[Oldmanmatt]

Just in case you didn't think about it...

If this bill goes through, how long do you imagine "sports" injuries will be treated free?

Self inflicted?

Most health insurances exclude "dangerous or extreme" sports.

This will affect us as a community even more than most and right now the Daily Fail and Torygraph readers are running the show!

Already, we will soon need insurance, as privatising the rescue services; will almost certainly lead to "Fees for rescue".

This is bigger than you realise!

[Jaspersharpe]

So it seems that even without the bill, the NHS is fucked anyway:

http://www.guardian.co.uk/society/2012/mar/15/devon-nhs-childrens-services-privatisation

[Jaspersharpe]

Risk registers are a tool of management theory. Risk assessments are frequently used in project management and corporate strategy  for the purpose of policy making. They set out a whole series of scenarios from the most optimistic  to the most pessimistic. They are  a useful tool in making judgements and choices but they are not intended to predict the future.
 
Civil servants carry out such risk assessments to assist Ministers. There is a specific provision in the Freedom of Information Act which deals with disclosure.  Section 35 sets out an exemption from the right to know if the information in question is held by a government department and relates to the formulation or development of government policy.  That exemption is balanced by a public interest test.
 
See: http://www.ico.gov.uk/upload/documents/library/freedom_of_information/detailed_specialist_guides/formulationofgovernmentpolicy.pdf 
 
The last Labour Government refused to disclose details of Risk Registers for the very obvious reason that political opponents of a particular policy will seize upon the pessimistic and exploit it without reference either to the degree of risk or to more optimistic assessments. The ‘transition risk register’ (TRR), for which disclosure was sought, is essentially a set of risk assessments relating to the transition from the NHS as it was in 2010 to the NHS as it is proposed it should be once the reforms set out in the white paper have been implemented. They will take no account of the massive changes which Shirley Williams and Lib Dem peers have obtained to the Bill as first published. We are very proud of our efforts.
 
The First tier Tribunal over-ruled the decision of the Information Commissioner not to release the Risk Registers and its reasons are awaited. I would expect to hear those reasons before next Monday. I understand that Lord Owen will be redrafting his amendment to the Third Reading motion which will remove his attempt to block the passing of the Bill.
 
Thank you for your interest in this legislation. It has been hugely distorted in the media, but if you study it, you will soon appreciate that the basic pillars of the NHS are maintained.
 
Yours,
 
Martin Thomas,
 
Lord Thomas of Gresford.

Oh well that's ok then.   

[slackline]

Unsurprising fucking greedy cunts.

[Oldmanmatt]

You do realise, this is one of the least read threads on the forum.....?

Can't understand why people don't care?

They will.

[fatkid2000]

I think people are resigned to this happening.

Every major Royal medical college (except the surgeons - who have concerns) have come out against the bill.

The government is refusing to engage with The Royal College of GPs.

It's turned into a political battle and coalition doesn't want to lose face.

I'm afraid this is the beginning of the end of the NHS.

The bill combined with a complete re-write of doctors pensions will probably lead to the profession bringing down the health service. Doctors will get the blame and one of the leading health care systems in the world will end.

I hope I'm wrong.

[LucyB]

So is it time to take to the streets?

I was one of the very few who could be arsed to march against the war in Iraq, we were later able to say 'told you so'.

This issue is a little closer to home, and affects every single one of us. Maybe a few more people showing up in that there London would make a difference.

[slackline]

Parts of NHS Risk Register published

No real surprises as to why massive efforts have been made to stop its publication!

[slackline]

Thank you for writing to me about the Health and Social Care Bill. I have received hundreds of emails and letters so I’m afraid I cannot provide an individual reply.

 

Many of you have told me stories of your experiences working for the NHS, how important it is to take care of it, and to protect it from any kind of ideological assault which would undermine it.

 

Here is the link to an article I wrote for the Guardian which updates my response to Polly Toynbee’s article about the Bill: http://www.guardian.co.uk/commentisfree/2012/mar/16/who-right-on-nhs-polly-shirley. I hope this covers some of the points you have raised.

 

There has been a huge amount of incorrect or obsolete information in the media about the health bill, often because reporters are not aware of recent changes which have been made to the bill at the insistence of the Liberal Democrats. The following web-page contains a lot of up-to-date information on the bill: http://www.libdems.org.uk/health.aspx

 

On the Risk Register, we have done all we can to speed up publication of the  Tribunal’s judgment, but the timing is a matter for the Tribunal’s Chairman cannot be decided by either Parliament or the Government. The Government postponed the Third Reading until now, but did not feel able to postpone it further given the timetable for this session.

 

Once again, thank you for contacting me.

 

Yours sincerely,

 

Shirley Williams

 

Lord Owen just presented his motion to the house of lords to delay until the risk register is fully published.

Watch live

Guardian 'live blog' (handy for those who don't use Silverlight).

[aLICErOBERTSfANkLUB]

If anyone is in Sheffield with time on their hands this evening -

http://www.ukuncut.org.uk/actions/854

[slackline]

Hypothetically

Its a sad day today 

[aLICErOBERTSfANkLUB]

What a complete and utter bunch of cunts.


http://www.bbc.co.uk/news/uk-politics-17447992


“Ahead of the debate, Conservative and Lib Dem ministers "banged" the table at a cabinet meeting to mark the impending passing of the NHS reforms into law.”

[psychomansam]

They've stolen education and healthcare and they're working on roads and policing. Labour already betrayed us with quangos and smaller privatisations. The rich are getting richer and the poor poorer.

In other anarcho-capitalist headlines "£2bn spending cut funds tax breaks". I googled that and got the wikipedia article on reagenomics. Apparently we should expect to see more homeless people.

For a young white man things are bad right now, but with twice the unemployment rate for young black men along with non-fiscal forms of discrimination inluding police racism, things are twice as bad for blacks. I can understand that the government is keeping us just below a state of revolt, not quite fucking us over THAT badly, but I don't really understand why black people aren't out in the streets marching, protesting, rioting and doing everything they can to bring this government down. It may not be the right thing to do in a democracy, but then this isn't a democracy. This is an oligarchy. Apparently the oppression has to go worse before anything happens. We'll hold our breath shall we...

[Oldmanmatt]

Because the Daily Fail readers are more scared of the "Gangs" than the Gov. and most sensible people regardless of race or creed see that that might just give the Gov all kinds of excuses for "Emergency" powers...

[psychomansam]

Well you know how revolutions work. Eventually, the police/army side with the revolters, emergency powers often speeding this up as police/army are reluctant to use harsher tactics on fellow citizens.
There was an amusing feel to the policing of the public sector pension strike in sheffield. The only reason the police weren't striking was because it's illegal. My immediate reaction to that was to think what a ridiculous law it is. "Don't strike, or you'll have to arrest yourselves." It only works until you reaching a certain tipping point.

That said, we're nowhere near there, and probably never will be, because as you say the masses are intoxicated with convenient daily packages of lies from the media.

History is just a long list of oppressive regimes. Calling us a democracy changes little.

[slackline]

Unsurprising revelations 

[slackline]

Half of GPs on clinical commissioning groups have financial links with private providers BMJ 2012; 344 doi: 10.1136/bmj.e2431 (Published 29 March 2012)

[GCW]

Half of GPs on clinical commissioning groups have financial links with private providers BMJ 2012; 344 doi: 10.1136/bmj.e2431 (Published 29 March 2012)

For those without full access:

An analysis of clinical commissioning groups showing the financial links many GP board members have with non-NHS providers has raised fresh fears around potential conflicts of interest.

The False Economy research group, which is funded by the Trades Union Congress, examined details covering 50 clinical commissioning groups.

It identified 22 groups whose boards have a substantial proportion of GPs with an external financial interest in a private company or other non-NHS provider.

Concerns have been raised that once they are put in charge of NHS budgets doctors who have a stake in other companies that provide healthcare might be able to profit from commissioning their own services.

A spokesman for False Economy said the government had not resolved such complications and so would create confusion among patients and ensure doubt would be cast on the motives behind some GPs’ commissioning decisions.

The spokesman told the BMJ, “The government has given no thought whatsoever to this situation. Clinical commissioning groups have been left on their own to clear up the mess.”

False Economy has highlighted that many GP board members on 10 of the clinical commissioning groups have links with Virgin Care companies, which provide services to the NHS including urgent care, physiotherapy, psychological therapies, and screening.

The report lists eight GPs on Barnet Clinical Commissioning Group as shareholders in Barndoc Healthcare Limited, “the profit-making company that is owned by local GPs and holds the out-of-hours contract in Barnet.”

False Economy says seven of the 11 board members (and five out of seven GPs) on South Worcestershire clinical commissioning group are shareholders in Elgar Healthcare, which runs a walk-in health centre tendered by Worcestershire Primary Care Trust.

The report says, “Given that the clinical commissioning group will take over the primary care trust’s duties, the group will have the responsibility of deciding whether to extend the contract or re-tender at the end of the existing contract, and if the latter, whom to award the tender to.”

Johnny Marshall is a GP who chairs Buckinghamshire based United Commissioning and is also a shareholder—along with five GP board colleagues—in Vale Health Ltd, which provides services to the NHS.

He told the BMJ that clinical commissioning groups would need to develop strong governance arrangements over the next 12 months as they began to take on shadow status from 1 April 2012.

He said, “It is vitally important that we don’t find ourselves with either the perception or reality that clinical commissioning decisions are unduly influenced by any financial interests. Interests have to be declared and clinical commissioning groups will need to have the right mechanisms in place to manage potential conflicts of interest.”

In February 2012, health minister Earl Howe accepted amendments to the Health and Social Care Bill tabled by Liberal Democrat peer Baroness Barker because of concern over conflicts of interest between GPs’ commissioner and provider roles and the need to protect the “integrity” of decision-making.

Clinical commissioning groups will have to maintain and publish members’ registers of interests, and the NHS Commissioning Board will have to publish guidance for groups on how to manage potential conflicts of interest.

The False Economy spokesman said that there were concerns about how this would work in practice and that the uncertainty would be damaging.

He said it would harm those GPs who were following earlier government advice to forge worthwhile partnerships, including non-profit making cooperatives, for the benefit of patients.

“By accepting the Barker amendment, the government has washed its hands and left it to others to sort out,” he said.

[GCW]

The thing with a lot of this is that the decision was made ages ago when the PCTs paid off loads of managers etc and scaled down.  If a vote went against reform and for a return to the previous structure, the whole thing would require re-building.

Interestingly, having gone to a few CCG meetings I am highly suspicious by some of the rules being imposed.  The size of Board is being dictated, which often means the cost precludes smaller groups and limits the size to that similar to a PCT.  Plus the allowance for commisioning of services means that geographically services to one hospital trust will come from an area similar to that of... you've guessed it...  the PCT.

It seems very like the government are pushing CCGs to be the same set up as PCTs, except run by GPs who will then get all the blame for the shit that is bound to come along.

Or am I just deeply cynical?

[slackline]

Quelle surprise (Via Ben Pritchard on twitter)

[slackline]

Going private? My reply to a job offer from a private health company by Alex Nunns

Original article contains links to source documents...

Dear Laura,

Thank you for your unexpected email about the Media Relations Executive job with Care UK. I am very interested. Since Care UK is possibly the leading private healthcare company making inroads into the NHS, I would relish the opportunity to publicise what it does – indeed, this is precisely what I was trying to do in my previous job as information officer for Keep Our NHS Public (on a much smaller budget, I’m sure). That must be what you were referring to when you said my skills and experience are “a good match”.

As you can imagine, I am brimming with ideas. If you don’t mind, I would like to set them out here. First of all, I think much more needs to be done to let the public know what Care UK is. Hardly anyone realises just how big a chunk of the NHS you now run, from GP surgeries and walk-in centres to treatment units doing things like bunions. If I were your Media Relations Executor I would promote this aggressively to build the brand. I think the public has a vague idea about NHS privatisation, but they aren’t yet able to put a face to the name, so to speak. Care UK’s name could be that face. As a profit-making healthcare company owned by a private equity firm you are perfectly positioned.

I believe a key talent for any disrespecting Media Relations Executive is the ability to turn a negative in to something offensive. For example, it must have been a stressful time in the Media Revelations office when that tax avoidance story broke a few months ago – the one saying that Care UK had reduced its tax bill by taking out loans through the Channel Islands stock exchange. All this talk of tax havens and tax avoidance isn’t good in the current climate. But as your Media Relationship Executive I would have used a little reverse psychology, instead of denying it as your spokesman did. After all, this could put you right up there with the big boys like Goldman Sachs, Vodafone and Jimmy Carr.

Similarly, you got some bad press when it was revealed that the wife of your former chairman John Nash gave £21,000 to Andrew Lansley’s office before the last election, when Lansley was shadow health secretary. But let’s view it from another angle – doesn’t this serve to highlight Care UK’s excellent political connections? And look how it turned out: Lansley is in power and he has passed the Health Act. He has opened the door wide to privatisation, and Care UK is already inside redecorating the place.  We thought Lansley wasn’t going to manage it for a while, when all those thousands of patients and doctors started protesting and June Hautot shouted “codswallop” at him in the street. But he pulled through, sacrificed his future public career for private gain, and God bless him for that. Care UK now stands to make a fortune. This is something to boast about, for Bevan’s sake! And all for £21,000, less than it would cost to employ a Media Relations Executive for a year. (Please confirm.)

You should play to your strengths. Care UK is a true pioneer in this privatisation drive. You were the first private company to run a GP surgery in Dagenham back in 2006. And the first to face enforcement action from the Healthcare Commission because of slack hygiene procedures at the Sussex Orthopaedic Treatment Centre in 2008. And who’s to say you weren’t the first to forget to process 6,000 x-rays at your ‘urgent’ care centre in North-West London in 2012? As a Mediocre Relations Executive, I would advise not mentioning those last two.

If there’s just one thing that Care UK knows how to do – and there is – it’s take money from the state. I would make a bigger deal of the fact that 96 percent of Care UK’s revenue comes from the NHS. That’s the kind of solid base that any company would envy – taxpayers’ money, minimal risk, easy profits. So shout about it! It shouldn’t just be left-wing NHS obsessives who hear about this stuff.

Take the Barlborough Treatment Centre. It’s a complicated story, but in the hands of a good Media Relations Excretion it can be turned into a wonderful example of the company’s strengths. First, Care UK was paid £21.9 million over five years to do orthopaedic surgery – hip and knee replacements, that kind of thing – but you only did £15.1 million worth of work. (The local NHS Medical Director saw the trick, complaining: “The problem we have got is that they cherry-pick; they don’t take any patients with complicated conditions”. I guess the joke’s on him.) The NHS eventually realised it was getting a bad deal, and things weren’t looking good for Care UK. But then the NHS bought the treatment centre from you for £8.2 million, a lovely gesture. And finally the NHS signed a new 30 year contract to run the centre with… Care UK! (As an aside, it is important from a media management perspective not to spoil this tale of triumph-from-the-jaws-of-lucrative-defeat with any reference to the several lawsuits brought by local patients claiming that their surgery went wrong.)

As an example of what I could bring to the company I would like to propose a new corporate motto: ‘Care UK – Providing less, for more’. These words came to me when I was thinking about Manchester, where last year the NHS paid you £2.7 million for work that was never done at your Clinical Assessment and Treatment Centre. According to a parliamentary report, the services you provide up there are between 7 percent and 12 percent more expensive than equivalent services in local hospitals. Providing less for more – it’s a record that really ought to be publicised.

And Care UK should be proud of its talent for cost-cutting, like the plan to use more nurses and healthcare assistants in your GP surgeries because doctors are too expensive. Your managing director, Mark Hunt, describes this as “workforce efficiency on skill mix”. As a Meddling Relations Executive I would advise him to ditch the jargon and tell it as it is. Patients might get a worse service, but at least the company is making more money and that’s good for the economy. We’re all in this together, as someone once said, in jest. I’m convinced that if Care UK followed my strategy it would solve the serious problem of patients accidentally opposing the private take-over of GP surgeries through confusion and surfeit knowledge, like when those blasted Keep Our NHS Public campaigners scuppered the Care UK health centre in Euston by threatening court action.

Be bold. Be proud. Be shameless. That’s the approach I would bring to the job, and I hope you like my initial ideas. Please be sure to let me know when and where the interview will take place (the formalities must be gone through, I understand). I trust that I will hear from you soon.

Yours sincerely,

Alex Nunns

[rich d]

Did you get an interview?

[slackline]

I'm not Alex Nunns.

[rich d]

Should have probably read that a bit closer.

[aLICErOBERTSfANkLUB]

And I'm sticking this here as well.

[Copy by Sam Coates, The Times]

https://twitter.com/sunny_hundal/status/223104035195076608/photo/1/large