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999 Call for the NHS

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By 999 Call for the NHS, Nov 11 2019 09:33PM

999 Call for the NHS has been calling for the Renationalisation of the NHS since we marched for the first time in 2014. We've seen, and supported, FOUR attempts at getting the NHS Reinstatement Bill on the parliamentary table and now in 2019 the issue of Renationalisation/Reinstatement comes around again as we enter the election campaign period where after decades of Austerity...


The two main parties are now both the investors of the future and have sudden access to billions of pounds with which to show just how much they love the NHS and promise to keep it alive.


Labour are currently sitting on the most recent version of the NHS Reinstatement Bill, reworking it apparently. But are they talking about the "Renationalised with NO PRIVATE CORPORATE involvement" that we are calling for? How will we reinstate the NHS as a public service?


Easy answer. End contracts for outsourced clinical services. But there are difficult questions. What about the embedded web of "invisible" services that stretch throughout the NHS, beneath and behind the blue logo? For example...



"What the hell is this?" we hear you say.


Well... since the NHS was fragmented by the internal market brought about by the last Health & Social Care Act 2012 healthcare became a business model not a care model. The new Clinical Commissioning Groups (budget holders)made up of health people, knew next to nothing about auditing, tendering, legal technicalities? So they needed an advisory support service.


In 2015 this was known as the Lead Provider Framework - an easy to comprehend network of Commissioning Support Units divided into 9 geogprahical streams with a list of companies that was already fairly unpleasant.





As things progressed in 2017 with the NHS moving ever closer to the American model, based on the likes of Kaiser Permanante and United Healthcare , with an array of new "innovative and disruptive" models of care from federations, hubs, integrated neighbourhoods, multispecialty community providers, primary care homes and networks never mind a literal headfuck of contracting and financial measures designed to confuse everyone it seems.


But have no fear the Lead Provider Framework is here! Naturally shapeshifting in order to meet the needs of poor commissioners out of their depth in the mire of transformational change. Now so much more than legal, auditing and backroom services. Below is a hint of the changes in 2017/18 - End to End Commissioning... take note of the third red column.





Late last year the transformation of the Support Services became much more complex - reflecting the complex top down restructuring being forced by NHS England and all encompassing as the new 2019 NHS Long Term Plan continued to push the envelope of what is called the LEFT SHIFT - more care in the community, closing A&Es, centralising acute services, selling off public buildings... plus the major onslaught of Digital, Apps all tied up with allure of data trawling for profit.



HEALTH SUPPORT SERVICES FRAMEWORK


This is part of NHS England's description:


The Health Systems Support (HSS) Framework provides a quick and easy route to access support services from innovative third party suppliers at the leading edge of health and care system reform, including advanced analytics, population health management, digital and service transformation... The Framework focuses particularly on services that can support the move to integrated models of care based on intelligence-led population health management. This includes new digital and technological advances that help clinicians and managers understand a population’s health and how it can best be managed.



The HSSF is divided into ten LOTS. Opening the lots is like opening Pandora's Box of USA & Global Corporates.Take a look at just one LOT No.6 - Transformation and Change Support



It is a shock but no real surprise to see some usual horses of the Apocolypse in there - KPMG, McKinsey, PriceWaterCoopers and Optum the subsidiary of United Healthcare of America (where SIMON STEVENS spent 9 years as President of Global Strategy) but then dig deeper into the "smaller names" and you discover more USA and global connections.


BDO, Capgemini, Centene, DGX Technology, GE Healthcare Finnamore Ltd are worth a look and even Moorhouse Consulting Limited looks innocent enough until you wonder what they are as "An Expleo Company" more of the same...



And what is Lot Number 6 all about?


Well NHS England kindly provide a description. Provision of a range of expert advice, analysis, transformational and change management capability to design and build the necessary infrastructure for an ICS / STP function effectively. Services include but are not limited to (edited list):


Patient pathway optimisation and care model design


Specialist advice on organisational redesign, governance and payment and contract reform


Communications and engagement


Primary Care at scale support


Is this supporting or twisting the arm of the NHS? Seems a great deal more significant that mere back room services.


Make up your own mind with THIS LINK


Our ask is simple. We know the task is epic and complex in its operation. But how are we going to rid the NHS of the corporate vultures? How do we remove the web of private providers who have now set up home in the framework? It can be done. But we need a government with the will to take it on. And that WANTS to see the NHS restored to a unified public service of support for all.


Renationalisation is about the stopping and rejecting of the USA Healthcare Model being promoted by NHS England, Health Secretary Matt Hancock with support from The Kings Fund, Nuffield Health and numerous other "think tanks". As an Addenbrookes innovation department staff member told us: "We're not innovating or integrating anything to do with clinical care. The only thing we're integrating is the accounts system".


So we need politicians who understand the future of our NHS rests on our ability to reject the profit & insurance model that is being foisted upon us.


Simple.








By 999 Call for the NHS, Mar 19 2016 09:24AM


Where were Labour?
Where were Labour?


Friday 11th March

Caroline Lucas presented the NHS BILL (formerly NHS Reinstatement Bill). It was an opportunity for the Labour Party to get behind something that (no matter how imperfect it might technically as a Draft Bill) set out clear aims to bring back the NHS into public hands again. Taking the private market culture out of it and making it impossible for private corporations to control - as they are doing now in our understanding.


Deborah Harrington gives us this brilliant thought as to why Labour chose not to support it with MPs attendance at the debate - despite over 42,000 signatures on a 38 Degree petition.


Thanks Deborah.


Some context for those who don't get the point of the NHS Bill and think there is no problem with Labour not turning up to support it.


The first problem of note is Simon Stevens.


Simon Stevens was an NHS manager. He became a health policy advisor to Alan Milburn, in 1997, along with Mark Britnell and Penny Dash. He was also a Labour councillor in Lambeth.


He introduced the first privatisations into the NHS, including the Foundation Trusts (making them arm's length business units, rather than publicly owned services), PFI, and bringing United Health in to run the first privatised GP practices, among many other things. (Hansard evidence click)


In 2006 he went to work for United Health (the US's largest private healthcare corporation) in their Europe division, and in 2008 as president of global operations.


(Mark Britnell went on to KPMG and Penny Dash to McKinsey, where her role has included being a Trust Special Administrator - a role created by Labour)


In that role Stevens led a lobby group, lobbying the US Trade Dept to use trade laws to break open public health services worldwide to create access for US markets. United Health also lobbied against Obama's affordable care act.

In 2014 the Coalition brought him back as NHS England's CEO. Within a few months he had produced the 5 Year Forward View, which is what all your hospitals are suffering under, all the closures, reductions in service, land sales.


The 5YFV is completing the implementation of the H&SCA (2012). Labour calls Lansley's Act the reorganisation of the NHS, as if it is done and dusted and behaves as if everything else is just a consequence of the de-funding. It isn't. It is the constant restructuring of the 5 YFV. The money is being used as a lever to get the changes made - comply and you'll be bailed out, is the message.


Labour welcomed Stevens' appointment and support the 5 YFV. You can't oppose privatisation of the NHS and simultaneously support Stevens.


The second problem of note

is private sector involvement in the NHS and public ownership.


No matter what the Labour Party says, it appears to have no intention of renationalising the Foundation Trust hospitals, which is essential if they are not to be sold off as hospital chains to foreign investors (one of the next privatisation steps).


It is impossible to get the Labour Party to commit to Bevan's principles. Efford's Bill was not a proper 'NHS' bill. They refuse to support the actual NHS bill on the grounds that it is another 'top down reorganisation'. This is based on three things: 1. that the NHS staff don't want any more reorganisations. This is not true. Staff know the NHS is in a broken up mess. They need it to be put back together. But Simon Stevens says, in the 5YF that staff do not want another reorganisation (as he downgrades, closes and restructures all our services), and Simon is god like in the infallibility of his pronouncements according to all the main Parliamentary parties. 2. That everything is just settling down after Lansley's Act. It isn't, as explained above. 3. They don't understand the bill's provisions for returning to Bevan's NHS, because they don't understand anything about the nuts and bolts of health provision.


And Labour is quite happy to sell off our public land and assets. They also had no problem with massive restructuring for the purposes of privatisation. It is only restructuring to bring it back into public ownership they object to.


The Bill itself was totemic. In the face of piss poor opposition to date from Labour to the Coalition's and now the Tories' brutal destruction (they would have had to confess -and renounce- their role in the privatisation to successfully oppose) their support for the bill would have been a marker of intent on their part. And, with the SNP support + Lucas herself would have indicated the start of a progressive alliance that might have posed a real threat to the government. Unfortunately that's of little interest to a large section of the PLP.


It should be a matter of concern to the Corbynistas that John McDonnell was happy for Labour MPs to attend and vote in favour of the bill. He thought any problems could be dealt with in committee stage. But Labour Central issued the standard reply to be sent to constituents by all MPs, presumably against his will? - and Corbyn's? - on Thursday, saying they all had constituency duties, when they had had months of notice and could have rearranged their schedules for the day.


You have to understand that this is a story of corporate capture of our democratic processes, not a question of party political purity. United Health, McKinsey, KPMG, PwC and others are making the decisions about our NHS - on behalf of both the Tories and Labour. New Labour introduced New Public Management - the idea that government is about management of an entrepreneurial culture, not about political ideology. They brought think tanks and management consultants in to take the place of the civil service. The same management consultants whose major clients are global corporations. We need to fight this corruption of our democracy. Then the Labour Parliamentary party might return to the values most of its supporters old and new hold dear.



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