NHS fees plan is a turning point in privatisation
The kite flown by a rightwing thinktank that everyone should have to pay for access to healthcare (£10 each can save the NHS, 31 March) marks a crucial turning point in switching towards a fully paid-for health service. This process has been long planned. First Blair encouraged and then pressured NHS hospitals into becoming independent foundation trusts, self-standing suppliers within a competitive market. Cameron took this much further by ruling that all NHS functions would be open to tender by any qualified provider. The Lansley health and social care bill, hatched in deepest secrecy before the 2010 election with not a word about it in the Tory manifesto so that it had no electoral mandate, opened the floodgates for full-scale privatisation of the NHS. But always the mantra was repeated that the NHS would remain “free at the point of service”. Now that assurance is being kicked away.
The thinktank authors decry the NHS as “an outdated, cosseted and unaffordable healthcare system”. They don’t mention that the Tory government has deliberately imposed a £20bn cut in NHS funding over the current five-year period to put it under intolerable strain and maybe breakdown in order to pave the way for a gradual switch to a fully paid-for private service, which has always been their secret aim, just like before 1948. Nor do they mention that the NHS, at a cost of 8% of GDP, is the most cost-efficient in the world, half the comparative cost of the private US healthcare system.
We now see why the Tories have been so keen to demean the NHS on every occasion over the past few months. Cue the need to junk the old, failing NHS and announce the dawn of a brand-new, burnished private healthcare system – and at a bargain price of £10 a month. But remember tuition fees: capped at £3,000, then trebled. If every UK adult paid £10 a month, this new tax would raise £5.4bn. Treble that, or more, and we’re talking serious money for the healthcare privateers.
Michael Meacher MP
Labour, Oldham West and Royton
NHS cuts: Leaked report says Tories will 'slash surgery funding by £1.5BILLION and lead to fatal diseases being missed'
Dr Baker, head of the Royal College of GPs, said: “This is extremely worrying as it will mean we can’t prevent things or pick up diseases at an early stage and patients will be harmed.
“Investment in general practice has already been cut to the bone and these projections show by the middle of the next Parliament, general practice will be teetering on the brink.
"If general practice is run on a shoestring, waiting lists will inevitably get even longer and standards of care will fall.”
Might it not, rather, be possible to work slowly from the present system towards a national insurance scheme? One could begin for example, with the establishment of the NHS as an independent trust, with increased joint ventures between the NHS and the private sector; move on next to the use of ‘credits’ to meet standard charges set by central NHS funding administration for independently managed hospitals or districts; and only at the last stage create a national health scheme separate from the tax system.
The evidence of fraud is weak but the damage is done: the health service is made to look like an impossible dream
Terrible news, isn’t it, that the NHS loses £5bn a year through fraud; just awful … to think that people would steal from the public institution we all claim to be so in love with.
But like so many fables of recent history – do people really breed for the child benefit?; do foreigners really leave their homes and friends and everything they know just to come and leech off our unemployment benefits, thinking, “I hope I get cancer, that way I can really max out my EU entitlements”? – we can file this under “It would be terrible, if it were true”.
The independent fact-checking organisation Full Fact took a restrained approach to this data, which was presented on Panorama earlier this week: it merely said we couldn’t know from the evidence we have whether this figure is correct. We have data covering bent dentists (or “bentists” as this report tragically never calls them) and we have evidence of fraud related to patient charges, and the two figures combined amount to £229m (it sounds like a lot, but as a proportion of the NHS’s annual £100bn budget, isn’t). It’s also a long way from £5bn.
If you want to talk about fraud across government, the greatest losses by a mile are through tax fraud and procurement, our overall lesson is, don’t tangle with rich people or the private sector, unless you want to lose your shirt. But let’s worry about that some other time.
So where on earth did the £5bn figure come from? Roy Lilley, health policy analyst and a former chairman of an NHS trust, says: “They took a lot of data from a lot of other countries, over a very long period, crashed it all together, and then said, ‘This is the average percentage lost through fraud – if the NHS is average, then this is how much they lose’.” Even taking an average like that was methodologically flawed – the sample was small and the range was huge, running from 0.6% in one country to more than 15% in another.
Assuming the NHS to be average is unreasonable – our healthcare is (altogether now) free at the point of use. There simply aren’t as many transactions within it, as there are in an insurance-based system, for fraud to creep into. And why should the NHS accept a decision by an accountancy firm that they are probably average, and being average they probably lose an average – which is to say outrageous – amount of money? They could reasonably turn around and say: “We’re not average, we’re excellent. We are first or second in the world on most metrics.”
What possessed Panorama to run something on such weak evidence? Has it had its budgets cut? Does it have an anti-NHS mole at the highest level? Someone should do a Panorama into what’s going on at Panorama. Or it might be easier just to collate an average competency of investigative journalists across six countries and 20 years and put them in the middle of it. See how they like it.
This government has denigrated the NHS so persistently that I find it impossible to believe it didn’t have a hand in these trumped-up fraud claims, yet simultaneously it’s relatively easy to believe that it has poisoned the well against the health service so effectively that conspiracy is unnecessary. The anti-NHS mood music has been set; now it can stand back and let that other (once loved) public institution, the BBC, do the work for them.
If you pan out from this story you will see that it’s part of the new landscape in which fraud is everywhere and everyone is out for whatever they can get. Councils are so fleeced by benefits’ claimants that they have to install lie detector software on their phone systems (not because it works, but to send a message). Outsourcing is a quagmire in which alleged dishonesty – charging the Ministry of Justice for tagging prisoners who don’t exist, for instance – is nominally penalised, then rewarded with fresh contracts.
In the rare event there is no scope for fraud, public systems are managed so badly that you’d be doing them a favour to steal from them, just to put them out of their misery. Student fees tripled and yet the government found a way not to make any more money out of it. “We just got it wrong,” it says, with a metaphorical shrug, and maybe a literal one too.
You find yourself, if you pay even modest attention, thinking: “What is the point of all this?” And that’s the point: to make public services look like an impossible dream, yesterday’s utopia.
I was raised under governments that would put out their own eyes before they would admit to having mismanaged anything, or admit any weakness in the way their institutions were run. It has been a difficult adjustment to make, to one that actively seeks to undermine its institutions, blows its own whistle, admit its own error.
It looks like honesty, but it’s not. The results of this hand-wringing can be traced most clearly in the university story: they admitted error just as a prelude to the claim that the whole sorry business is now unaffordable. Will fees have to go up? They can’t rule it out. Is this the end of a fees cap altogether? You might think that, they couldn’t possibly comment (until after the election). If they had come out fighting, we could have fought back; coming out crawling, whimpering at their own inadequacy, all we can do is accept that they’ve done their best.
Except that I don’t believe it. I don’t believe that everyone’s bent or incompetent. I don’t believe our institutions are unviable. I just think we’ve got the wrong people in charge.
Rosamund Urwin: If you love the NHS, don’t let it be murdered
The demise of the NHS is in no way inevitable — it is being slowly murdered by this Government
This week, “WithoutTheNHS” trended on Twitter. People were listing the ways our health service had changed their lives. Things like “My cousin would never have been able to afford the treatment she has had for breast cancer”, and “I may not have made it out of my incubator…”, and “I’d be dead”.
I thought of how the NHS has helped me. The monitor strapped to my chest as a child to record my tachycardia. The ambulance that a decade ago took me to St Thomas’ A&E after I’d been hit by a motorbike. The antibiotics pumped into my arm one summer to shrink a hand swollen by a fly’s bite. I thought too of all the doctors and nurses I’ve come across who, as one medic friend puts it, f*** their lives to save ours.
This may sound sentimental, like a love letter to a dying institution. But the demise of the NHS is in no way inevitable — it is being slowly murdered by this Government. Thanks to the Tories, it faces a financial black hole. As a report published today — London’s NHS at the Crossroads — warns: “If it continues on the course projected by the current Government… huge gaps will open up between resources and demand.”
We didn’t hear about that in yesterday’s Budget. Instead, there was a declaration that spending on health will keep rising. After all, the Tories keep stating that the NHS budget is ring-fenced. Shame that in real terms it has actually been falling.
That isn’t their only half-truth on health. David Cameron pledged the NHS wouldn’t be sold off, yet 70 per cent of the contracts awarded after the new competition regulations went through Parliament went to private companies. This is privatisation by stealth, as is set out in a new documentary — Sell-off: The Abolition of Your NHS — which will be screened for the first time tonight.
The Tories want us to buy the myth that the NHS is bloated. Inefficient. A dinosaur. That way they can justify an enormous, top-down reorganisation — one they had again promised not to enact. But in reality, it is one of the most efficient healthcare systems in the world: a 2011 report in the journal of the Royal Society of Medicine found that only Ireland saved more lives per pound spent.
We also spend a much lower percentage of our GDP on health than other countries: 9.3 per cent compared with 15 per cent in the US. So much for the supposed savings from privatisation.
The former Chancellor Nigel Lawson once called the NHS “the nearest thing the English have to a religion”. When the Coalition came to power, the NHS was more popular than it had ever been. We mustn’t let the Tories destroy our faith.
Why Are American Health Care Costs So High?
The Health and Social Care Act 2011, passed by the Coalition, essentially moves us towards the American Healthcare System. Instead of Primary Care Trusts driving down costs by commissioning primary, community and secondary health services from providers using 80% of the NHS budget. Instead, clinical commissioning groups are now responsible for commissioning health services and arranging emergency and urgent care services within their local authority boundaries only.
This act frees up access to NHS money, together with the Any Qualified Provider (AQP) status, or more succinctly, anyone who wants to put a bid in, ultimately this makes it easier for the private sector to cash-in at taxpayers’ expense.
What’s worse, while the NHS was run not-for-profit, taxpayer money spent on NHS services remained within the UK economy. But now, private healthcare giants such as Care UK, Capita, Circle, Interserve, Serco, Virgin Care, and United Health are bidding for and winning AQP status. They run for-profit, then cream off money and seek to use aggressive tax avoidance techniques to minimise their own tax burden within the UK.
This is the Tories vision of better healthcare, but better for whom?
The medical records of every NHS hospital patient in the country have been sold for insurance purposes, The Telegraph can reveal.
The disclosure comes days after controversial plans to extract patient data from GP files were put on hold, amid concerns over the scheme.
Those in charge of the programme have repeatedly insisted that it will be illegal for information extracted from GP files to be sold to insurers, who might seek to target customers or put up their prices.
However, a report by a major society of actuaries discloses that it was able to obtain 13 years of hospital data – covering 47 million patients – in order to help insurance companies “refine” their premiums.
The report by the Institute and Faculty of Actuaries details how it was able to use NHS data covering all hospital in-patient stays between 1997 and 2010 to track the medical histories of patients, identified by date of birth and postcode.
This is Tory NHS England, where skimming off profit always comes first.