Category Archives: Campaigns

Join us on September the 12th at the Quaker Meeting House, Sheffield, at 6pm.

PM Boris Johnson, on the steps of Downing Street: “My job is to protect you, or your parents or grandparents, from the fear of having to sell your home to pay for the costs of care and so I am announcing now on the steps of Downing Street that we will fix the crisis in social care once and for all with a clear plan we have prepared to give every older person the dignity and security they deserve.” July 24th 2019

 

Social Care: Fixing the broken system – The Marmot Review 10 years on.  Economic growth is not the most important measure of our country’s success. The fair distribution of health, well-being and sustainability are important social goals. The Marmot Report.

We invite our Yorkshire community to join this vital conversation on ensuring that, finally, a Prime Minister’s words become action. For too long successive governments have promised action and failed:

  • Labour admitted yesterday that it had failed to transform the life chances of Britain’s poorest children, despite a succession of initiatives costing billions of pounds. (The Times, February 25, 2005)
  • The Government has cut funding for childcare despite a Conservative manifesto pledge to double the number of free hours parents get, says the NAO (Independent, March 2,  2016)
  • Theresa May pledges to seek long-term solution to social care squeeze … through a properly funded social care system”. Then, in 2017. May’s opinion poll lead ahead of a June 8 election halved in two recent polls since she set out proposals to reduce financial support for elderly voters. Theresa May’s social care package fails “to tackle the biggest problem” facing elderly people, Sir Andrew Dilnot has said.(Independent, May 18, 2017)

 

Format

Dr Simon Duffy, Founder of the Centre for Welfare Reform: The “what and how to” challenge to Boris Johnson based on Simon’s policy proposal for the Reclaim Social Care campaign.

A panel of experts, council members and users, will join him, with full participation from the audience.

We will agree a list of demands to present to the Prime Minister that must be included in his plan. Easy sound-bite pledges and promises of money mean nothing if there is no improvement plan.

The goal of the Great Yorkshire Conversation is to get the right government action and the right funding to put right the system that has been broken by Austerity and sticking plaster policies.

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Introduction

 

The  SHA Council agreed to pull together some of the existing policies on prevention and public health, introduce new proposals that have been identified and put them into a policy framework to influence socialist thinking, Labour Party (LP) manifestoes and future policy commitments. The SHA is not funded by the industry, charitable foundations or by governments. We are a socialist society which is affiliated to the Labour Party (LP) and we participate in the LP policy process and promote policies which will help build a healthier and fairer society within the UK and globally. An SHA working group was established to draft papers for the Central Council to consider (Annex 1).

 

The group were asked to provide short statements on the rationale for specific policies (the Why?), reference the evidence base and prioritise specific policies (the What?). Prevention and Public Health are wide areas for cross government policy development so we have tried to selectively choose policies that would build a healthier population with greater equity between social groups especially by social class, ethnicity, gender and geographical localities. We have taken health and wellbeing to be a broad concept with acknowledgement that this must include mental wellbeing, reduce health inequalities as well as being in line with the principles of sustainable health for future generations locally and globally.

 

The sections

 

These documents are divided into five sections to allow focus on specific policy areas as follows:

 

  1. Planetary health, global inequalities and sustainable development
  2. Social and the wider determinants of health
  3. Promoting people’s health and wellbeing
  4. Protecting people’s health
  5. Prevention in health and social care

 

The working group have been succinct and not reiterated what is a given in public health policies and current LP policy. So for example we accept that smoking kills and what we will propose are specific policies that we should advocate to further tackle Big Tobacco globally, prevent the recruitment of children to become new young smokers, protect people from environmental smoke and enable smokers to quit. We look to a tobacco free society in the relatively near future. Whether tobacco, the food and drink industry, car manufacturers or the gambling sector we will emphasise the need to regulate advertising, protecting children and young people especially and make healthy choices easier and cheaper through regulations and taxation policies.

 

Wherever appropriate we take a lifecourse approach looking at planned parenthood, maternity and early years all the way through to ageing well. We recognise the importance of place such as the home environment, schools, communities and workplaces and include occupational health and spatial planning in our deliberations.

 

We discuss the NHS and social care sector and draw out specific priorities for prevention and public health delivery within these services. The vast number and repeated contact that people have with these servces provides opportunities to work with populations across the age groups, deliver specific prevention programmes and use the opportunities for contacts by users as well as carers and friends and relatives to cascade health messages and actions.

 

The priorities and next steps

 

In each section we have identified up to ten priorities in that policy area. In order to provide a holistic selection of the overall top ten priorities we have created  a summary box of ten priorities which identify the goals, the means of achieving them and some success measures.

 

This work takes a broad view of prevention and public health. It starts with considering Planetary Health and the climate emergency, global inequalities and the fact that we and future generations live in One World. A central concern for socialists is building a fairer world and societies with greater equity between different social classes, ethnic groups, gender and locality. We appreciate that the determnants of such inequalities lie principally in social conditions, cultural and economic influences. These so called ‘wider determinants and social influences’ need to be addressed if we are to make progress. The sections on the different domains of public health policy and practice sets out a holistic, ecological and socialist approach to promoting health, preventing disease and injury and providing evidence based quality health and social care services for the population.

 

The work focuses on the Why and What but we recognise the need for further work to support the implementation of these priorities once agreed by the SHA Council. Some will be relatively straightforward but others will be innovative and we need to test them for ease of implementation. A new Public Health Act, as has been established in Wales, but for UK wide policies would make future public health legislation and regulation easier.

 

The SHA now needs to advocate for the strategic approach set out here and the specific priorities identified by us within the LP policy process so they become part of the LP manifesto commitments.

 

Dr Tony Jewell (Convener/Editor)

Central Council

July 2019

The complete policy document is available below for downloading.

Public health and Prevention in Health and Social carefinaljuly2019

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You may have seen the Panorama programmes about the shocking crisis in social care. If not, please see links to iPlayer at the end of this post.

Below is a motion that I’ll present at my local Labour Party branch meeting on 9 July next week.

The motion has been agreed by the Reclaim Social Care Group (RSCG) with the aim of getting it discussed and accepted as union policy at Labour Party Conference this year.  Although I’m not ‘registered’ disabled, I’m a member of Disabled People Against Cuts (DPAC).

The RSCG is co-ordinated through the umbrella group, Health Campaigns Together (HCT). It includes representation from Socialist Health Association (SHA), and KONP (Keep Our NHS Public).  Also included in RSCG are the National Pensioners’ Convention (NPC), several unions including Unite and Unison branches, and a wide range of disabled people’s user-led groups, and writers and academics.

Motion: Reclaim Social Care

England’s social care system is broken. Local Authorities face £700m cuts in 2018-19. With £7 billion slashed since 2010, 26% fewer older people receive support, while demand grows.

Most care is privatised, doesn’t reflect users’ needs and wishes; charges are high. Consequences include isolation, indignity, maltreatment. Disabled and elderly people face barriers to inclusion and independent living, thousands feel neglected.

8 million unpaid, overworked family carers, including children and elderly relatives, provide vital support.

Public money goes to shareholders and hedge funds as profits. Service users and families face instability as companies go bust.

Staff wages, training and conditions are slashed. Staff turnover over 30%.

This branch demands Labour legislates a duty on the SoS to provide a universal social care and support system based on a universal right to independent living: 

 

  • Free at point of use

 

  • Fully funded through progressive taxation

 

  • Subject to national standards based on article 19 of the United Nations Convention on the Rights of Persons with Disabilities addressing people’s aspirations and choices and with robust safeguarding procedures.

 

  • Publicly, democratically run services, designed and delivered locally, co-productively involving local authorities, the NHS and service users, disabled people and carers

 

  • Nationally agreed training, qualifications, career structure, pay and conditions.

 

  • Giving informal carers the rights and support they need.

 

Labour to establish a taskforce involving user and carers organisations, trade unions, pensioners and disabled people’s organisations to develop proposals for a national independent living support service, free to all on the basis of need.

 

(250 words)

Notes for members

SoS – Secretary of state

Reclaiming Our Futures Alliance (ROFA).

This is an alliance of Disabled People and their organisations in England who have joined together to defend disabled people’s rights and campaign for an inclusive society. ROFA fights for equality for disabled people in England and works with sister organisations across the UK in the tradition of the international disability movement. We base our work on the social model of disability, human and civil rights in line with the UN Convention on the Rights of Persons with Disabilities (CRPD).

We oppose the discriminatory and disproportionate attacks on our rights by past and current Governments. Alliance member organisations have been at the forefront of campaigning against austerity and welfare reform and inequality.

National independent living service

The social care element of Disabled people’s right to independent living will be administered through a new national independent living service managed by central government, but delivered locally in co-production with Disabled people. It will be provided on the basis of need, not profit, and will not be means tested. It will be independent of, but sit alongside, the NHS and will be funded from direct taxation.

The national independent living service will be responsible for supporting disabled people through the self-assessment/assessment process, reviews and administering payments to individual Disabled people. Individuals will not be obliged to manage their support payments themselves if they choose not to.

The national independent living service will be located in a cross-government body which can ensure awareness of and take responsibility for implementation plans in all areas covered by the UNCRPD’s General Comment on Article 19 and by the twelve pillars of independent living, whether it be in transport, education, employment, housing, or social security. The cross-government body will also be responsible for ensuring that intersectional issues are adequately addressed.

BBC Panorama – Social care 

Part 1:  https://www.bbc.co.uk/iplayer/episode/m0005jpf/panorama-crisis-in-care-part-1-who-cares

Part 2 – https://www.bbc.co.uk/iplayer/episode/m0005qqr/panorama-crisis-in-care-part-2-who-pays

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Integrated Care is the most recent re-naming of Accountable Care: the system currently being implemented in the NHS in England and which is derived from the US. This blog addresses issues arising from this implementation and whether or not Integrated Care is fit for public purpose.

The narrative that comes from Westminster, echoed by parts of the media and even some campaigners, is that whilst cuts and closures, underfunding, understaffing and poor NHS management at the highest levels are all contributory factors to the problems the NHS faces, there is no overarching concern with Integrated Care itself.

On the contrary, the bringing together of commissioners (purchases of services) and providers of services is viewed as getting rid of the hated ‘purchaser-provider split’ which is isolated in this narrative from all other structural components and becomes a proxy for the market system. On this point alone the move to Integrated Care is seen as a stepping stone to a return to public service. There is even some movement to reclaim ‘integrated’ as a term of public service.

There are very good reasons why tackling this issue head on may be politically sensitive. Labour is keen to claim for itself not only the creation of the NHS (which it historically deserves) but a current role as the best defence against Trump. The Secretary of State for Health also claims that he will not allow the NHS to be in US-UK trade talks ‘on his watch’. That is understandable, but the love affair of the major UK political parties with United Health and Kaiser Permanente, amongst others, goes more than skin deep. US Integrated Care has been introduced into the NHS piecemeal over the last 30 years and we are now into the full adoption of an NHS ‘version’ being rolled out at speed. It’s here where the argument lies for politicians, think tanks and amongst campaigners . A question mark is raised over its origins and over whether it is irredeemably bad for the NHS or not.

Our counter argument is threefold:
1. The Integrated Care System does not in fact remove the ‘purchaser-provider split’, but merely changes it to a different type.
2. The constraints put upon the NHS to meet the requirements of Integrated Care are set out in terms of restructuring the service in such a way that it will no longer meet the key tenets embedded in it from its creation: delivering all services for everyone within (mostly) easy reach.
3. “One thing the community cannot do is insure against itself. What it can and must do is to set aside an agreed proportion of the national revenues for the creation and maintenance of the service it has pledged itself to provide.” Bevan’s statement worked on a national level while the ICS model creates a risk and reward system in which profit and loss are to be shared locally between the constituent players of 44 ‘local health economies’. This is entirely upending the basis for financing the NHS.

Integrated Care
The concept of Integrated Care is a longstanding method in the United States which was created to try and reduce the healthcare costs which are spiralling out of control. The most expensive part of any healthcare system anywhere in the world is acute care. It needs higher concentrations of staff per patient, more infrastructure – both buildings and equipment – and changes more rapidly than other parts of the service in its response to technological advances.
It follows from an accounting point of view that any measures which can be taken to ‘reduce demand’ on the acute sector will reduce costs. Part of the cost reduction exercise in the US involves forming collaborative bodies (Accountable Care Organisations aka Integrated Care) which share profit or loss across the different constituent bodies – that is to say the insurance groups who provide the funding from their clients (state or private) plus various hospitals, GP practices and other health services. The profit and loss sharing is designed to provide incentives for keeping people out of hospital and in theory to keep them more healthy in the community.
From the above, it is clear that purchasing and providing still exist within US Accountable Care and that it in no sense represents a return to the kind of planning required to run a public service NHS. The same is true of the system being implemented in England.

Restructuring the NHS
In order to attempt to meet the accounting criteria behind Integrated Care, the NHS’ historical provision of local GP family practices, local District General Hospitals that include full Accident and Emergency and other local services must be dismantled. Acute and emergency provision is calculated to be more cost effective if it is concentrated in hospitals that service a much larger population. Local hospitals then become satellites to the centralised major trauma hospital no longer offering the full service we are used to.
GPs are being corralled into much larger units which may run the satellite hospital or work from large centralised clinics. Property made ‘surplus’ from these restructurings can be sold as a result.
These changes are an intrinsic part of the development of Integrated Care. They are not optional, nor do they come about only as a result of the last nine years of below inflation funding.
None of the descriptions above are based on assumptions. They all come from official NHS England and Sustainability and Transformation Partnership policy documents. The reality is evident on the ground.

Risk and Rewards
“Risk and reward sharing is underpinned by a theory of change that expects a provider to adjust its behaviour in response to financial incentives”
Early adopters of the ACO model in 2012 in the US, known as Pioneers (see our report on ACOs for more details), were allowed to move to a full capitated budget. This represents the full transfer of risks from the commissioner to the ACO and it means the ACO has the incentive to cut costs in order to maximise its profit share from the budget. As in those early pioneer ACOs, NHS England has made it clear that it wishes to pass all financial risks to the Integrated Care Systems. But unlike the US model, an NHS ICS does not necessarily have to include acute hospital services in its provider collaboratives. As the greatest losses fall on acute hospital services this creates the possibility of a collaborative being formed only from those providers who can best make profits.
Our report into ACOs explains how many of the participants in the early US pioneer programme failed to see many of the implications of a shared savings programme, seeing only its potential benefits. They later discovered that they had serious financial difficulties.
This question of risk and reward sharing is one of the most important issues for an NHS provider and illustrates how they have moved from being government provided services to government commissioned services. Under this scheme an NHS provider could potentially suffer significant losses risking its financial viability to the point where it may collapse as a business.

The failures of private sector providers, as we have seen in recent years, causes inconvenience for commissioners and loss of services for patients but the potential collapse of an NHS body would have far more serious ramifications. There is also the case where a majority of an ICS’ services are provided by private sector organisations which opens the door to profits flowing out of NHS funds. Furthermore the arrangements for how both risks and rewards will be shared between providers adds another layer of complexity to the transaction costs of the NHS. This, of course, provides yet more work for management consultancies, big accountancy firms and lawyers.

What’s to be done?
We fully appreciate the desire of campaigners to achieve victories in the face of what feels to be overwhelming odds. Each local victory does throw a welcome spanner in the works. However, to ignore the structural changes being brought in and not to recognise the part that each individual closure or downgrade plays in the overall pattern of change is to ignore the elephant in the room.
That is why we think the slogan ‘Act Local, Think National’ should always be embedded in every campaign. It is important to understand that the national picture gives the corporate sector a major role in the future of the NHS as it has done increasingly over the last thirty years and that the model currently being adapted is specifically based on US Integrated Care.
This is a system built fundamentally on business principles with competition and the profit motive in its DNA. This is not a system that lends itself to public ownership and provision serving the public interest.
President Trump’s statement about the NHS being on the table in future trade talks set off a raft of responses including Jeremy Corbyn tweeting, ‘Labour will [..] ensure US private companies cannot lay a hand on our NHS. The NHS is not for sale’ and Matt Hancock saying, ‘not on my watch’. It has understandably provoked a lot of comments on social media and discussions in the press about the importance of keeping the US out of the NHS in the future. But the challenge is to change the conversation so that we openly oppose US corporate interests influencing our NHS now.

Deborah Harrington

Who We Are

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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.

 

 

 

 

 

Copyright © 2018 Health Campaigns Together

 

 

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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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