No, not in the future. It is being privatised NOW.
Yesterday, EveryDoctorUK, the campaigning organisation headed by the redoubtable Dr Julia Patterson, launched the #ScrapNHSBill campaign. (Crowdfunder link here. Please donate even a couple of quid if you possibly can: https://www.crowdfunder.co.uk/scrap-nhs-bill )
Think this is just another charity asking for your money? It is, yes. But this one, and its campaign, is potentially going to save your life, and stop you from being bankrupted by the American style healthcare that this government is in the process of bringing in, channelling money and profit to its friends in the same way as it has done with PPE and other contracts.
This is important. No matter how tired you are, how poor you are, how disillusioned you are and how busy you are, this is the campaign that you MUST take the minute, spend the pound, spare the energy for, because this could mean life or death for you or a member of your family.
The NHS Bill – the “Health and Care Bill” – currently sits at the committee stage in Parliament. It has received its second reading, and is now being examined line by line for its implications. We still have a chance to stop this Bill, but the window for doing so is narrowing. Only serious effort by all of us will make a difference, so before I write anything else, I encourage you to go and support EveryDoctorUK.
Why must we stop this Bill?
Because once it is passed, we effectively don’t have an NHS any more. We will have what is called an NHS, but effectively it will be run by private entities, and it will charge for its services. And those private entities will be the ones which have profited off us, the electorate, during this pandemic, paying billions of money to their friends for systems (looking at you, Test and Trace) that don’t work and PPE (looking at you, Matt Hancock) that isn’t fit for purpose.
How will the NHS change?
The plan is to break up the NHS into over 40 ICS – Integrated Care Systems – delivering care at a regional level. This is what the government briefing paper says:
“Several provisions in the Bill were originally proposed by NHS England, such as establishing existing Integrated Care Systems (ICSs) on a statutory footing, formally merging NHS England and NHS Improvement, and making changes to procurement and competition rules relating to health services.”
Is it true that the NHS asked for these Integrated Care Systems?
Yes and no. The NHS believes that the system requires reform. The briefing paper for the government says that:
“The NHS England Chief Executive, Sir Simon Stevens, said the Bill’s proposals for integrated care were “widely supported”:
They go with the grain of what our staff and patients can see is needed, by removing outdated and bureaucratic legal barriers to joined-up working between GPs, hospitals, and community services.
The Chief Executive said the reforms would “undoubtedly both help tackle health inequalities and speed the recovery of care disrupted by the covid pandemic.””
So to an extent, the NHS itself wants reform. It wants changes to a system that is too complex to function efficiently, and which is wasteful, not fit for purpose and which is also not addressing the severe recruitment and retention issues in the NHS, or the issue of underfunding.
So what’s the problem?
The NHS doesn’t want the reforms that are being put though in this Bill, because the Bill is being used to privatise it by the back door under the cover of “reforming” it.
Why not? What is “wrong” with the idea of ICSs? Why are they a bad idea? Surely it would be better if decisions about levels of services and patient care were made closer to the patient?
It would be if those decision were made by a trust / ICS that was adequately publicly funded and which was bound to maintain the principle that the NHS should be free for all at the point of treatment, funded by public levies such as National Insurance. But unfortunately, this won’t be the case.
The ICSs are referred to throughout the White Paper and the Bill as “providers”. This designation conceals the fact that those providers will sit as a board, and on the board can be representatives of private companies, for example, US insurance companies, who are not accountable to us, the electorate of the UK, but to their shareholders, who will expect that they should make a profit. (Friends of the Tories can sit on them too . . . see below.)
They will in short, not be operating the socialist care system that the NHS was designed to be, but a capitalist system where, by cutting the NHS up into 40+ pieces, the government has attempted to obscure the fact that it is no longer, effectively, the public NHS as we have always known it.
Why is it the case that private companies can buy a stake in the carved-up NHS?
Because this Health and Care Bill removes Section 75 of the 2012 Health and Social Care Act. Unfortunately this means that the government will be able to dish out health care contracts to mates and donors without much scrutiny – and we all know what they have done with PPE and procurement during this pandemic.
Give me an example of how this could change things for me.
Firstly, the ICS will make decisions about how your healthcare is funded, what treatments are available in your area, and where money will be spent. It will also make decisions about which services will be cut. So imagine, for example, that you have early Alzheimer’s, and you could have access to the new drug which has shown in clinical trials that it can reverse Alzheimer’s. But your ICS providers have decided that they will not fund that drug. So you can’t have it . . . unless you pay for it. Imagine that you are a mother of a child with complex special needs, who requires intensive speech and language therapy (SALT). But your ICS has decided that SALT is not something it will fund – it has cut the funding. So your child can’t have it . . . unless you pay.
Yes. Your ICS is not obliged to organise hospital care in your area. So if there is no ICS funded hospital in your area . . . but only separately funded private hospitals to which the ICS will refer you, you will have to pay for your treatment. Or the ICS could fund a hospital in your area, but decide that it wants the hospital to run at a profit, so it will levy a charge for treatment there. (And of course, there is nothing to say that the same person who sits on the board of an ICS can’t also be a shareholder in a private hospital, is there?) A third alternative is that the ICS could decide to run a very basic hospital service in your area, but if you want specialist treatment you will have to pay. You want a broken leg dealt with, you might just get that. You need an emergency stent for a heart attack, you might be asked to pay. Because a private insurance company that sits on the board of an ICS wont be there to do you any favours. It will be there to make a profit for its shareholders.
And what about a duty of care?
What duty of care? If there is any duty of care it could be limited. The thrust of the reforms is also very much about improving the health of the population so it doesn’t need extensive health care. This means that if, for example, you have certain conditions, or certain lifestyle factors that impact your health adversely, you could be charged a premium for your care. (This is why the government wants to sell your NHS data to Palantir, although that is currently on hold.)
Yes. Most of you have probably heard of what is pejoratively called “bed-blocking.” This is when a person – perhaps an elderly, isolated, frail or vulnerable person – remains in a hospital bed on a ward for longer than they clinically need to, because after a procedure they are no longer able to care for themselves. They perhaps haven’t the money, or the cognitive ability, or the familial support system or the physical strength to look after themselves any longer. They need social care.
At the moment, that person cannot be thrown out of a hospital, because the hospital has a duty of care. It has to do what is called a “discharge to assess.” Before a person leaves hospital – many of you may have been through this process, or perhaps had a relative go through it – they are assessed by a physiotherapist, and occupational therapist and the medical staff to ensure that when they leave the hospital they don’t immediately end up back there because they have been discharged unsafely (a “failed discharge”).
If this Health and Care Bill goes through, that duty will have been removed. The ICS can direct that you be discharged from hospital if it believes that your clinical needs have been met without even considering whether you are fit to look after yourself. It will improve the speed of throughput of patients, and thus the profitability of the ICS. It won’t improve the outcome for you though, will it? But they don’t care.
What can I do about this?
Write to your MP. You can use some of the information in this article. Write to neighbouring MPs if your MP is useless (Mine is John Penrose. He’s worse than useless: he is actively malign, sits on the 1822 Committee which wants to privatise the NHS and is married to Dido Harding.)
Support EveryDoctorUK (link above) and make your views known to the NHS.
Keep informed at this link and support actions there: https://keepournhspublic.com/ . Attend protests if you safely can. Stand up for the NHS staff who are demoralised more every day by people who are bullying them over mask wearing and vaccines. Follow prominent voices on social media. https://twitter.com/JujuliaGrace and https://twitter.com/NHSMillion as well as https://twitter.com/keepnhspublic
Make your voice heard! The NHS has never been more in peril than it is now. If this Bill passes, then the changes will come in in April 2022, less than a year away.
The NHS isn’t going to be privatised “in the future”. The NHS is being privatised NOW, while you – while we – are all tired and demoralised, and grieving and done fighting.
That is WHY is it being privatised now – because the government thinks you won’t notice.
You have only one voice. I have only one voice. But if we all raise our voices as one we can save the NHS which has supported our 20th century ancestors from cradle to grave, which supports us now, and which we need to be here supporting our children and our grandchildren.
Don’t leave this fight to someone else. YOU matter in this fight. Raise your voice NOW to keep our NHS public, owned by us, paid for by us, and out of the greedy hands of speculators, venture capitalists, disaster capitalists and American insurance companies.
They’re all sitting there salivating waiting to snap it up. Stop their greedy mouths, and send them away hungry.