(This post is longer than usual, but most important, because it illustrates how the priorities of society have been perverted and corruption rules. It is not generally known to the British public, having been imposed by stealth. Epicurus, a kind man, would have been appalled)
“Since 2017 Integrated Care Systems (ICSs) have taken over National Health Service (NHS) purchasing as well as the provision of NHS services. ICSs decide who gets the services, which are free and which have to be paid for by patients. The idea is that the less care offered patients the more money is made by ICS’s. Since 1977 it has been Tory policy to return healthcare to private ownership by stealth, fragmenting once fully integrated services into competing and commercially-driven units. This to be done without public scrutiny or debate, little by little, and scarcely noticed by the ultimate customers.
“The first thing to be privatised was hospital cleaning. Then, in 1997, the Tories created an “internal market” – service purchasers and service providers – hospitals and GPs had to compete for “customers”, the successful being rewarded by greater funding. It was explained in parliament that “in competition doctors would impose on themselves controls they wouldn’t accept if imposed upon them by government.’
“Legislation in 1990 and 1997 then turned NHS hospitals into trusts (commercial businesses) that then went on to build their own hospitals. The result is that the NHS developed a huge 80 billion pound debt as trusts tried to compete and be self contained. The 2012 Health and Social Care Act enabled trusts to raise 49% of their budgets from private sources, including the charging patients. 60% of the NHS budget was, under the Act, given to Clinical Commissioning Groups (CCG’s), comprised of GPs and other doctors, the object being to commission services from both private and NHS organisations.
“Because the latter had no business experience, private consultants (KPMG, Price Waterhouse and others) actually ran the business side and effectively began overseeing the day-to-day franchising of NHS services. The Health Minister was removed from responsibility for healthcare provision, and a man called Simon Stevens was put in charge. Stevens had previously led the opposition to Obamacare in the US. Stevens created the NHS England’s Sustainability and Transformation Plans (STP’s), which were intended to save 5 billion pounds a year by 2020 by reducing access to to care (my underling).
“The STPs divided England into 44 areas , which were pressured to amalgamate hospitals, shrink specialist units and cut the number of hospital beds (the bed-to-patient ratio is now on of the lowest in any developed country). Accident and emergency units which require expensive equipment and a high number of staff are being cut from 144 to about 50. GP services are being replaced by nurse practitioners and pharmacists.. Patients are exhorted to consult private, for-profit healthcare organisations (Doctaly, GP at hand and myGP). This is the signal for US healthcare companies to enter the market , with their huge resources and equally high charges. 1000 GP practice have closed since 2014 and the number with more than 20,000 patients on the books has tripled. Non-urgent operations such as hip replacements and increased waiting times for everything have encouraged patients to seek private treatment. Over the last few years American firms have appeared on the British market in a big way: Medtronic, Qualcomm Life, Kaiser, IBM, Optum, Centene, Priory Group.
“All this has put up operating costs , since private companies have higher overheads, have to offer shareholder dividends, and pay their CEOs more than if government was still funding health (overheads of American health companies are estimated at $3.6 trillion). Management and administration of the NHS now costs 14% of NHS spending. It is estimated that privatisation has probably added at least 9 billion pounds to the NHS budget.
“And now Stevens is asking the Government to scrap Section 75 of the 2012 health and social care Act, which in practice means de-regulating the health sector entirely and making ICS’s more attractive to profit-making US companies.
“Meanwhile, surprise, surprise, NHS property and land assets worth 10 billion pounds are being sold to private developers!” ( John Furse, London Review of Books, 7 Nov 2019. )
My comment: This all amounts to a form of theft from the public of the most respected and necessary public service, to the benefit of those for whom money is all that matters. One’s strong impression is that efficiency has fallen and morale is bad. Certainly, there is much more complaining. My sister, who does not have much money, was told she had to have a hip replacement. But no surgeon was available on the NHS for months ahead, so in pain and desperation, she had to pay out of pocket for the surgery. Never mind. Who in government cares? The important thing is that important people are making tons of money. This is a huge and un-debated scandal.
Why is this information on an Epicurean blog site? Because it offends against all ideas on moderation and any form of social welfare and care for the sick and poor. And the sick and poor voted for the Tories unaware of what was going to hit them! You couldn’t make it up!