A hint as to where Devon’s “health service” could be headed

No more prescriptions, instead:

“We are all used to going to the doctor and have them write a prescription for medicine. But what we are less used to is the idea that the doctor or nurse or social worker might give us a prescription for a walking group, soup and sandwiches in the local village hall, an Age UK befriending service.”

Patricia Hewitt, ex-New Labour Blairite MP, privatisation enthusiast and now chair of the Norfolk & Waveney Sustainability and Transformation Plan (STP)


Needless to say, the walking classes which would likely be volunteer run for free, soup and sandwiches in the village hall perhaps provided by the food bank and befriending by an already overstretched and underfunded charity – definitely NOT by her STP!

How much do PFI contracts cost DCC?

“A Labour pledge to bring “wasteful” PFI contracts back in the public sector would cost a massive £671m in Devon, it has been revealed.

Shadow chancellor John McDonnell told the annual party conference last month the contracts were set to cost the taxpayer £200bn over coming decades and private companies were making “huge profits”.

The cost to the county for all the buildings, such as schools, hospitals armed forces’ accommodation, funded by private finance initiatives was estimated to be around £2.4bn just four years ago.

Newly released figures by the county council show that Exeter Schools would cost £210m to buy out with £322m for an energy for waste (EFW) plant and £139m for a Devonport EFW scheme. …

… Private companies carry out the construction work and maintenance, in exchange for regular payments from the taxpayer.

It has proved controversial with criticisms that it is overly generous to the private contractors.

Some schools, including in Exeter, have said the quality of parts of their new buildings have been poor.

Other public bodies, such as hospitals, have complained that large debt repayments, over long periods of time, make it difficult for them to balance their books.

However, defenders of PFI said it provided new infrastructure which would otherwise be unaffordable.

The biggest margin on a project in Devon came with a deal for new accommodation for services’ personnel at Devonport Naval Base in Plymouth.

Its estimated cost of £554m, which will also include service and maintenance charges, is more than 12 times the initial building price. …

… Devon County Council said it could not “accurately” estimate the cost of terminating contracts without going into negotiations.

Cabinet member for finance John Clatworthy said the schools PFI contract in 2005/6 was £348m.

He wrote: “Set against this was a grant of £248m that would be received from central government – of the balance, £75m would be met from the delegated schools budget and the remainder (£75m) would be met by the council.”


The free market – where you are free to walk away from responsibility for your actions

“The boss of Monarch was setting-up his own firm as the stricken airline was going to the wall, it has emerged.

Andrew Swaffield insisted he was “heart broken” by the firm’s collapse, with the loss of more than 1,800 jobs. Yet as Monarch was for fighting for survival, polo playing Mr Swaffield found time to get a new firm for himself off the ground.

Records show electronic paperwork to establish Alcedo Consulting Services was received by Companies House last Friday. The two directors are Mr Swaffield and his partner William Low, 51. The company was formally incorporated on Monday – the same day Monarch plunged into administration.

Stefan Stern, director of the High Pay Centre, branded the timing “shocking”. He said: “He appears to have been planning his escape route before the passengers or crew. “It used to be women and children first, now it seems to be chief executive first. “It’s such bad taste and, frankly, stupid, to do this now.”

The firm is named after Mr Swaffield’s polo team, Alcedo, which recently won several trophies at the Cowdray Park Polo Club in West Sussex.

In a message seen by the Mirror, he insisted Monday’s collapse of Monarch was “the hardest day of my entire career. “Seeing the end of the company and 1,800 people losinzg their jobs has been heart breaking.’

Mr Swaffield previously ran a consultancy firm, CST Consulting, after losing his job at British Airways in 2005. He said: “I have done the same again today knowing that I am leaving, so that I can start the process of planning my future and if I manage to secure any work I will have a company through which to process it. “It can take up to a year to secure chief executive level roles and consulting is a good stop gap.”

Records show Mr Swaffield became chief executive of another company, Shelfco 2017, that was set-up on September 25. The other directors include Nils Christy, Monarch’s chief operating officer, and Christopher Bennett, its finance director. It is registered at Monarch’s Luton Airport headquarters.

It came as millions of holidaymakers and bank customers are set to pick-up the bill for Monarch’s rescue flights.”


The NHS: one doctor’s story

“An open letter to Prof Ted Baker, following his attack on the NHS
Dear Professor Baker,

It seems like only yesterday that another Professor – Stephen Hawking – felt compelled to raise concerns in the press about the current state of the NHS. If you recall, Hawking’s critique of Jeremy Hunt’s predilection for statistical cherry-picking prompted an extraordinary barrage of tweets from the Health Secretary, admonishing one of the world’s greatest scientists for his cluelessness on the matter of, well, scientific methodology.

Professor Baker, your interestingly-timed intervention today has prompted quite the barrage of headlines itself, hasn’t it? An NHS ‘unfit for the 21st century’, indeed? And that picture you paint of A&E departments’ disgraceful ‘unsafe practices’ – our ‘wholly unsatisfactory’ arrangements that ‘endanger patients, as well as denying them basic privacy and dignity’. It’s almost as if you think we’re somehow choosing to ‘keep piling patients into corridors where staff cannot even see them’ or to force patients to queue, hour upon hour, in ambulances outside log-jammed hospitals. Actually, you go further, don’t you? You directly blame us for the hellish conditions that patients and staff alike endured last winter, condemning our culture of ‘learned helplessness’ that leaves our patients abandoned, unmonitored, without even essentials like oxygen.

There’s just so much blame in your interview, isn’t there? Previous NHS staff, current NHS staff, ‘archaic’ NHS systems, bad managers, bad previous governments. Blimey. No-one, it seems, is immune from your blame. Except, that is, the one glaring exception. The one cherry you chose not to pick, so to speak.

Nowhere in your remarkable blame riff is there any mention of the funding climate in which frontline staff and managers alike are struggling – fighting tooth and nail, frankly – to keep on delivering a halfway decent standard of care for our patients. We are trying so unbelievably hard, Professor Baker. But we already have one of the lowest numbers of beds per capita of any country in Europe, as well as being one of the most under-doctored. And, of course, we have a government, currently, who has chosen to subject the NHS to the most draconian and sustained funding squeeze in NHS history. Right now, the NHS in my region is having to cut even more beds, hundreds of them. It simply cannot afford to do otherwise – like every acute Trust in the country. That’s not really going to help the patients stranded, bedless, in corridors about which you care so deeply, is it?

Of course NHS reform is needed. Of course we need greater community capacity and better integration between hospitals and primary care. But in omitting to mention the political context to your argument – the political choice to provide the NHS with inadequate resources safely to manage not only winter, but all-year-round rising demand – you come across, I’m afraid, as an oddly partisan chief inspector of hospitals. Why the omission, Professor Baker? Why blame the NHS and its dog, yet fall so shy and silent when it comes to acknowledging the political choices to underfund and understaff the NHS into a skeleton service in place of excellence?

Do you really think your admonishing letter to Trust CEOs, telling them to jolly well stop leaving patients in corridors, is going to do anything other than incense us all? Where else would you suggest we put them? Toilets? Broom cupboards? I believe Jeremy Hunt’s new toilet is rather lavish – perhaps we could squeeze one or two in there?

Anyone would think you were giving the Department of Health comms team a helping hand in the pre-emptive deflection of blame for the looming winter crisis away from the government and onto anyone else but Theresa and Jeremy. I thought nothing could surpass for sheer stupidity last week’s news that NHS staff were forced by NHS bosses to chant “we can do it” as an approach to managing ED winter pressures. But you, Professor Baker, have managed to out-Brent even that David Brent of a spectacle: instead of empty exhortation, you have apparently plumped for his more bullying style of management, through the medium of tetchy, head-masterly letters saying ‘you can and will pull your socks up – or else’. In all those years you’ve worked in the NHS since 1972, have you never noticed that nothing good ever comes from a caning?

Let me remind you what blame culture achieves, Professor Baker. First, it demoralises and undermines frontline staff. Then, it makes us feel hopeless and impotent. We stop trying to speak out, we become cowed and silent. And now, all that bullying and blame has managed to make the NHS less safe, not more, by allowing a culture to flourish in which no-one feels they can change anything, let alone risk speaking out for the sake of our patients.

In your interview, you’ve just achieved all of the above. I’m a hard-working NHS hospital doctor, and you’ve made me feel angry, demoralised, hopeless and incredulous – all in the same moment. That is not leadership, Professor Baker, and it is certainly not conducive to high standards of patient care. It serves only to present you to the public and NHS staff alike as a hospital chief inspector who seems to care more about playing a political game than the vital matter of patient safety.

How incredibly, bitterly disappointing.

Incidentally, please consider this letter my raising of safety concerns on behalf of NHS patients nationwide, as my duty of candour demands me to do.

Dr Rachel Clarke


An open letter to Prof Ted Baker, following his attack on the NHS

Playing politics with peoples’ lives

“Labour has called for an inquiry after the collapse of a private ambulance firm that has contracts with the NHS and other private health organisations.

Private Ambulance Service, which the trade union Unison described as running an “abysmal” operation, was issued a winding-up notice by the Inland Revenue on Friday. The firm is expected to stop trading on 9 October.

The company has been employed in Bedfordshire and Hertfordshire as non-urgent patient transport service. It worked for hospitals including Watford General and Bedford hospital.

Labour MP Justin Madders, the shadow health minister, said: “It is still staggering that under the Tories so many parts of the NHS are being packaged up and sold off to companies who are unable to run the services properly.

“Several hundreds of staff and thousands of patients are now faced with huge uncertainty because of the failings of another private ambulance firm, and it’s not the first time this has happened.”

Madders called for an inquiry into what went wrong, saying the government should place “an immediate halt” on issuing other patient transport contracts until “lessons have been learned”. …”


Privatised good, nationalised bad? Think again

The NHS has about 1,700,000 UK workers:

“In December 2016, NHS Improvement forecast that NHS trusts would end 2016/17 with a potential deficit of £750–£850 million.”



Carrillion has about 48,500 UK workers:

Shares in the beleaguered Carillion construction group, which is working on the HS2 London to Birmingham rail line and the vast Battersea Power Station project, plunged by 20% on Friday after the company issued its second profit warning in two months.

Carillion reported a first-half loss of £1.15bn and said its full-year performance would be worse than previously expected. It described the loss as “disappointing”. The shares, which were changing hands at 190p little more than three months ago, closed at 51p.

The company is struggling with a large debt pile and badly-performing contracts. It said it would write down £200m on 23 support services contracts, and was taking a £134m charge relating to its UK and Canadian construction businesses. …”