Category Archives: Campaigns

The long-running Lincolnshire health visitors’ dispute is coming to an end with a pay victory that sees the vast majority of the workforce being upgraded.
Unite, Britain and Ireland’s largest union, today (Thursday 5 December) hailed the victory, which will see most of the union’s members move onto the grade 10 pay scale, as ‘highly significant’.
Unite regional officer Steve Syson said: “Thanks to the tremendous solidarity that our members have shown since this dispute started in the summer, we have achieved a highly significant and welcome victory.
“The health visitors’ determination against what they considered as a gross pay injustice was buttressed by the firm backing from the people of Lincolnshire and from supporters across the UK.”
The dispute had centred on the council’s insistence on different contracts for grade 9 and grade 10 health visitors, while Unite has consistently argued that as all health visitors have the same qualifications they should be paid the same.
The health visitors have now suspended their month-long strike action while the authority upgrades the health visitors; however, Unite reserves the right to reinstitute strike action if the council does not abide with the agreement. Besides the grade 10 job roles, the health visitors will receive between £2,000- £6,000 in a one-off transitional payment.
More than 70 Unite health visitors voted for the month-long, now suspended, strike that started on 18 November. Of those, about 58 will now be fast tracked to the grade 10 posts with 16 further Agenda for Change (AfC) staff awaiting confirmation; about 13 have left or are departing to take up alternative employment within nursing, which leaves a handful of relatively new health visitors on grade 9.
Unite pledged today that it would explore every avenue to get those still on grade 9 uplifted to grade 10 as soon as possible.
Unite regional secretary for the East Midlands Paresh Patel added: “I think that a number of factors contributed to this positive outcome, including the fact that the council was, and even now, is continuing to lose highly skilled health visitors at the rate of knots, as our members are offered alternative roles elsewhere in recognition of their experience.
“There was also the stark realisation by council bosses that our members were prepared to take further strike action on top of what they had already taken in the summer, after a second ballot confirmed they were prepared to continue on with further industrial action.
“This victory should be seen in the context of a broader campaign for a fully-resourced health visiting service across England – that fight will continue across the country in 2020.”

Twitter: @unitetheunion Facebook: unitetheunion1 Web: unitetheunion.org
Unite is Britain and Ireland’s largest union with members working across all sectors of the economy. The general secretary is Len McCluskey.

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Staff at Frimley Health NHS Foundation Trust, who face being transferred to a wholly owned subsidiary (WOS) designed to avoid paying tax, will strike in protest for a further three days this month.

Unite, Britain and Ireland’s largest union, said today (Thursday 5 December ) that its estates’ management, equipment maintenance, catering, portering, procurement and security staff, numbering about 90, will strike from 07.00 on Wednesday 18 December for 72 hours.

This latest wave of industrial action follows two days of strike action last month.

Unite will be coordinating  the strike action with the GMB union – altogether about 1,000 staff at Frimley Park Hospital, Camberley; Wexham Park Hospital, Slough; and Heatherwood Hospital, Ascot are affected by the trust’s plans.

Unite said that it had evidence that the trust is intent on pushing ahead with its flawed business model, as it is issuing new uniforms without the distinctive NHS logo on the clothing, which previously had been the case.

Unite regional officer Jesika Parmar said: “The latest bout of strike action this month demonstrates the continuing depth of anger at what we believe is biggest proposed wholly owned subsidiary in England so far, which could adversely affect up to a 1,000 employees at the trust.

“Our members have voted overwhelmingly that they have no wish to be employed by a WOS designed to avoid paying tax. They are concerned that their pay and employment conditions will be seriously eroded by such a plan.

“Already the trust is issuing new uniforms without the NHS logo on the clothing, which previously had been the case – it is clear that the trust bosses don’t see this new venture as being part of the NHS, which is disgraceful.

“The trust is also attempting to undermine the strike by employing expensive agency staff.

“We are calling on the trust’s board to ditch these misguided and flawed plans. We are seeking an undertaking from the trust that it will agree to continue to employ all our members and not transfer them to a WOS.

“We remain strongly against the formation of these entities which, we believe, could lead to a Pandora’s box of Carillion-type meltdowns – with knock-on effects for patient services and jobs.”

The Frimley trust provides NHS hospital services for about 900,000 people across Berkshire, Hampshire, Surrey and south Buckinghamshire. Unite has 220 members at the trust and only balloted those directly affected by the WOS.

Unite members voted by 92 per cent to strike.

Notes.

Unite has waged an extensive campaign against these wholly owned subsidiaries as they could lead to job losses and salami slicing of service provision.

Unite is concerned that trusts are forming these wholly owned subsidiary companies in England so that they can register for VAT exemption and compete on a level playing field with commercial competitors who register for VAT exemption for their work in the NHS, when NHS trusts can’t.

There were more than 30 such subsidiaries in England in 2018.

The Department of Health and Social Care announced last year that it was consulting on this issue. The consultation ended in November 2018 and the requirements that trusts and foundations have to meet to create wholly owned subsidiaries were tightened up.

This also included a condition to consult stakeholders, such as staff and the wider community. A number of trusts have already decided to abandon plans to set up such a subsidiary.

Email: shaun.noble@unitetheunion.org

Twitter: @unitetheunion Facebook: unitetheunion1 Web: unitetheunion.org

Unite is Britain and Ireland’s largest union with members working across all sectors of the economy. The general secretary is Len McCluskey.

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A major fire at a Travelodge in Brentford, London, today saw more than 100 firefighters respond.

Matt Wrack, FBU general secretary, said:

“This fire is yet another sign of this government’s utter failure to get to grips with our fire safety crisis. Two years on from Grenfell, there has still been no comprehensive programme testing building materials.
“The approach so far has been the agonisingly slow removal of one particular kind of cladding, but that barely scratches the surface.
“The Tory manifesto made no new policy proposals to tackle the fire safety crisis – just more of the same indifferent inaction. They have slashed the fire and rescue service and could not even bring themselves to mention it in their manifesto. Their record is nothing short of shameful.
“We need to bring together firefighters, government, tenants, and the fire safety industry to properly implement the Grenfell inquiry recommendations and get to grips with this crisis before we have another tragedy.

Media contact: Joe Karp-Sawey, FBU communications officer

joe.karpsawey@fbu.org.uk

Notes

The FBU recently called for a forum of all those needed to drive through sweeping changes to UK fire safety, writing to representatives from the government and shadow cabinet, the London Fire Brigade, the National Fire Chiefs Council, the Mayor of London, the Local Government Association, the first ministers of Scotland, Wales and Northern Ireland, fire safety bodies and the Grenfell community. For more information, please see here: https://www.fbu.org.uk/news/2019/11/25/firefighters-call-forum-implement-grenfell-inquiry-recommendations

The FBU is the trade union representing the overwhelming majority of firefighters in the UK and serves as the professional voice of firefighters and the fire and rescue service. The union is a core participant in the ongoing Grenfell Tower Inquiry.

The FBU’s initial response to the publication of the Grenfell Tower Inquiry phase one report is available here: https://www.fbu.org.uk/news/2019/10/30/fbu-response-grenfell-tower-inquiry-phase-1-report

The FBU launched its Grenfell: Never Again campaign on the second anniversary of the fire, with five demands:

1) the removal of all flammable cladding;

2) retrofitting sprinklers wherever a risk assessment deems necessary;

3) ensure a strong, democratic voice for tenants;

4) reverse the cuts to firefighter numbers and fire safety officers and;

5) create a new national body to oversee the fire and rescue service.

 

For more information, please see here: www.fbu.org.uk/grenfell-never-again

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David Taylor-Gooby, Secretary of the North East Branch, has asked us to put this information on the website.

Dr Williams is a respected as a hard working MP, with a reputation for honesty and integrity.  He is an SHA member, in fact the only NE MP in the SHA.  He still practices as a GP.  He is a formidable SHA campaigner, but only has a majority of 888.  David would like to enlist our support for Dr Williams where we can.

 

Jean

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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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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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