Simon Stevens, the new chief executive of NHS England, former President of global health at UnitedHealth, a large US health corporation, proposed the Five Year Forward View in October 2014.

Five Year Forward View is written in code, to give the impression that it is in favour of sustaining the NHS according to its founding principles and merely wants to make it more financially sustainable.

Closer scrutiny reveals a five year plan to impose “new care models” ( NCMs), inspired by the US health market. These would replace our current GP surgeries, District General Hospitals ( DGHs) and tertiary care.

The plan depends on a gigantic shift of clinical services out of DGHs and into large new out-of-hospital providers fashioned after American health maintenance organisations, such as Kaiser Permanente. The remaining hospital care would be divided between dumbed down smaller hospitals and networks of large specialised providers, often using ‘prime contracting.’ The closure of fully backed A&E departments would accelerate.

Five Year Forward View alleges that these NCMs, as well as much more ‘self- care’ by patients, would drastically reduce demand for hospital care and ramp up “efficiency”, such that it would be possible to save up to £30bn a year by 2020.

The plan is predicated on an attack on the national terms and conditions of the NHS public sector workforce, the downgrading of its training, and drastic reduction in numbers employed.

The aim is to cut staffing costs by; increased productivity up to 2-3% a year, meaning more patients per nurse; reduced skill-mix; local pay; 24/7 working with unsocial hours paid at reduced rates; staff required to work “across organisational and sector boundaries” (that is to be outsourced ), and have “flexibility to deliver new models of care, including the development of transitional roles’ ( meaning lower qualified staff taking on doctors and nurses roles ). There would be a huge increase in unpaid labour in the form of volunteers.

This plan is about destroying our NHS services and imposing NCMs, as attractive investments for multinational corporations, which are already circling like vultures to enter the healthcare market opened up by the Health and Social Care 2012.

The ” test bed ” for the NCMs is to be Greater Manchester under Chancellor George Osbornes 27.2.15 ‘ Devo Manc’ proposals. Greater Manchester is to be a “trailblazer for the objectives set out in the five year forward view”.



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  1. duncanenright says:

    I don’t think this is a helpful contribution. If we want to meet the health needs of people in the UK in the 21st century we need to think again about how we organise our care. The more that can be done to provide healthcare for people at home, or close to home, the sooner people get better and the more they can stay close to neighbours and family and care services. The last thing most sick people want is to be put into hospital, but too many current pathways lead to just that – irrespective of whether it is the right course of action. We need to be far more patient-centred and human in the way we care, and that means constantly looking for “new care models”.

    1. Duncan: If we want to meet the health needs of people we need a properly funded health service, all private intervention means; costs rise and provision falls, Either you believe in the NHS or you believe in private health care.

      I have said it many times before and not one Neo-Liberal has yet provided evidence to the contrary; that we have the money to fund our NHS and all our public services, but corrupt politicians refuse to do it.

      Our NHS works but corrupt Neo-Liberal politicians are dismantling it, these changes are designed to that end.

      Until Neo-Liberal politicians of all the major parties started undermining our public services we had the care services that apparently you worry about today, the private sector was supposed to provide better care and Thatcher called it care in the community.

      The truth is the private sector has in fact destroyed that care, due to putting the costs above the means for people to afford, the greater the private intervention in our NHS the same will happen, as we are already seeing.

      Lets get the private sector out of our NHS!!!!

  2. Irwin says:

    It is always possible that there is a secret plot. But the 5YFV announcements are not a plan. But what is it in the announcements that is inconsistent with SHA policies?
    Maybe that is does not rely on abolishing the market competition architecture (it just ignores it). And it does not offer proper accountability. And it is dangerous unless funding is adeqaute.
    DevoManc looks ever more like some political vanity project and less like the way forward for integration and democractic accountability; but as we discussed on Saturday we need to be clear about what exactly we are for as well as what we are against.

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