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By Steve Carne, Mar 20 2018 02:28PM

Steven Carne

Tues 20th March


To my horror this morning I came across a supreme example of all that we have been warning about for some time: profiteering private companies moving into controlling positions of our NHS, edging aside publicly accountable NHS organisations and local authorities.


The news? Well for those of us who know the familiar chess moves of the privateers it seems that USA’s Centene - through its subsidiary Centene UK -may be set to take over the NHS Commissioner’s role in a recently- awarded £206m community services contract, once the Greater Nottingham Accountable Care System is implemented.


This would allow the company to manage the contract and determine/influence the award of any sub-contracts – effectively closing that much talked about problematic "Purchaser Provider Split". What better way to solve it than to allow a private company controlling a local health and social care system to be able to commission itself?


Centene UK’s discredited subsidiary Ribera Salud – which is being kicked out of the Spanish public health service by the Valencia Green/Podemos/Socialist government –  has just appointed former New Labour Health Secretary Alan Milburn as a Director and has sent lots of executives to the UK to help Centene UK with its plan of buying primary care and mental health companies. Am I just imagining it?


It seems campaigners' worst fears may be being realised. Now we have to decide what are we all going to do to stop this happening.


First of all, let’s not be like the Trojans



I remember making a speech in Manchester in 2015 in Manchester. I was speaking about the dangers of DEVOMANC, which was being rolled out after secretive meetings between ten Labour Councils and then Chancellor George Osborne (look at the expression on Osborne's face below).


The spin was that devolving £6bn NHS funding to Greater Manchester local authorities with an elected Mayor and LOCAL decision making body, would enable the public and councillors and community leaders to make better decisions, control the destiny of their LOCAL environment, communities...


My speech was all about the mythical Trojan Horse. The long suffering people of Troy welcomed the Wooden Horse into their gates believing they had won the long war and the Greeks were leaving - only to be butchered and slaughtered at night by the soldiers contained within the belly of the wooden structure...


For me this is a symbol of what is happening now in our NHS.


Pretty sure local people in Manchester can tell us more about what their horse is looking like.




So waking up this morning to the Nottingham alert about their Sustainability & Transformation Plam reminded me of Manchester. They are both in the first group of local NHS and social care services to become an Accountable Care System and the image of that Trojan Horse loomed in my head as the possibility of its treacherous shell being dragged in and celebrated by the unsuspecting public appeared to be very real.


Yesterday's blog post reported Nottingham Clinical Commissioning Group’s award of a £206m out-of-hospital community services contract to a non-NHS community interest company.


As if that’s not bad enough, this new contract seemingly includes the strange proviso that when the Greater Nottingham Accountable Care System is set up (presumably hoping two national Judicial Reviews will not touch them) there will be a contract variation - saying that it is likely to replace the Clinical Commissioning Group with a “Care Integrator” - oh surpise... Centene.


Quick reminder:

USA corporation awarded a £2.7m contract last summer to help set up the Greater Nottingham Accountable Care System.

Shares in Ribera Salud the now-disgraced private healthcare company currently being investigated for fraud and being kicked out by Valencia government

Alan Milburn is now on the Board of RIbera Salud

Their execs over here supporting Centene


Alarm bells anyone? Read the whole shocking article by CLICKING HERE


So...don't be a Trojan and dont let councillors claim


It's All Greek To Me!


That's not good enough. Put them on the spot. Especially with urban council elections coming up. Let's make our elected representatives and local NHS organisatisations come clean about EXACTLY what the local Sustainabilty and Transformation Partnership’s plans are for becoming an Accountable Care System (which NHS England is currently redecorating as Integrated Care systems to escape those pesky American health care connotations).


In most areas, there will be plans for both STP “footprint” and “locality” Accountable/Integrated Care Systems. Ask them questions and demand some answers.


What happens when a private company assumes the NHS commissioner’s role in a complex contract involving many Accountable Care System “partners” - both NHS and corporate?


Are they happy with the possibility of a private company in charge of a massive contract for a period of 7 years or more? Thus making it impossible for the next government - whoever they are - to change the circumstances?


And what about the lack of public accountability - since as a private company they will claim COMMERCIAL CONFIDENTIALITY and will not answer to Freedom of Information requests? Commercial interests are one thing. What about patient and medical interests?


And lo the Horse did stand in the centre of the city and the good people did sleep

Unware of the army inside the belly of the beast...



Take a look at your LOCAL politics. Behind the mask of devolution - seemingly benign and helpful and progressive in its concern that LOCAL Councillors and public service organisations are seen to be participating in LOCAL decision making - is there yet more shrinking of the government's duty to protect the welfare of the whole population through good quality healthcare, education, social care... ?


Is your area talking about LOCAL control, more joined up thinking, an elected regional mayor, with Council cabinets making executive decisions that the full Council doesn’t get to debate or vote on?All under the guise of making politics more LOCAL, ACCOUNTABLE and INTEGRATED for the local population?


The glorious Trojan Horse that is Accountable Care.


It is time to say NO to Accountable Care - don't be bamboozled by the name changes and games that some local councils are playing. Visit our latest #NHS4ALL page to find out more.


There are things we can and must do.


Visit #NHS4ALL


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