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INVESTIGATE the murky depths of private company takovers disguised as mergers and "improvements".
We take a look at just one area but we are sure you will know more.
Today NHS England put news on its website about its intention to hold a national consultation on Accountable Care Organisation contracts, but didn’t say when.
The 12 week consultation will be about the legal/statutory arrangements for a contentious new form of local NHS and social care organisation that’s based on the business model used by Medicare/Medicaid in the USA. This only provides a limited amount of state-funded health care for people who are too poor or ill to afford private health insurance.
NHS England’s draft Accountable Care Organisation contract is the subject of our
Judicial Review that will be heard in Leeds Court on April 24th.
The grounds for the Judicial Review is that the Accountable Care Organisation
contract payment mechanism is unlawful.
NHS England on its press release says that no ACO contract will be awarded until
the consultation is finished. It also states that the aim of the consultation is to provide f
urther clarity about Accountable Care Organisations’ role and scope.
Doesn't appear we will be asked if we think Accountable Care Organisations are a good
thing and if we would like them to be set up. That decision has already been made.
The announcement also contains a surprising statement, that on the face of it
reverses everything we’ve previously heard:
"An ACO is not a new type of legal entity and so would not affect the commissioning structure of the NHS. An ACO would simply be the provider organisation which is awarded a single contract by commissioners for all the services which are within scope for the local accountable care model."
This is not what has been understood to date. NHS England and local NHS organisations have been "reassuring" everyone that Accountable Care Organisations would end the purchaser/provider split (they would and hand everything to a private entity) BUT... now they’re saying an Accountable Care Organisation would simply be “the” provider organisation for all the NHS and social care services available in the area through their “care model”. SO... are they shifting the goalposts or what?
There’s nothing about WHEN this consultation is to take place - it could be that NHS England are awaiting the outcome of the Judicial Review of its ACO contract, since it wouldn’t make much sense to consult on a contract that could be ruled unlawful by the courts.
Whenever it does happen (in whatever hollow form it takes), there’s little hope that it will be any more than a tick box exercise to create murky compliance with the rules of engagement. Taking note and listening to the consultation outcome doesn’t amount to anything, as the people of Calderdale and Greater Huddersfield know full well from their experience of the Right Care, Right Time, Right Place hospital cuts consultation.
If what you are hearing coming out of the Secretary for Health's mouth can taken at face value at all?
When Jeremy Hunt spoke about the consultation at the Health Select Committee on Tuesday, taking note and listening is all Hunt referred to:
“...we will take note of any conclusions that are made, in terms of regulations that are put before Parliament.”
“We are committed as NHS England and the government that we will listen carefully to the outcome of that consultation carefully in the way that we implement the ACO policy.
I think that is a very big step forward for people who are concerned that - and this isn’t the case - that this is a vehicle for privatisation.”
“We are not sure that we are able to specify by law which type of company - I think we legally have to be impartial about which type of body bids for NHS contracts.”
The law that he referred to is the Public Contract Regulations 2015.
This specifies that health services being put out to contract have to include a call for competition.
Finishing off and downplaying the significance of Accountable Care Organisations, the press release adds:
“ACOs are only one tool for integrating primary care, mental health, social care and hospital services and not the only or main way to integrate services. Most areas are seeking to do so through voluntary, non-contractual partnerships where GPs, hospitals, commissioners and local government collaborate to improve services for their population. NHS England will be announcing the next wave of these collaborative partnerships shortly.”
So we're all feeling so much better aren't we?
Best read the NHS England announcement for yourself and make your own mind up.
We need to reach new ears.
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