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.