Swire sees the light on hospital beds (because it could be a big vote loser?)

Owl is concerned that local MP Hugo Swire is very, very slow in the uptake. After resting on his laurels by seeing community beds in his constituency staying while those in Neil Parish’s patch of EDDC have all gone (except for Tiverton – not part of East Devon which can’t be closed because it is a PFZi hospital), he finally wakes up and realises that it has left a black hole that will stop many people voting for either of them next time! AND result in people switching their votes to Claire Wright (Independent, East Devon) and maybe Caroline Kolek (Labour, Tiverton and Honiton)!

Sir Hugo Swire said the area’s demographics are 20 years ahead of the national average and it was ‘absolutely ridiculous’ the two services should have separate funding.

This comes after Dr Mike Slot raised concerns to Devon’s health watchdog that carers are not available to implement ‘care at home’ – the model the NEW Devon Clinical Commissioning Group’s (CCG) moved to after it closed 140 community hospital beds across the county.

Dr Slot said: “The loss of community hospital beds was intended to be offset by increasing the capacity of community care so that patients could be cared for in their own homes.

“This may or may not have been realistic since many of the patients in the hospital system cannot be managed in the community, even with excellent community services.

“However, with or without community hospital beds, it is an excellent idea to expand community services so that all those patients who can be cared for out of hospital can remain at home.

“Unfortunately, there is not sufficient capacity in the home care services to do this job.

“When GPs ring the single point of access number asking for rapid response or night sitting, the carers are not available.”

In a joint statement, the CCG and provider trust the Royal Devon and Exeter Hospital acknowledged that recruitment had been ‘challenging’ in a few places, but the bodies were working hard alongside other agencies to address the issues.

A spokeswoman said more than £2.5million had been redirected into growing and strengthening their community teams so more people can be cared for at home.

They added: “A large part of the reinvestment has been to increase the number of nurses, therapists and support workers and in most areas we have successfully recruited the additional staff.”

Social care was brought under the remit of health secretary Jeremy Hunt in the last cabinet reshuffle – a move welcomed by Sir Hugo, who said: “I think in future there will be far greater use of hubs.

“We must look to do the same with social care. It requires brave, strategic thinking. We have to get it right.

“The East Devon demographic is where the country is going to be in 20 years’ time. Sidmouth is even ahead of that. East Devon should be a template – use us as a guinea pig for integration of health and social care.”

http://www.sidmouthherald.co.uk/news/concerns-over-recruitment-for-new-care-at-home-model-after-east-devon-hospital-bed-closures-1-5395962

Important health meeting in Seaton on 23 March

From the blog of DCC East Devon Alliance councillor Martin Shaw:

“Seaton and Area Health Matters – Going Forward Together

Friday 23rd March 2018 – Seaton Town Hall

9.00 for 9.30 am start – 1.00pm

Book here: https://goo.gl/forms/7laMUjhByt8F0w053 (right click on link to open booking form)

You are invited to participate in this community led event with key stakeholders around the future health and wellbeing of all the people in our communities, in response to the new landscape affecting Seaton and surrounding area as a result of NHS and Government policies advocating Place-Based Care in health provision and cross-sector collaborative working with community groups

The aim: To discuss what we know, where there are gaps/challenges and how, as a community we will address these to ensure collaborative approaches to co-design and co-produce local health services/activities that meet the needs of all the people in our communities.

Invitees: Management and senior level employees and volunteers / trustees from community, voluntary and social enterprise sector as well as public and private organisations.

Area to include: Seaton, Colyford & Colyton, Beer, Axmouth, Branscombe

PROGRAMME:

Welcome: Mayor of Seaton – Cllr Jack Rowland

Community Context:

Dr Mark Welland – Chairman of Seaton & District Hospital League of Friends
Roger Trapani – Community Representative, Devon Health and Care Forum
Charlotte Hanson – Chief Officer, Action East Devon
Strategic and Services Overview – Place Based Care:

Laura Waterton – Royal Devon and Exeter NHS Foundation Trust
Richard Anderson – Health and Social Care Community Services Manager
Dr Jennie Button – Social Prescribing Lead – Ways 2 Wellbeing project in Seaton
Workshop, Networking and Discussion will form the main part of this event:

Workshop 1 – What is working well and what are the challenges for Seaton and surrounding area?
Workshop 2 – Working together to improve health and wellbeing outcomes? What support do we need?”

Important community conversation on health and wellbeing in Seaton and area to begin on 23rd March

Unitary authorities – the austerity measure that can’t be stopped?

Wonder what that new £10m EDDC HQ will be used for?

“Simon Heffer writes in the Sunday Telegraph to call on the Government to simplify and streamline the UK’s councils, replacing the system of county and district councils with county-level unitary authorities.

The need for “wholesale reform”, he says, has been made urgent by the problem of “social care that will break local government” and former chancellor George Osborne’s “disastrously flawed business rate system, which has had a profound effect on revenue-raising”.

He says that a system of unitary authorities would reduce payroll, offer the chance to sell off assets, and improve the handling of planning decisions, while the Government should remove “huge strategic questions such as social care from council control altogether”.

The Sunday Telegraph, Page: 21

“NHS chiefs pocket £166 MILLION in bonuses – while nurses suffer 1% pay cut”

“Nurses, midwives and other carers battered by David Cameron’s assault on NHS wages are night furious at revelations their bosses’ pay packets have risen by 36%.

Senior managers pocketed £166million in bonuses and other extras last year – as the Tory-led Coalition slashes £20billion in costs from the beleaguered service.

That is up 36% from £122million the year before.

The rise, on top of their annual salaries, could have paid for an extra 4,000 nurses, who have suffered a 1% cut. …”

https://www.mirror.co.uk/news/uk-news/nhs-bonuses-chiefs-pocket-116-3553527

Our NHS but not “OUR” NHS

Another post from the Save Our Hospital Services Facebook page, which has nearly 11,000 (yes, ELEVEN THOUSAND) members

“The STPs have driven a huge wedge between hospitals and areas within the “footprints” people have been horrified to find that their services have been down-graded and moved to other hospitals some distance away.

In Devon there were threats made to move maternity and acute services from North Devon to Exeter some 55 miles away and even further away from some of the outlying villages.

The various committees and groups set up to implement the STPs have wasted vast sums of money on wages, premises, expenses and admin staff. There have been endless ridiculous consultations with all sorts of groups where the public’s views were dismissed—the public have watched on while these people have wasted money.

The STPs have been successful in taking huge sums of money from the system and putting it in the hands of people who should actually have been working in hospital. Management consultants and makers of pretty information books have had a great time too.

Meanwhile back in the hospitals beds have been closed to save money and then we find that there are not enough beds. The boards of hospitals ( NDDH – North Devon District Hospital) have been taking pay rises in some cases already earning a quarter of a million pounds per year- this individual has now had a vote of no confidence made against him by the consultants – yet still he cashes in.

The CCGs across the country have been following orders and cutting community hospitals and beds relentlessly rather that protesting and thinking about patient safety in their areas. They have all done great jobs at implementing STPs – well done but you should have been advocating for your patients.!!!!!

The public are furious across the country about this government’s shameful treatment of the NHS and its front line staff. They see the staff run off their feet, suffering stress and leaving. The hospitals which are under threat of closing or losing services have staffs that have no confidence in the system and no job security. How has this come about? The STPs have demoralised everyone, put hospitals against hospitals, made the public feel that because they live in certain areas that their lives are not as important as the lives of people in neighbouring areas.

The STPs are now morphing into ACOs and ACSs and goodness knows how many quangos and private companies (yet again) will be raking in their pounds of flesh before patients are considered. The whole nation is up in arms about the effects of cost cutting.

Deficits in hospitals do not represent overspending- they represent the needs of the people in that area.

No area is the same – we do not all fit into a formula – some populations have more elderly people, some have more babies, some have more people drinking and smoking, some are more polluted, some are deprived, some are wealthy. The STPs do not address these considerations.

ACOs are very suspicious- a move to the American (rubbish for the people) insurance based system. They break up the system even more and are not accountable to anyone. Private companies such as Virgin bully and sue if they do not get their own way over contracts already. What will happen when even more is thrown open to the sharks waiting to take a profit out of people’s ill health?

The demise of Carillion should send a warning shot across the bows of anyone who feels that public services are safe in the hands of profiteers.
People are angry- STPs started this – put a stop to it now and reinstate the NHS.”

Our local health services: our last line of defence

From the Save Our Hospital Services Facebook site:

:… these guys are our last line of defence. They need to work harder at not being manipulated.

Health and Adult Care Scrutiny Committee, County Hall, 25 January 2018

“I take my Scrutiny duty very seriously,” declared Cllr Brian Greenslade (Barnstaple North) at the Devon County Council Health and Adult Care Scrutiny Committee meeting at County Hall on 25 January. Save our Hospital Services (SOHS) members from North Devon who attended this and many other such meetings know this to be only too true.

Indeed, were it not for Cllr Greenslade and his meticulous colleague, Cllr Claire Wright (Otter Valley) it is doubtful how much scrutiny by the Scrutiny Committee there would be at all. One thing is certain: given the scale, speed and scope of the changes now being pushed through in health and social care services in Devon, real information, real questions and real answers have never been so vital. It is literally a matter of life and death.

At a previous Scrutiny meeting, the Chair, Cllr Sara Randall Johnson, in clear cahoots with Cllr Rufus Gilbert, manipulated proceedings. The two managed to prevent Cllr Wright putting a motion she had already tabled, thus shutting down a debate that may have saved in-patient services at some community hospitals.

This so outraged some councillors and members of the public that their chorus of complaints and the consequent internal investigation prompted the county’s lawyers to lecture councillors as to their legal obligations to scrutinise. The investigation and warning came too late for the community hospitals, but could better behaviour be expected from now on?

Indeed, it could. But then, on 25 January, the Chair of the Standards Committee was sitting in. This time Cllr Wright was allowed to say quite a lot, pose many more questions, and state much more of the obvious in defence of our health and social care services.

However, far too many of our County Councillors still appear unwilling to spend time and effort educating themselves as to the issues, facts and figures, whilst being only too willing to swallow propaganda and projections put out by overpaid health bosses bent on making severe cuts to our NHS services.

No one, even councillors who have barely raised a whisper in opposition, is in any doubt as to the real motive for all these health service changes: cuts and cutbacks designed to save £557 million over the next five years. The aim is to ration, restrict and remove elements of care and treatment for however many people it takes to save that amount of money. Cost comes first, clinical need a poor second.

Dr Sonja Manton was again allowed to speak at great length. She is NHS Devon’s lead cost-cutter, qualified by means of a doctorate in Systems Dynamics, not qualified in Medicine or any form of clinical care. Which sort of gives the game away –as does her most obvious skill, talking for a very long time without saying anything at all.

When questioned by Councillor Wright, she appeared, as ever, not to have the required data or evidence to hand. Cue the now customary promise to look it up and pass it on. The pattern that follows has been obvious for more than 15 months now. The Scrutiny Committee ends up waiting a long time for what they have asked for – if they get it at all — making real scrutiny in public for the public impossible. The lack of real information, the failure to meet requests, the failure to resolve contradictions in presentations cause real difficulties for our County Councillors meeting after meeting – not least again on 25 January.

It has been reported that Devon’s Clinical Commissioning Groups are bent on steamrollering ‘Accountable Care Organisations’ into position from 1 April. To prove that the joke is on us for what is, after all, April Fool’s Day, they have given the Scrutiny Committee no information about them at all. This is particularly scandalous and frightening. As Brian Greenslade stated: “I want to know where we are…..we need to understand where we’ve got to and what this may mean.”

One faint beacon of light is the announcement, on the same day as the Scrutiny meeting was held, that NHS England will hold 12 week consultations on the implementation of ACOs https://www.england.nhs.uk/…/consultation-aco-contracts/ which puts a very slight delay in place. But the website does not elaborate on how much time after closure of consultation implementation could happen. The Consultation could well be the outcome of an exchange between Sarah Wollaston, Chair of the Health Select Committee, and Jeremy Hunt, Secretary of State for Health and Social Care, as well as an attempt to water down the possible impact of a Judicial Review, which is being filed by a group of Health Care professionals, to challenge the government’s attempt to circumvent Parliament and democratic scrutiny and allow ACOs to operate

ACOs are financially constrained, business-based American-style systems of healthcare purchasing and provision, which will pave the way for further privatisation and still more rationing and restriction of provision. Councillor Martin Shaw from Seaton had done a lot of research on ACOs and put his findings online. But, incredibly, he had to force the whole issue onto the Committee’s Agenda just to secure the very limited discussion that took place.

Until this announcement it was the case that ACOs (unless the Judicial Review has effect) were to be imposed without any debate, discussion or statute. So an ACO could be and, in many cases, will be, a private business, primarily accountable to shareholders and managers rather than patients and the public. And even now we don’t know how ‘public’ the consultation will be. As Jan Goffey, Mayor of Okehampton, declared, “Sick people should never be regarded as a profit-making opportunity.”

Eventually even the Chair, Sara Randall Johnson said, “We need more information.” We have heard her, and others, say this before. Is this a way of avoiding doing anything? Or is it something more cynical: a way of helping to destroy our NHS, but giving themselves the excuse that they just did not know?

If so, it will only be because they failed to find out – or scrutinise.”

Privatisation: “Heads want pay code after £500,000 academy boss”

Wonder what chiefs of Accountable/Integrated Care Organisations will get? Half a million is probably chicken feed for them!

“Head teachers say the pay levels of all school staff in England, including academy bosses, should be in a fairer framework to stop “fat cat” pay gaps.
The chief executive of the Harris Federation was revealed last week to have become the first in the state sector to earn £500,000.

The National Association of Head Teachers wants more transparency over spending “public money”.

The Department for Education has written to 29 trusts about high pay.
But the academy trusts it has asked to explain their levels of pay, where bosses earn over £150,000, are only small, single-school trusts.
The much bigger multi-academy trusts, including Harris, have so far been exempt from this challenge over how much they pay their bosses and managers.

The most recent figures, from 2015-16, show more than 120 academy trusts paying someone more than £150,000 – the large majority of which will be in multi-academy trusts.

A spokeswoman for the Harris Federation says its chief executive Sir Dan Moynihan’s earnings of up to £500,000 reflected the high performance of the trust. …”

http://www.bbc.co.uk/news/education-42959627

Has the NHS already been privatised? Of course it has!

People are confused when the Government says “The NHS has not been privatised” thinking: “Well, it’s still free so it can’t be private”. THIS IS WHAT THE GOVERNMENT WANTS YOU TO THINK. The reality is that many services have already been privatised. So, why don’t we pay for them? WE DO! The private companies (eg Virgin, which already has more than £1 billion of NHS contracts) charge the NHS for their services, adding on their cut for profits (directors salaries, perks and pensions) and their rewards to shareholders by way of dividends. This ADDS to the cost of the NHS which allows Jeremy Hunt to say we cannot afford it!

Of course we can’t if we are already paying private companies over the odds

And see the letter below this image:

For example:

Guardian letters:

“The problem with the King’s Fund’s latest analysis (NHS privatisation would be ‘political suicide’ says thinktank, theguardian.com, 1 February) is that it ignores the fact some privatisation has already taken place. Of course it would be madness for any government to hand over the whole NHS to insurance companies, or privatise it in the way that Margaret Thatcher privatised British Gas. There is not even a majority for this among Tory party members. But only a handful of people seriously believe that’s the plan: the private sector doesn’t want most of the NHS – care, complex care, treatment of chronic illness, most mental health services. No matter how wealthy you are, you can’t buy any private equivalent to NHS emergency services, maternity, or many others.

Instead private firms want to take over services that they see as potentially profitable – especially the provision of simple elective surgery – the bread and butter of Britain’s tiny private hospitals (average size 50 beds). But the lack of any public support for privatisation has not stopped commissioners giving contracts to Virgin and other private companies for work previously done by NHS trusts. This, by any reasonable definition, is privatisation. In 2015-16, 7.6% of NHS spending was on private providers.

Reshaping the law to allow this piecemeal privatisation was the aim of the Health and Social Care Act 2012, which compels CCGs to put services out to tender. The King’s Fund lends weight to disingenuous government denials that they have been privatising services. They would do better to endorse demands for the repeal of the 2012 act and the reinstatement of the NHS as a publicly owned and publicly provided service.
Dr John Lister
Co-chair, Keep Our NHS Public”

https://www.theguardian.com/politics/2018/feb/04/risks-of-outsourcing-and-privatisation-laid-bare

Virgin – propped up by British Government

“As Britain’s best-known businessman, seen by millions as a buccaneering role model, Sir Richard Branson has produced bookshelves of advice about “relying on yourself”, creating a “nation of go-getters” and “standing on your own feet”.

As he wrote in his self-help manual, Screw It, Let’s Do It: “If you want milk, don’t sit in the middle of the field in the hope that the cow will back up to you.” This year, however, is likely to be one where Branson gets most of his British milk from the taxpayer teat.

Using recently published company accounts and regulatory disclosures, The Sunday Times has established that Branson’s Virgin Group is on course to join what critics call the “corporate welfare state” — with the majority of its UK revenues coming from work subsidised, or wholly funded, by the public purse.

More than 80% of revenues at Virgin UK Holdings, Branson’s main holding company in Britain, already come from operations dependent on public funding, mainly rail and the NHS, the accounts show.

Branson’s companies received £320m from taxpayers in 2016 for running public services. Some £262m of this was from the health service or local councils for medical and social care through his Virgin Care business. Then there was a net government subsidy of £58m for Virgin’s share of the East and West Coast rail franchises, a joint ventures with Stagecoach.

Virgin UK Holdings does not own all Branson’s British businesses, such as his stakes in Virgin Money and Virgin Atlantic, his biggest cash cow in 2016. And the tycoon — who lives mostly in his tax haven personal island of Necker in the Caribbean — now has substantial international interests, not least his space venture.

Nonetheless, in the UK, the balance of his income is shifting more towards public services. In a deal likely to be completed this year, Branson will slash his interest in Virgin Atlantic, from 51% to 20%. He has already cut his stake in Virgin Money to 35%.

Even in 2016, with the airline still on board, healthcare and rail accounted for about 40% of Virgin’s total UK revenues. By comparison, the now-collapsed Carillion earned about 45% of its UK income from the government that year.

Virgin Care has more or less doubled its NHS work in the past two years. If that growth were to continue, it is easy to imagine that more than half of Virgin’s UK revenues could be derived from public sector work — particularly in light of the likely reduction of Branson’s airline holding.

“Branson poses as a champion of competition, but has always been reliant on getting government-granted contracts and monopolies.” said Branson’s biographer, Tom Bower. “But as that sort of work grows, so does the risk that political controversy over it contaminates the brand loyalty, which is Virgin’s only real asset.”

Branson’s recent deal to escape up to £200m in future payments to the Treasury for his 10% share of the East Coast rail franchise drew that sort of political flak. Lord (Andrew) Adonis, a former transport secretary and chairman of the National Infrastructure Commission, called it “scandalous” — though Virgin points out that it has lost money on East Coast, and paid a £2m premium to the government last year.

On the far more lucrative West Coast line, Virgin’s 51% share generated revenues of £1.1bn, profits of £34m and it paid £7.5m in tax in 2016-17. The franchise also netted Branson £60m in state subsidy that year — and almost £1bn since 2008, according to the Office of Rail and Road (ORR) regulator.

Virgin says most of this money was paid to Network Rail to maintain the tracks its trains use. The ORR, however, defines it as a subsidy to Virgin, since the operator would otherwise have to pay Network Rail itself.

West Coast is much improved under Virgin — though Branson cannot claim all the credit, as he often does. The £9bn upgrade, allowing today’s faster, more frequent trains, was funded by further Treasury cash.

Despite all the subsidies, Virgin now charges £338 for a standard peak return from London to Manchester, up 50% since 2008. The morning peak period, during which such fares apply, finishes as late as 10.40am, while the evening peak for most English destinations starts at 3.01pm.

However, it is the NHS that has the potential to cause Branson the greatest political grief. Tellingly, in the 400 NHS and social care contracts now run by Virgin, its branding is extremely low-key. The Care Quality Commission, the health regulator, strongly praises many of its services. Yet middle England may not always agree. In Somerset and Yorkshire, where Virgin runs NHS contracts, there have been controversies about care standards. In Surrey, Virgin was criticised for suing the NHS, winning a multimillion-pound settlement. There is also controversy about tax. Branson’s core health and social care company, Virgin Care, made more than £8m profit in the year to March 2017. Its accounts, published on December 28, show a liability for corporation tax of £1.6m.

Across the web of companies that make up the Virgin Care group, however, “administrative expenses” of £31m were set against profits, reducing tax liabilities to nil. Virgin Care claims on its website that “we have always paid our UK taxes in full and will continue to do so”. In fact, it has never paid any UK tax — because, it says, it has never made a profit.

Virgin declined to respond to detailed questions about what the administrative expenses were, though it said they were less than in the public NHS.

Branson says Virgin Care has “saved the NHS and local authorities millions” and insists he does “not want or intend to profit personally from the NHS”. If and when a dividend was taken from the work, a spokesman said, all the money would be invested back into NHS services.

Virgin said last night that it had “many successful businesses across the world”, and continued to “start and invest in new ventures”. It said the publicly funded businesses accounted for a smaller share of profits than of revenues, and pointed out that it might no longer run West Coast after 2019, when its current deal ends, though it is bidding for a 30% share in the new franchise.

Branson’s trajectory in Britain seems clear, however. While Virgin’s name still adorns many UK businesses, it no longer owns most of them, including Virgin Mobile, Virgin Media and Virgin Radio, instead licensing other companies to use the Virgin brand. “Virgin is increasingly living off the state,” said Bower.

Yet even as it does so, new questions are being asked over the model, and even the very principle, of private involvement in public services. With the collapse of Carillion, the rise of the hard left, and a scathing National Audit Office verdict on the Private Finance Initiative, could Branson, for once, have misjudged a trend?”

Source: Sunday Times (paywall)

Who fights for the NHS in East Devon? Your Independent councillors!

At today’s Save Our Hospital Services demo in Exeter today. East Devon Alliance and Claire Wright make their mark but not an East Devon Tory (including our two East Devon MPs) to be seen!

East Devon Alliance DCC Councillor Martin Shaw

East Devon Alliance EDDC Councillor Cathy Gardner

DCC Independent Councillor Claire Wright

East Devon Alliance Councillors Marianne Rixson with East Devon Alliance Councillor Cathy Gardner

One of the many interviews the independent councillors did on the day.

“Hundreds protest NHS crisis in Exeter as councillor warns: ‘Only Derriford and RD&E will be left’ “

Brilliant coverage of today’s NHS demo in Exeter including interviews with EDDC East Devon Alliance councillor Cathy Gardner, DCC East Devon Alliance councillor Martin Shaw and DCC Independent Councillor Claire Wright making excellent points about the destruction of our NHS.

https://www.devonlive.com/news/devon-news/hundreds-protest-nhs-crisis-exeter-1162119

“Fix the NHS: Protesters rally in London [and Exeter] to call for government action

“Health workers, activists and unions are marching in central London on Saturday to protest against government inaction over the NHS winter crisis.

Hospitals have been overwhelmed in recent weeks by a surge in admissions that has led to delays of up to 12 hours on emergency wards, patients left on trollies for hours and thousands of patients forced to wait in ambulances before receiving urgent care.

Two pressure groups, the People’s Assembly and Health Campaigns Together, have organised the rally to call on the government to plug funding and resource gaps in the health service. …”

https://www.theguardian.com/society/2018/feb/03/fix-the-nhs-protesters-rally-in-london-to-call-for-government-action

“Autocratic top-down management” fails NHS and leads to mediocrity

“Autocratic management is a leading cause of poor NHS care, according to the compiler of a European health service league table that ranks Britain 15th.

The UK trails Slovakia and Portugal while the best performers such as the Netherlands and Switzerland pull away, according to the Euro Health Consumer Index. Treatment is Britain is mediocre and there is an “absence of real excellence” in the NHS, the report concludes. Only Ireland does worse on accessibility measures such as availability of same-day GP appointments, access to specialists and waits for routine surgery.

The findings come after a global study this week found cancer survival in Britain still lagged well behind the best in the world.

Arne Björnberg, who compiles the Euro Health Consumer Index, said: “Cancer survival rates are one of the prime examples of NHS mediocrity.”

More money is needed to improve care, according to a study that finds a strong correlation between treatment results and how much countries spend on health.

However, Professor Björnberg said that the most urgent lesson the NHS could learn from other countries was about the corrosive effects of an “autocratic top-down management culture”. He said: “As a Scandinavian what strikes you when you visit the UK is British management is extremely autocratic. Managing 1.5 million using a top-down method doesn’t work very well. If you go and ask a secretary or a receptionist anything out of the routine in Scandinavia, the most negative response would be: ‘I’ll see what I can do’. But in the UK they will say: ‘I’ll have to talk to my manager’. Subordinate staff are not allowed to use their brains in the UK and managing a professional organisation like healthcare like that is not a good idea.”

The Netherlands has consistently topped the rankings, which some have attributed to a system of competing insurance companies. However, Professor Björnberg said that the main lesson to be learnt from the Dutch was not about market forces but the need to put doctors in charge and force them to take account of patients’ views.

“If you have intelligent people and make them talk to customers frequently, that is a good idea,” he said.

“You have 1.5 million intelligent and dedicated people working for [the NHS]. Liberate the medical profession and put politicians and amateurs at arm’s length.”

[Autocratic top-down] NHS bosses dismissed the findings, preferring an index compiled by the US-based Commonwealth Fund, which ranks Britain top of 11 global health systems. The NHS scores well on measures such as equal access, but ranks tenth at keeping people alive.”

Source Times (paywall)

Virgin: rewarded for failure

Virgin already run children’s services, many GO’s surgeries and other former public services in Devon. They will no doubt bid as aggressively as usual for more Devon health care services when Devon gets its (Un)Accountable (Non)Care (Non-scrutable) System which will allow wholesale privatisation of our NHS.

“Virgin Trains will be handed a lucrative new contract to run services on the west coast main line despite serious criticism of its owners’ handling of the east coast franchise.

The Department for Transport is expected on Monday to award the company a new deal to operate the line between London and Scotland for another two years. The contract will take the form of a “direct award”, when the incumbent is handed a short-term deal without other train operators being able to bid.

The announcement could prove awkward for Chris Grayling, the transport secretary, who has been criticised for his handling of Virgin’s east coast franchise. It is being scrapped in 2020, three years early, after the company overestimated passenger numbers and suffered a revenue shortfall. It is feared that the franchise could collapse even sooner, forcing the government to rewrite the contract or even renationalise the line.

The confirmation of the west coast deal could be seen as a “reward for failure” by critics of Britain’s privatised railway. The west coast is the country’s most profitable rail line, making £51 million for Virgin — a joint venture between Sir Richard Branson’s Virgin Group and Stagecoach — in 2016-17.

It will also fuel concerns over the franchising system, which has suffered a shortage of bidders in recent years. A third of rail franchises are let on a direct award basis. However, the DfT is preparing to mount a staunch defence of the deal, insisting that it merely represents confirmation of a contract announced more than a year ago, before the east coast fiasco.

Sources said that the west coast was well run, with the franchise delivering more than £200 million a year in premium payments to the government, reversing a previous position when it made a £75 million net loss.

It was also claimed that comparisons with the east coast were unfair. The east coast is 90 per cent run by Stagecoach. However, the west is 51 per cent owned by Sir Richard’s company, with Stagecoach holding a 49 per cent stake.

Stephen Joseph, executive director of the Campaign for Better Transport, said: “There is a need for a fundamental review of franchising. We can’t keep the railway running on direct awards. We need long-term thinking.”

The existing west coast franchise had been due to end in April. The government announced more than a year ago that a direct award would be made, allowing Virgin to run the line up to April next year. At that point, a new franchise was expected to be created — “the west coast partnership” — to run both west coast trains and HS2 services when the high-speed line is built in 2026.

However, it is believed that Virgin will now continue to run the line for a further year — up to April 2020 — delaying the start of the long-term west coast partnership by 12 months.

The direct award is expected to require Virgin to improve its passenger satisfaction ratings, extend free wifi in carriages, introduce passenger compensation for trains that are at least 15 minutes late and accommodate work needed to prepare for HS2.

A DfT spokesman said: “As set out in November 2016, we intend to award a short-term contract to operate services on the west coast main line until the start of the new west coast partnership, which will run services on the west coast line and shape the future of HS2.”

Source: Times (paywall)

“Protest in Exeter [tomorrow, Saturday 11 am] will call on Government to ‘fix our NHS’ “

“Tomorrow (Saturday) will be a national day of action and Save Our Hospital Services Devon will be among those calling for:

 An immediate cash injection to relieve the crisis facing the NHS, which has seen ‘unacceptable’ waiting times in A&E, delays admitting and discharging patients, deaths on trolleys and in waiting ambulances, and the cancellation of all routine operations.

 An end to the closure of hospitals, wards and beds in Devon.

 No imposition of Accountable Care contracts in Devon or any other part of the country, but a return to a fully public, fully funded, fully accountable NHS, free at the point of use.

 Fair pay for NHS workers and the restoration of bursaries for student nurses.

The protest will begin in Princesshay Square at 11am tomorrow (Saturday).”

http://www.sidmouthherald.co.uk/news/protest-in-exeter-will-call-on-government-to-fix-our-nhs-1-5379581

And another wobbly privatisation domino: Virgin Care

“IF Carillion was a financial wreck that had to be fed ever more contracts to keep going until it was too late, something similar can be seen in the UK’s outsourced health services.

The company now winning the most NHS contracts is Virgin Care, which provides everything from children’s services in Devon to urgent care in Croydon and adult social care in Somerset. Yet it has a balance sheet that makes Carillion’s look like a picture of health.

On a total turnover of £252m up to March 2017, Virgin Care companies recorded losses of £15.9m last year. Set against this, income from several joint venture partnerships with local GPs totalling £4.2m still left the group with an eight-figure loss. Having been in the business several years now, the fact that Virgin can’t make a profit on its healthcare contracts raises the awkward question of whether it, like Carillion, has been bidding too low for them – and in the process elbowing out the NHS organisations with which it often competes. (When it loses, recent legal action against health commissioners in Surrey showed, those elbows are pretty sharp – see Eyes 1439 & 1440).

Liabilities exceeding assets

The years of loss-making have left the Virgin Care companies, mainly Virgin Care Ltd and Virgin Care Services Ltd, with liabilities exceeding assets by around £28m, and most of what assets the companies do have are in the “intangible” form of technology Virgin Care has developed. The losses are replenished by loans from unknown sources within the wider Virgin group. Since its accounts also show that it doesn’t expect profits for the “foreseeable future” – which again questions the wisdom of low-balling bids – these will have to keep rolling in for some time yet.

The business is spared from insolvency by ultimate owner Sir Richard Branson promising from his bolt-hole in the British Virgin Islands to continue to provide support, allowing Virgin Care’s directors and its auditor KPMG (which checked the Carillion numbers!) to declare that the companies are “going concerns”.

So long as Beardie continues to plough cash into the healthcare companies, the contracts carry on rolling in (a record £1bn worth last year), and other parts of the business such as his rail group secure large taxpayer bailouts, all remains well. But relying on the kindness of strangers, ie taxpayers, and a proprietor with who-knows-what long-term plans to provide stable public services looks about as sensible as it was to rely on Carillion.”

http://www.private-eye.co.uk/issue-1462/news

“Special scrutiny meeting may be held over set up of shady Accountable Care System in Devon”

Again, Martin Shaw (East Devon Alliance Independent)and Claire Wright (Independent)to the rescue! From Claire Wright’s blog:

“A special health scrutiny session may be held in the next few weeks, if it transpires that a controversial Accountable Care System is to be established in Devon in April, it was agreed at last Thursday’s Health and Adult Care Scrutiny Committee meeting.

My Independent colleague, Martin Shaw, put together an excellent and very well researched paper on the subject – found here:

http://democracy.devon.gov.uk/mgConvert2PDF.aspx?ID=13776 and presented it to the committee last week.

He asked for an urgent special meeting of the committee as the pace of change is looking very fast.

The main concerns about ACS’s (Accountable Care Systems) and ACOs (Accountable Care Organisations) are that they are the very opposite that their name implies, that they would not be set up in statute and may not be subject to the usual checks and balances that legally constituted NHS organisations are.

The language is the same as used in the United States healthcare system, which is quite understandably worrying many people.

There is also a great fear that such organisations will source much more work from the private sector over much longer contract periods.

Any such organisation or system may not be able to be held to account by the only legal check on health services – Devon County Council’s Heath and Adult Care Scrutiny Committee.

I formally proposed that the committee holds such a meeting in February preferably. This was agreed subject to the date when the Devon Accountable Care System may be established.

I am delighted to see that nationally, a judge has granted permission for a campaign group to pursue a high profile judicial review against the government on this issue.

So we will see.”

http://www.claire-wright.org/index.php/post/special_scrutiny_meeting_may_be_held_over_set_up_of_shady_accountable_care

What Swire thinks of NHS: likes dementia tax, tax on pensioner perks and Hunt “open to all options”

Owl says: “Hunt open to all options” sends a chill through my wings. It not only means he has NO plans but also that the option to keep the NHS a public service is doomed.

“A political consensus is emerging here at Westminster about what has to be done to save the NHS, which we all know is in crisis.

The main cause that has been targeted is social care, which has been created by an ageing population and yes, cuts to local Government.

Jeremy Hunt has now persuaded the Prime Minister to bring social care into the NHS, which is a good thing, but in my books the budget, which currently sits at the Ministry for Housing, Communities and Local Government also needs to be transferred.

The NHS rather than councils should be in charge of commissioning social care.

As we all know, old age is a condition lottery; one person might require £100,000 of 
care, another £20,000. Is it not a fairer solution to pool the risk between as many people as we can so that everyone loses something but nobody loses everything?

In my view, the so called ‘dementia tax’ was a good manifesto pledge because it suggested those who own their homes contribute to their own care rather than allowing our children and grandchildren, who are finding it difficult to get on the property ladder themselves, to pay for it. But it was flawed because it didn’t have a cap, which meant it failed to pool that risk.

Just how should we pay for it? Anyone I speak to seems to suggest that they wouldn’t 
mind paying a bit more in tax to sort it out. But how? Take 
money out of peoples’ estates after they die? Labour tried
that, and it was quickly dubbed, by my side, as being a ‘death tax’.

Maybe the Government could raise tax by means-testing pensioners benefits such as winter fuel allowances and ending the pension triple lock, but again whenever this has 
been floated there has been opposition to it, most recently by the DUP.

Another idea floating around Parliament is turning national insurance into a ring-fenced health tax. Sarah Wollaston, the Conservative chairwoman of the Health Select Committee believes national insurance should also be extended to those beyond retirement age who are presently exempt.

I have spoken to Jeremy 
Hunt many times about social care and the truth is he is not wedded to any one idea, he is ‘open to all options’, including a dedicated tax, because he knows more money must be found and fast.

What is needed is courage and leadership to drive forward solutions, but integrating social and health care must be the right place to start.”

http://www.exmouthjournal.co.uk/news/how-can-we-save-the-nhs-1-5366945

““CAMPAIGNERS REVEAL CASH-STRAPPED KENT NHS TRUST PAID MILLIONS TO A PRIVATE COMPANY TO FIND SAVINGS”

Dame Ruth Carnell is also leading Devon’s STP after her appointment os chief of the “Success Regime” on which her consultanct company worked prior to her appointment.

PRESS RELEAE:

“Two local Kent campaigners claim they had to mount a year-long investigation, involving numerous Freedom of Information (FOI) requests and a meeting with top NHS executives, in order to confirm that a small private consultancy firm had been paid over £6 million of local NHS funds to find cuts and “efficiency savings” in Kent.

Diane Langford and Julie Wassmer say they became concerned when they saw Dame Ruth Carnall, a former NHS executive who heads the private consultancy, Carnall Farrar, had been made Independent Chair of the Programme Board of the local Sustainability & Transformation Plan (STP) – one of 44 regional bodies put in place by NHS England to implement cuts and “savings” within the NHS.(1)

Author and campaigner, Julie Wassmer says “I raised concerns with former Canterbury MP, Julian Brazier, at a public (CHEK) meeting last March, questioning how Dame Ruth could possibly claim ‘independence’ when her own company was set to profit from the contract. At the same time, I was aware that my colleague, Diane Langford, had already been coming up against a wall of obfuscation in trying to discover how much that contract was worth and who was actually making the payments.”

Ms Langford, a writer and former Hansard transcriber says: “I actually submitted my first Freedom of Information request in December 2016, then dozens more to all eight Clinical Commissioning Groups (CCGs) in Kent and Medway as well as to Kent County Council (KCC) and NHS England in order to try to establish who was paying Carnall Farrar. As each respondent has up to 20 days to reply, it was an extremely time-consuming process and all the bodies denied having paid the firm though KCC had disclosed that the money came from ‘the NHS.’”

A complaint to the FOI Ombudsman against Maidstone and Tunbridge Wells NHS Trust was triggered when no reply was received within 20 days.

Eventually the campaigners found that millions of NHS money had been paid to Carnall Farrar by Maidstone and Tunbridge Wells NHS Trust, of which Glenn Douglas was then CEO. Wassmer then obtained a meeting last month, at which the campaigners discussed with Douglas (now – CEO of the Kent and Medway Sustainability and Transformation Partnership) and Michael Ridgwell (its Programme Director) the huge sums that had been paid to Carnall Farrar and why they were not appearing on the Trust’s usual spending records for payments of £25k and over.

“Ironically,’ says Wassmer, “this was on 7th December, just before the local NHS was about to implode with the pressure of Christmas and New Year emergencies. Michael Ridgwell was unable to produce an exact figure of how much had been paid to Carnall Farrar, but suggested the sum of £2.2M. I then explained that with the help of research organisation, Spinwatch,(2) we had actually confirmed that a figure of £6,051,199 had been paid to September 2017 (3) – though only just over half of it had been logged in the Trust’s spending records, with no record of any significant spending on Carnall Farrar before June 2017 – and no trace of the remaining millions. At the meeting Glenn Douglas explained to us that as the STP is not an “organisation” it is not obliged to publish its payments, but Michael Ridgwell then agreed to publish the full expenditure on the Trust’s website and has since done so. These records show that Carnall Farrar has been paid well over half a million pounds a month since September last year, although it’s not known whether this money is on top of the £6m it has already charged the local NHS.“

The campaigners insist it is crucial to challenge the lack of clarity, transparency, and accountability surrounding such huge payments. Even more so as the government now seeks to introduce new bodies – Accountable Care Organisations – that could see billions of pounds of the NHS budget handed to commercial companies.

“This is public money,” says Wassmer, “NHS funds being diverted away from services and into the pockets of private consultancies. We know that over £6 million, and possibly more, has been paid from the local NHS budget to this one consultancy for barely 18 months’ work on the local STP. How much more is going to management consultants across the whole of the UK? It’s almost impossible to hold the system to account and I fear it will only be worse with the impending introduction of so-called Accountable Care Organisations (4). Paying millions to private companies, like Carnall Farrar to find damaging cuts within an underfunded service is not only senseless – it’s immoral.”

Diane Langford agrees: “This lack of transparency conceals not only the sums involved, but the role consultancies like Carnall Farrar play in axing services. At our meeting on 7th December, we mentioned that Dame Ruth Carnall had appeared in a 2011 list compiled by the Sunday Telegraph of the highest paid NHS “fat cats” – earning an annual salary of over £200,000 at that time.(5) Glenn Douglas was on the same list, and while he admitted he was still earning in excess of £200,000 a year, the point is that as an NHS member of staff he can be held duly accountable for his work, in a way that private companies like Carnall Farrar cannot.”

Dr Coral Jones, GP, vice -chair of Doctors in Unite and member of Keep our NHS Public commented: “As the campaigners Diane Langford and Julie Wassmer have uncovered, over £6 million has been paid to a single consultancy company run by a former director of NHS London to tell the Kent and Medway CCGs how to cut services. Downgrading of services at QEQM hospital in Margate, as proposed by Carnall Farrar, will put lives at risk. Patients in Thanet and all those in East Kent living miles away from Ashford will be at risk of death, or avoidable disability, after a review of Kent and Medway urgent stroke services plans to concentrate hospital treatment for strokes in three sites across Kent and Medway. There is no discussion of alternatives apart from the concentration of services in three hospitals, and none on how to avoid the poor outcomes for patients when treatment is delayed due to travel times. The use of management consultancy companies is widespread in the NHS. Their reports, costing many millions of pounds, all follow the same formula of cuts, re-configurations and concentration of services. On Saturday 27th January at 10.30 am there will be a community conference (6) at Queens Rd, Baptist Church, Broadstairs CT10 1NU to oppose downgrading of local NHS services and I urge everyone concerned about the NHS in Kent & Medway to come along.” ENDS

Source: http://www.spinwatch.org

“NHS protest march to be held in Exeter City Centre”

Organisers say everyone concerned about their health service across Devon is welcome

Hundreds are expected to join a protest march through Exeter city centre to protest at hospital closures across the county.

The Save Our Hospitals Campaign is holding a march in the city on Saturday February 3 which is open to anyone who has concerns about the reorganisation taking place across Devon where four hospitals have already closed while beds have been closed at several more.

Spokesman for the group Mike Dallimore from Brixham where the minor injuries unit has been closed, cited the closure of hospitals at Dartmouth, Bovey Tracey and Ashburton and beds at Paignton Hospital.

He said the group feared Devon would ultimately be left with only two hospitals in Plymouth and Exeter.

It comes as Foreign Secretary Boris Johnson was understood to be pushing for an extra £100m a week for th NHS in England after Brexit.

The group organised a protest march in Totnes last month which hit the headlines when a mock coffin was left outside the office of Totnes MP Sarah Wollaston covered in posters saying ‘cuts cost lives’ with the figure 120,000 ‘ unnecessary’ deaths.

The protest will start at Bedford Square in Exeter at 11am and possibly march through the city centre, said Mr Dallimore.”

http://www.devonlive.com/news/devon-news/nhs-protest-march-held-exeter-1104504