CCP spokesman said yesterday that its existing functions and personnel will simply ‘move across’. Its significance will grow enormously because under the Bill, private-sector companies are set to carry out NHS work on an unprecedented scale, making the competition regulator more important than ever.

Last night doctors’ leaders said Lord Carter’s dual role was untenable and called on him to resign from the CCP.

Dr Clare Gerada, chairman of the Royal College of General Practitioners, said: ‘He cannot have any credibility when he is also heading a company with such huge interests in the very contracts his organisation is meant to police. GPs are being minutely scrutinised for possible conflicts of interest. But if we are going to have to have transparency it has to apply throughout the system.’


Big business: American healthcare firm McKesson is worth £80m-a-year and has paid Lord Carter, the head of the NHS regulator, £799,000

Dr David Nicholl, a consultant neurologist from Birmingham and leader of a campaign against the Bill at the Royal College of Physicians, said: ‘You simply can’t have someone doing this job who is also involved in private healthcare to this extent. Lord Carter has a clear conflict of interest.’

The Mail on Sunday made repeated approaches to McKesson, which said Lord Carter was unavailable for comment.

A dapper, softly spoken figure with a penchant for dark Savile Row suits and pink shirts, Lord Carter discussed his role as a regulator in a rare interview with the King’s Fund health think-tank in 2009.

He said: ‘The word I stress time and time again is transparency. I always work on the basis that when you’re doing anything, contracting, procuring, merging, that the public will peer into it at some point.’

He added that he believed that private-sector competition for NHS contracts was bene-ficial because it encouraged fresh ideas, especially if the firms involved happened to be based abroad.

‘Looking outside to the independent sector, looking to bring in solutions from other countries, is one of the good ways to bring in innovation,’ he added.

Yesterday a CCP spokesman insisted there was no conflict of interest because Lord Carter never ruled on contracts involving firms with which he was involved, while he had also declared his McKesson role when he was appointed to the CCP in 2008.
'He steps down from any investigation where there is potential conflict of interest.
'He was appointed for his experience in this area.
'The CCP has a track record of making objective assessments.'

The spokesman said: ‘He steps down from any investigation where there is potential conflict of interest. He was appointed for his experience in this area. The CCP has a track record of making objective assessments.’

Lord Carter, 66, is said to be a consummate operator in both business and Whitehall. He was made a Labour peer by Tony Blair in 2004 and he was best man to former Justice Secretary Jack Straw at both his weddings.

His close New Labour connections saw him lead numerous policy reviews before the last Election, such as those which recommended cuts to legal aid.

Later this month, the CCP is set to publish an investigation with big implications for the NHS’s future – a complaint brought by Virgin Healthcare over a contract for physiotherapy and orthopaedic services in North Yorkshire.

Virgin – known as Assura until it was bought last week by Sir Richard Branson – claims that it was unfairly discriminated against because the NHS trust that won the contract offered an ‘unrealistic’ lower price.

There is already evidence that Lord Carter and one of his former colleagues can have difficulty in keeping the public and private sectors separate.


Last summer, documents obtained by Spinwatch under the Freedom of Information Act disclosed that the former CCP chief executive, Andrew Taylor, helped an alliance of private firms draft a letter to the Department of Health asking for an investigation into alleged ‘maverick behaviours’ by NHS trusts, claiming they were facing discrimination in the awarding of contracts.

The investigation was carried out by Mr Taylor’s and Lord Carter’s own organisation, the CCP – and in a boost to the Government’s case for the Health Bill, it found that the lack of private-sector involvement was making some patients wait too long for treatment.

Later, Mr Taylor was in email contact with the same firms, advising them to lobby the Government to beef up com-petition regulation once the Bill became law.

He has now left the CCP. Since last September, he has been working for Lord Carter at McKesson as operations vice-president ‘responsible for driving McKesson UK’s organisational strategy and business operations, delivering financial and operational excellence’ – in other words, how best to profit from the Health Bill.

McKesson’s spokesman said Mr Taylor was unavailable for comment.

At present, McKesson, the 15th-largest US company, is one of the biggest suppliers of information technology to the NHS and runs its national payroll system – so paying the salaries of 1.4 million people.

However, in the US it has been involved in both criminal and civil fraud cases, including multiple court judgments and awards of damages running into hundreds of millions of dollars for defrauding the American state-run health programmes Medicare and Medicaid.

In a case in Nevada last year, it was one of three companies against which damages of $162.5 million were awarded after patients caught hepatitis C from routine colonoscopies.

Last year McKesson’s former world chief executive, Charles McCall, lost his appeal against a ten-year jail sentence imposed in San Francisco for one of the biggest corporate frauds in American history, which cost shareholders $8.6 billion.

[TonyGosling]

Nick Clegg the non-leader PR front leader who can no longer lead with any credibility
well done LibDems - well done democracy

Lib Dems refuse to back NHS reforms
(UKPA) – 55 minutes ago
Liberal Democrats have refused to fully endorse controversial reforms of the health service in a blow to party leader Nick Clegg.
Critics of the NHS overhaul hijacked a pro-change motion at the party's spring conference. Activists voted 314 to 270 to remove a crucial line calling for peers to back the final stages of the Health and Social Care Bill.
The move demonstrates the continuing strength of opposition within party ranks to the controversial health service.
But the result does not oblige the Lib Dems to "kill the Bill" as opponents had pushed for on Saturday.
The Deputy Prime Minister escaped the potential embarrassment of an outright bid to enshrine withdrawal of the Bill in party policy after members rejected a rebel motion.
But he watched on in the conference hall as Lib Dem activists lined up to criticise the NHS shake-up and eventually reject the call in the "Shirley Williams motion" for peers to support the legislation in its final stages.
Baroness Williams, an early critic who later gave the Bill her backing after securing a raft of changes, has been seen as vital in helping to reach out to disgruntled party members.
She told conference she believed the Bill represented the "greatest step forward" in saving the NHS.
"We have stopped the process of privatisation. I wouldn't be standing here if I believed for one moment it undermined the NHS," she said.

[TonyGosling]

this is what happens when you privatise health - you get untrained nurses on the cheap - this is how private companies do it cheaper - a salutory lesson indeed for these fascist times

Pictured: The moment paralysed man was left brain-damaged after bungling nurse 'turned off his life-support machine'
http://www.dailymail.co.uk/news/article-1323510/Jamie-Merrett-left-bra in-damaged-nurse-Violetta-Aylward-turned-life-support-machine.html
By Jenny Hope and Paul Bentley
UPDATED: 13:14, 26 October 2010
This is the moment when an agency nurse working for the NHS turned off her patient’s life support machine by mistake.
Her devastating actions, captured on a camera Jamie Merrett had installed by his own bed, left the 37-year-old with severe brain damage.
He was starved of oxygen as the untrained agency nurse panicked and struggled to work basic resuscitation equipment....
....His sister Karren Reynolds, who discovered the footage on his computer, said: ‘He doesn’t have a life now. He has an existence but it’s nowhere near what it was before.’
Referring to the footage, she told the BBC’s Inside Out programme: ‘The point at which the carer gives the nurse the Ambubag [resuscitation equipment] and she says, “What do I do with this?”.
‘You know things are going to go really wrong from then on in. I can’t imagine what Jamie must have been thinking. He said to me later, “Did you see me praying?”.’
Katherine Murphy, of the Patients Association, said: ‘The NHS has been warned repeatedly about ensuring the staff it hires, agency or otherwise, were suitably trained to look after their patients.’
A confidential report by Wiltshire social services, leaked to the BBC, concluded the agency was aware it should supply a nurse trained in ventilator care, but had no system for ensuring this happened.
Seamus Edney, Mr Merrett’s solicitor, said: ‘In my experience this is the worst case of negligence on the part of a nurse.’
Miss Aylward has been suspended while the Nursing and Midwifery Council investigates.
Ambition 24hours, the agency which supplied her, said it was not able to comment as an internal investigation was ongoing.
NHS Wiltshire Primary Care Trust said it had ‘put in place a series of actions to ensure such an event will not occur again’.

[TonyGosling]

As she signs on the dotted line and passes this Health And Social Care bill into law, legislation designed by the City to bomb Britain back to the stone age, the Queen gives a Diamond Jubilee speech about how much Britain is all about neighbourliness and caring for others.
One thing I notice is how every single article of the 40 odd I've looked at today praises our psycho-queen to the heavens.
What a lily-livered elitist lot our royals and MSM are.

And her new £85k window is dominated by the lion and the unicorn of Babylon - where is Cyrus when you need him?

This is the only page I found with any hint of criticism:
Politics live blog: MPs debate health bill and Queen addresses Parliament
http://www.guardian.co.uk/politics/blog/2012/mar/20/health-bill-andy-b urnham-queen

[Disco_Destroyer]

[TonyGosling]

The evil evil greedy greedy b****** at the private healthcare industry just did in one of the greatest achievements of mankind.

And so it came to pass. Despite near universal professional opposition and strong political pressure, the Section 75 regulations that explicitly open up the NHS to competition law were approved in the House of Lords last week. A three-line whip on Liberal Democrat peers ensured a majority of over a hundred, with Baroness Shirley Williams speaking warmly of "an exciting new direction" for the NHS. The rage expressed across social media forums is unlikely to disappear but what can opponents do next?

The NHS and the Section 75 regulations: where next?

What can opponents do now that the regulations have been approved?
http://www.guardian.co.uk/healthcare-network/2013/apr/30/nhs-section-7 5-regulations-where-next

Bob Hudson
Guardian Professional, Tuesday 30 April 2013 08.30 BST

The Section 75 regulations that open up the NHS up to competition law were approved in the House of Lords. Photograph: AFP/Getty Images

And so it came to pass. Despite near universal professional opposition and strong political pressure, the Section 75 regulations that explicitly open up the NHS to competition law were approved in the House of Lords last week. A three-line whip on Liberal Democrat peers ensured a majority of over a hundred, with Baroness Shirley Williams speaking warmly of "an exciting new direction" for the NHS. The rage expressed across social media forums is unlikely to disappear but what can opponents do next?

The most obvious route is national politics. Given the unlikelihood of the National Health Action party making any significant inroads, it is to the Labour party that hopes will turn.

On the surface the signs are encouraging. According to its most recent policy paper on the matter, Labour is committed to repealing those parts of the Health and Social Care Act that force competition into healthcare, and will return to the NHS the status of 'preferred provider'. This is a reassuring stance but one with three weaknesses:

• Labour needs to win an overall majority at the 2015 general election – it cannot rely on a possible coalition with the Liberal Democrats to deliver on these pledges.
• Unless it ends the purchaser-provider split and brings foundation trusts back into a public sector 'NHS family' it will still be exposed to competition law – and it has not pledged to do this.
• By 2015/16 private companies could be well-entrenched in the NHS with long-term contracts that would be expensive and legally difficult to cancel.

This does not mean that opponents must simply wait and hope for the best. The task now is one of damage limitation in the short term with a view to political change in the medium term – but how? The answer may lie in calling local NHS commissioners to account in a way that has never been possible since Bevan's centralised NHS model triumphed over Herbert Morrison's municipalist vision in the 1940s.

Accountability of local NHS services to local people has always been problematic. Representative accountability was rejected in the 1940s (when local authorities lost their municipal hospitals) and again in the 1970s (when community health services were transferred from local government to the NHS). In place of this a range of ineffective local patient forums have been and gone – CHCs, PPI Forums, PALS and LINks. Few believe the latest incarnation – Local Healthwatch – will constitute an improvement. The only real option left by this accountability vacuum is to exert direct public pressure on the main local commissioners of healthcare – clinical commissioning groups (CCGs).

Whereas few people had ever heard of primary care trusts , the government has now declared that local GPs are in charge of the NHS. There is now a recognisable point of accountability, and general practice is embroiled in the hurly burly of politics — including the awarding of contracts to private companies.

How will CCGs respond? Some will be pro-privatisation – many CCG board members have private company interests and these must be exposed and challenged. Others will reflect the majority view of GPs, one of opposition to the privatising measures in the NHS Act. It is here that the opportunity exists to form an alliance with those campaigning for a public sector NHS, but to do so will require investing in forms of public engagement hitherto unattained.

Current models of engagement such as patient reference groups in GP practices and set-piece consultation meetings are not up to the job. Better options could include:

• Setting up a representative local 'civil assembly' – a more robust version of the foundation trusts governors model – to act as a sounding board for CCG decision-making.
• Involving patients in the performance monitoring of commissioned services – a local version of CQCs 'patients by experience' programme.
• Citizens panels and juries to explore specific service proposals – putting debates on service provision out into the open rather than keeping them behind closed doors.
• Developing local community health champions and patient leaders, drawing on the unused social assets that exist in all communities.

None of this will be without cost but CCGs need to look upon it as an investment. By engaging the public every step of the way – in planning, commissioning and, contracting, delivering, monitoring and evaluating local healthcare – they will secure greater legitimacy for their decisions. Moreover this process will expose private sector bids to the public gaze, and no private company enjoys this sort of attention. And of course this would all be in line with what is claimed to be the fundamental tenet of the NHS changes — 'no decision about me without me'.

This article is published by Guardian Professional. Join the Healthcare Professionals Network to receive regular emails and exclusive offers.


http://www.bcfmradio.com/wp-content/Podcasts/20130503170001.mp3
http://www.bcfmradio.com/wp-content/Podcasts/20130503180001.mp3

[TonyGosling]

GPs who hit the 111 jackpot: It's the helpline that's meant to save patients like baby Axel. But as this devastating dossier reveals, the biggest beneficiaries are the fat cat doctors who made millions from a firm that runs it
Harmoni, Britain’s largest urgent care provider, has been sold for £25 million
The GPs’ co-operative was formed in Harrow, North London in 1996
All of the five doctors who founded it are now millionaires
Firm is expanding massively despite claims it is stretched to breaking point
Last year, it was sent out 'Mayday' texts to doctors, begging them to work
http://www.dailymail.co.uk/news/article-2336000/GPs-hit-111-jackpot-It s-helpline-thats-meant-save-patients-like-baby-Axel-But-devastating-do ssier-reveals-biggest-beneficiaries-fat-cat-doctors-millions-firm-runs -it.html
By Zoe Brennan

PUBLISHED: 23:28, 4 June 2013 | UPDATED: 07:41, 5 June 2013


So what is Harmoni? And how have ordinary GPs managed to pocket so much money, at the same time as horror stories about out-of-hours care have spiralled out-of-control?

In order to answer those questions, we must go back to 1996, when a group of doctors founded a GPs’ co-operative in Harrow, North London.

When, in 2004, the New Labour government negotiated controversial new contracts with GPs, allowing them to opt out of evening and weekend care for a pay cut of just £6,000, this co-operative stepped into the gap.

Harmoni became a pioneer in what is termed ‘telehealth’ — an umbrella term used to describe treating patients with the help of telecommunications technology. The company acquired private equity backing, and went from strength to strength.


Devastated: Axel's mother Linda Peanberg was placed in a queue with her dying son in her arms

In particular it has won the lucrative contracts for more than a quarter of the nation’s new 111 non-emergency medical call-lines, which are the centre of a growing scandal over the quality of patient care.

As we shall see, however, this is not just an issue of service: it is also about the huge profits these changes to the NHS are generating for certain individuals.

Some of Harmoni’s 111 contracts have already begun, others are being rolled out. One contract alone — for providing 111 cover for Sussex, Kent and Medway — is worth £28 million. This contract was awarded to Harmoni in partnership with the South-East Coast Ambulance Service (SECAmb).

In total, Harmoni makes £100 million a year from NHS contracts, and will soon care for 15 million patients outside opening hours.

Yet although Harmoni is being paid huge amounts to provide this service, it does not seem to translate to a high standard of care. A whistleblower who had worked as a Harmoni GP recently revealed that the company was using one nurse to cover 250,000 patients.

The whistleblower also said that doctors are being paid £1,350 a shift — £150 an hour — to plug gaps in the service, and European locums with poor English were flying in on easyJet to cover shifts.

In Saturday’s Mail, another whistleblower who works for the 111 helpline revealed that call-centre workers were being told to keep patients in the dark about how long they would have to wait to see a doctor, saying that ‘a doctor will be with you as soon as he can’ when they know it won’t be for up to 14 hours.

Last year, it emerged that Harmoni was regularly critically understaffed to the point of being unsafe, and was sending out ‘Mayday’ texts to doctors, begging them to work.

Little wonder the whistleblowing GP said that working for Harmoni was like sitting with a loaded gun about to go off, adding: ‘Everything is secondary to meeting budget.’

For some patients, this catastrophe has already happened.

Patients like Axel Peanberg King — a seven-week-old baby with pneumonia — whose case was downgraded from ‘urgent’ to ‘routine’ after a telephone consultation with an out-of-hours GP unit run by Harmoni. He was made to wait for four hours at home before an appointment at a clinic was arranged.

When his mother finally arrived at the emergency clinic with her dying son in her arms, she was placed in a queue, and her desperate pleas for help ignored.

Axel’s deteriorating condition was eventually spotted by an off-duty paediatric nurse — but it was too late to save him.

The coroner said he died as a result of ‘wholly inadequate’ decisions made by the out-of-hours doctor, but added that it was impossible to say whether earlier intervention would have averted the family’s tragedy.

The fact that blame was not laid squarely at the door of Harmoni in this case is legally important, of course — but of little consequence to the grieving family left feeling that their baby was let down.

Despite accusations that Harmoni is already stretched to breaking point, the organisation continues to expand at a rate of knots.

Last November — just after Axel died — Harmoni was sold to a company called Care UK for £48 million. It was at this point that the GPs who founded the company involved cashed in.

Harmoni’s finances are complex, but the Mail has established that the five doctors who founded the company in 1996 are all now millionaires, after a deal with a private equity company saw turn-over increase from £3 million in 2004 to £100 million last year.

As a result of the sale to Care UK, one Harmoni founder, Harrow-based Dr David Lloyd, is estimated to have made at least £2.8 million. A father of three, he still works at the Ridgeway GP practice in Harrow, yet seems to enjoy the fruits of his labour.


On a break in Arles, France, he enthusiastically tweeted about the beautiful ‘light’ and exclaimed ‘What a nice villa!’

Another Harmoni founder, Kenyan-born Dr Nizar Merali, also received an estimated £2.8 million from the deal.

He lives in a £2 million detached house in North London. Tellingly, when asked why he decided to sell the company, Dr Merali cites the case of a German locum, working for a provider taken over by Harmoni, who gave a pensioner a fatally high dose of morphine in 2008.

Dr Merali, 60, told the Mail: ‘Just like that incident, any out-of-hours provider at any time, in any part of the world can be unlucky, and incidents can occur such as those.

‘There was a degree of responsibility resting with me at the top end, as the only clinical doctor on the board. And really, the responsibility was too much.’

Pointedly, he added: ‘I have not regretted it; all those things you hear in the news are absolutely valid.’ However, Dr Merali insisted that he and his fellow founders did not make outlandish sums of money.

‘There are lots of costs involved before the money is in your pocket,’ he said.

Nor are the Harmoni founders the only ones to benefit from the company’s sale.

In addition, some 500 GPs working as out-of-hours doctors for Harmoni gained £25,000 each, received in February. As Dr Merali joked: ‘Hopefully, they will all be able to buy BMWs for their spouses.’

Of course, some may question whether the health budget should end up lining the pockets of individuals wealthy enough to splash out on luxury cars.

It doesn’t seem to be something which troubles former directors of Harmoni, such as Drs Adrian Richardson and Thomas Davies, who were reported to have earned £1 million each from the sale.

Dr Richardson still works as a GP in Willesden, North-West London. He lives in fashionable Hampstead Garden Suburb, on a leafy street of houses worth £2-3 million apiece, with his wife, Alison, and their two teenage children.

Dr Davies now lives in an attractive £2 million property set in extensive grounds in Northamptonshire. The five-bedroom farmhouse has commanding views of the countryside and a bespoke gym. Dr Davies also owns a stable of racehorses.

On a website for his GP practice in Hillingdon, he says: ‘Away from the practice, hobbies include breeding thoroughbred horses, gardening and messing about on boats.’


Harmoni's website boasts of the firms 15 years experience in delivering out of hours service

Obviously not short of a few pennies, in 2006 Davies and his racing partner turned down an offer of £1 million for Speciosa, their winning thoroughbred — which they had bought for just £30,000.

Another Harmoni director, Dr Ian Goodman, is also believed to have made more than £2 million from the sale, and now lives in a £1 million home in Stanmore, Middlesex, with his wife, Elizabeth, and their teenage son.

Dr Goodman chairs the Hillingdon Clinical Commissioning Group (CCG), which is responsible for buying health services for local people using public funding, and was recently accused by an MP of trying to put so many NHS operations out to tender to private companies that it ‘would have destabilised the whole hospital’.

But this is not simply about Dr Goodman and a few other doctors who, like him, got ‘lucky’ selling Harmoni.

It reflects the murky connections and conflicts of interest which define in this new Wild West landscape of privatised medical care.

The British Medical Journal has revealed that more than a third of GPs on the boards of Clinical Commissioning Groups in England have a conflict of interest resulting from directorships or shares held in private companies such as Harmoni.

Andy Slaughter, Labour MP for Hammersmith, says: ‘The people who are making decisions on closing A&E units are the same people who, in many cases, have shares in the possible eventual providers for the services they are replacing.

‘This is the bulk of NHS spending they have in their hands. It is either a touching naivety in the system, or worse.’

Private equity firms ‘see it as a massive opportunity’, he adds. He says he believes some of the figures reported after the Harmoni sale were ‘low estimates’ of the profits made by individual GPs, and the situation was ‘very opaque’.

Nor is that the only murky issue. The former chairman of Care UK, which owns Harmoni, is venture capitalist and Conservative Party donor John Nash, who donated £21,000 to the personal office of Health Secretary Andrew Lansley in 2009.

It’s certainly a booming business. The operating profits of Care UK soared by several millions of pounds last year, which fed back to the firm’s ultimate owners, a private equity firm called Bridgepoint Capital.


Expanding: In total, Harmoni makes £100 million a year from NHS contracts, and will soon care for 15 million patients outside opening hours

And who is the chairman of the advisory committee at Bridgepoint? Why, none other than former Health Secretary Alan Milburn — the same man who was at the helm up to 2003 when negotiations were going on with GPs prior to their contracts being changed so they no longer had to work at nights and weekends, effectively ushering in the era of private firms operating the NHS’s out-of-hours services.

His secretary confirmed his role at the equity company, though a spokesperson for Harmoni insisted that ‘Alan Milburn does not work with Harmoni’. No, he just advises the company that owns it.

There are further intriguing links which are only now emerging.

A man named Jim Easton was on the NHS Commissioning Board, which oversees England’s NHS budget (£95.6 billion for 2013-14).

It was responsible for the procurement process for the new NHS 111 services, in which Harmoni was so very successful.

In October last year — after enjoying an exotic holiday in Egypt, which he documented on his Twitter page — Easton resigned from the NHS Commissioning Board to become the healthcare managing director of . . . Care UK, the company that took over Harmoni just a month later.

He said the new role was an opportunity ‘too good to miss’. Little wonder, given Care UK’s turnover is projected to hit £700 million.

Yet the company makes so much money by keeping its costs terrifyingly low. Its subsidiary, Harmoni, is recruiting call operators in the London area, offering a rate of £9 an hour. Alarmingly, candidates for the post of ‘health adviser’ — working on the 111 lines — do not need prior medical knowledge, and are given basic four-week training.

Harmoni protests that it provides a robust system, yet the company’s stock response will offer little consolation to those who believe their loved ones have died as a result of the chaotic out-of-hours system.

A spokesman for the firm says: ‘We would like to express our deepest sympathy to those families who lose a loved one in any circumstances.

‘Sadly, any large health care provider like Harmoni will be involved over time in the care of some patients who then die, making it essential to understand the causes of death and any lessons for the service.

Harmoni always undertakes a detailed review of the circumstances surrounding such deaths to see what, if any, lessons can be learned. ‘However, we firmly believe we have the right underlying systems, policies and procedures to ensure a safe and robust out-of-hours service.’

As we have seen, many families who have used their services take a very different view. The mother of little Axel Peanberg King, who died of pneumonia, says: ‘It all feels very sinister when you begin piecing it together — there are so many vested interests in healthcare now.

‘A lot of decisions are made with financial interests in mind.

‘I am not surprised there is a whole fracas over 111. You speak to call handlers who are not medically trained. I don’t understand how they think they can get untrained people to tick boxes — that is not medicine.’

[TonyGosling]

World’s largest private healthcare company HCA plans expansion into NHS
http://www.independent.co.uk/life-style/health-and-families/health-new s/worlds-largest-private-healthcare-company-hca-plans-expansion-into-n hs-8659439.html

Paul Gallagher - Friday 14 June 2013 - Independent

The world’s largest private healthcare company co-owned by the assets management firm whose profits helped fund Mitt Romney’s presidential campaigns is looking to expand further into the NHS, according to newly published documents by the Competition Commission.

The Hospital Corporation of America (HCA) already caters for around half of all private patients in London and runs three joint NHS ventures, renting building space from public hospitals for exclusively private treatment. HCA told the commission’s ongoing investigation into the private healthcare market that it wants more NHS partnerships.

Although Mr Romney stepped down as the head of Bain Capital in 1999, he received a share of the profits in 22 new funds created by the firm during the next 10 years as the company’s assets grew 20-fold. The governor of Massachusetts negotiated a retirement agreement with Bain that has paid him a share of its profits ever since, bringing the Romney family millions of dollars in income each year aiding his political aspirations. The information was revealed after Romney was forced to publish his financial disclosure documents during the 2012 presidential campaign.

Merrill Lynch, Kohlberg Kravis Roberts and Bain Capital completed its $31.6bn acquisition of HCA in 2006. They invested $1.2bn each with borrowed money for the rest. Financial analysts predict the private equity firms will eventually treble their initial investment by the time they sell all their shares - a process they have begun with Bain and KKR selling $2.5bn worth of stock in March.

HCA International Ltd, its UK arm which runs the Harley Street Clinic and Portland Hospital among other significant institutions, has more than doubled in size since 2006, when its profit before tax was £30m. By 2011 that figure had grown to £61.7m, according to the company’s latest accounts, of which it paid £14.4m in tax. Its turnover has risen from £217m to £353m while the highest paid director’s salary also doubled from £900,000 to £1.8m in the same period.

The size and ambition of the firm is revealed in the commission’s report, Private healthcare in central London: horizontal competitive constraints, which shows that nine of the 10 NHS Trusts with the highest revenue from private patients are located in the capital: HCA caters for almost half of all private patients in central London and between 30-40 per cent in Greater London. For critical care the central London figure rises to 72 per cent.

HCA’s three joint ‘NHS Ventures’, all providing cancer care, are located at University College Hospital London (UCH), Queen’s Hospital in Romford, Essex, and The Christie NHS Foundation Trust in Manchester. Regarding the ventures, otherwise known as NHS Private Patient Units (PPUs), HCA told the commission it was “looking for more partnerships”.

Finding itself with two spare wards after it opened in December 2006, Queen’s has rented one of them to HCA since February 2010 and the company rents the 5 floor of UCH for its private cancer centre.

The value of private healthcare for NHS acute trusts grew by 5.3 per cent in 2011-12, compared with the previous year, when it increased from £448m to £471m.

HCA’s website states: “HCA NHS Ventures provides continually high-quality treatment, within state-of-the-art facilities, supported by the latest technology and the infrastructure of large NHS hospitals. Although these joint ventures are with NHS Trusts, patients are treated in an exclusively private setting.”

Several medical insurers told commission investigators of their “serious concerns about the lack of competition in central London, and in particular about the strong position of HCA” as insurer spending on HCA hospitals increases.

The report added: “AXA noted that NHS Trusts which outsourced management of their private facilities were attracted to bidders who were likely to generate the most income for the Trust, which it suggested tended to be the high cost providers such as HCA.”

AXA, the second biggest insurer behind Bupa, said HCA’s plan to take over Guy’s and St Thomas’s NHS PPU, which could otherwise emerge as a competitor to HCA’s London Bridge Hospital, as an example of it stifling competition. HCA is preferred bidder for a 25-year tender.

Insurer WPA “expressed a concern that when HCA took over the running of an NHS PPU they tended to be much more expensive”, the commission’s report added.

The Health and Social Care Act, which came into effect in April, has been criticised for making it much easier for private healthcare providers to strike deals with the NHS and pave the way towards a US-style healthcare system.

New independent think tank Centre for Health and the Public Interest (CHPI) published a report this week (Wed) warning that “the introduction of greater use of for profit providers as a result of the Health Act is likely to substantially increase the amount of healthcare fraud in the NHS”.

It named HCA in a list of several American health firms that have settled fraud cases in the US. The report, Healthcare Fraud in the new NHS market – a threat to patient care, concluded that new system “will result in less money for patient care when funds are already scarce in the NHS”.

The CHPI report found the use of payment-by-results contracts with private providers was providing opportunities for ‘upcoding’ - with patients categorised as having more serious conditions than they actually have. It said: “The risks to the English NHS are increased by the fact that some companies entering the new NHS market have settled major fraud cases in the US.”

HCA had to pay more than $1.7bn in fraud settlements in the US in 2003 after admitting 14 felonies, the report stated.

Health policy academic Colin Leys, co-author of the report, said: “The use of Payment by Results contracts with private providers in the new NHS market provides significant opportunities for making fraudulent claims. Where NHS hospitals have maximised income by overcharging since the introduction of Payment by Results, in the past, the funds did not leave the NHS, whereas any overcharging by private providers will see funds shifted away from patient care to corporate profits. Private providers also have an incentive to overcharge because company law requires them to maximise the return to shareholders.”

According to a New York Times investigation, the secrets of HCA’s rapid growth included getting more revenue from private insurance companies, patients and national social insurance programme Medicare through “much more aggressive billing”, reducing expenses and finding new ways to reduce the cost of its medical staff which led to conflict with doctors over patient care.

Kidney specialist Dr Abraham Awwad told the newspaper: “Their profits are going through the roof, but unfortunately it’s occurring at the expense of patients.”

Christina McAnea, head of health at the union UNISON, told the Independent: “HCA is not the only private company queuing up to get a lucrative slice of the NHS budget. Starved for cash hospitals will increasingly go down this route in an attempt to bridge the gap between the rising cost of healthcare and shrinking NHS budgets. However, transparency and accountability will suffer. Private companies are not subject to Freedom of Information legislation and concerns have been raised that fraud will increase - HCA’s parent company has already been found guilty of fraud in the US.”

HCA argued that London was one of the most competitive parts of the UK and that its medical facilities were world class with high patient satisfaction. Last week an independent audit of patient satisfaction at HCA’s hospitals and joint venture NHS private patient units broke records for high levels of approval by patients, a company press release said.

A spokesperson for the company added: “Unlike many other UK private hospital groups, HCA does not routinely provide care for NHS funded patients.

“HCA’s NHS Ventures business is focused on running the private patient units in NHS hospitals on behalf of the NHS. The NHS PPUs we run have generated additional income for the NHS. We share the income of our private patient work with our partner NHS Trusts so that it can be invested back into more care for NHS patients.”

“HCA provides high quality, often complex, care for private patients from our London hospitals treating people from the UK and across the world. HCA hospitals are part of London’s position as a global centre of healthcare excellence, competing with New York, Singapore, Thailand, and Germany.”

[TonyGosling]

111 non-emergency phone service on brink of collapse as NHS Direct looks to pull out of contracts
http://www.independent.co.uk/news/uk/home-news/111-nonemergency-phone- service-on-brink-of-collapse-as-nhs-direct-looks-to-pull-out-of-contra cts-8736270.html

Doctors and nurses have called for an urgent overhaul
Charlie Cooper Monday 29 July 2013

Doctors and nurses have called for an urgent overhaul of the NHS 111 non-emergency phone line, after one of the main providers, responsible for services in a quarter of England, said it would pull out of all of its contracts.

The Government was forced to reassure the public that all 111 services would continue to operate safely after NHS Direct, which operates 9 of the 46 regional contracts for the service, said that it had become "financially unsustainable" for it continue doing so.

Dr Clare Gerada, chair of the Royal College of General Practitioners, told The Independent that 111, which launched in April, but has been beset by delays and widespread concerns about the quality of its service, was a "monumental, expensive, unnecessary, appallingly-executed reorganisation" and the Royal College of Nursing said parts of the service were "in chaos" with urgent action needed to prevent "tragic consequences" for patients.

Since its launch, the NHS 111 phone service has been criticised by doctors and more recently by MPs on the health select committee for making patients wait hours for a call back, not having enough clinical staff manning phone lines, and depending on computer algorithms that often directed people to A&E and GP services unnecessarily.

The service is run by different organisations in different parts of the country, with private companies, local ambulance services and NHS Direct, which used to operate the national non-emergency phone line, all taking on contracts last year.

However, NHS Direct said yesterday it was seeking "a managed transfer" of its 111 contracts, which have between two and five years left to run.

Nick Chapman, the chief executive of NHS Direct, said: "We will continue to provide a safe and reliable NHS 111 service to our patients until alternative arrangements can be made by commissioners.

"Whatever the outcome of the discussions on the future, patients will remain the central focus of our efforts, together with protecting our staff who work on NHS 111 to ensure that the service will continue to benefit from their skills and experience."

NHS Direct was originally contracted to manage the phone line in 11 regions, but dropped plans to launch the service in Cornwall and North Essex. Earlier this month it revealed that call volume at two of its call centres was 30 - 40 per cent lower than contracted. The company is paid according to the number of calls it takes, but calls were taking too long because of technical difficulties and problems connecting with local NHS services, according to a report by the Trust Development Authority.

Yesterday, the Government sought to reassure people that the 111 phone line was safe. Dame Barbara Hakin, NHS England's deputy chief executive said that the NHS was already in negotiation with possible new providers to take on NHS Direct contracts.

A Department of Health spokesman said: "The majority of the country has a high quality NHS 111 service, but we know that NHS Direct has struggled to meet the standards required, and it is only right that NHS England take action to ensure patient safety is not compromised."

However, Andy Burnham, Labour's shadow health secretary, accused the Government of destroying NHS Direct, "a trusted, national service" in an "act of vandalism".

"It has been broken up into 46 cut-price contracts," he said. "Computers have replaced nurses and too often the computer says 'go to A&E'."

Dr Gerada said that the introduction of 111 had "destabilised" a system that was functioning well under NHS Direct and called for non-emergency phone services to be operated in closer collaboration with local GP services.

"The big problem about 111 is of course money," she said. "It was the lowest bidders on the whole that won the contracts…If you pay £7 a call versus £20 a call you don't have to be an economist to see that something's going to be sacrificed. What's sacrificed is clinical acumen."

Dr Chaand Nagpaul, chair of the British Medical Association's GP committee said 111 had been "an abject failure".

"The decision by NHS Direct to seek a withdrawal from its contracts to provide NHS 111 reveals worrying flaws not just with the tendering process for NHS 111 contracts, but for how contracts are awarded and monitored throughout the NHS," he said. "A number of local GPs and the BMA raised concerns during the tendering process about the low nature of some of the successful bids, which were ignored."

Meanwhile, a Channel 4 investigation at another 111 provider, Harmoni, has reported staff shortages, long waits and cases of ambulances being called out unnecessarily.

The Dispatches programme, broadcast tonight, reports one call centre manager saying the service was "unsafe" at weekends, with too few staff to deal with the calls coming in.

[TonyGosling]

Book review: A Quiet Word By Tamasin Cave and Andy Rowell

MARK LEFTLY Author Biography Sunday 23 March 2014
http://www.independent.co.uk/arts-entertainment/books/reviews/book-rev iew-a-quiet-word-by-tamasin-cave-and-andy-rowell-9208042.html

A Quiet Word: Lobbying, Crony Capitalism, and Broken Politics in Britain has the title of an ultra left-wing rant fuelled by conspiracy theories, poor research, and unfounded assumptions. But it is, on occasion, a chillingly accurate description of how presentation and spin trumps substantive argument in the upper echelons of power.

Tamasin Cave and Andy Rowell are furious that politicians, the media, and the public have been overwhelmed by lobbyists and masters of the dark arts of public relations.

Disingenuous, misleading, and deceitful, what they inelegantly describe as the “influence industry” is, they argue, “a serious, hidden feature of British politics”, which permeates and shapes every debate from nuclear power to schools.

The authors are directors of Spinwatch, the raison d’etre of which is to probe and attack corporate PR and lobbying, so this is not a sober, distanced investigation. But the book comes along at the right time, just weeks after the seriously diluted Lobbying Bill became law. More importantly, they accurately essay a world that most people don’t see, but which most certainly exists. A chapter on how lobbyists manipulate the media should become mandatory reading in journalism courses.

Clearly, the press should be sceptical of any word that comes out of a PR’s mouth and avoid them as often as possible. Yet the authors point out that those who should be intractable foes mix at expensive parties, while those same PRs and lobbyists will invoke legal threats if a story that doesn’t suit them is about to appear.

There is a page in this chapter that shows up the book’s strengths and flaws.

First, the authors superbly turn lobbying’s own sinister words against it. An industry “excellence awards” praised Hill & Knowlton for a strategy on pesticides for “avoiding national press coverage … as this would attract a strong response from the environmental NGOs”; in other words, lobbyists were rewarded for burying a legitimate story.

But the media, and the London Evening Standard in particular [disclosure: the Standard is a sister title of The IoS], come under fire for “recurring coverage supporting the case for expansion of Heathrow”.

This is unsubstantiated and seems to be an accusation that stems from the authors’ own disagreement with a third runway. If the coverage is supportive, it is because journalists have read documents like those that have been buried in the Airports Commissions website, including impeccable data from National Air Traffic Systems.

This is, then, an imperfect book skewed by its own anger – but A Quiet Word is important and, generally, right.

[Whitehall_Bin_Men]

"If we don't get a new government next May, we will have no NHS left."
http://www.independent.co.uk/life-style/health-and-families/health-new s/thousands-join-new-jarrow-march-in-protest-at-nhs-cuts-9716618.html

[Whitehall_Bin_Men]

Leaks show that US multinational private healthcare vultures are now directing UK CCGs, doctors' clinical commissioning groups
http://t.co/l2twyOqCHA