Category Archives: Campaigns

Security staff at Southampton General Hospital being attacked in the A&E department is key to an industrial dispute over pay and sickness pay.

Unite, Britain and Ireland’s largest union, said its 21 security staff members were being attacked on a regular basis by members of the public either under the influence of drink or drugs, or with mental health problems.

Unite is currently holding a ballot for strike action or industrial action short of a strike of its members, employed by Mitie Security Ltd, at Southampton General Hospital over pay and conditions. The ballot closes on Wednesday 15 March.

Unite said that Mitie Security was refusing to provide adequate personal protection equipment (PPE), such as stab vests and  safety restraints, even though knife-related incidents are increasing.

Unite lead officer for health in the south east Scott Kemp said: “With cuts to the police force and mental health services, there is a tendency for those suffering from various conditions to be dropped off at the hospital and left to the security guards. 

“The statistics are not easily available as to the number of our members who have been injured. There has been a lack of proper investigation into the incidents over a considerable period.

“The guards report incidents that have occurred on every shift, but the bosses at the University Hospital Southampton NHS Foundation Trust and Mitie Security will only investigate when someone is injured.

“Our members are very concerned over incidents occurring right across the Tremona Road site when there has been little or no support from the police who are under pressure because of government cuts.

“Our argument is that we should not have to wait for someone to get injured before a full investigation is instigated.

“That is why the sick pay arrangements are really important. At present, if the security staff are injured at work, and if the resulting investigation finds in their favour, they get two weeks’ full pay and then two weeks’ half-pay. After that, it is the statutory minimum.

“We have members getting beaten up and then having to return to work after two weeks, when they are clearly not fit to, as to drop down to half-pay would mean missing mortgage or rent  payments and significant financial hardship.

“What we want is enhanced sickness payments for those off work due to being injured protecting patients and hospital staff; proper and transparent investigations into all attacks; and our members having the necessary personal protection equipment.

“Our members are seeking six months’ full-pay, followed by six months’ half-pay for all sickness absences. We don’t think those are unreasonable requests, given the level of violence in today’s society generally.”

Unite said that the demand for an increase in pay from the current £8.64 an hour reflected the stress of the job. The security staff are seeking £10.50 for security officers and £12.16 for supervisors, with additional payments of 50p per hour on night rates; £1 an hour on Saturday and double time on Sunday.

Scott Kemp added: “Our members are at the forefront of providing security and a safe environment for staff, patients and visitors – that’s why Mitie’s management needs to get around the table and negotiate constructively.

“There is now a good window of opportunity for such talks before the ballot for strike action closes on 15 March.”

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This is a talk given by Public Matter’s Deborah Harrington at an NHS event held jointly by NEON (New Economics Organisers Network) and Health Campaigns Together for The World Transformed in October 2018 in Liverpool.

The brief was to speak for no more than 7 minutes and ‘not to dwell on the history’ but on how to move forward.

The talk began with a quote from the novelist Milan Kundera:

“The struggle of man against power is the struggle of memory over forgetting.”

“We allow our futures and our present to be reshaped by others against our interest if we forget what’s important in our own collective history.

Every NHS campaign meeting contains powerful stories from campaigners – on resisting service closures and cuts, fighting for pay and conditions and more. But I would like to make my first point about what we can learn about building a movement from right at the start of the life of the NHS. From Bevan, in fact. I think this has great relevance to what we are talking about today.

In the first half of the 20th century (don’t worry, it’s not a history lesson) the country as a whole suffered from two world wars, an appalling flu epidemic that wiped out whole communities and the Great Depression. The people didn’t need to be lectured about the Big Society to realise they were all in it together (well, almost all).

The fight was between different political factions at government level about what services were to be delivered and how to deliver them.

Doesn’t that sound familiar?

The arguments were fierce, but Bevan won the day (with a few compromises along the way). But it only lasted 3 years before the principles upon which the NHS was founded were under attack.

If you have never read Chapter 5 of Bevan’s set of essays written in 1952, In Place of Fear, you should. Essential reading for two very important reasons: first he counters the arguments put up against his NHS and secondly he makes his case for his vision of the NHS stand out powerfully against the opposition. If you haven’t read it, you may well be shocked to see him facing all the same arguments we face today: the necessity of having out of pocket payments, the cost of immigrants, the unaffordable burden of the old and the excessive demands made on the system ‘because it is free’. I want to stress from this is that there was general support amongst politicians and public alike that the issue was not over whether there would be a National Health Service, but what form it would take. And Bevan held out for his vision – a socialist enterprise in a very rich capitalist society.

So we move on to the second point – which is defining what a vision of a public service NHS should look like today and what are the threats facing it. I would argue that cuts and closures are the symptoms of the threat, not the threat itself. The threat is from a globalised free market vision of public services as divisible into those which can provide a profit stream and those that can’t.

It’s across the services, not just the NHS and it is across the world, not just in the UK.

But the questions which are thrown out at the public – it’s the old/it’s the immigrants/it’s too much demand/it’s unaffordable – are the way in which the corporate sector frame the situation to cast doubt on the future existence of the NHS in its current form.

And that’s where the catch lies – because the corporate sector which is the engine of this change does have a vision of what the future form should be (effectively to turn it into a UK version of Medicare) and they are doing a hard sell on it. And their sales pitch is seductive.

In it they say that in order to have high quality services we must bring them together, in fewer locations. Surplus land can be sold to help pay for the transformation and the new buildings to house new services can be rented from the private sector ‘bringing investment’ into the NHS. They say the new services will utilise new technology to fit modern lifestyles, that personal health vouchers for those with long term or complex conditions will empower them with choice, that the service will be personalised, focused on you, the patient.

They say it’s the quality of care and the joined up nature of the care that matters, not whether the provider is public or private. So the second take home message is to understand the opposition’s arguments, learn how to demolish those arguments quickly and efficiently and to move on to promoting our shared vision. Because our struggle today is not for any old NHS but for a universal, comprehensive, equitable, public service NHS. Because ‘free at the point of need’ only matters if the service you are getting is worth having. And because every word of their seductive sales pitch is designed to hide the destruction of the NHS’ values of universal and comprehensive care and its ethos of public service, not corporate profit.

And so to my third and final point. Across the country we have individual campaign groups who are extraordinarily knowledgeable about their CCGs, STPs, and all the NHS in England acronym soup. We have umbrella groups which link them together which allows lessons learned in one place to be shared with others. But we also have a wide variation in the individual groups. At the grassroots level look at any group on social media and you will see pro-NHS campaigners arguing from a racist and xenophobic perspective that ‘our’ NHS can’t cope with the demand from ‘non-contributors’. Time and again someone will say that ‘the NHS is what they pay their National Insurance for’ (spoiler alert: it doesn’t). And others (whether well meaning and mis-guided, or simply trolls) saying that the NHS needs to change if it is to continue at all.

At the political and opinion forming level (think tanks, politicians, main stream media) there appears to be a consensus that the Health & Social Care Act (2012)  ‘failed’ and that, whilst parliamentary time is so bound up in other matters, it is good that Simon Stevens is working around that legislation to put the NHS in England back together again. My colleague Jessica and I had a meeting with an MP from the North West who said that this view pervades all political parties and indeed it is reflected everywhere from the cross party Health Select Committee to the recent publication from the Labour Party ‘A Picture of Health’.

But we need to remember what is at the heart of our campaign and keep our message simple and strong. And for that I will quote Jessica’s grandfather, the late Julian Tudor-Hart, who wrote in his essay ‘The Inverse Care Law’ in 1971 ‘the availability of good medical care tends to vary inversely with the need for it in the population served. This inverse care law operates more completely where medical care is exposed to market forces, and less so where such exposure is reduced.’

Because I would argue that the 2012 Act has not failed.

It has done its intended job of ripping the NHS into fragments so that its pieces can be reassembled like jigsaw pieces. It absolutely leaves the NHS exposed to market forces and they are being embedded at every level from decision and policy making to running services. The evidence from across the world proves the Inverse Care Law right. So my last take home message would be to remember that this is a struggle that goes further than England’s boundaries. And it also goes across time.

There is a short term and very urgent battle to be won but it is in a broader and ongoing battle of ideals and ideology that isn’t going away any time soon.”

On the platform with Deborah was Bonnie Castillo, Executive Director of the National Nurses United Union in the USA. The NNU is part of the fight for universal healthcare in the USA. Bonnie explained how important the NHS is as a beacon of hope for them, “Your fight to defend the NHS is our fight’ she said.

From this Saturday there is to be a week of cross-Atlantic campaigning as described here in the Guardian. They want Britons to join in with the NNU’s National Medicare for All week of action, running from 9-13 February. NNU is the largest union representing bedside nurses in the US.

https://www.theguardian.com/society/2019/feb/03/momentum-founders-emma-rees-adam-klug-nhs-style-healthcare-in-us?fbclid=IwAR0TXvaVmpkJ-DCPnlbXbp-Ykt6ouW7-NUshTBYTubZXk5yYECiRFqco7Qs

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Some quick notes on UnitedHealth pulled together fast, to brief those unfamiliar with the threat to the NHS that it poses:

NHS chiefs tell Theresa May it is time to curb privatisation: can it be true?

This is the ultimate in cynical deception. We’re told that the fox is trying to improve the security of the NHS henhouse! In fact the part of the Health and Social Care Act 2012 that Stevens proposes removing makes monopoly control of the NHS illegal under competition law rules. That ban has, as intended, blocked the NHS from excluding private sector competition for its budget and was used as a means for the private sector to extract profits from public funds which should have paid for patient care. But the same rules also make control of the NHS by a company, such as a health insurer like UnitedHealth, illegal. It is these rules that Stevens is now saying he wants removed, at the time when UH is already entrenched inside the NHS: UH man Stevens heads the NHS and UH subsidiary Optum is involved across the country in processing patient care payments for GP practices. This legal change will not halt the privatisation of the NHS, it will accomplish it!

Simon Stevens is posing as a neutral bystander when he is in reality facilitating UnitedHealth’s control of the UK health system. He is enabling a corporate monopoly of the NHS whilst pretending to be against privatisation. Removing competition rules would also have the effect of allowing a now legal takeover to take place behind closed doors, away from public scrutiny.

Thanks to Stevens diligent work facilitating and heading up UnitedHealth’s expansion into the UK over a period of nearly two decades, UnitedHealth, through its subsidiary Optum, is today now well placed in the system to integrate and siphon off the UK’s NHS budget.

Simon Stevens’ CV is here: http://selloff.org.uk/nhs/CVforSimonStevens260516.pdf

Here is an update on UnitedHealth in the NHS:

They have had CCG contracts in every STP area

Their decision support software is used in most GP practices (it was bought by Stevens for the NHS in 2009)

UH was hired onto NHS England’s commissioning outsourcing framework in 2015

UH was hired as consultant and supplier to all of NHS England’s own Commissioning Support Units

UH was selected as one of only two companies on the NHS Shared Business Services Medicine Management Framework offered to CCGs. It has a business relationship with the other one

UH is shaping and integrating the system via IT system involvement, handling contracts and/or advising on cuts in many areas

They have been handling referrals for at least 21 CCGs, which has included developing a list of “procedures of limited clinical value” for CCG use in negotiations with providers, many of which are elective procedures that private providers can sell to patients denied NHS care for them.

Optum was hired last year by NHS England and the Department of Health to shape Independent Care Systems across the NHS, so far they operating in this specific capacity in at least 7 STPs

The Senior Clinical Advisor to NHS England on Integrated Care Systems is the director of an LLP (Limited Liability Partnership) which co-owns a company with Optum; and he also was hired last year by NHS Right Care to focus on leadership https://www.england.nhs.uk/rightcare/2018/08/14/professor-nick-harding-obe-joins-nhs-rightcare/

Hired by NHS England to benchmark spend in local area teams, and devised a “data capture template” for specialised services

Partnered with at least two of the largest “GP Super Partnerships” which are expanding and together span ten STP areas so far

GPs from one of the GP super partnerships have formed a company with Optum

Processing data for multiple CCGs, including identifiable data. Controlling data access for staff in Lincolnshire

Optum staff can be found in key roles in the NHS, including CCGs, Hospitals and at STPs. Also there are many NHS staff have left for Optum in recent years.

Wider influence in the system: partnered with NHS Confederation, the Kings Fund and Nuffield Trust, 2020Health. Optum sponsors BMJ events. The BMJ publishes research from OptumLabs. Regular presence at and sponsor of NHS meetings and conferences.

Paid associate of the All Party Parliamentary Group on Health, which “is recognised as one of the preferred sources of information on health in parliament” (quote is from the APPG website)

Corporate Partner of the National Association of Primary Care involved in implementing the primary care home model across the NHS. Optum is also on their council

Training the “Next Generation” of GPs, on a programme funded by NHS England

Handling Freedom Of Information Requests in Lincolnshire

Six Lords have interests in UnitedHealth, one of them is on the NHS Improvement Board (Lord Carter has shares).

Partnered with charities AgeUK and Alzheimers Society and in education with health departments within the LSE and Imperial college.

An UnitedHealth Director was chosen by the Department of Health to drive new technology and drugs through the NHS – until he was announced as the new Optum CEO. The position was subsequently taken by Lord Darzi – who heads an Institute which is partnered with Optum.

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Dear #Justice4NHS Supporters

We wish you a Happy New Year but we are very sorry to tell you that the Court of Appeal has ruled against our case.

The good thing is that – fingers crossed 3rd Time Lucky! – we are now applying for permission to appeal to the SUPREME COURT

We are doing this because the Court of Appeal ruling has not grappled with the vital issues that our case raised. This is not just our opinion, it is also the informed opinion of our legal team.

To say the least this is very annoying – and just plain WRONG. We can’t let the Courts sweep vital public interest and legal issues under the carpet.

We hope you feel as proud as we are, that the 999 Call for the NHS #Justice4NHS legal challenge has been a grassroots crowdfunded case from the very beginning and that together we are all defending the NHS.

If we had not brought our case to the courts, NHS England would have already implemented their contentious new contract back in April 2018.

We can’t thank you enough for helping us through the various stages of this the 2-year legal battle. We hope you may also be able to help take this case forward to the Supreme Court.

We can’t give up now. In 2019 our campaign messages about the damage to our NHS we are all seeing, must be even louder and clearer.

This contentious ACO contract, if implemented, would only increase this damage .

And that is why…

We are not going away.

We wish you all a new year in which you can find hope and strength in the knowledge that what we are doing together is right. It’s a long, tough fight but together we are strong. And we see that more and more of the public are beginning to hear and understand our reasons.

We will shortly begin #Justice4NHS CrowdJustice Stage 6 to raise funds to cover the costs of applying to the Supreme Court for permission to appeal. The amount we are likely to need to raise for this stage is approximately £5,000.

Don’t forget you can also sign up as an Ambassador to receive updates and news about the campaign. SIGN UP

We can’t thank you enough for helping us through the various stages of the the 2-year legal battle and we hope you will continue to lend your support again in 2019.

Thanks and best wishes

Jo, Jenny & Steve

And all the 999 Call for the NHS team

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A Christmas message from Aimee Shalan
Dear friend,

This year has been yet another difficult and tragic one for Palestinians.

The shocking use of force by Israeli forces against demonstrators in Gaza has killed scores and injured thousands, many with horrific limb injuries.

Demolitions continue to be a day-to-day reality for many Palestinians in the West Bank. Not only have individual homes and buildings such as schools been demolished, but entire villages like Khan al Ahmar have been threatened with demolition and forcible transfer.

We have also witnessed a dangerous politicisation of humanitarian aid, with the US administration cutting all funding to UNRWA, the UN agency responsible for humanitarian support to Palestinian refugees. These cuts greatly threaten Palestinian refugees’ access to healthcare, education and emergency food assistance.

Amid such bleak circumstances, I am incredibly proud of all that MAP has achieved and want to thank our supporters for their generosity and kind support – facilitating our essential and lifesaving work.

This year alone, we have spent more than £1 million on limb reconstruction supplies to help save limbs and lives in Gaza. In the West Bank, we purchased a brand new mobile health clinic, so we can continue to bring doctors, nurses and community health workers to vulnerable Bedouin communities. And in Lebanon, the dedication and hard work of our community midwives has helped to enhance the care offered to pregnant Palestinian women and their new-born babies.

These are just a few examples of the scope and diversity of our programmes, ranging from emergency assistance to programmes building the long-term capacity of Palestine’s health system. All made possible thanks to the support and generosity of people like you.

As we look to 2019, there will be more challenges ahead. There is serious concern that the “Peace Plan” from the US administration could further endanger the rights of Palestinians living as refugees and under occupation. Bedouin communities will need all the more support and some 1,500 patients in Gaza will need up to two years of painful limb reconstruction treatment from a health system which the WHO has long-warned is “on the brink of collapse”.

Together we are improving the health and dignity of Palestinians and will continue to do so, despite all the pressures. Thank you for your kindness.

My very best wishes for Christmas, with the hope of a brighter year in 2019.

Aimee Shalan
Chief Executive, Medical Aid for Palestinians

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Dear HCT affiliates,

Please find below our December newsletter. We at HCT wish you all a hearty seasons greetings and look forward to a prosperous new year.

Make our NHS Safe for All Campaign
Safety in the NHS in terms of safe staffing and provision is a key talking point in our campaigning, especially going into winter where services are stretched to the limit and dangerous situations can often arise. Health Campaigns Together are very interested in collating data around safety in our NHS and we need your help to kick-start our campaign. If you have any information around an NHS safety concern in any area then please email in confidence to John Lister hctsafetylog@gmail.com – a new and dedicated email set up for this purpose. You can also get more closely involved by signing up to support us and help develop the proposed charter for safer services.
Winter crisis
Sadly, a winter crisis in our NHS has almost become normalised now. We in HCT are all aware of the now seemingly perpetual winter the service suffers, but we must make sure that we keep the plight of the NHS in the news at both a local and national level. Please keep up the excellent work you are all doing in drawing the public’s attention to the conditions in the service over winter. Knowledge is power and if the public aren’t aware, they cannot challenge local representatives. The results from FOIs for OPEL (Operational Pressures Escalation Level) reports are always a good way into the local press in this area.
Social Care Conference
We are delighted to report that thanks to all of you our regional social care conference on 17th of November was a great success with over 100 attendees. There was some very productive networking, and commitment made for future groups and projects, including some important issues raised by disability campaigners. These regional conferences are a great way to feed ideas in from all around the country where we can all make a difference.
HCT help with launch: People’s Assembly “Britain is Broken” national campaign
Last week, friends of HCT the People’s Assembly Against Austerity invited HCT to speak about the NHS crisis as part of a nationwide campaign to highlight the devastating effects of austerity across the country. Our secretary, doctor Aislinn Macklin-Doherty chaired and introduced a dynamic and powerful range of speakers from Unite trade union activists on strike for better pay in the catering industry, to Richard Burgon Labour MP for Leeds. This was an exciting launch to what will be an important campaign to make the voices heard of those hardest hit by austerity. There are other events planned.
Warwick University debate
On 27th of November HCT officer and editor of our paper, John Lister took part in a debate at Warwick University with the Wolverhampton trust CEO. It was a lively and informative event with a lot of agreement on safety and staffing levels. The Institute of Economic Affairs’ Kate Andrews was due to attend but unfortunately withdrew at the last moment citing Westminster business. This is a shame as it would have provided a valuable opportunity to challenge her over her organisation’s pro-privatisation interests.
Google is gobbling up millions of NHS patient’s data
For several years giant tech companies from silicon valley have been making moves to access the wealth of information locked in the NHS. In the last fortnight we heard that finally Google seem to have crowbarred their way in via a subsidiary company they own called DeepMind who had made an agreement with The Royal Free NHS Trust (amongst others) to gain access to 1.6 MILLION patient’s records. With no public scrutiny.
Shockingly in July of this year the Independent Commissioner’s Office ruled that The Royal Free and DeepMind had acted outside the law in sharing this data and importantly, DeepMind PROMISED no other body would have access to patient’s data. But this seems to have been totally dropped when Google announced it had taken over DeepMind’s data. Most shockingly of all this has not made any waves in news headlines and HCT believe this is a very serious issue that needs to be addressed.
For more detailed info please read this report, evidence that good investigative journalists do still exist!
If you are a Royal Free patient or someone who wants to get involved personally with this campaign, please email Aislinn directly at aislinnmacklin@doctors.org.uk
HCT January issue
For inclusion in the January issue of our paper please submit copy and photos to John Lister by Friday 21st December at healthcampaignstogether@gmail.com ‘FAO The Editor’ in subject heading.
Dr Youssef El-Gingihy updated book launched this week
Dr Youssef El-Gingihy is a Tower Hamlets GP at the Bromley by Bow Centre. Many will be familiar with his book How to Dismantle the NHS in 10 Easy Steps which tells the story of how the NHS is being sold off. The new edition contains extra chapters on the junior doctors’ strike and the introduction of US style healthcare models of accountable/integrated care. It also has a coda on how we can save the NHS.
Student groups
Can we ask all affiliated groups to reach out to their local student organisations in order to better facilitate working with younger people and encourage the next generation of health campaigners and activists? We are very lucky to have a wealth of talent across the British Isles involved in Health Campaigns Together but we need to further strengthen our networks with other demographics in order to assure our future and gain new ideas. Why not find out your local FE and HE student union/relevant student societies and invite yourselves as a speaker? Your suggestion could be just what they are waiting for.
Trade Union Delegates needed
Please can our HCT affiliates from trade union branches and trades councils make sure you have chosen your delegate and remember to send them to the HCT affiliates’ meetings? Representation is so important in facilitating good discourse.
Interserve Group

Note that yet another multinational private provider involved in massive public sector contracts is in deep trouble. Watch how this unfolds over the coming weeks!

 

HCT and Keep Our NHS Public websites

Please don’t forget to regularly log in to both our major campaigning websites for new content and information. A lot more news is covered in detail here.
www.healthcampaignstogether.com
www.keepournhspublic.com/newsLocal News
Save Our Services in Surrey
If you are in or around the Surrey area on Saturday 15th of December then please consider joining health workers and others at the march and rally for public safety, and against austerity. Junior doctor and NHS activist Sonia Adesara will be speaking. Assemble at 11am outside Woking borough council offices, marching to the town square. This will be a peaceful, family-oriented event. The march will centre around the mainly pedestrian areas to Jubilee Square for the speeches. Bring home-made banners and placards and be ready to make some noise.
Join Save Our Services in Surrey: www.sosis.org.uk
saveourservicessurrey@gmail.com
www.facebook.com/sosinsurrey
@sos_surrey (Twitter)
South Tyneside Hospital
Monday 17th of December 12-1pm (Harton Lane entrance), South Shields NE34 0PL A Judicial Review challenging Phase 1 of the downgrading and closure of vital acute health services in South Tyneside will take place at the Administrative Court in Leeds over 3 days from Tuesday 18th to Thursday 20th of December 2018. The day before the court case begins there will be a protest vigil at the Harton Lane entrance to South Tyneside Hospital to remind people of the fight and the ongoing service restructuring that is paving the way for increased privatisation here and throughout England.
Success in Nottingham!
Nottingham City Council has pulled out of the Notts Integrated Care System stating there has been a poor degree of information sharing and involvement. This is a impressive victory from our colleagues at Nottingham Keep Our NHS Public who are doing great work. This victory is in no small part due to their local efforts in lobbying and raising awareness around the subject, and from their contact with Cllrs on the Health Scrutiny Cttee & Health & Wellbeing Board. Richard Buckwell (Chair of Nottingham KONP) said:
“We believe it will have a significant effect on progressing the ICS locally & is an excellent message to other authorities as the Greater Nottingham STP was often seen as a lead area on progressing STPs which have now morphed into ICSs.”
Dates for your diary
Our next HCT affiliates meeting is on Saturday 2nd February at Unite the Union, 128 Theobald’s Rd, London WC1X 8TN
Next year’s AGM is on Saturday 6th of April
Kind regards,
The Health Campaigns Together team

Health Campaigns Together

www.healthcampaignstogether.com
Email: healthcampaignstogether@gmail.com
Twitter:@nhscampaigns
Facebook.com/healthcampaignstogether

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A coalition to defend #ourNHS

Follow-up meeting

Thursday December 13, 13.30 – 16.00 at Carr’s Lane Conference Centre Birmingham, B4 7SX

Please let us know if you will be attending, by emailing reclaimsocialcare @gmail.com

 

.

Jan Shortt, NPC General Secretary

Gill Ogilvie, GMB regional organiser

Reclaim Social Care Conference Nov 17, Birmingham

Speakers included

  • Health Campaigns Together editor John Lister,
  • Eleanor Smith MP who has put forward the NHS Reinstatement Bill aimed at preserving the future of the NHS,

and campaigners from

  • the Relatives and Residents Association,
  • North West UNISON Dignity in Care Campaign,
  • “Being the Boss” / Reclaim our Futures,
  • National Pensioners Convention
  • and the Centre for Welfare Reform,

as well as Prof Peter Beresford of Essex University and Gill Ogilvie, a GMB official who has led campaigns for children’s services.

Conor McGurran of NW Region UNISON

Simon Duffy (behind him Prof Peter
Beresford and chair Ann Bannister)

Between them they outlined some of the complexity and the varied interest groups affected by the crisis in social care, spelled out some outlines of policies and objectives that should be the basis for campaigning, and agreed on the need to combat the current dysfunctional and unfair system, while challenging any further cutbacks or privatisation.

It was clear from the conference that there is a common basis for a campaign for a publicly funded and provided social care service that respects the individual needs and capacities of all citizens.

The social care service we want would deliver support as required on the basis of needs and choices, giving a voice to service users, and with services delivered to all without means tested charges and funded nationally from general taxation.

There was also support for public control and ownership of most services, to end the scandal of public money flowing to tax dodging corporations and cheapskate, exploitative home care companies; and proper status, pay, terms and conditions for all care staff, including training where required and a career structure.

We will be posting video and extracts from speeches, but in the meantime please see:

 

The Debate over Social Care

The worsening plight of social care and the financial problems posed for local government have been unveiled by a new National Audit Office Report, available HERE. But how can the problems be addressed, and how far can social care be integrated with the NHS as part of a longer term development?

These are complex questions. Professor Bob Hudson’s BLOG is a basis of discussion, and while many campaigners will share some of these views, many will differ on his conclusions. The debate is an important one in shaping the policy of any future government to replace the Tories, so we invite campaigners to respond and develop this discussion, offer us your thoughts and suggestions, and help us develop a parallel campaign for properly funded and publicly accountable social care in parallel with the fight to defend, reinstate and fully fund our NHS.

Send any contributions (or suggested links and other material) to us at hcteditorial@gmail.com.

FEATURED BLOG

 

Response

 

Links to other articles and analysis on social care:

 

 

  • Hundreds of care home patients have died dehydrated or malnourished – Guardian report based on official figures:
    “More than 1,000 care home patients have died suffering from malnutrition, dehydration or bedsores, new figures reveal.
    “At least one of the conditions was noted on the death certificates of as many as 1,463 vulnerable residents in NHS, local authority and privately-run care homes in England and Wales over the past five years..
    “The figures have been obtained by the Guardian from the Office for National Statistics (ONS), which completed an analysis of death certificates at the newspaper’s request.
    “It follows a separate Guardian investigation that revealed some of the country’s worst care homes were owned by companies that made a total profit of £113m despite poor levels of care.”

 

  • Fair care: A workforce strategy for social care – New IPPR report on the social care system argues that says nearly half of the 1.3million people working in the care sector are earning less that the real living wage of £9 an hour, with one in four (325,000 people) on a zero-hours contracts.
    It warns that unless pay and conditions are improved there could be a shortage of 400,000 care workers by 2028.
    Nearly two-thirds of home care workers are only paid for contact time and not for travel between the homes of people they care for.
    One in three carers said they often don’t have enough time to prepare a meal or help with washing and bathing, while a staggering 89 per cent said that they don’t get enough time even to have a chat with clients.

 

 

 

 

 

 

  • Beyond barriers How older people move between health and social care in England – Another reminder of how far the current health and care system is from any real “integration”. Following comprehensive reviews of 20 local authority areas, the CQC has called for a new approach to the way the country runs health and care services.
    The ‘Breaking Barriers’ report followed people’s journeys through the health and social care system and identified gaps where people experienced poor or fragmented care, with findings showing “the urgent necessity for real change.”

 

 

 

 

  • A fork in the road: Next steps for social care funding reform – A joint report between the Health Foundation and the Kings Fund, which highlights low public awareness of social care and a lack of agreement on priorities for reform as major barriers to progress, despite apparent political consensus on the need for urgent action.
    It argues that reforming the current system will be expensive, but states that if reform is chosen, England is now at a clear ‘fork in the road’ with a choice between “a better means-tested system” and one that is “more like the NHS” — free at the point of use for those who need it.

 

 

 

 

 

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Chipping Barnet CLP notes that access to contraception is a fundamental human right underpinning equality, impacting on the health, structure and prosperity of both society and families. The 2012 Health and Social Care Act disadvantaged women, separating much of the funding for contraceptive care from the NHS by moving the responsibility for commissioning into Local Authorities, with NHS providers competing for contracts. As a result, the commissioning of contraception is now separate from the commissioning of other aspects of women’s health, including abortion. From both a woman’s and a clinical perspective, this is illogical. Compounding this, the impact of austerity on Local Authorities has led to a reduction in services, reduced access and to a postcode lottery for contraception in England.

Chipping Barnet CLP believes that contraceptive services need to be fully funded and accessible in all areas of the UK, with co-operation replacing competition. It welcomes the commitment of the Shadow Health Department to abolish competitive tendering for these essential services, and to work with clinicians to establish centres of excellence alongside regular accessible clinics to which women have free and easy access to confidential care.

Chipping Barnet CLP calls on the Labour Party to resolve to deliver fully funded contraceptive services in all areas of the UK, setting up a working group whilst still in opposition, composed of experienced clinicians and commissioners, to write a blueprint for delivery which will be implemented within the first year of the Labour Government.

Published by Jean Hardiman Smith with the permission of Sarah Pillai ( Chipping Barnet CLP )

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Reclaim Social Care Conference 17.11.18 final flier

Full details also on the Events page. Please circulate as widely as possible.

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Scrap a new contract that could wreck our NHS!

The quango NHS England is currently holding a badly-publicised public consultation on its new Accountable Care Organisation contract – which it has renamed the Integrated Care Provider contract.

Most people won’t have heard about this. Have you?

Why is NHS England consulting on it now, before they even know if their new contract is lawful?

This autumn, 999 Call for the NHS is challenging the lawfulness of this contract in the Court of Appeal.

Many thanks to over 750 individuals, NHS campaign groups and trade union branches, who have crowdfunded the £18K costs of the Appeal through CrowdJustice  – info here. http://bit.ly/999CourtofAppeal

NHS England’s consultation is online here.

999 Call for the NHS’s response is online here. (Downloadable word doc.) You’re welcome to use and adapt it for your own response. We do not accept the basic premise of the consultation – that contracts are an appropriate way of planning, delivering and managing NHS services. We are campaigning for the NHS Bill to reinstate the NHS as a  fully publicly funded, managed and provided service.

If you prefer a consultation that is shorter and more to the point, 999 Call for the NHS will shortly be carrying out our own consultation online. Please come back soon to find the link. We will collect the responses and send them to NHS England before their consultation ends on 26th October.

The proposed new contract might sound like a dry legal issue that’s hard to get bothered about. The reality is anything but.

This is about whether patients can continue to access the treatments they need, or whether the doctor – patient relationship will be undermined by making doctors put financial considerations ahead of patients’ clinical needs.

This new 10 year contract is driven by NHS England’s cost-cutting aim of avoiding a projected £22bn funding shortfall by 2020/21 – the result of nearly a decade of NHS underfunding by the government.

The Accountable Care Organisation/Integrated Care Provider contract would pay a new type of  legal entity for a whole range of NHS and social care services in a given area. It would use the same lump sum payment arrangement that has been used to pay for psychiatric intensive care – with disastrous results. Just think about the dire shortage of acute mental health beds.

This contract is explicitly intended to “manage demand” for NHS services – in other words, to restrict patients’ access.

Its cost-cutting payment mechanism would drive down safety standards as well as restricting patients’ access to care.

An Integrated Care Provider could be a private company or joint venture

The new type of single legal entity could be an NHS organisation like a hospital Trust, or a GP Federation, a private company or a joint venture or special purpose vehicle that could include NHS providers and private companies.

This is a complex contract where the legal entity that holds the contract would then subcontract to a number of different healthcare providers – whether NHS, private or 3rd sector companies. This comes with all sorts of risks and hazards.  (For more info, see our answers to questions 3,4 and 5 in NHS England’s Integrated Care Provider Contract consultation.)

The Contract’s wide loopholes would allow far greater privatisation of NHS services – under this contract, a private company could control the delivery of the whole range of out-of-hospital NHS and social care services for a large area. Or indeed could win multiple contracts across many areas, and so establish a near- monopoly.

NHS England has admitted that under current NHS and social care legislation, it is powerless to stop private companies bidding for this – or any other – contract.

Un-evidenced, cost-cutting “care models” and “modern workforce”

This Accountable Care Organisation/Integrated Care Provider contract is designed to cement new NHS “care models” that copy the USA’s Medicare/Medicaid system. This provides a limited range of publicly-funded health care for people who are too poor or ill to access private health insurance.

Under the new “care models, District General Hospitals are being cut and downgraded. Community Hospitals beds are being closed. Family doctors are going under, as they are asked to take on more and more while there is a shortage of GPs and GP funding is flat. They are being replaced by huge new GP super practices serving 30K-70K patients, that are likely to become Integrated Care Providers.

Increasingly, these practices are being taken over by companies like Modality. Modality now operates in 7 Sustainability and Transformation Partnerships across England and has over 300,000 patients registered with it.

Budding local Accountable Care Systems (now rebranded as Integrated Care Systems) say that this is all fine, as care will be delivered out of hospital, in people’s homes, in large scale GP hubs and by means of digital technology.

But the new “care models” come with a “modern workforce” employing cheaper, less qualified new grades of staff – and relying on unpaid volunteers, friends and family.

None of this adds up to a comprehensive NHS that cares for everyone on the basis of clinical need. Instead care will be allocated on the basis of decisions about money.

NHS England laid out its plan for setting up these new care models in its 2015-2020 Five Year Forward View. Since then it has set up Vanguard schemes to trial these new ways of providing NHS and social care. There is just one small problem. There is no real evidence that they work. That is the conclusion of the National Audit Office report.

Opening the NHS to deregulated trade

The NHS quangos are aiming to change the whole architecture of the NHS, so it can deliver these American care models. All the better to open the NHS gates to American corporations, post-Brexit.

Stewart Player recently pointed out that

“…the aim is to impose a kind of global homogeneity of healthcare organization. Such standardization will attempt to safeguard and simplify investment strategies, and to embed corporate control of both purchasing and service delivery within rapidly evolving ‘mixed economies’ of care…

“The use of capitated budgets for ACO providers, for example, is expressly geared towards private investor interests, as the upfront capital can be invested in the global markets, with returns on equity in excess of 16%.”

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Ray Tallis is an active member of Keep Our NHS Public and a strong defender of the NHS. This should be a very interesting lecture

Public Lecture: The Royal College of Physicians and the Politics of Healthcare 2018

8 November 2018
Liverpool Medical Institution, Mount Pleasant, L3 5SR

6pm: Welcoming drinks
6.30pm: Lecture

Raymond Tallis is a philosopher, poet, novelist and cultural critic and was until recently a physician and clinical scientist. In the Economist’s Intelligent Life Magazine (Autumn 2009) he was listed as one of the top living polymaths in the world.

Born in Liverpool in 1946, one of five children, he trained as a doctor at Oxford University and at St Thomas’ in London before going on to become profritic and was until recently a physician and clinical scientist. In the Economist’s Intelligent Life Magazine (Autumn 2009) he was listed as one of the top living polymaths in the world.
Born in Liverpool in 1946, one of five children, he trained as a doctor at Oxford University and at St Thomas’ in London before going on to become professor of geriatric medicine at the University of Manchester and a consultant physician in healthcare of the elderly in Salford. Professor Tallis retired from medicine in 2006 to become a full-time writer, though he remained visiting professor at St George’s Hospital Medical School, University of London until 2008. He was visiting professor of English at the University of Liverpool until 2013.
Over the last 20 years, Raymond Tallis has published fiction, three volumes of poetry, over two hundred articles and 23 books on the philosophy of mind, philosophical anthropology, literary theory, the nature of art and cultural criticism. Together, these works offer a critique of current predominant intellectual trends and an alternative understanding of human consciousness, the nature of language and of what it is to be a human being.

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Calderdale and Kirklees 999 Call for the NHS

It’s our NHS – the profiteers, privatisers and austerity liars can jog on

Scrap a new contract that could wreck our NHS!

The quango NHS England is currently holding a badly-publicised public consultation on its new Accountable Care Organisation contract – which it has renamed the Integrated Care Provider contract.

Most people won’t have heard about this. Have you?

 

Why is NHS England consulting on it now, before they even know if their new contract is lawful?

This autumn, 999 Call for the NHS is challenging the lawfulness of this contract in the Court of Appeal.

We are currently crowdfunding the £18K costs of the Appeal through CrowdJustice – please give whatever you can afford. Any amount, big or small, is a huge help and much appreciated. Here’s where you can donate and find out more. http://bit.ly/999CourtofAppeal

NHS England’s consultation is online here.

999 Call for the NHS’s response is online here. (Downloadable word doc.) You’re welcome to use and adapt it for your own response. We do not accept the basic premise of the consultation – that contracts are an appropriate way of planning, delivering and managing NHS services. We are campaigning for the NHS Bill to reinstate the NHS as a  fully publicly funded, managed and provided service.

If you prefer a consultation that is shorter and more to the point, 999 Call for the NHS will shortly be carrying out our own consultation online. Please come back soon to find the link. We will collect the responses and send them to NHS England before their consultation ends on 26th October.

The proposed new contract might sound like a dry legal issue that’s hard to get bothered about. The reality is anything but.

This is about whether patients can continue to access the treatments they need, or whether the doctor – patient relationship will be undermined by making doctors put financial considerations ahead of patients’ clinical needs.

This new 10 year contract is driven by NHS England’s cost-cutting aim of avoiding a projected £22bn funding shortfall by 2020/21 – the result of nearly a decade of NHS underfunding by the government.

The Accountable Care Organisation/Integrated Care Provider contract would pay a new type of  legal entity for a whole range of NHS and social care services in a given area. It would use the same lump sum payment arrangement that has been used to pay for psychiatric intensive care – with disastrous results. Just think about the dire shortage of acute mental health beds.

This contract is explicitly intended to “manage demand” for NHS services – in other words, to restrict patients’ access.

Its cost-cutting payment mechanism would drive down safety standards as well as restricting patients’ access to care.

An Integrated Care Provider could be a private company or joint venture

The new type of single legal entity could be an NHS organisation like a hospital Trust, or a GP Federation, a private company or a joint venture or special purpose vehicle that could include NHS providers and private companies.

This is a complex contract where the legal entity that holds the contract would then subcontract to a number of different healthcare providers – whether NHS, private or 3rd sector companies. This comes with all sorts of risks and hazards.  (For more info, see our answers to questions 3,4 and 5 in NHS England’s Integrated Care Provider Contract consultation.)

The Contract’s wide loopholes would allow far greater privatisation of NHS services – under this contract, a private company could control the delivery of the whole range of out-of-hospital NHS and social care services for a large area. Or indeed could win multiple contracts across many areas, and so establish a near- monopoly.

NHS England has admitted that under current NHS and social care legislation, it is powerless to stop private companies bidding for this – or any other – contract.

Un-evidenced, cost-cutting “care models” and “modern workforce”

This Accountable Care Organisation/Integrated Care Provider contract is designed to cement new NHS “care models” that copy the USA’s Medicare/Medicaid system. This provides a limited range of publicly-funded health care for people who are too poor or ill to access private health insurance.

Under the new “care models, District General Hospitals are being cut and downgraded. Community Hospitals beds are being closed. Family doctors are going under, as they are asked to take on more and more while there is a shortage of GPs and GP funding is flat. They are being replaced by huge new GP super practices serving 30K-70K patients, that are likely to become Integrated Care Providers.

Increasingly, these practices are being taken over by companies like Modality. Modality now operates in 7 Sustainability and Transformation Partnerships across England and has over 300,000 patients registered with it.

Budding local Accountable Care Systems (now rebranded as Integrated Care Systems) say that this is all fine, as care will be delivered out of hospital, in people’s homes, in large scale GP hubs and by means of digital technology.

But the new “care models” come with a “modern workforce” employing cheaper, less qualified new grades of staff – and relying on unpaid volunteers, friends and family.

None of this adds up to a comprehensive NHS that cares for everyone on the basis of clinical need. Instead care will be allocated on the basis of decisions about money.

NHS England laid out its plan for setting up these new care models in its 2015-2020 Five Year Forward View. Since then it has set up Vanguard schemes to trial these new ways of providing NHS and social care. There is just one small problem. There is no real evidence that they work. That is the conclusion of the National Audit Office report.

Opening the NHS to deregulated trade

The NHS quangos are aiming to change the whole architecture of the NHS, so it can deliver these American care models. All the better to open the NHS gates to American corporations, post-Brexit.

Stewart Player recently pointed out that

“…the aim is to impose a kind of global homogeneity of healthcare organization. Such standardization will attempt to safeguard and simplify investment strategies, and to embed corporate control of both purchasing and service delivery within rapidly evolving ‘mixed economies’ of care…

“The use of capitated budgets for ACO providers, for example, is expressly geared towards private investor interests, as the upfront capital can be invested in the global markets, with returns on equity in excess of 16%.”

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