Union Safety - Official Website of NW BT Union Health and Safety Coordinators Committee: NHS To Be Replaced By Regional Integrated Care Organisations From April 2021

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The above headline will now doubt be accused of being alarmist, as much as Corbyn's claims during the December 2019 general election that the NHS Is For Sale to the US; was accused of being lies!

However, as always the truth of the matter is more complicated, nevertheless the basis tenant of the argument remains true!

Ever since the 2010 general election, Unionsafety has highlighted the risks to the NHS and the hidden Tory aims of replacing the NHS with a US-style private health insurance scheme. We also argued that a UK/US trade agreement was the biggest single threat to the NHS and that Brexit was necessary in order for the Tory Government to be able to privatise the NHS and abolish the service in all but name.

Perfect examples of this are the fact that ALL private healthcare companies such as Virgincare, Peninsular Healthcare and Circle Health which provide NHS healthcare services; remain hidden behind the NHS Logo and no public information exists to show that these are NOT NHS services but run by private for-profit companies. GP surgeries all over the country are now being run by these private healthcare organisations with absolutely no public knowledge or scrutiny.

The latest exampled of this is the so-called NHS Track and Trace service which in fact is entirely run by private companies that have donated to the Troy Party and in which Dominic Cummings and Ben Warner (advisors to Johnson) are involved with.

Ask yourself this: Is MY GP surgery run by a private healthcare company? Do I know how to find out?

But where is the evidence for the headline to this article?

Simply put, in the letter to the right of this page and entitled: IMPORTANT – FOR ACTION – THIRD PHASE OF NHS RESPONSE TO COVID-19; despite it being a cover for the final breakup of the NHS into Integrated Care Organisations consisting of multiple NHS CCGs all blended into one autonomous organisation! No financial or clinical control will be exerted upon them by NHS England once they are set up!

The following 'instructions' to Chief executives of all NHS trusts and foundation trusts, CCG Accountable Officers, GP practices and Primary Care Networks, and all Providers of community health services, and lastly NHS 111 providers; come in NHS England’s 31st July letter pictured right:

“Working across systems, including NHS, local authority and voluntary sector partners, has been essential for dealing with the pandemic and the same is true in recovery. As we move towards comprehensive ICS coverage by April 2021, all ICSs and STPs should embed and accelerate this joint working through a development plan,agreed with their NHSE/I regional director, that includes:

•Collaborative leadership arrangements, agreed by all partners, that support joint working and quick, effective decision-making. This should include a single STP/ICS leader and anon-executive chair,appointed in line with NHSE/I guidance, and clearly defined arrangements for provider collaboration, place leadership and integrated care partnerships.

•Organisations within the system coming together to serve communities through a Partnership Board, underpinned by agreed governance and decision-making arrangements including high standards of transparency –in which providers and commissioners can agree actions in the best interests of their populations, based on co-production, engagement and evidence.

•Plans to streamline commissioning through a single ICS/STP approach. This will typically lead to a single CCG across the system. Formal written applications to merge CCGs on 1 April 2021 needed to give effect to this expectation should be submitted by 30 September 2020.

•A plan for developing and implementing a full shared care record, allowing the safe flow of patient data between care settings, and the aggregation of data for population health.
Finally, we are asking you –working as local systems –to return a draft summary plan by 1 September using the templates issued and covering the key actions set out in this letter, with final plans due by 21 September. These plans need to be the product of partnership working across STPs/ICSs, with clear and transparent triangulation between commissioner and provider activity and performance plans”

You can download the letter by clicking the above picture.

These autonomous organisations will then be free to be bidded for take-over by multi-national health care companies, primarily American e.g. United Health who the current head of NHS England, Sir Simon Stevens used to work for as the head of their European operations!

These are being set up to mirror the way in which American healthcare works in order to make the take over of NHS England easier, as has the fact that the Government has recently wiped out ALL NHS Debt. Again such actions are only done when privatisation is being prepared for e.g. Royal Mail, Water and Electricity services and British Telecom.

The UK/US Trade deal being negotiated right now will include access to UK healthcare services, formally known as the NHS!

All without any say or knowledge of Parliament as a result of the Tory Trade Bill which does not allow any scrutiny of trade deals agreed by the Government by MPs or Select Committees in Parliament.

In effect Parliament voted to remove it's own rights of scrutiny completely and ALL trade deals will be negotiated in secret with the terms of those agreements made and unable to be scrutinised at all!

Pic: NHS US Vulture

As Unionsafety has reported since 2010, subsequent Tory Governments aims has always been to destroy the NHS via funding shortages, cuts in services, staffing crisis, and latterly by deliberately running down stockpiles of PPE and equipment required in the event of a pandemic! Covid-19 has given them even more power to decimate the NHS.

As readers of this website already know, the NHS will be fully privatised and is being re-organised to ensure a full breakdown of the NHS from a national service to a regional one in order to facilitate separate organisations that can then easily be taken over by US healthcare insurance companies.

Part of this plan is to ensure that ALL NHS Trusts are set free in order to facilitate buy-outs. This year, Matt Hancock wrote of around £148 million of NHS debt. This is only ever done by the Gov immediately prior to a sale of a national interest. BT and Royal Mail are examples of just this.

Sustainability Transformation Plans (STPs) and Integrated Care Systems (aka Accountable Care Organisations) are set up in the same way as American healthcare systems, and have now been put in place across England and once fully functional by April 2021; the National Health Service will no longer exist!!

Around 31 healthcare procedures previously paid for by the NHS have been removed and are now only available privately.

The then separate healthcare organisations (Integrated Care Organisations) each providing services only within a locally defined area, will be independent and; following a US/UK trade agreement, will then be open to being bought out by US healthcare companies which will then be free to ensure private healthcare insurance is required by ALL patients living within the catchment area of that particular ICS!

They will decide exactly which healthcare procedures they will actually fund, e.g. No IVF, No Proton Beam treatment for Cancer, No examination and removal of facial skin tags, lumps and growths. Some of these are already no longer done by the NHS in Merseyside & Cheshire, Nottingham, Grter Manchester and West Yorkshire & Harrogate ICO.

In Cheshire and Merseyside, an ICO is already up and running, calling itself a healthcare partnership! The map below provides you with the detail of the new ICO replacing the 9 CCGs. An example of the amalgamation of Hospital care services in the new area has seen stroke patients receiving treatment not in their local hospital, but in one single hospital designated as taking all such patients in the new area covering 2.3 million people! Likewise, fractures and heart treatments are similarly designated to a single hospital irrespective of where the patient lives. Patient choice is a thing of the past!

Proof of this can be seen when reading the Cheshire and Merseyside ICO 'Business Plan'!

But finding all of this out is not easy at all and we rely upon the various campaign groups such as Keep Our NHS Public, 999 Call For The NHS, and similar local groups fighting this form of Americanisation of the NHS.

This is of course why Brexit was so necessary, without which a UK/US trade deal could not happen, along with the sale of NHS England to US and other private healthcare multi-national companies.

So just what are ACOs or to use the more acceptable term used by the Government, Integrated Care Systems?

A clear explanation comes from NHS Campaign Group Keep Our NHS Public.

Run by NHS Clinicians, NHS Specialists and GPs as part of their Executive Committee, and includes founder member Professor Wendy Savage, She was a Fellow of the Royal College of Obstetricians and Gynecologists, and Honorary Consultant at The London Hospital, now Royal London Hospital.

They explain fully just what Integrated Care Organisations (ICS) aka Accountable Care Organisations (ACOs) truly are:

NHS England first divided the English NHS into 44 local health systems or ‘footprints’ (now ‘Sustainability and Transformation Partnerships’) and required each of these to integrate its local health and – where local authorities are willing – social care services, through cross-boundary working and pooled budgets.

Since 2017, these Partnerships have been required to deliver ‘accountable care’ by morphing into Accountable Care Systems (ACSs), with the aim of eventually becoming Accountable Care Organisations (ACOs).

Far from replacing competition with collaboration, NHSE intends to replace multiple smaller NHS contracts with a single long-term lead ACO contractor for each area of England.

NHS England argues that introducing ‘accountable care’ (a term often and misleadingly replaced by the more politically acceptable ‘integrated care’) is central to Government aims for ‘financial sustainability’ of the NHS.

In this context, ‘sustainability’ means reducing services to match insufficient funding: despite being one of the richest

countries in the EU, the UK currently spends below EU average levels on healthcare.

Both ACOs and ACSs are being introduced without adequate public involvement or consultation; and where NHS and social care services are seriously under funded;

They are being implemented beyond any legal framework, creating problems of governance and accountability.
They have no robust evidence base to support their use in the context of the English NHS.
They will help strip NHS assets, such as land and buildings, so ending the social ownership of much of the NHS estate while allowing private companies to profiteer from it. See the Naylor Report which is available from the Unionsafety E-Library here
They will apply unprecedented cuts in spending and transfer the NHS’s funding shortfall to new local, self-contained areas.
They incentivise rationing of services and – even more concerning – denial of care and so are fundamentally at odds with social solidarity and the values of equity and universalism that underpin the NHS.
They increase the potential scope of NHS privatisation. For example, multiple procurements will be replaced by a single, major, long-term contract to provide health and social care services for an entire area. The draft model contract for ACOs published by NHS England allows for, and is likely to attract, bids from multinational corporations.
They rely on unrealistic expectations, for example about collaboration and risk-sharing between private and NHS providers.
They entail ‘transforming’ the NHS workforce, replacing experienced clinicians – including doctors and nurses – with technologies (Artificial Intelligence, Telephone and Video GP and Hospital consultations) and introducing new lower skilled and lower paid roles, such as ‘physician and nurse associates’.
ACOs are likely to under-deliver required skill levels and undermine NHS terms and conditions of employment.

This is a time of unprecedented NHS and social care funding shortfall. No one can deny that acute, primary care and community NHS services and social care need to be better integrated.

But major funding input is the first and foremost requirement, to restore safe level of service provision and to facilitate moves towards better integrated delivery of services

What is clear is that despite the lack of evidence, accountable care systems are being introduced at breakneck speed, and in the absence of public involvement and consultation, parliamentary scrutiny or appropriate legislation.

Simon Stevens, Head of NHS England, has made clear in his July letter of his intention that ACSs will develop into ACOs and NHS England’s model contracts assume a tendering process inclusive of bids from private companies or special purpose vehicles to run whole systems of the erstwhile NHS.

Here and now, the development and management of accountable care systems themselves are being offered to private companies – as in Greater Nottingham.

These unevidenced and undemocratic proposals are facilitating increasing privatisation of the NHS, by giving private corporations new roles and powers to shape the NHS in their interests.

It must be remembered that (Sir) Simon Stevens was once vice president of United Health in Europe, America's 6th largest private healthcare provider. His being made head of NHS England was always the one single piece of evidence that the NHS was being re-organised to reflect US healthcare organisation and hence the latest and final knife to the throat of the NHS being introduced i the form of Accountable Care Organisations; now re-named Integrated Care Organistions.

Source: 999 CAll For The NHS / Keep The NHS Public / NHS England / Unionsafety