“NHS privatisation soars as private companies win 70% of clinical contracts in England”

Privatising the SERVICES of the NHS allows Tories to say that it remains “free at the point of use”. What is actually happening is that we are paying through the nose when we use the service by allowing those private companies to cream off profits for their directors and shareholders, moving excess profits to tax havens. This makes the service much more expensive to run but keeps rich investors very happy.

And it is the same with privatised social care – though here the same rich investors push up the direct costs to the service users.

“NHS spending on care provided by private companies has jumped by £700m to £3.1bn with non-NHS firms winning almost 70 per cent of tendered contracts in England last year.

Private care providers were awarded 267 out of a total of 386 contracts made available in 2016-17, including the seven highest value opportunities, worth £2.4bn. …”

https://www.independent.co.uk/news/health/nhs-privatisation-contracts-virgin-care-richard-branson-jeremy-hunt-a8134386.html

“IFS warn austerity ‘baked in’ a Tory manifesto with ‘notable’ lack of social care funding”

In a dire warning the IFS added: “even in 2023–24 day-to-day spending on public services outside of health would still be almost 15 per cent lower in real terms that it was at the start of the 2010s.”

“The Institute for Fiscal Studies is deeply unimpressed at what it deemed a “lack of significant policy action” in the Conservative Party manifesto.

The Tory social care crisis for Britain’s elderly and infirm that Johnson had promised to fix when he became PM did not even get a mention in the manifesto. Johnson had previously claimed that he had a plan ready to sort it out.

The IFS concluded that the manifesto plans meant people expecting relief for Britain’s public services after a decade of austerity would instead see “cuts to their day-to-day budgets of the last decade baked in.”

Economic researchers at the independent think tank calculated that the National Insurance threshold rise to £9,500 that Boris Johnson appeared to have lied or been mistaken about will actually only save most in paid work “less than £2 a week” and highlighted the “notable omission” for any plan to deal with the crisis in social care funding.

Nigel Edwards, chief executive at the Nuffield Trust, an independent health think tank, said he was “bitterly disappointed” to see “unnecessary delay” in tackling the issue of social care.

IFS director Paul Johnson said: “If a single Budget had contained all these tax and spending proposals, we would have been calling it modest.

“As a blueprint for five years in government, the lack of significant policy action is remarkable.”

Main manifesto pledges quickly debunked

Speaking at a launch event in Telford, Boris Johnson reaffirmed his commitment to take the UK out of the EU by the end of January, so they could “forge a new Britain”. “We will get Brexit done and we will end the acrimony and the chaos,” he said.

As well as a flagship promise of 50,000 more nurses for the NHS in England despite Brexit “chaos”, the manifesto included a U-turn restoring maintenance grants for student nurses previously scrapped by the Tories.

Tory sources later acknowledged that about 30,000 of the additional nurses would come from measures to retain existing staff rather than new recruits, and the main Tory manifesto pledge was debunked among other claims by a fact checking service within hours of the launch. Labour called the Tory figures “deceitful.”

Chief executive Will Moy said the Conservative Party could “do more to meet the standards we expect” after investigating its pledges on paving the way for 50,000 new nurses and limiting day-to-day spending increases to only £3 billion, despite promising a litany of public services investment.

The fact checkers also slammed Johnson’s use the the slogan “get Brexit done”, a phrase that appears 22 times in the manifesto including on the cover, when a deal with the European Union could take “years to negotiate”.

“The Brexit process will not be completed by January,” despite what Johnson keeps repeating said the independent organisation.

‘Older people face a triple whammy’

“After a decade of the Conservatives cutting our NHS, police and schools, all Boris Johnson is offering is more of the same: more cuts, more failure, and years more of Brexit uncertainty,” Jeremy Corbyn responded.

He added: “Boris Johnson can’t be trusted. Older people face a triple whammy as he has failed to protect free TV licences for over 75s, refused to grant justice to women unfairly affected by the increase in the state pension age, and not offered a plan or extra money to fix the social care crisis.”

The lacklustre manifesto may be down to Conservative complacency after recent polls. The latest polling released on Sunday, created by Datapraxis using YouGov polling and voter interviews, suggested the Tories were on course to secure their largest Commons majority since 1987 – a majority of almost 50 MPs.

This would mean if Boris Johnson met the public services spending promises in his manifesto the UK would still be looking at a decade of cuts “baked into” our services, according to the IFS analysis.

Boris Johnson’s broken promise to fix Tory social care crisis

Paul Johnson of the IFS’ initial reaction to the Tory manifesto was scathing: “If the Labour and Liberal Democrat manifestos were notable for the scale of their ambitions the Conservative one is not. If a single Budget had contained all these tax and spending proposals we would have been calling it modest. As a blueprint for five years in government the lack of significant policy action is remarkable.

“In part that is because the chancellor announced some big spending rises back In September. Other than for health and schools, though, that was a one-off increase. Taken at face value today’s manifesto suggests that for most services, in terms of day-to-day spending, that’s it. Health and school spending will continue to rise. Give or take pennies, other public services, and working age benefits, will see the cuts to their day-to-day budgets of the last decade baked in.”

“One notable omission is any plan for social care. In his first speech as prime minister Boris Johnson promised to ‘fix the crisis in social care once and for all’. After two decades of dither by both parties in government it seems we are no further forward.

“On the tax side the rise in the National Insurance threshold was well trailed. The ambition for it to get to £12,500 may remain, but only the initial rise to £9,500 has been costed and firmly promised. Most in paid work would benefit, but by less than £2 a week. Another £6 billion would need to be found to get to £12,500 by the end of the parliament. Given the pressures on the spending side that is not surprising.”

“Perhaps the biggest, and least welcome, announcement is the ‘triple tax lock’: no increases in rates of income tax, NICs or VAT. That’s a constraint the chancellor may come to regret. It is also part of a fundamentally damaging narrative – that we can have the public services we want, with more money for health and pensions and schools – without paying for them. We can’t.”

School cuts barely reversed

The Conservative manifesto confirmed previous commitments in England to increase school spend in England by £7.1 billion by 2022–23. However, that would leave spend per pupil in real terms after a decade of austerity at the same level as 13 years ago, the IFS explained.

In contrast the IFS found the Labour commitment of a £7.5 billion real terms increase by 2022–23 a 14.6% rise in spending per pupil.

Unlike Labour and the Liberal Democrats the Conservative manifesto refused to extend free, pre-school childcare.

IFS researchers warned that the Conservative manifesto pledges left “little scope for spending increases beyond next year outside of those planned for health and schools.”

In a dire warning the IFS added: “even in 2023–24 day-to-day spending on public services outside of health would still be almost 15 per cent lower in real terms that it was at the start of the 2010s.”

@BenGelblum

IFS warn austerity ‘baked in’ a Tory manifesto with ‘notable’ lack of social care funding

A quarter of Devon’s children live in poverty says Devon County Council

It’s what people voted for when they voted Conservative for continued austerity.

“A quarter of Devon’s children are living in poverty once housing costs taken into account.

More than 35,000 children in Devon are living in poverty once housing costs are taken into account, councillors have heard.

A Children’s Services Self-Assessment went before Devon County Council’s Children’s Scrutiny Committee last Monday which provided an up-to-date evaluation of the needs of children and families in Devon.

The report outlined how 14 per cent of the local authority’s children are living in poverty (before housing costs), but that rises to 25 per cent (after housing costs) are taking into account.

More than 10 per cent of children are entitled to free school meals, the report added, and also says that 41,000 households in the county are affected by fuel poverty.

Cllr Rob Hannaford, chairman of the Children’s Scrutiny Committee, said that the figures were shocking and in many areas, including Devon, growing up in poverty is not the exception but the rule.

Commenting on the report after the meeting, he said: “These local figures for child poverty in Devon are truly shocking, and it’s completely unacceptable and wrong in 2019, in one of the richest countries in the world, that we are still dealing with this most basic of issues affecting so many children.

“Large numbers of people seem to just wrongly assume that because we live a beautiful part of the country, that we don’t experience the same serious social problems that other areas do. These new figures again show in stark reality that this is just not the case, and much of our poverty and hardship is hidden by the affluence that some others have.”

Cllr Hannaford added: “Thousands more families across Devon, are living on the cusp of the poverty line. One unexpected setback – like redundancy or illness – could push them into the poverty trap.

“Overall there are more than four million children in the UK growing up in poverty. The situation is getting worse, with the number set to rise to five million by 2020. And those poverty rates have risen for every type of working family – lone-parent or couple families, families with full and part-time employment and families with different numbers of adults in work. This is the first time in two decades this has happened, and incredibly it is happening at a time of rising employment, and these figures in Devon are in line with these trends.

“But the evidence is clear – poverty can make existing vulnerabilities worse. Growing up in poverty puts at risk the building blocks of a good childhood – secure relationships, a decent home, having friends and fun, and an inspiring education.

“A child is said to be living in poverty when they are living in a family with an income below 60 per cent of the UK’s average after adjusting for family size. So it’s just not acceptable that some people still seem to trot out the same old tired response that no one is really in poverty these days, and it’s like Victorian times or the 1930s, such as when children didn’t have shoes on their feet.

“My grandparents were brought up in near slum conditions, and at times they also did not have proper shoes, and went hungry, are we really seriously saying that we want to inflict all this misery and hardship on children today?”

He continued: “Clearly the biggest driver for children’s poverty nationally and locally is the profound lack of social, affordable, decent housing. The figures are stark. 120,000 children in England are living in temporary accommodation. There are also 90,000 children living in families who are ‘sofa-surfing’. And of course this accommodation is usually terrible.

What is poverty in the UK?

“B&Bs where sometimes the bathroom is shared and there is nowhere to cook. Places where vulnerable adults can be living on the same corridor. Office block conversions – individual flats the size of a parking space, where families live and sleep in the same single room. And even converted shipping containers – cramped and airless – hot in the summer, freezing in the winter. This is a reality that shames the whole nation.

“Rising living costs, low wages and cuts to benefits are creating a perfect storm in which more children are falling into the poverty trap. Shockingly, two thirds of children living in poverty have at least one parent in work. Many families are struggling to cope with the rising cost of living. The prices of essentials like food and fuel are going up and this hits Britain’s poorest families hardest. We know that parents are skipping meals so they can afford to feed their children, and in winter many families are forced to make the impossible choice of feeding their children or heating their homes.

“So we know what actually causes child poverty and we know how to end it. We know that the income of less well-off families has been hit by severe real-terms cuts in benefits and by higher housing costs. And we know that work does not always guarantee a route out of poverty, with two thirds of child poverty occurring in working families.

“Yet in many areas, including Devon, growing up in poverty is not the exception, it’s the rule, with more children expected to get swept up in poverty in the coming years, with serious consequences for their life chances. Policy makers can no longer deny the depth and breadth of the problem, and the Government must respond with a credible long term child poverty reduction strategy.”

The report revealed that in primary schools, 10.9 per cent of pupils are entitled to free schools meals, and 10 per cent in secondary schools, but Cllr Hannaford feared that the numbers were in reality much higher.

He added: “The percentage is shocking, but there is a feeling in rural areas that it may be more as there is a stigma about people and they don’t claim it so they don’t have the finger pointed at in the local community.”

Cllr Margaret Squires, who represents the Creedy, Taw & Mid Exe ward, added her concerns to those of Cllr Hannaford.

She said: “A headteacher who had moved down here from London said to me the deprivation they see is different. Down here, people don’t want others to know they have free school meals, so they are working every hour they can. But it means that the children are missing out as the parents are so tired, they haven’t got the time to sit and listen to them read.

“I my area, we are virtually fully employed, but some of them work two jobs so they can live in the area, and to survive, they are working all these hours, but it not recorded as deprivation as they don’t have time to sit and read with their children.”

The figures in the report showed at as of September 1, 2019, 771 children were being looked after by the council – a rate of 54.8 per 10,000 children – an increase from 750 – 52.2 per 10,000 children – at March 31.

At September 1, 2019, 3,219 children had been identified through assessment as being formally in need of a specialist children’s service, an increase from 3,318 in March 2019, but the number of children subject of a child protection plan had decreased from 518 to 505 between March and September.

The report also said that there were 25 unaccompanied asylum-seeking children in the area, and that eight children and young people who turned 18 years old and who were in the care of the local authority were living in unsuitable accommodation during 2018-19.

Cllr Linda Hellyer questioned what the council was doing about it, why they were unsuitable, and what have we done to get them somewhere better.

In response, Darryl Freeman, Head of Children’s Social Care, explained that the definition of unsuitable included prison, where two of the eight were in custody. He added that the council will continue to work with them, assuming they allow them to remain in touch, and to ensure that they have choices once they leave custody.

The report also added that the top three risks for the future were increase in demand, across all services, recruitment and retention, particularly of experienced social workers, and sufficiency of provision for special needs children and placements for Children in Care.

The council also earlier this year adopted a new Children and Young People’s Plan, which is the single plan to co-ordinate developments for the next three years

Each priority in the plan has a detailed strategy/ action plan below it with a multi-agency group led by a senior manager from the partnership.

The self-assessment report was noted by the committee.

https://www.devonlive.com/news/devon-news/child-poverty-devon-truly-shocking-3579939

Questions for the Tory candidate as he rushes around East Devon

Claire Wright has been clear with her manifesto – protecting what is best about East Devon, standing up for the NHS am]nd social care, conserving the environment and improving education and inequality.

https://claire-wright.org/2019_site/wp-content/uploads/2019/11/GEManifesto2019FINAL5.pdf

Unfortunately, the Conservative Party has not been so clear.
Other party manifestos are unimportant in East Devon.

A vote for anyone other than Claire Wright is a vote for the Tories.

Our parachuted-in, Tory apparatchik candidate is throwing himself around the constituency like a whirling dervish (mostly accompanied by the same old 5-6 people – who must be finding it quite tiring) But has anyone asked him these questions and, if so, has he given any answers?

If not, maybe hustings will provide a platform for him to answer.

What do you think of the Tory fake-news “factcheck uk” Twitter account? Is that acceptable?

What do you think of the “50,000 more nurses” which includes 19,000 that you think you might be able to persuade NOT to leave? Is this acceptable?

What do you think about the “20,000 more police” when you got rid of 21,000. Is this acceptable?

What do you think of the “60 new hospitals” when itis actually only 6 – the others to get minimal funding to plan new hospitals, not build them? Is this acceptable?

Why has social care been left out of the manifesto? Is this acceptable?

All the above is said to be taking 10 years to achieve – if at all? Is this acceptable?

“Boris Johnson under fire over ‘vague’ social care funding plans”

Yet millions of over 65’s will vote for them over an issue (Brexit) that will affect their children and grandchildren much more than them, and where those people often have very different views to them. THIS, and the state of the NHS, should be their main worry.

“Nicky Morgan has defended Boris Johnson over his decision to shelve plans to overhaul social care funding in the Conservatives’ manifesto launch.

The Conservative party has pledged to allocate an extra £1bn a year for the social care sector as part of a cautious manifesto, while guaranteeing that no one should have to sell their home to meet the costs.

But it falls short of Johnson’s rallying cry on the steps of Downing Street when he took office, claiming “we will fix the crisis in social care once and for all … with a clear plan we have prepared”.

Theresa May was forced into a U-turn when her 2017 manifesto social care plan was labelled a “dementia tax”, and Johnson has now committed only to saying the party will “build a cross-party consensus” on how it should be funded in the long term.

Sir Andrew Dilnot, the former chair of the commission on funding of care and support, said the Tory plans were “very vague”. And the head of a thinktank has said Johnson’s pledge is too little to plug the gap needed to cater for the country’s ageing population. …”

https://www.theguardian.com/society/2019/nov/25/boris-johnson-under-fire-over-vague-social-care-funding-plans?CMP=Share_iOSApp_Other

No-one cares about social care: 74,000 over 65s have died while waiting for social care since last election

Covert euthanasia?

“A charity has blasted the government for the time it has “wasted” on drawing up a social care paper that still has not materialised.

Age UK called on the next government to spend £8bn over the next two years to prevent further decline in the adult social care sector.

The charity pointed out since the 2017 election 74,000 over-65s in England have died while waiting for the care they asked for, equating to a rate of 81 deaths per day, in analysis released yesterday.

Caroline Abrahams, director at Age UK, said the political system has “completely failed” to reform social care, despite it featuring heavily in the 2017 election campaign.

She said the last third months waiting for the promised social care green paper, which has now been delayed six times had been “effectively wasted ..waiting for the social care green paper that never was”.

“Social care is not some kind of nice-to-have optional extra, it’s a fundamental service on which millions of older and disabled people depend every day,” Abrahams said.

“Good care provided by kind and committed people, enriches lives and makes it possible to have dignity and hope. The reverse is also true: if you need care and you can’t get it then there are very serious implications for your health and your wellbeing – as the NHS knows all too well.”

Age UK estimates that between the 2017 and 2019 elections 1,725,000 unsuccessful requests have been – or will be made – by older people for care.

“It is appalling that one and a half million older people in our country now have some unmet need for care, one in seven of the entire older population. This is a shameful statistic, and older people are developing new unmet needs for care every day.”

https://www.publicfinance.co.uk/news/2019/11/charity-demands-action-social-care
(pay wall)

Devon Clinical Commissioning Group £66 million in debt and heavily criticised

“One of England’s largest clinical commissioning groups has increased its planned deficit by nearly £40m.

Devon CCG, formerly part of a “success regime”, is now forecasting a £66m deficit in 2019-20, despite initially targeting ending the year £27m in the red.

The £1.2bn-income CCG broke even for the first time in its history in 2018-19, after it achieved a £25m deficit which unlocked £25m of commissioner sustainability funding.

Devon’s problems are compounded by the “increasing expectation” that several of the county’s providers are at risk of missing their control totals, according to the CCG’s latest finance report.

Additionally, Torbay and South Devon Foundation Trust, which was not part of the success regime, has expressed concern about a “top-down approach” by Devon’s sustainability and transformation partnership over the creation of a long-term financial plan.

It comes just two months after HSJ revealed external consultants reported a culture of “learned helplessness” and “crisis mentality” among Devon’s NHS leadership, with individual chiefs “retrenching” back into their organisations when faced with difficult decisions.

Savings plans

Devon’s STP initially forecast a deficit of £115m for 2019-20 against a control total of £43m. However, the area then went through an “intensive programme supported by NHS England/Improvement” to reach an “acceptable position”, according to Devon CCG’s board papers.

This resulted in the forecast deficit being reduced to £70m and was based on “accelerating” transformation programmes across Devon, with the CCG tasked with finding the extra £45m of savings required to hit it.

This meant the CCG’s savings plan rose from £36m to £81m.

The revised plan is yet to be approved by NHSE/I, but the CCG now says it cannot find savings worth £39.5m, leading to the rise in the deficit forecast.

Asked what transformation programmes the CCG had hoped would yield savings, a spokesman said this included:

Revising down the level of forecast demand growth so it was “more closely aligned” with national benchmarking;

Managing demand for hospital services by accelerating planned improvements in productivity; and

Updating “projected increases” in additional funding.

But, according to the CCG’s board papers, it will not be possible to deliver the proposed savings due to pressures within “continuing healthcare, prescribing and independent sector contracts”.

Control totals

The CCG’s finance report also warns Devon’s providers are increasingly at risk of missing their control totals.

Torbay and South Devon FT has moved its forecast deficit from £3.8m to £18.8m after missing out on expected income in relation to social care services provided to Torbay Council, failing to deliver savings schemes such as reducing outpatient follow-up appointments, and spending more money than planned on agency staff.

The trust also reported sickness levels in “key specialties” — such as emergency, respiratory and stroke — adversely affecting the organisation.

This autumn, the trust hired KPMG to review its finances, but the “draft” report has not yet been published.

Additionally, the trust’s finance committee has heard concerns from members about a “top-down approach” being adopted by STP chiefs in charge of preparing a long-term financial plan for the health economy.

According to the committee’s minutes, the approach “does not take account…of the unique position of Torbay and South Devon as an integrated trust which carries the risk of adult social care”.

The minutes went on to state that members felt it is “imperative” the trust “challenges the modelling approach” used by the STP to avoid financial targets which “lack credibility”.

The trust did not answer when HSJ asked it to clarify what the problem was with the STP’s modelling approach.

Asked for a response to the allegation of a top-down approach, Devon STP’s finance lead John Dowell said: “All partners across the Devon system… are fully focused on solving the performance and financial challenges we face.”

Elsewhere in Devon, University Hospitals Plymouth Trust did not comment when asked if it was on track to achieve its finance plan to break even. However, its latest board papers stated it faced a “forecast shortfall” against its £25m savings programme which — alongside other finance pressures — means the trust is facing a “significant challenge to deliver its financial plan”.

Both Northern Devon Healthcare Trust and Royal Devon and Exeter FT are on track to hit their targets (breakeven and £8.6m surplus respectively).

Devon Partnership Trust, which provides mental health services, is also reporting being on track to deliver its planned £1.6m surplus, according to its latest board papers.”

Source: Health Services Journal