2023-08-25 10:28

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The Abolition Of The NHS And Introduction Of Insurance Based Healthcare In England

Replaced by 'The National Integrated Health & Care Services Organisation' perhaps?

Unionsafety Web editor, Chris Ingram gives his personal run-down of Government policies which have led to the inevitable and imminent abolition of the NHS, aided and abetted by a weak and compromised (as far as the NHS is concerned) political party in opposition. The right-wing tabloids and both TV and Radio News media's omission to fully report on the issues, and the public disinterest shown towards the destruction of the NHS and politics in general, have contrived to help destroy the National Health Service:

In 1948 the then Labour Government began a service which was to become the best national healthcare service in the entire world. So began the duty of the UK Government to provide a National Health Service, along with a constitution owned by the people of the UK; and with the responsibility to ensure it continued with each subsequent Government.

That ended in 2012!

Previous Labour Government’s from 1997 onwards introduced the Oliver Letwin/John Redwood NHS policy paper of 1988 entitled ‘The Greatest Enterprise’ on how to dismantle the NHS; into Government policy!

The basic necessity was to free up all hospitals from Government spending directives, and give them total control over their own budgets – via NHS Foundation Hospital Trusts. Without this, privatisation was not going to be easily and quietly introduced. Indeed, some say it would have been almost impossible to do so by stealth.

In 2004, they went further and attacked the GP practices by bringing in legislation allowing any private companies to take over whole practices which saw Virgin Care, Circle Health, and more recently Operose Health (Centene owned) buying up 41 GP practices in the London area.

The final nail in the coffin of the NHS was hammered in via new legislation:

The Health and Social Care Act 2012 removed the duty of the Government to provide any form of healthcare services by removing it from the duties of the Secretary of State For Health, including the abolition of the Primary Care Trusts and Strategic Health Authorities, and the subsequent creation of supposedly GP led, Care Commissioning Groups (CCGs).

Since then, the abolition of the skeleton which remained – in name only under the NHS logo – has continued to be slowly demolished; a process which will end on its completion with new legislation in 2022.

First, via the HSC Act 2012, came:

* the removal of the duty on the Government to provide any form of healthcare,

* the legal instruction to put out ALL healthcare services provided by the former NHS to private tender

* the NHS logo to be used to hide the actual private service provider’s name from the public

* the introduction of the ‘any qualified provider’ clause which basically allowed literally anyone with money to provide what was formally provided by the NHS.

* Ambulance service changes allowing private companies to bid for services

* various reforms to the funding and provision of healthcare in England, aimed at facilitating full privatisation by stealth of the NHS.

Central to all of this was private healthcare company consultants from the USA and insurance based groups, along with financial right-wing think tanks.

McKinsey & Company, Health Care of America, United Health, Kaiser Permanente, The Kings Fund, Centene Corporation, Operose Health Corporate Management, Palantir, Babel, Circle Health, Serco; are simply just a few of them.

Together they and Tory right-wing politicians and private healthcare companies in the UK, meet in secret to plan the introduction of US–style healthcare based on medical insurance into England.

Of course the establishment of private healthcare company officials into posts within the NHS in England and on the NHS Board gives the game away:

* Sir Simon Stevens - previous CEO of United Health's European operations into being head of NHS England, the 6th biggest US healthcare company.

* Dr Emily Lawson - NHS England Chief Commercial Officer - previously worked for McKinsey & Company for 14 years.

* Dr Timothy Ferris Director of Transformation - CEO of Massachusetts General Physicians Organisation, and a Professor of Medicine at Harvard Medical School. He will retain his US posts.

See: Privatisation Of NHS England Boost As Top US Healthcare CEO Hired

* Susan S. Kilsby joined the Board of NHS England in January 2021 - She was Senior Independent Director and Remuneration Committee Chairperson, Goldman Sachs International. She is a non-exec director at Unilever. From 2009 through 2014, Mrs Kilsby was as Senior Advisor at Credit Suisse where she focused on senior level coverage of global corporations.

* Samantha Jones was NHS England’s Director for New Models of Care and responsible for the inclusion of Centene in promotion of new models of healthcare based on studies of ICS across the world. With the Principia Vanguard scheme in Rushcliffe, Nottinghamshire being one of many that Samantha Jones was responsible for funding and overseeing as NHS England Director of new care models. She became CEO of Centene in January 2019. She also became Director of 9 other Centene Corporation UK subsidiaries. On 30th March 2021 Ms Jones, was appointed to a civil service post as Boris Johnson's health adviser on NHS Transformation and social care.

Check out the list of NHS Board members here to see just how few of them actactually have anything close to healthcare or NHS experience and knowledge! They are a majority of people with business backgrounds and remain business orientated individuals now determening the future destruction of what is left of the NHS. They know little of how to provide healthcare services.

Private healthcare organisations are embedded into NHS England and in advising Boris Johnson on the future of the NHS and turning it into what should be named 'The National Integrated Health & Care Services Organisation'!

Worse still: Ever since the New Labour Government introduced the Alternative Provider of Medical Services (APMS) contract in 2004, across the UK, commercial for-profit providers have been able to tender for NHS-funded GP services. Neither Scotland nor Wales have implemented APMS contracting, but the contract form has been used increasingly in England.

Meanwhile, Alan Milburn ex-Labour Health Secretary and other existing or passed Labour MPs have personal interests in private healthcare companies (26 at last count), which may well explain the lack of true opposition from Kier Starmer and co to the abolition of the NHS.

Lancashire has more of these privately run GP practices than anywhere else in the North West, which puts them at risk of takeover by big corporations like Centene Corporation/Operose Health. As an example of what is to come, recently 41 London GP surgeries were sold to and taken over by Operose Health LTD, a subsiduary of US company Centene Corporation.

The Naylor Report, advocating the sell-off of NHS hospitals, property and land top private investment companies and US insurance companies was introduced as policy by the Theresa May Government, and continues to this day!

The ease at which this could be done was facilitated well in advance by the Tories in 2013 when they set up a limited company called NHS Property Services giving them ownership of some 3,600 hospital buildings. NHSPS is owned by the Dept of Health.

See The Naylor Report - The Truth Of NHS Property Privatisation

The fact that Healthcare is a devolved responsibility saved the rest of the UK (so far) from the abolition of the NHS in Wales, N.Ireland and Scotland.

This year, the remnants of the NHS in England will be finally buried with the transformation plans of the Tory Government with an 80 seat majority, to take over the skeleton of NHS services and hospitals transforming them into 42 autonomous and privately run Integrated Care Systems (ICS).

Along with the abolition of NHS terms and conditions, nurses and clinical staff will be expected to work more ‘flexibly’ and even between hospitals and clinics in differing locations!

Their contracts taken over by one of the 42 ICS which will replace national terms and conditions. Will NHS staff be deemed as then working for the newly formed Integrated Care Board, when it is enshrined in law in 2022?

So proclaims the Government's consultation document (available from the E-Library).

Each ICS will have full financial autonomy and the power to decide which healthcare services they will provide and those they will not, using 'Right Care' set of spending benchmarks authorised by NHS England and being used to cut medical services and procedures by all of the ICS' across England.

'Right Care' was headed by the Chief Medical Officer Dr Nick Harding of private US healthcare company Centene aka Operose Health in the UK, when he worked at NHS England on secondment as Senior Clinical Advisor for the NHS England Accountable Care Systems, known now as Integrated Care Systems (ICS) Primary Care Development Programme and for 'Right Care'.

Indeed, so far 31 procedures formerly provided by the NHS have been deemed not cost effective, and no longer provided by the NHS service providers (private companies running healthcare services including GP practices and ambulance services in England).

The 31 procedures no longer carried out by NHS

Even more cuts in services are to come as exemplified by this from the Lancs and S Cumbria Integrated Care System Board meeting 3rd Feb 2021:

The NHS England and the ICS' wants to cut £113m from Clinical Commissioning Group costs by reducing patient referrals to these services:

And £154m cuts in these hospital treatments:

At national level, even worse, and hidden amongst all of the complicated documentation involved in ICS' is The Integrated Care Provider (ICP) Contract which is being pushed by NHS England as a contract to enable joined up decision making and integration of services.

It will enable commissioners to award a single contract to a provider that is responsible for the integrated provision of general practice, wider NHS and potentially local authority services.

No wonder the Government is claiming that competition will be limited within NHS service provision!

ICS' will also be mandated to make a profit and be able to keep that profit to themselves and their shareholders. It is inevitable that existing limited companies, already formed by NHS Foundation Trusts, will eventually become Plcs along with the bodies running the 42 ICS, and floated on the stock exchange as in the USA.

Pic: Legislation recommended by NHS England - click to download from E-LibraryFurthermore, in the 2022 legislation, the Secretary of State will be named as the person in Government to oversee the new healthcare services in England, making him personally in charge of the newly and fully privatised healthcare service – 'The National Integrated Health & Care Services Organisation for want of a better term.

The National Health Service it certainly is NOT with budgets, spending, and provision of healthcare services all being devolved to the 42 privately owned and run Integrated Care Systems (ICS).

Contrary to the lies by the Government that new legislation making ICS' organisations the legal replacement for the NHS and that they will ensure far less competition, the reality is that this is only because the private companies concerned will be working together and be offered a 10 year contracts to run ALL NHS services in the ICS.

This means that no matter the political make-up of future Governments, these private contractors will not be effected ted and no future government will be able to reverse this total abolition of the NHS.

In 2022, the NHS will be completely abolished in England!

Currently there are 42 ICS' organised with 32 listed on the NHS England website, with the remainder to be listed by end of April. These will give 10 year contacts to independent and private healthcare providers of services, under the Integrated Providers Contract; once the legislation, yet to be publicised, is passed in 2022.

The current 32 ICS' listed include areas that are healthcare partnerships or STPs and not yet ICS' at the time of writing, causing somewhat a confusing picture:

·  Bath and North East Somerset, Swindon and Wiltshire
·  Bedfordshire, Luton and Milton Keynes
·  Berkshire West
·  Birmingham and Solihull
·  Bristol, North Somerset and South Gloucestershire
·  Buckinghamshire Integrated Care System Pic: documentation which will abolish the NHS - available from the E-Library
·  Buckinghamshire, Oxfordshire and Berkshire West
·  Cornwall and the Isles of Scilly
·  Dorset
·  Frimley Health and Care
·  Greater Manchester Health and Social Care Partnership
·  Hampshire and the Isle of Wight
·  Hertfordshire and West Essex
·  Humber, Coast and Vale
·  Joined up care Derbyshire
·  Lancashire and South Cumbria
·  Norfolk and Waveney
·  North Central London Partners in health and care
·  North Cumbria Health and Care System
·  North East London
·  North West London
·  Nottinghamshire
·  One Gloucestershire
·  Somerset

·  South East London
·  South West London Health and Care Partnership
.  South Yorkshire and Bassetlaw Integrated Care System
·  Suffolk and North East Essex
·  Surrey Heartlands Health and Care Partnership
·  Sussex Health and Care Partnership
·  West Yorkshire and Harrogate
·  West Yorkshire and Harrogate Health and Care Partnership

Click on the links above to go to the relevant website which provides details of the organisations that make up the ICS as it currently stands.

In addition, 13 final ICS' were announced on 19th March:

  1. Cambridgeshire and Peterborough
  2. Mid and South Essex
  3. The Black Country and West Birmingham
  4. Herefordshire and Worcestershire
  5. Northamptonshire
  6. Coventry and Warwickshire
  7. Leicester, Leicestershire and Rutland
  8. Lincolnshire
  9. Shropshire, Telford and Wrekin
  10. Staffordshire and Stoke-on-Trent
  11. Cheshire and Merseyside
  12. Kent and Medway
  13. Devon

Whilst until legislation is passed in 2022, these ICS have no legal standings and are purely how NHS services are being organised and provision of services are determined, controlled and implemented; the reality is that they will develope further into autonomous 'systems' implementing cuts in healthcare services, and privatisation of those services and supporting the selling off of NHS hospitals, properties, and lands.

As such, they can be disbanded, re-arranged, and reversed by a new government. Once the legislation is passed that the Tory Government intend to place before Parliament in2022; any changes will be nigh impossible by future governments.

Of coruse what is also kept quiet is the inventing of another tier of baurocracy and mony making as a new NHS Integraated Care Board will be enshrined in law, making the replacement NHS, 'The National Integrated Health & Care Services Organisation', name even more appropriate.

In 2022, the NHS as determined by the 1947 Act will be finally abolished!

What is next for healthcare in England?

Consultation on changes continue, but with little public notice and extremely short, less than 4 weeks in some cases, timescales for responding to the documentation. An example of this is the NHS Provider Selection Regime Consultation on proposals to change the way NHS private providers are chosen. This lasted from 11 February to 7th April and outside of the NHS, little knowledge of this existed.

A previous example was that of the Integrated Care consultation which ran for less than a month, from 11th December 2020 to January 8th 2021

The introduction of private medical insurance and a two tier healthcare system will be introduced under the guise of ‘personal choice’ and the cutting of healthcare procedures from non-paid-for healthcare provision will continue unabated.

Pic: NHS Consultation - available from the E-LibraryEventually and given the speed of changes being secretively introduced could be before the next general election; medical insurance will be introduced in order to ensure all NHS services are provided to those insured. Those not, will be unable to access ALL NHS services, with the list of those services requiring medical insurance increasing. American medical insurance companies will no doubt be given preference when tendering to provide such medical insurance services in the UK.

This may well mean that both National Insurance Contributions AND private medical insurance will be required to be paid in order to fully access the NHS for treatment and general healthcare. Expect too, charges to attend your GP surgery to be introduced.

Also, do not forget that Ambulance Services, GP practices as well as Hospitals are all part of the NHS and hence the 42 newly formed ICS' determine their shape, form and service provision.

Sources: UK Government and NHS England website, The Guardian, The Independent, The Financial Times, Government consultation documents, The Mirror, The Mail on Line, The I newspaper website, the US Government website, 999 Emergency Call for the NHS, Defend Our NHS, Keep Our NHS Public, NHS Support Federation, National Pensioners Convention,Calderdale and Kirklees 999 Call for the NHS Daily Telegraph, Unionsafety news pages, Unionsafety E-Library.

Further information available in the Unionsafety E-Library using search category 'National Health Service''

and on the NHS Privatisation News Archive page.

Pic: Bak to News icon link

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