Transcript THE NHS IMPROVEMENT PLAN (2004)

KEEP OUR NHS PUBLIC
Fight the White Paper
Wendy Savage MBBCh(Cantab) FRCOG
MSc (Public Health) Hon DSc
Co-chair KONP
Haringey 22.11.10
Keep Our NHS Public
Launched September 2005 by
NHS Consultants Association
NHS Support Federation
and Health Emergency
Website
www.keepournhspublic.com
Aims of KONP
To build a broad non-party political
coalition which will campaign to protect
the NHS from further privatisation and
fragmentation
To inform the media, public and MPs
about the government ‘reforms’
To keep our NHS public which means
publicly provided as well as funded
‘Equity and Excellence:
Liberating the NHS’ ?
Transfer the responsibility for the NHS from the
Secretary of State for Health to a new NHS
Commissioning Board
Abolish Strategic Health Authorities (SHAs)
Abolish PCTs
Create 500-600 groups of GPs called consortia
which would take on the commissioning
(purchasing) of services.
They would replace 152 PCTs. They would be
responsible for 80% of NHS budget – and have
not been trained for this job ?half don’t want it
‘Liberating the NHS’ ??
Force all hospitals to become Foundation Trusts
(FTs) and encourage them to become employee led
social enterprises.
Encourage ‘any willing provider’
Increase the powers of Monitor (who oversees
FTs) as sole economic regulator
Reduce NHS management costs by 45% over the
next 4 years.
Estimated cost of re-organisation is £1.7bn in the
first year alone (government figures ) up to £3bn
(Kings Fund)
‘Liberating the NHS’ ???
Strengthen CQC -become effective regulator
‘We will give every patient the power to choose any
health care provider that meets NHS standards
withiin NHS prices. This includes independent,
voluntary and community sector providers’
Comment from Tribal a private health care firm
‘This white paper could amount to the
denationalisation of healthcare services in
England and is the most important redirection of
the NHS in more than a generation, going
further than any Secretary of State has gone
before
The effect of the White Paper
Managers will be demoralized, lose their jobs
and some, after hefty redundancy, are likely to
be re-hired to work for consortia
Consortia must use any willing provider so
private companies bid for services cheaply
Consortia fail, taken over by private
companies
NHS fragmented reduced to basic backup
Government tactics
Reassuring language-ie liberating, clinicians in
charge, patient choice, positive spin
‘Consultation’ is about ‘how ‘not ‘what’
Directing PCTs and SHAs to start process of
getting rid of managers
Getting their message across as if changes
have already happened although no electoral
mandate or debate in Parliament
Useful points to remember & use
Remember that FT survey found that 75% of
population did not want private sector in NHS
Private companies primary duty is to their
shareholders
Cooperation not competition needed in health
care
Market costs at least 10 bn a year to operate
Exploit differences between Con Dems
The fight must continue
Efficiency savings can be made by abolishing
the market
Evidence is that health care is an unsuitable
service for market mechanisms
Increases inequity
Affects the elderly and other most vulnerable
Why should ordinary people pay for the
bankers excesses and failure of government
regulation of the financial markets?
Lansley’s stated aims
Patient centred approach ‘no decision
about me without me’
Clinicians in charge not managers
Reduced bureaucracy
Improved outcomes measure by PROMs
not targets
All could be achieved without this massive
upheaval
What can we do?
Let MPs know in every constituency that
another ‘re-disorganisation’ is the last thing
we as citizens or the NHS staff want
Point out that abolishing the market and the
purchaser-provider split introduced in 1989
by Kenneth Clarke would save at least £10
billion a year
Join &/or donate to KONP so we can
mobilize people via meetings website etc
Market-driven politics
1. Real markets are deeply political-state
omnipresent-national politics and the state
always targets-businesses want to enter NHS
2. Convert services into commodities and
workforce into one orientated to profit and
get government to underwrite risk.
3. Market competition transforms commodities
4. Consequences, inequality of provision, high
costs and corruption (eg US health system)
Further reading
Colin Leys Market-driven politics (2001) Verso
Allyson Pollock NHS-plc (2005) Verso
John Lister Health Policy Reform (2005) The NHS after
60:for patients or profits? (2008)
Stewart Player & Colin Leys Confuse and Conceal
Merlin Press 2008
On the Brink Report for BMA London Regional Council
by John Lister January 2009
House of Commons Health Committee (2010)
Commissioning. Fourth Report of session 2009-10
An NHS beyond the Market report of a round table
discussion download from www.bma.org.uk