The Crowdjustice judicial review of Accountable Care Organisations – update

“Update on OUR NHS – Comprehensive Healthcare for All – STAGE 3

Hello Friends

As a backer you know our Judicial Review, challenging NHS England’s contentious Accountable Care Organisation contract, will be heard on Tuesday 24th April at Leeds High Court, 1 Oxford Row Leeds LS1 3BG

We’d like to invite supporters and fellow campaigners to a rally outside the courts from 9. 30am, to support the vital NHS principles our Judicial Review aims to defend. We will be inviting Press & Media.

This week we had a really good meeting with our legal team from public law firm Leigh Day and Landmark Chambers, to discuss the ‘skeleton case’ – a summary outline – which is due to be sent to the court in the next few days.

The skeleton case is based on our deep concern that the payment mechanism proposed for the Accountable Care Organisation contract is not only unlawful under current NHS legislation – but will lead to restrictions and denial of NHS care, and the abandonment of the core NHS principle of providing comprehensive care to all who have a clinical need for it, free at the point of use.

This would mean replacing treatment based on patients’ clinical need with treatment based on assessments of financial risk and returns – a total departure from core NHS principles, replacing them with health insurance company principles.

This is because the Accountable Care Organisation contract requires NHS commissioners to pay a fixed lump sum to cover the whole range of services for the population in a given area – rather than the present system which pays NHS providers an agreed price for the treatments they have actually delivered to patients.

Without reference to the number and complexity of treatments delivered to patients, the ACO contract’s proposed fixed population payment would pass financial risk to the providers – and from providers to us the patients.

Why? Because if providers were to get more patients needing more complex treatments costing more than the fixed lump sum they receive, they would face spending money they don’t have. They’re not likely to want to do that. The only way to avoid that would be to restrict or deny patients’ access to treatments. Particularly patients whose treatments are more costly and whose prognosis means their treatment is not such good value for money.

In our view, NHS England is playing fast and loose with existing NHS law about how prices are set and payments are made for health care provided to NHS patients.

Although we don’t in any way support the 2012 Health and Social Care Act, which increased private companies’ access to NHS contracts, fragmented the NHS and removed the Secretary of State’s duty to provide a universal, comprehensive health service in England, it is the law.

If NHS England wants to change price setting and payment methods for the provision of NHS services, it should do it in accordance with the law. If changing payment mechanisms means changing the law, that is something for Parliament – and the public that puts MPs there – to decide.

Ask yourself… “what happens when government and its quangos decide they are above the law?” It doesn’t bear thinking about.

As well as being undemocratic, NHS England’s proposed changes to how NHS services are priced and paid for would undermine the NHS as a comprehensive health service for all who have a clinical need for it.

They are about enabling moves to a cut price, bargain basement NHS that uses the same business model as the USA’s limited state-funded health insurance system that provides a restricted range of health care for people who are too poor or old to pay for private health insurance.

Thanks for your support so far.

Please share this with friends and campaigners.

We will fight this all the way.”