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NOT JUST WHO, BUT WHAT?

By Steve Carne, Nov 14 2018 05:45PM

So Matt Hancock, Health Secretary has told the Health Service Journal today that the government "is not going to hand (Integrated Care Contracts) to the big private healthcare companies". And that he was hoping for cross-party "buy-in" for changes to current NHS Laws, and was "absolutely up for" seeking to agree proposals with the Labour Party.


Well he would wouldn't he? Let's hope the Labour Party can agree to disagree with him on that one. Too often in recent years we have seen the traps of the reasonable compromising middle of the road cross-party solution...


Sometimes the old ones are the best...




Right now Opposition MPs (yes, in theory we do still have them) need to be calling out the "Austerity -thinking" that Conservatives are using to destroy our public services and institutions and - more importantly - people's lives. Poverty levels are rising and even the UN has been in the UK investigating the effects of Austerity in creating yet more poverty in the UK.


Will the government take note? Dont hold your breath.


The HSJ reports that the government QUANGOS "NHS England and Improvement are expected to propose changes to the Health & Social Care Act 2012 later this year, in the NHS long-term plan, or early next year".


Our question about the new 10 Year Plan we keep hearing about is: What's a Quasi Autonomous Non- Governmental Organisation doing creating or proposing government policy? Has Parliament abdicated all responsibility for that role? This is especially worrying as a recent poll of MPs revealed that a shocking number of them didn't really understand the NHS England terminology and changes taking place - there was a "Knowledge Barrier" apparently.


We've learnt over the years NHS England are really good at Knowledge Barriers.



To deflect any opposition to his announcement, Hancock throws the worn out mantra "We do not want a big top-down reorganisation of the NHS". Ask any clinician, NHS Staff member and they will tell you their experience is NOTHING BUT continual 'Top Down' change, over and over.


Indeed the current restructuring and reconfigurations (you'll know them as closures, mergers and downgrades) that are being pushed through the 5 Year Forward View Sustainability & Transformation Partnerships and leading us to Integrated Care Systems are NOTHING BUT Top Down Re(DIS)Organisations.


And a major (albeit quiet) tool in this process is the the proposed Integrated Care Provider contract - don't forget its original name of the Accountable Care Organisation contract before Ben Bradley MP (Labour) helpfully pointed out to Jeremy Hunt at a Health Select Committee meeting that it was poor judgement to choose the title so directly connected to the USA heathcare model it is based on. Well done Ben.


Will the contract ONLY be given to NHS Organisations?


Labour are missing the point if that is the only question they feel qualified to ask.




Matt Hancock knows this. It's not just the matter of WHO the 5 or 10yr contract is given to. It's WHAT the contract is that is the crux of the matter.


For us the ICP (formerly the ACO) contract is WRONG. And we think (one reason we're returning to the Court of Appeal on the 20th November) the introduction of the contract is UNLAWFUL. Because it changes the funding mechanism of the NHS, the way in which providers will be paid, forcing them to change their behaviour by prioritising price, value and financial conditions over quality and excellence of care being offered to patients. Something that politicians were, time and again, promised WOULD NOT HAPPEN during debates when passing the awful 2012 Health & Social Care Act.


We are no fans of the HSCA 2012.


But the law is the law. If NHS England want to "work around it" and bypass it what is the point of having our parliamentary democracy?



There is no intention to have ICPs awarded to private healthcare providers


Hancock trumpets in one breath. All very well but... define 'NHS Organisation' and define 'private'. All private profit seeking health companies use the blue logo to hide behind and most of them have .nhs in their website URLs. They are technically the modern NHS - a series of providers not a unified network of coordinated services (you can see where the cry "it needs joining up" comed from).


In the next breath though Hancock changes his tune. He's got his eyes on the GP Federations and Super Hubs that are emerging.


"I don't want to rule out groups of GP practices coming forward and running integrated care, and GPs are largely private organisations".


Yet another cliched tired mantra beloved of the right-wing "Austerity thinkers". GPs didnt used to be private. They were self-employed but contracted to the NHS. They couldnt trade their patients on the stock market. But they can now as more of them are "encouraged to become Social Enterprises or Community Interest Companies - private business entities.


So it's clear to us that it is not just WHO is handed the 5 or 10yr contract (meaning even a change of government can't amend or retract. The question politicians should be asking is "WHAT IS THE CONTRACT that is being given?"


And WHAT are the consequences of this proposed contract?


By forcing NHS Providers to accept a fixed annual sum at the beginning of the year and to estimate their services ahead of actual delivery, based purely on financial risk not clinical need, NHS England are changing the focus and ethos of our NHS.


We're convinced this seemingly innocent looking contract hides a findamental attack on the core principle of the NHS - to provide high quality comprehensive healthcare for those in clincal need - regardless of social status and ability to pay.



That's one reason why we are marching back to the Court of Appeal. Join us if you can.


To find out more CLICK HERE



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