NHS : Privatisation Issues And Related News

Discuss news stories and political issues that affect carers.
More on the NHS using private companies ... news from the Yorkie Post :


http://www.yorkshirepost.co.uk/news/hea ... -1-8831566


Hospitals across Yorkshire could follow ‘VAT scam’ Trust, warns MP.


AN MP who campaigned to stop a hospital trust forming a new company to run services in a move he described in Parliament as a “VAT scam” has warned many more could be on the way across Yorkshire.

Keighley’s Labour MP John Grogan has pledged to bring cross-party colleagues together with health ministers to discuss the proliferation of NHS trusts forming subsidiary companies to run non-clinical activities such as facilities, estates and purchasing - measures critics say will lead to lower wages and poor conditions for staff, and amount to “backdoor privatisation” of the NHS.

Following Airedale NHS Trust’s decision to create a private company to run some services at its hospital in Keighley, made in private at its board meeting last week, Mr Grogan raised the issue in Parliament, with Leader of the House of Commons, Andrea Leadsom, calling the decision “concerning” and urging him to take it up with health ministers.

Mr Grogan said: “Now that such a senior minister has expressed concern the sensible thing for the Airedale NHS Foundation Trust Board is surely to put their plans on hold and at the very least start a proper consultation with all the information in the public domain.

“But this is a wider issue than Airedale,” he added. “Authorities across Yorkshire are considering setting up private companies to run large parts of their activities. This is concerning not just because it will cost the Government in terms of VAT, at a time when the Chancellor is trying to find money in the budget for NHS pay, but also because these companies will be able to set terms and conditions for their staff.”

Airedale NHS Trust said the new company would allow its teams to work “more efficiently, run their own budgets, make their own decisions and bid for other contracts”, and formal TUPE consultations with staff and unions have begun, with the intention of the new company going live on February 28 next year.

The GMB union has called for the plan to be “binned”, claiming it is “the bean counters spotting a way to save money”.

“The Trust also clearly sees it as an opportunity to crush terms and conditions for the lowest paid employees,” GMB senior organiser Pete Davies said.

Airedale is not the first hospital trust in Yorkshire to form a subsidiary company. Barnsley Hospital NHS Trust launched Barnsley Facilities Service, on September 1, with 140 former trust employees providing “estates, facilities, procurement, security and resilience and health, safety and fire services” to the Trust.

Regional head of health at Unison, Tony Pearson, said new plans were “springing up all over the place”, with York Teaching Hospital NHS Foundation Trust being the latest to engage with the union about a proposal which could save “significant” sums,, and Rotherham is also considering cost-saving options.

“The real problem for the unions is that there will be huge chunks of the NHS workforce going out of the NHS,” he said. “They object to us using the term privatisation but they are wholly owned private companies that are allowed to set their own terms and conditions. They are not worth the paper they are written on and can be torn up at any time.”

A spokesperson for York Teaching Hospital said it is “actively exploring” an alternative model for delivering estates and facilities services.

Rotherham NHS Trust said it was exploring how services could be provided to ensure it was getting “value for money”, but nothing had yet been decided.


Yet another one to keep our eyes on ?
Yet another one , Capita ... a primary care support services contractor ... gp trainees :


https://www.theguardian.com/society/201 ... ils-to-pay


Hundreds of trainee GPs facing hardship as outsourcing firm fails to pay.

Exclusive: Payment delays by Capita leave some trainees unable to cover mortgages and forced to ask for emergency funds.


Hundreds of trainee GPs have not received their salaries from the outsourcing company responsible for paying them, forcing some to turn to charities for emergency funds.

Some GPs have been unable to cover their mortgages because of the delays by Capita, which holds a contract to administer training grants for GPs through a body called Primary Care Services England.

A letter sent to NHS England on 30 October by the British Medical Association and seen by the Guardian warns that some practices were “having to pay trainees out of already overstretched practice budgets, or trainees are going months without being paid if the practice cannot cover the shortfall”.

Capita confirmed it had outstanding payments to some trainee GPs but it was unable to say how many it is responsible for paying, or how many it has failed to pay.

The BMA estimates that hundreds of trainees have been affected, although NHS England was also unable to give a number. The Cameron Fund, a charity for the prevention of hardship among GPs and their dependents, said it had received three applications for emergency funding in the last week alone.

“This is actually probably the tip of the iceberg,” said the treasurer of the charity, Dr David Wrigley. “NHS England has commissioned out what was a very efficient service run within the NHS, and now Capita runs this contract in what I’d call another botched privatisation.”

One trainee GP, who asked not to be named, was not paid for two consecutive months by Capita. At the end of October she posted on a private message board for GPs asking: “Anyone know of how I access hardship funds (quickly) to feed children/pay nursery/mortgage (quickly)?”

She applied for charitable assistance immediately afterwards, she told the Guardian. The Cameron Fund gave her emergency funds so she could buy a present for her daughter’s seventh birthday.

“It’s pretty stressful. A constant drain. I’ve run out of energy to be able to fight it,” she said. Her surgery also provided her with a loan last month to tide her over, but did not hold enough surplus funds to do the same to help her again.

But in the last 24 hours, she says, “partners literally just stepped forward [and have] all taken a pay cut and provided me with a loan to get me through the month as they were worried about my family”.

Capita has faced issues with its primary care support services contract since it was awarded in June 2015, including missing records, administrative errors preventing GPs from working, and missing payments. Critics will see the latest revelations as evidence of the dangers of outsourcing NHS services.

An NHS England spokesperson said it was “holding Capita’s feet to the fire on needed improvements”. It added: “In the meantime, the lead employer for Health Education England or the GP practice are responsible for paying their GP trainee salaries and are subsequently reimbursed for this. Backlogs are being prioritised by Capita.”

But while it now says that it is piling on the pressure, six months ago NHS England appeared to be sanguine about Capita’s performance, with the GPs’ magazine Pulse reporting NHS England saying it was “encouraged” by the progress made by its much-criticised contractor in implementing a recovery plan.


Capita says that in some cases it has not received all the information it needs to pay salaries from the relevant employers. A spokesperson said the problems were an “inevitable” part of “a major transformation project to modernise a localised and unstandardised service”.

It added: “We have made significant investment to deliver improvements and these have been recognised by NHS England and demonstrated through improved service performance and improved customer satisfaction. We are continuing to transform locally managed operations into a modern and efficient national customer-focused service for NHS England and all primary care organisations.”

The BMA’s letter, to the NHS chief executive, Simon Stevens, details a range of problems with Capita.

“We are disappointed at the lack of progress that has been made,” it says. “These issues have been ongoing since NHS England commissioned Capita … and it is unacceptable that more progress has not been made to getting these resolved.” The BMA also claims there have been significant issues with processing both locum and trainee GPs’ pension contributions.

“The reality is that there are huge levels of funding that should be going to GP practices that are not going through,” said a BMA spokesperson, Dr Krishna Kasaraneni. “All the issues we’ve identified add up to this being a patient safety matter. Patients are at risk.”

One doctor in her third year of GP training who asked not to be named told the Guardian her salary had not been paid from April until August this year.

“My surgery gave me a loan initially, and then when it still wasn’t being paid, I had to dig into savings,” she said. “I was pretty frustrated. The people who were in charge of solving it clearly weren’t all that bothered, and it took a lot of very angry emails to get the fifth month paid. If it hadn’t been I was about to apply to a charity for help as I was running out of money.”

At the Cameron Fund, Wrigley says he believes Capita’s failings are so serious that the public accounts committee should be investigating the contract.

“NHS England have known about this for a while and the BMA has been putting constant pressure on, and it’s all promises that it’ll get better but it doesn’t. I heard [that in] Nigeria trainee doctors weren’t getting paid but you don’t expect it in the world’s fifth richest economy,’ he said. “It’s a complete failure and I’d like the contract taken back to be run by the NHS.”

New systems for cervical screening and GP payments and pensions that are also contracted out to Capita are due to go live next July. The BMA has told NHS England that it has “no confidence” in Capita’s ability to deliver these services.

“The consequences of failings will be very serious for practices, potentially affecting their viability,” its letter concludes. “All of us who work in general practice and who depend on this service, expect to see much more robust stance taken by NHS England to resolving these many problems.”

At the Cameron Fund, Wrigley is anticipating more requests for help. “I expect we’ll see more [applications],” he says. “There’s no sign of Capita sorting its act out.”


Oh dear !

There is no smoke without a fire.

So many questions ... no answers ?
Today's Guardian ... Care UK target West Country GPs :


https://www.theguardian.com/society/201 ... ts-care-uk

Private health firm gives GPs operation price list for impatient patients.

Campaigners alarmed after Care UK sends letters to hundreds of NHS doctors in west of England.


A private healthcare company has sent letters to hundreds of GPs setting out a price list of operations they could offer their patients to beat NHS delays and restrictions.

Care UK, which runs nine centres offering treatment on the NHS, said it intended to use spare theatre time to provide “self pay” procedures ranging from earwax removal to hip replacements.

The company said it was trialling the scheme at two treatment centres in the west of England but insisted core work at the sites would remain NHS referrals.

The move has, however, alarmed some GPs and health campaigners who fear it is another example of creeping privatisation in the NHS.

The procedures are being offered at the Emersons Green treatment centre near Bristol and a second centre in Devizes in Wiltshire. The list of treatments on offer ranges from earwax removal (£160) to hip replacements at just under £9,000. Other procedures being offered include cataract surgery, tonsillectomies and vasectomies.

Mike Campbell of campaign group Protect Our NHS said: “It is totally wrong that hard-pressed GPs are being encouraged to recommend their patients to a private company where patients will be paying when they should be getting their treatments free.

“More people are having to pay for urgent procedures, either by dipping into savings or by taking out health insurance. For those who can’t pay, waiting lists grow.”

Dr David Porteous, a Bristol GP, argued that it normalised the idea of paying for healthcare. He said: “It’s about removing the expectation of state provision of services.”


The NHS Bristol clinical commissioning group made it clear it had not encouraged Care UK to write the letters and was not suggesting to GPs that they promote the service.

A spokesperson said: “We commission Care UK to provide a number of planned care treatments. As a private provider of healthcare, they are able to offer self-pay treatments for patients, completely separate from the NHS. We are keen to stress there will continue to be a clear separation between NHS and private treatments.”

A Care UK spokesperson said it had begun to offer a “self-pay option” at the two treatment centres to give “an additional treatment option for patients who find their access to NHS funded procedures has been restricted or delayed”.

They added: “Our focus will be on making use of otherwise unused theatre time to give easy, affordable access to procedures which have been restricted or de-prioritised by NHS commissioners, but which are nonetheless beneficial to patients’ wellbeing and quality of life.

“This option is essentially the same as that already offered to patients by NHS hospitals and gives an additional high quality, transparent, value-for-money alternative to private health insurance and to the much higher prices charged by existing private hospitals.”

Care UK said clinicians received no financial incentive to treat self-pay patients and their decisions were based purely on clinical need. In addition, the company followed strict legal guidelines to ensure that the request to explore self-pay is initiated by the patient.

“I would like to stress that Emersons Green and Devizes treatment centres will continue to see NHS-funded patients for the same range of services as we have been doing in recent years,” the spokesperson added.

Care UK has close links with the NHS. It has won contracts worth many hundreds of millions of pounds and provides a range of NHS-funded services for NHS bodies in England. They include NHS 111 telephone advice centres, GP practices, walk-in centres, out-of-hours GP services, diagnostics facilities and treatment centres, and healthcare services in prisons and other secure facilities.

Research by the trade union Unite in 2014 said that Care UK had won contracts worth £650m from the NHS over the previous two years.

The company was involved in a row when it emerged that Caroline Nash, the wife of Care UK chairman John Nash, had in 2009 donated £21,000 to Andrew Lansley, the then Conservative shadow health secretary, at a time when he was drawing up controversial plans to allow more private provision in the NHS, which would later emerge in the health and social care bill 2010.


Make of this one what you will.

A two tiered health system based NOT on need , but ability to pay !

Note well the final paragraph.

The basic essentials to survive in this Sad / Angry New World based on the ability to ... pay ???
Another one brewing under the radar ... today's Guardian :


https://www.theguardian.com/society/201 ... t-plan-nhs


Labour demands Commons vote on 'secret' plan for NHS.

Party says ministers are trying to push through changes that could lead to greater privatisation and rationing of care.


Labour is demanding that MPs be allowed to debate and vote on “secret” plans for the NHS that they claim could lead to greater rationing of care and privatisation of health services.

The party says ministers are trying to push through the creation of “accountable care organisations” (ACOs) without proper parliamentary scrutiny.

Jonathan Ashworth, the shadow health secretary, has written to Andrea Leadsom, the leader of the House of Commons, urging her not to let “the biggest change to our NHS in a decade” go ahead without MPs’ involvement.

NHS England’s chief executive, Simon Stevens, and the government see ACOs as central to far-reaching modernisation plans that they hope will improve patient care, reduce pressure on hospitals and help the NHS stick to its budget.

ACOs involve NHS hospital, mental health, ambulance and community services trusts working much more closely with local councils, using new organisational structures, to improve the health of the population of a wide area. The first ACOs are due to become operational in April in eight areas of England and cover almost 7 million people.

Labour has seized on the fact that the Department of Health plans to amend 10 separate sets of parliamentary regulations that relate to the NHS in order to pave the way legally for the eight ACOs.

In his letter, Ashworth demands that Leadsom grant a debate on the plans before the amended regulations acquire legal force in February.

“Accountable care organisations are potentially the biggest change which will be made to our NHS for a decade. Yet the government have been reluctant to put details of the new arrangements into the public domain. It’s essential that the decision around whether to introduce ACOs into the NHS is taken in public, with a full debate and vote in parliament,” he writes.

A number of “big, unanswered questons” about ACOs remain, despite their imminent arrival in the NHS, he adds. They include how the new organisations will be accountable to the public, what the role of private sector health firms will be and how they will affect NHS staff.

Ashworth also says “the unacceptable secrecy in which these ACOs have been conceived and are being pushed forward is totally contrary to the NHS’s duty to be open, transparent and accountable in its decision-making. The manner in which the government are approaching ACOs, as with sustainability and transformation plans before them, fails that test.”


Stevens’s determination to introduce ACOs has aroused suspicion because they are based on how healthcare is organised in the United States. They came in there in the wake of Obamacare as an attempt to integrate providers of different sorts of healthcare in order to keep patients healthier and avoid them spending time in hospital unnecessarily.

A Commons early day motion (EDM) on ACOs also being tabled by Labour on Thursday, signed by its leader, Jeremy Corbyn, and other frontbenchers, notes that “concerns have been raised that ACOs will encourage and facilitate further private sector involvement in the NHS”.

In his letter Ashworth adds: “There is widespread suspicion that the government are forcing these new changes through in order to fit NHS services to the shrinking budgets imposed from Whitehall.” The EDM also notes “concerns that ACOs could be used as a vehicle for greater rationing”.


The King’s Fund, an influential health thinktank, denied that ACOs would open up NHS services to privatisation. “This is not about privatisation; it is about integration,” said Prof Chris Ham, its chief executive.

“There is a groundswell of support among local health and care leaders for the principle of looking beyond individual services and focusing instead on whatever will have the biggest impact in enabling people to live long, healthy and fulfilling lives,” added Ham.

Dr Chaand Nagpaul, the chair of the British Medical Association, backed Labour’s call for greater transparency but said care services should be integrated.

However, he added: “ACOs will not in themselves address the desperate underfunding of the NHS and may divert more money into processes of reorganisation. Current procurement and competition regulations create the potential for ACOs to be opened up to global private providers within a fixed-term contract and with significant implications for patient services and staff.”

The Department of Health refused to say if MPs would be able to debate ACOs. “It is right that local NHS leaders and clinicians have the autonomy to decide the best solutions to improve care for the patients they know best - but significant local changes must always be subject to public consultation and due legal process.

“It is important to note that ACOs have nothing to do with funding - the NHS will always remain free at the point of use,” a spokesman said.


Fair enough ... introduction without a debate ?

We've all seen that recently ... our own supporting organisations guilty on that one !

If nothing other than a structure change to integrate the systems , why the secrecy ?
A prosperous new year ... for Sir Richard Branson ?


https://www.theguardian.com/society/201 ... -contracts


Richard Branson's Virgin healthcare firm scoops £1bn of NHS contracts.

Virgin Care’s success highlights fears over role of private companies in NHS and casts doubt on recent assurances by Jeremy Hunt.

Richard Branson’s Virgin Care won a record £1bn of NHS contracts last year, as £3.1bn of health services were privatised despite a government pledge to reduce the proportion of care provided by private companies.

Overall, private firms scooped 267 – almost 70% – of the 386 clinical contracts that were put out to tender in England during 2016-17, according to a new report. They included the seven highest value contracts, worth £2.43bn between them, and 13 of the 20 most lucrative tenders.

The £3.1bn in contracts, a big rise on the previous year’s £2.4bn, prompted concern that profit-driven companies are increasingly involved in delivering care, in a development that undermines repeated assurances by the health secretary, Jeremy Hunt, that they play only a marginal role.

“These figures clearly show that privatisation has a strong momentum within the NHS,” said Paul Evans, the director of the NHS Support Federation, a campaign group which monitors the privatisation of NHS services and which produced the report. “The doors to private sector involvement in the NHS remain open despite promises to move away from market-based approaches by NHS leaders and politicians. Privateers continue to win huge new NHS contracts.”

Virgin’s £1bn haul means it now has over 400 separate NHS contracts.

Its growing role has prompted particular anger among anti-privatisation groups. It pays no tax in the UK and its ultimate parent company, Virgin Group Holdings Ltd, is based in the British Virgin Islands, a tax haven.

In addition, it came under fire for suing six clinical commissioning groups (CCGs) in Surrey, NHS England and Surrey county council last year after losing an £82m contract for children’s services to a rival bid involving a local NHS trust and two social enterprises. A settlement of the action appears to have involved the six CCGs paying Virgin an undisclosed sum.

Virgin said it had been so concerned over “serious flaws in the procurement process” that it had no choice but to launch the proceedings.

The private sector’s £3.1bn of wins last year represented more than two-fifths (43%) of the £7.2bn of contracts tendered by the NHS for services including babies’ health and out of hours GP care. That dwarfed the £2.55bn (35%) of tenders won by NHS trusts and £1.53bn (21%) by not-for-profit organisations, including charities.

The expanding role of for-profit firms comes despite a pledge by the NHS England chief executive, Simon Stevens – backed by Hunt – to abolish the purchaser/provider split in the health service introduced by Margaret Thatcher’s government in 1990, which helped facilitate competition in healthcare and the outsourcing of services, and promote greater integration of health and social care services.

“Private health providers now have a strong foothold,” said Evans. “Billions of pounds-worth of opportunities to bid for NHS business are still being advertised, despite numerous failures and widespread criticism.”

Critics say that the sector’s continued success stands in sharp contrast to a long history of winning contracts, often by undercutting rival bids from NHS trusts, only to then hand back those that do not yield a profit or have them taken away because they have provided inadequate care.

The report details “a catalogue of failures” – dozens of examples of private firms taking over NHS services since 2012 but then abandoning them, either because they cost them too much to provide, or could not recruit enough staff, or went into administration – or, often, because of serious complaints about the quality of their service.

For example, in 2014 Circle pulled out of its 10-year contract to run Hinchingbrooke hospital in Cambridgeshire – the first NHS hospital to be run by a private firm – two years early after encountering financial problems and heavy criticism from the Care Quality Commission (CQC), which regulates NHS care standards.

In 2013, Serco ended its contract to provide out of hours GP care in Cornwall after staff falsified data about its performance. And in 2015, Coperforma’s £63.5m takeover of non-urgent patient transport to hospital in southern England was branded an “absolute shambles” by health unions after kidney patients awaiting dialysis and cancer patients undergoing chemotherapy missed vital appointments. It finally lost the contract in late 2016.


“The NHS is currently going through the biggest financial squeeze in its history, which has translated into service closures and greater rationing. Now on top of that this report reveals more evidence of increasing NHS privatisation accelerating at an alarming rate, and yet this toxic outsourcing agenda is failing both patients and staff alike,” said Jonathan Ashworth, Labour’s shadow health secretary.

Care UK, which has links to the Conservative party, gained the second biggest share of NHS contracts last year – worth £596.3m. It won a contract worth £169.5m in partnership with an NHS trust, and three others for £135.6m, £120.9m and £115m in its own right.

Both it and Virgin Care have benefited by changing tactics to target often high-value contracts for community-based health services as the NHS in England increasingly moves care out of hospitals, the report says. Care UK already runs the NHS 111 telephone advice service and walk-in centres in some areas. In 2009, its chairman, Sir John Nash, donated £21,000 to Andrew Lansley, who as the Conservative health secretary in the coalition a year later forced NHS bodies to tender out far more services through the controversial Health and Social Care Act.

“Dysfunctional” NHS procurement rules mean that private firms could land another £10bn of contracts in the next three years, said Evans. The NHS Support Federation, which is funded by individuals, charitable trusts and trade unions including the TUC, tracks publicly available information about NHS tenders.

Virgin Care and Care UK defended their role in delivering NHS-funded healthcare. A Virgin Care spokesman said:“We have a strong track record of delivering high quality, free NHS services over the last 11 years. More than 93% of people rating the services we run would recommend them, while the CQC have said in their recent report we can evidence the improvements we have made to community services.”

A spokesperson for Care UK said: “We have a very strong track record in partnering with the NHS to deliver high-quality and patient-focused care. This includes three services rated outstanding by the CQC and consistently high patient feedback scores.”

A Department of Health spokesperson said: “Spend on private healthcare by the NHS accounts for just eight pence of every pound and this government is fully committed to a world-class NHS owned and funded by the British taxpayer and free at the point of use, now and in the future.”




Make of this what you will ... it's happening now.

A slippery slope ... and the angle is getting steeper.
The fallout from the collapse of Carillon is affecting many sectors as most readers will already be aware of through the media coverage.

One comment from thousands around as I type worthy of posting as OUR NHS will also be affected :
The Chickens of PPP and PFI have come home to roost, facilities and provisions were taken away from Local Authorities, and Hospital Direct Labour organisations and the work was outsourced to Private Companies.

The Private Sector was considered to be superior to the inhouse provision, the Mantra of Public Bad, Private Sector Good echoed throughout the land.

What a total and utter travesty, we now have Thousands of small suppliers and Sub Contractors who are likely to go to the wall in the Aftermath of the Failure of Carillion.

Labour and Conservatives PFI is a Concept that is Dead in the Water, face up to how you need to Build and Finance Construction Projects. PPP & PFI RIP.

The NHS link ?

https://www.carillionplc.com/solutions/ ... ealthcare/


Truly frightening !
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The Eye's view on Virgin Care :


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

Deep in Virgin territory.

NHS outsourcing, Issue 1462.


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).

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.


So much for financial prudence ?
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Really good article from one of my old manors ... Nawfook ... as it's called by the natives :


http://www.greatyarmouthmercury.co.uk/n ... -1-5506974

Privatisation debate sparked as number of non-NHS providers in Norfolk is revealed.


It is an organisation which is ever-changing and one the British public hold close to their hearts. And as the NHS looks set for another unpredictable few years, health correspondent Geraldine Scott explores the various non-NHS organisations which make up Norfolk and Waveney’s heath service.

A debate has been sparked about the privatisation in the health service as the number of non-NHS organisations providing care and services in Norfolk was revealed.

Concern was raised in February when board papers from the region’s mental health trust suggested Richard Branson’s Virgin Care could be interested in running children’s mental health services in Norfolk.

And although commissioners were quick to rubbish the “unfortunate speculation” it shone a spotlight on the non-NHS firms providing health services in Norfolk.

Non-NHS providers can include charities, such as Change, Grow, Live (CGL) - a new charity which took over drug and alcohol treatment services from April.

Or the term can refer to social enterprises, such as East Coast Community Healthcare (ECCH), which provides services in Great Yarmouth and Waveney. Another social enterprise is IC24, the provider of the NHS 111 telephone service.

Alternatively, it can mean private, profit-making companies in the traditional sense, such as ERS Medical, a private firm which provides non-emergency ambulances.

Or the use of private firms by NHS providers when they do not have the capacity to look after patients.

One example is the use of the Priory Group by the region’s mental health trust for inpatient services, if there are no NHS beds available. Another is at the ambulance trust where £1.7m was spent on bringing in private resources in the first five months of 2017/18.

In a survey carried out by the NHS Norfolk Action Group (NHS NAG) last year, out of 295 people asked 277 said they would prefer to be treated by the NHS than a private firm.

And the majority of people also said they were concerned to learn about non-NHS companies operating health services in the county.

But the non-NHS providers hit back, with the majority pointing out any surplus was reinvested to improve the care patients received.

A spokesman for Norfolk and Waveney’s clinical commissioning groups said: “It is commonplace for non-NHS organisations to provide some NHS services. Indeed, some of the organisations listed by this newspaper employ local GPs, nurses and hospital doctors to provide those services to patients, at NHS rates.

“Care and nursing homes, pharmacies, and social enterprises such as IC24 and ECCH are contracted to provide services and are regarded as crucial and cherished members of the wider NHS family. Private hospitals bring additional expertise and are used to add valuable capacity when required, relieving pressure on a busy NHS.

“Spend on non-NHS organisations represents a small fraction of the NHS budget.“

But Jan McLachlan, Sue Vaughan and Jan Ainsley - from the NHS NAG - said: “The creeping privatisation agenda has been operating very stealthily [...] this is because if the public really knew how far down the line NHS privatisation really was there would be a massive outcry.”

They cited the controversial Naylor Review into the sale of surplus NHS land as an example. And said as STPs progress it will mean “a mixture of public and private health and care providers and will have multinational businesses as partners”.

All the organisations contacted by this newspaper said patient care and safety was their top priority.

Vicki Markiewicz, director of CGL, said their services typically outperformed the national average by 30pc. She added: “We work hard to make sure that our partners, supporters and service users have complete confidence in what we do and how we operate.”

Chief executive of IC24, Yvonne Taylor, said they were “very different from a private company” and would welcome the opportunity to meet with NAG.

While ECCH chief executive Jonathan Williams added: “ECCH is different because it is owned by its employees who have a real say in how the organisation is run.”

East of England Ambulance Trust said they had hired hundreds of new staff in recent years to meet growing demand, but admitted they still used private ambulance services “as a flexible resource to meet spikes in demand”.

But a spokesman said they continued to increase their own frontline staffing which helped them “significantly reduce the use of private ambulance services this financial year”.

ERS Medical did not respond to a request for comment.

More than £20m spent with non-NHS companies in three months

More than £20m was spent on non-NHS companies by Norfolk’s NHS in the space of three months.

Providers and commissioners - those who buy the care - must, by law, publish data on any spending over £25,000.

And analysis by this newspaper found between December last year and February this year, the county’s five commissioners, the ambulance trust, the mental health trust, and the community health trust spent at least £20,677,266.40 on health and social care services provided by non-NHS organisations.

Organisations which appeared in the data regularly included Integrated Care 24, ERS Medical, and Bourn Hall fertility clinic.

But hundreds of thousands of pounds were also spent with Global Diagnostics Ltd - which provides radiology services.

Some payments went to private care home groups, or staffing agencies.

While others went to charities such as Voluntary Norfolk and Age UK.

Hundreds of thousands of pounds was also spent with Spire Healthcare, which runs private hospitals.

Chief says PFI helped deliver world-class hospital

Perhaps the starkest example of private involvement in Norfolk’s NHS is the private finance deal used to build the county’s busiest hospital, the Norfolk and Norwich.

Around £20m a year is paid to consortium Octagon Healthcare for building the hospital - and accounts show there is still £194m to pay off.

But the financial pressure this places on the hospital has been cited as one of the reasons the trust is running a deficit.

In the NAG survey, 281 people said they did not think future building should be funded out of PFI.

But Richard Parker, NNUH chief operating officer, said: “The PFI arrangement has helped us to deliver a world-class hospital, providing a fantastic environment for our staff to deliver care and for the people of Norfolk to receive care. Since moving to our current site we have been able to expand dedicated services, develop a teaching hospital and become an internationally renowned centre for research working with partners in the Norwich Research Park and UEA.”

New care system bid for Norfolk

Councillors and representatives from health and social care organisations in Norfolk have been working through a bid to create an integrated care system (ICS) in Norfolk.

It comes as the next stage of the region’s healthcare overhaul, known as the sustainability and transformation partnership (STP). And the idea is the Norfolk-wide system will take more control of funding with less involvement from national bodies.

Some, including Professor Stephen Hawking, launched legal action over the introduction of accountable care organisations (ACOs) - a different version of integrated care being introduced elsewhere in the country. They believe the partnership bodies are a step towards privatisation. But a spokesman for the STP said the Norfolk system would “bear no relation to American models of care”.

The Department for Health and Social Care have previously strongly rejected such claims. It said it was “misleading” and “irresponsible scaremongering” to suggest ACOs were being used to support privatisation of the NHS.


Enough in the above to draw just one conclusion ?

The private sector are enjoying a feeding frenzy at the expense of the taxpayers ... you , me and virtually everyone else !!!

Perhaps it REALLY is the present Government's intention to allow this to continue ... the few making monies beyond their wildest dreams in some cases.

The irony is ... take any other LA ... would they not report the same ???