The future of the NHS (if any)

[Alan H]

Latest post of the previous page:

Ah. The Sustainability and Transformation Plans aka Tory cuts: GP surgery numbers to be cut as part of major plans around sustainability

Local areas are proposing to reduce GP surgery numbers as part of significant long-term plans to make savings, it has emerged.

A campaign group has uncovered a number of Sustainability and Transformation Plans (STPs) - the blueprints for how services are going to be provided in 44 areas across England - which detail plans for the future of general practice.

One area is proposing to reduce the numbers of GP practices, claiming that the current set-up will ''will over-stretch... workforce and finances', while another is planning to cut GP workload by a third and significantly reducing patients' face-to-face contact with primary care.

This month, Pulse reported that GPs were being 'excluded' from discussions over the plans, and in some instances have not even had sight of them before publication next month.

[Alan H]

This is the biggest change to the NHS you've never heard of

The government's Sustainability & Transformation Plans (STP) have been shrouded in secrecy. Despite being the biggest change to the NHS since the Health & Social Care Act 2012, they will not be voted on them in parliament.

So what exactly are the STPs? The NHS will be divided up into 44 footprints, but you need a glossary to translate these terms. Sustainability means cuts. This is part of the drive towards £22bn in cuts by 2020 – bearing in mind that we've already had £15bn in NHS cuts in the last parliament generating a manufactured crisis. Cuts mean a massive programme of hospital closures across the country and it will also lead to mergers and permanently selling off the NHS estate of land and assets.

The bogus narrative around unsustainability and unaffordability has been spun by the private healthcare and insurance industry, captured politicians and the media. In truth, we spend much less on healthcare than other advanced economies.

In order for these footprints to receive funds, there are strings attached. The footprints will have to sign up to transformation, which basically means privatisation. The footprints will have to adopt unproven models of care.

Unproven? Where have we come across that before...

According to the Dalton Review, the aim is to create chains of super hospitals, which can be run by the NHS or private companies. The GP Forward View states that GPs will be merged into networks of federated organisations. This restructuring is designed to entice the private sector. Chains of hospitals and networks of GPs can be bought out by corporations or private equity. This is a far more attractive prospect for investors than running a small GP surgery or a district general hospital.

And the starting gun has been fired. In my neighbourhood of Southwark, several GP surgeries are merging into Nexus Health Group.

The worst part is that integrated care may not even lead to savings. All of which will mean denying access to hospitals, specialists and sometimes life-saving treatment. To put it bluntly, private healthcare, Private Finance Initiative (PFI) consortia, platoons of management consultants, “big four” accountants and lawyers will continue to cream off billions whilst patients suffer.

[Alan H]

'Toxic' Jeremy Hunt compares himself to Nye Bevan as he refuses live radio call to resign

[Alan H]

Hunt: We want talks with doctors

Health secretary Jeremy Hunt says the way to resolve the junior doctors row is to proceed with the contract deal that was rejected by junior doctors in July.

He doesn't do irony, does he?

[Alan H]

[Alan H]

More idiocy from Jeremy 'liar' Hunt. Read the comments from doctors: Hunt: Patients to register with GPs and receive health advice through app

[Alan H]

GPs are asking patients to consider using private health insurance in bid to cut NHS costs

The letter from NHS Basildon and Brentwood CCG, sent last week, asks GPs to display a patient leaflet, which is headlined: “Do you have private healthcare cover?” It explains that “as part of a local NHS project your GP may ask you if you have private medical insurance”.

[Alan H]

‘Jeremy Hunt has blood on his hands’ – Raymond Tallis’s expert assault on the Health Secretary

In a scathing essay, Professor Raymond Tallis explains why he believes the Health Secretary, Jeremy Hunt, is destroying the NHS – through creeping privatisation, spending cuts, media storms and a simple lack of understanding

[Alan H]

How many times does the lie by Lying Liar Jeremy 'Liar' Hunt need to be debunked before he admits he was lying? The evidence of an NHS weekend effect is shaky

We call on Theresa May to act in the public’s interest and take immediate action over freshly disputed evidence surrounding a “weekend effect”. Department of Health documents leaked to the Guardian and Channel 4 News revealed NHS policy concerns from Jeremy Hunt’s own civil servants. His repeated claim about thousands of patients dying unnecessarily because of poor weekend hospital care “has not been helpful” in justifying new seven-day services. The internal briefing document proposed other means to vindicate his policy, but repeats the assertion that “eight independent studies have set out the evidence for a ‘weekend effect’ – unacceptable variation in care across the week”.

The evidence for these claims is not supported by reliable research. Of the eight “studies” cited by Hunt, only four are independently peer-reviewed, yet peer-review is essential. Three use data from the same population and are not independent, with just two from the last decade. The remainder are not peer-reviewed medical literature, being opinion pieces, the lowest form of clinical evidence. Critically, when his claims began, at least 13 independent, peer-reviewed papers were available to the secretary of state that refute his definition of a weekend effect.

Hunt has cherrypicked research, causing a devastating breakdown of trust between government and the medical profession. In making these claims without faithfully representing the evidence, he has obstructed fact and misled parliament and the public.

We call on Theresa May to commission an independent inquiry into the process behind these policies. It is wrong to waste precious resources, or lives, because of bad evidence. Like NHS treatments, health policy should be evidence-based to demonstrate clinical and cost-effectiveness. Additionally, we call for a pause on any policies or contractual reform driven by this evidence until it can be examined objectively and with rigour.

Dr Taha Nasser
Dr Ben White
Dr Hugo Farne
Dr Antonio De Marvao
Dr Rachel Clarke
Dr Margaret McCartney
Dr Philippa Whitford MP
Dr Phil Hammond Vice-president, Patients’ Association
Professor Alistair Hall Epidemiologist
Professor Trisha Greenhalgh Evidence-based practice
Professor Neena Modi President RCPCH
David Owen House of Lords
Professor Robert Winston House of Lords
Professor Stephen Hawking

[Alan H]

What works for getting you quickly and cheaply from A to B will clearly also help diagnose and treat your medical conditions... National 'Uber-style' private GP service sparks backlash

[Alan H]

We can afford the NHS. The question is whether we are willing to pay for it

[Alan H]

NHS still affordable by 2030, experts conclude

New OBR projections show NHS share of GDP could increase by almost a fifth by 2030.

Despite the current short-term funding crisis in the NHS, and constant speculation about the need for alternative sources of funding for healthcare (such as an insurance-based system or 'top-up' fees for patients), the amount the health service is projected to cost the UK in the long term continues to be affordable through general taxation, say experts at the Nuffield Trust health think-tank today.

Prof John Appleby, Chief Economist at the Trust, was commenting on new long-term projections from the Office for Budget Responsibility (OBR) on how much spending on the health service could grow in the future, based on increases in the population and other factors. At the same time, a new House of Lords Committee is taking evidence on the long-term sustainability of the NHS up to 2030.

The OBR's projections show funding on the NHS as a percentage of GDP. The U.K. currently spends 7.4 per cent of its national wealth on healthcare, or £140 billion - the projections show that by the end of the current Parliament in 2020, that figure will have dipped to 6.9 per cent, based on the existing known funding settlement from the Government; but that by 2030, spending could increase to 8.8 per cent of GDP, or £234 billion at today's prices. This would translate into almost an extra £100 billion of spending in real terms by 2030.

Commenting on context of the OBR's projections, Professor Appleby said:

“Only five years after the NHS was established in 1948, Parliament was so worried about its long-term affordability that it appointed a commission to examine whether funding would be able to meet demand in the future. At that point the UK was spending a mere three per cent of its national wealth on healthcare, or around £13 billion at today's prices. That figure for share of GDP has now more than doubled to 7.4 per cent and funding has risen in real terms by around four per cent each year on average.

“So looking at the historical trends, an increase to 8.8 per cent of GDP from the current 7.4 per cent over a decade and a half is actually not that high - less than a tenth of one per cent of GDP each year. The potential increase of £100 billion represents an average annual real terms increase of 3.5 per cent, less than the historical UK average of four per cent each year. This projected increase in share of GDP of 1.4 per cent over the next 15 years is the same as the increase over just five years between 1999/2000 and 2004/5. From this perspective, then, the increase in projected spending does not seem out of line with history - and indeed, is slightly lower than the long-term growth in spending.

"The real debate the UK needs to have is over how much more we want to spend on the NHS, not whether we need to change the way the health service is funded".

Professor Appleby added that from an international perspective, a national public spend of 8.8 per cent by 2030 would simply take the UK to the levels of public spending for France, the Netherlands, Denmark, Sweden, Germany and Japan - in 2015.

[Alan H]

Another of Jeremy 'liar' Hunt's wheezes: Hunt's flagship named GP policy ‘had no impact on continuity of care’

[Alan H]

On Crapita's (many) failures in their £47.1 million NHS job: Dear GMC, it’s me again

[Alan H]

Lying liar Jeremy 'liar' Hunt caught lying again by telling lies: Judgment Day : 28.09.2016

Justice for Health was set up by NHS staff and powered by your crowdfunding to contest the legalities of contract imposition.

It is now established, beyond doubt, that the Secretary of State for Health, Jeremy Hunt, is not imposing the disputed contract on junior doctors and that employers of junior doctors are not legally compelled to use it.

Throughout the year we have seen the SoS repeatedly declare imposition of the new contract on junior doctors. Through the process of litigation in the High Court we finally have clarity on his decision-making and legal powers.

● Mr Hunt is not imposing
● He never was
● He never meant to suggest he was
● He claims no-one ever thought he was

Mr Hunt’s last minute legal acrobatics have saved him from losing the case but bring no comfort to the thousands affected by his actions in the last year.

He did not previously clarify his position when faced with thousands of cancelled operations, a devastated workforce or a health service in chaos, but instead, only when his actions faced High Court scrutiny.

[Alan H]

You may have heard that Jeremy Hunt won a court case against junior doctors - but actually the victory was ours

By clarifying that he is not imposing a contract but merely recommending one, he has dodged a bullet. However since the legal challenge was to stop Hunt’s imposition, we have done that, so the victory is ours

It turns out Jeremy Hunt, the Secretary of State for Health, is not imposing a contract on us junior doctors. He claims he never was, and no one ever thought he was. As a member for Justice for Health, the group who launched the legal bid against the contract, I feel a little bit confused by his words. I am left wondering what he meant by his “nuclear option” and by his repeated comments in parliament and the press when he said “yes I am imposing a contract”. He is clearly not a man of his word.

The day Jeremy Hunt first used the word imposition, I cried. In the same way a patient might feel when they get told a serious diagnosis, I had a complex mix of emotions of both anger and fear. The anger was simple; Jeremy Hunt had ignored the concerns of hard working doctors who have made huge sacrifices to ensure their patients get good care. We were being treated like ungrateful children and brushed to the side. The fear however was more intense, as there was genuine concern for the future of our beloved NHS. How could someone who was prepared to belligerently push through dangerous plans, ignoring even his own advisors warnings on the risks, be trusted to have patients’ best interests at heart. Like many, I started to question his underlying motives.

As one commenter put it:

Hunt only 'won' because he lied, yet again - this time saying to the court that he wasn't imposing the contract. We all know what Hunt actually said. If he had told the truth, Hunt would have lost.

[Alan H]

Jeremy Hunt Is The Biggest Ever

Recently the Health Secretary released a press statement about the latest round of NIHR research funding where the messaging was clear: this is the ‘the largest ever investment into health research.‘ Reading this statement and its beatification by the Daily Mail and chums alarm bells rang on my bullshit-o-meter. They were mentioning ‘new investment’ and how it was mind-bogglingly large but also let slip about the success of ‘previous rounds of funding’. There was a glaring absence of any links or info that would inform the reader just how much that previous round had been i.e. how much of an increase is ‘largest ever’?

In the end it was easier to submit an FOI request than to discover the figures online. Here’s how the situation breaks down. In 2011, a 5 year fund of £800 million was awarded. In 2016, another 5 year fund of £816 million was awarded - “the biggest ever”. The money is spread out evenly over each 5 year period. So, over a 10 year period, the annual spend has risen from £160 to £163.2 million or an annual increase of 0.002% Now, inflation is pretty low at the moment and who knows what will happen over the next 5 years, but it’s safe to say this is a real terms decrease in funding: a cut, not an increase.

Earlier this year, Jeremy was admonished by the Kings Fund for similar wool-pulling misrepresentation of numbers when he claimed to be giving the NHS the ‘sixth biggest increase in history’ when it was more like the 28th biggest increase.

[Alan H]

Pregnant women could be forced to show their passports at hospital before giving birth

A pilot scheme backed by the Home Office will see every mother-to-be told to prove their right to use the health service when their labour is booked in.

The London trust behind the scheme said all those seeking to give birth would be asked for photo identification, or proof of right to remain in this country.

The trust board papers also say changes in the law will mean patients are charged for ambulance and A&E services if they cannot provide proof of identity, unless the situation is an emergency or matter of life and death.

[Alan H]

GP satisfaction with Capita plunges to 21%, official survey shows

Only one-fifth (21%) of GPs are satisfied with the primary care support service provided by Capita, according to the company's own survey.

This is a drop from 63% satisfaction with support services in November last year, after Capita took on the contract from a host of local providers, but before they took on vital services such as clinical supplies and the movement of patient records.

Capita, which received over 1,000 responses from GP practices, found that these had by far the lowest average satisfaction score of all primary care providers, rating the service at less than three out of 10 (2.91), based on a scale from extremely dissatisfied (1) to extremely satisfied (10).

[Alan H]

No extra money for NHS, Theresa May tells health chief

[Alan H]

NHS healthcare: coming to you from the tax haven of the Bahamas:

The BBC has learned that 12 NHS GP practices and urgent care centres across the West Midlands are ultimately owned by a company based in a tax haven in the Bahamas. Malling Health exchanged bank loans with an interest rate of 4% for a loan at 20% interest with the owner of Bahamas-based Butterfly Ventures. The company says this arrangement is more flexible, but experts claim it's a way of diverting money into a low tax area.