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A warning in the mail

Posted on April 01, 2013 by

We’ve covered the privatisation of the NHS, and how it will impact on the independent Scottish NHS, at length previously on this site. But for those of you who think the extent and pace of privatisation south of the border is being exaggerated, the British Medical Journal has helpfully posted an article explaining what’s going on.

(We’ve just noticed Owen Jones has a piece in the Independent too, and there’s a chilling insight from an East London GP in the Guardian. Even the indefatigably Tory Telegraph is ringing alarm bells all over the shop.)

closedhospital2

You can read the whole thing here. But the short version runs like this.

1. Private providers will have ‘rights’ to bid – although it’s hard to see any consumer-market mechanism at work when the criterion for appointment doesn’t seem likely to extend beyond “cheapest tender”.

2. They’ll cherrypick the most profitable bits of the service – leaving the taxpayer to continue funding the awkward unprofitable stuff – and once a service is in private hands then there’ll simply no longer be any public-provider capacity left to take it back in the event of underperformance.

(We are, with touching and somewhat uncharacteristic naivety, presenting such underperformance due to private-sector involvement as a mere possibility.)

3. The whole process becomes an ever-accelerating runaway train, on course for complete privatisation by unaccountable profit-driven corporations.

4. With the vast bulk of NHS expenditure then transferred off the UK public books, the Barnett formula comes into play and slashes the Scottish block grant by billions of pounds, far too much to be recouped by savings elsewhere, leaving the Scottish NHS no option but to privatise too.

If that’s all too abstract and you want a real-world example to compare, though, or if you just want to see whether Tory ideology is really any different to that of Labour, almost exactly the same thing has already happened in very recent memory to another (once-) precious British institution: the Royal Mail.

closedoffice

Two successive Labour governments – hiding behind a figleaf of EU law – hived off all the lucrative bits of the postal industry to the private sector in the early 2000s, leaving the core business with all the expensive loss-making bits. To cut costs we’ve subsequently seen a bonfire of Post Offices, tens of thousands of job losses, the end of the second post (which was in reality the end of the first post), threats to daily deliveries in rural areas and a swingeing 35% increase in the cost of a stamp.

The Tories are, as usual, continuing Labour’s work with enthusiasm. Desperate postal workers are on the verge of strike action against yet another round of closures, job losses and real-terms pay cuts, and the government has approved plans to sell up to 100% of the business to the private sector.

A service already measurably, visibly worse – yet more expensive – than it was just a decade ago will continue to decline in quality and increase in price, while largely foreign-owned companies take billions in profit out of the UK economy.

If you want to know what the UK’s NHS will look like ten years into the future, simply have a look at the coffee shop, nail salon or simply boarded-up empty property where your local sub-Post Office used to be, while you wait for your mail to arrive some time in the middle of the afternoon.

It’s not hard to see why Scotland’s posties support independence.

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Morag

That’s too depressing for this time of night.  I really am off to bed now.

rabb

It’s quite simple.

Independence or bust!

Undecideds please take note of the above. Barnett consequentials will devistate the Scottish NHS as a result. Privatisation in Scotland is now a certainty.

There is nothing ANY Scottish government can do to stop this other than independence.

Barontorc

Morag – there’s so much more coming down the UK’s desperation pipeline, ‘feeling depressed’ doesn’t nearly come into it, try’ surviving it all’ as a must do.
Today, I spoke with an elderly lady who has just been in hospital with a lung infection and she was full of praise for the care shown to her. When I told her that her hospital and the whole NHS was in jeopardy, she couldn’t take it in. I told her the English NHS was going under and was being taken away bit by bit for privatisation and it was coming to Scotland if we voted NO, she again couldn’t accept it. She said what worried her most about independence was she would automatically lose her right to her disability benefit.
 
This is the sort of thing that ‘surviving’ this anti-independence propaganda is all about – the YES campaign has to make these worries go away for the ‘Don’t-Knows’ and even many firmly traditional NO-ists like her who are steeped in Labour loyalty, but see the devastation going on all around them.

Geoff Huijer

I hope this is not an April Fool’s joke…it’s difficult to tell
these days with the ridiculous goings-on at Wasteminster…

CameronB

Vote No in 2014, for more Thatcherite style privitisation of democratically accountable local services and an end to the right of collective bargaining.

douglas clark

Cameron B has the right of it. We need out of this mad mad Westminster government.

Chic McGregor

OT but in similar seasonal mode.
 
Cameron advocates a Glasgow United team for the Premiership to thwart independence (Newsnet Scotland)
 
Edinburgh Pandas to join local ‘Swingers Club’.
 
BBC to adopt new policy of impartiality on the issue of independence.
 
 
 

Soutron

Apologies in advance for the long post…As a clinician currently working for the NHS down south I can fully attest to the fact that this is happening NOW and at a dizzying pace. ‘AQP’ (any qualified provider) is already in full effect in some trusts and is going to be rolled out everywhere. 
 
The message that ‘patient choice’ is at the centre of this is absolute rubbish. It’s a cost saving measure and one based on ideology. The private firms win gov contracts by offering cheaper care (but at what cost?!) than the equiv NHS department can provide.
 
As Rev Stu points out, once NHS departments are killed off, they won’t be back. At that point, only private providers will be competing for gov health contracts increasing competiition and pushing down cost. 
 
UK gov healthcare budgets will slowly but surely reduce to reflect this, cutting the private firms cash and profits. Patient care will begin to suffer further as profits are put first and shortcuts are taken (best practice replaced by fastest, cheapest practice). When this happens, don’t be surprised to start seeing ‘top up’ fees being introduced to make up for the shortfall. 
 
Perhaps it’ll start as a £20 ‘top up fee’ for your high street endoscopy (that’s no joke, endosopy’s covered by AQP) but I bet that before you know it, prices will increase and create a burgeoning market for health insurance as prices become prohibitive. As health insurance becomes more commonplace, the current AQP scope will widen to encompass previously unprofitable areas (complex surgery etc). The process starts again and voila, the US healthcare system before you know it.
 
The MSM is absolutely complicit in this process. The fact that there has been virtual silence from the press on AQP, combined with the unrelenting NHS bashing of late speaks volumes. In the past our love for the NHS would make it too politically damaging to touch. They are working on eroding that inconvenient barrier.
 
On a brighter note, I converted an undecided friend to a yes vote over the weekend (swayed by cultural possibilities such as Scottish film studio etc) along with another pal’s (previously staunchly unionist) dad, who we’ve been working on for a while. The bedroom tax pushed him over the edge. Though he’s still not a firm yes, if you had talked to him a few months ago, you would have thought him impossible to turn, even to undecided. It really fills me with hope. There must be thousands more like him.
 

Linda's Back

 Can’t rely on Westminster to protect services. Coalition government is slashing Royal Mail services in order to privatise and last Labour government  closed 7100 local post offices in their 13 years in office.
No wonder the main Communication Workers union branch in East of Scotland voted to campaign for YES vote in 2014. 

Aucheorn

@Chic McGregor says:
 
 
BBC to adopt new policy of impartiality on the issue of independence.
 
Let me see now………  could that be an April fool ?

Dave Beveridge

“24 hours to save the NHS”
That slogan was used brilliantly by Bliar back in 97.  We need to do the same.  It’s easy to just trundle along complacently assuming that the NHS will always be there for you, but we need to fight to the death to protect it.
Could this be the thing that turns some of the MSM?  Surely they’d rather see it free to all at the point of use rather than being butchered by evil scumbags we didn’t even vote for?

Shirley

The BBC News has been giving a lot of coverage to the various cuts coming into effect today. The Bedroom Tax, Legal Aid changes, NHS changes, tax changes etc. And they have had on some people strongly criticising them. So for once they can’t be accused of ignoring, or agreeing with, Westminster’s awful policies.
I  have been trying to persuade Rev Stu to post a poem, but he seems not to be into poetry. The poem is called ‘Dreamers’ and is by Andrew Redmond Barr. I haven’t got a link, but it’s easily googled. 
It’s about Independence, so quite suitable for this site. I think it’s quite moving and deserves wider coverage than it’s had.
I’d be interesred to know if anyone else likes it, or is Rev Stu right, and political anoraks and poetry don’t mix? (Not what he actually said, but definitely a possibility I suppose.)

tartanfever

Congratulations to the happy couple on the birth of their new child ! Labour and the tories have given birth to a bouncing fit gorgeous baby this morning – the bedroom tax.
Parents are said to be very proud of their achievement.

Chic McGregor

Auchreon
I thought the article was (you know? A subtle one)
But since it is not, I’ll relate, one of the most profound culture shocks I ever experienced was an advert on a hoarding in the USA circa 1992, the text of which read:
“If happiness is just wheelchair away, why not rent one of ours?”
 

bc

Why would privatisation of the NHS have barnett implications? Just because NHS provision in many areas is to be privatised, it does not follow that NHS funding is going to be privatised. In fact, the entire NHS south of the border will remain free at point of use and publically funded.
Whilst lefty idealogues certainly care about the mechanics of *how* the NHS is implemented, all most people care about is the core principle that the NHS remains free at point of use to all. That is not changing. Even if your hip operation is provided by a private company – it is still being paid for by the taxpayer. Therefore there are no barnett consequentials of “privatisation” directly.
The NHS south of the border is moving towards the French of German models. You know, those national health systems that are constantly held up as shining examples? They work in exactly the same way – provision is private, and funding is public. If you start getting hysterical and complaining that we’re moving towards some US style model and it is the end of the NHS and all the rest of it – it means you can’t be taken very seriously. In fact, it means you are misinformed or willfully lying to whip people up into an ignorant froth, one that doubtless you wish to usher towards the path of independence.
If someone would explain why is it good for the French and the Germans but a disaster in England, I would be very happy.
 

Alexicon

Sorry for the O/T on this serious subject.
Councillor Terry Kelly (there’s nats under my bed!) has been making a right Jeremy Hunt of himself over on his blog, well not blog just a rant site.
link to councillorterrykelly.blogspot.co.uk
Another O/T.
Rumour has it that Henry McLeish has joined the YES campaign. Anyone got any info?
 
 

dundee bloke

Chic and others, I nearly forgot the date when I saw this, checkout the ‘authors’ name 
 

By SCOTT ENGLISH 
Published on Monday 1 April 2013 08:11

 
ATHLETES taking part in the Commonwealth Games in Glasgow next year will be able to choose whether they represent Scotland or Great Britain, The Scotsman can reveal today.

Aplinal

I remain puzzled that more is not being made of the impact on Barnett of the privatisation of public services in the rUK.  Are the MSM ignorant of this, or don’t they care about their Scottish readers, viewers, listeners? 
 
How can this message be got across to ordinary voters?  Or is the YES campaign holding on to the idea that a late ‘surge’ will do the job.  I no longer think it will.  This is a MAJOR change in the relationship between the citizen and the state, and yet this hardly rates on the radar.  I see the BBC is at least highlighting the issue today, but will they do anything more over the next weeks and months? I remain unconvinced.

Alexicon

Seems that the Henry McLeish rumour was a joke of the day.

velofello

Unfortunately life’s smart alecs don’t accept forecasts, the catastrophe has to occur to them before they will believe:-
don’t drink and drive;don’t use your mobile whilst driving;don’t speed in town. And that’s just the subject of motoring.
Why is Baillie so determined to fault find the NHS in Scotland? Is it solely to attack the Scottish government or related to the English NHS privatisation? And  the smart alecs? “Naw, its jist the rough and tumble o’ politics, keeping the government on its toes”.
Does that justify her lying? “C’mon pal all politicians lie”.
I read the article in the Sunday Herald by McCabe and referenced y Rev Stu.
I haven’t studied it in great detail but at the he outset seemed to complain of the Scottish Government’s centralisation of powers – a Scottish Labour theme, and the towards the end of his article expects the Scottish Government to intervene on the bedroom tax!

Malcolm

 
bc says:
 
1 April, 2013 at 10:35 am
Why would privatisation of the NHS have barnett implications? Just because NHS provision in many areas is to be privatised, it does not follow that NHS funding is going to be privatised.
 
Most likely because the WM gov will split NHS budgets into  (very much diminished) public and (very much larger) competitive tender components, classifying the whole Scottish budget as public, meaning Barnett consequentials will necessitate enormous cuts to the Scottish NHS budget and implementation of the same system of private provision instead.
 
Always bear in mind the reason this is being done is to make those with directorships and shares in private companies wealthy, and so scenarios like the one I have just mooted are not something that would trouble the tories sleep.
 

Alan Gerrish

 
Aucheorn says:
1 April, 2013 at 8:41 am

@Chic McGregor says:  BBC to adopt new policy of impartiality on the issue of independence. Let me see now………  could that be an April fool ?
 
You gotta believe it!  Just heard on Radio Scotland’s 11.00 News summary (re Bedroom Tax) that “Labour and Charities are against it”.
Guess that means that,by omission,the SNP , like the ConDems, are for it?
What was that saying about old dogs and new tricks…..?

Les Wilson

If this does all come about, then with Independence with England indeed all of rUK, what stops them simply coming North for treatment?
Then the Scottish health service would go bust, so what do we do with a constant flood of the sick? Not an easy one is it? Or course rUK would be wearing a big grin, “gotcha again!”

Clydebuilt

Craig Murray blogged on the NHS  a few months back, citing a journalist who had been investigating the BBC ‘s lack of coverage of the privatisation of the NHS in England ( to English viewers) The journalist was making the case that down south the BBC had been covering up the NHS changes.

Scott Minto (Aka Sneekyboy)

@bc
 
Eventually, privatisation will result in private companies charging patients. Its a slippery slope and if you trust Westminster not to go down that route then you are more trusting than I.
 
But REGARDLESS of what money gets pulled out of the NHS in England by privatisation, CUTS are going ahead anyway!
 
Patient care will suffer under budget cuts warn NHS finance bosses
 
The NHS in England has been told to save £20 Billion… the equivalent Barnett Cut for Scotland is £2 Billion (Or about 18% of our health budget).
 
Now its true that we can take the cuts from elsewhere, but other departments are ALREADY getting cuts also and Health is the Biggest devolved spend.
 
So just on the CUTS in England ALONE, we are about to lose nearly A FIFTH of our health funding.
 
We need to break free of that Barnett Trap!

Scott Minto (Aka Sneekyboy)

If you want to know why the NHS in England is being privatised then this will help…
 
link to twitter.com 
 
AND if you want to know why the people doing this have not been ripped to shreds by the BBC then this will help…
 
link to twitter.com

rabb

Les Wilson says:
1 April, 2013 at 11:28 am

If this does all come about, then with Independence with England indeed all of rUK, what stops them simply coming North for treatment?
Then the Scottish health service would go bust, so what do we do with a constant flood of the sick? Not an easy one is it? Or course rUK would be wearing a big grin, “gotcha again!”
 
Les,
It’s simple. The rUK NHS (or private healthcare insurance more like) would pay for the treatment in Scotland. Like it does now or when you get ill in France or Spain or anywhere else they have a cross border agreement.
 
Our NHS would not be bust. It would be making a healthy profit for the people of Scotland. I would hope this revenue would then be ploughed back into OUR NHS.

I’m not entirely sure there would be a “mass influx” of people from rUK anyway unless you know of some unionist plans for a national plague of some sort??

Scott Minto (Aka Sneekyboy)

@ Les
 
Rabb is right. The funding follows the patient.

cirsium

RevStu – the BMJ article is dynamite.  Thanks for the link.  The fate of the Royal Mail is a useful analogy.   The privatisation of the NHS in England/Wales should not be viewed in isolation.   Since the UK government’s catastrophic decision to prop up failed banks and their bondholders with taxpayers’ cash, the Bank of England has been undertaking quantitative easing.  

“By a continuing process of inflation, governments can confiscate, secretly and unobserved, an important part of the wealth of their citizens…. There is no subtler, no surer means of overturning the existing basis of society than to debauch the currency.”[J M Keynes]

Earlier in the year, the Bank of England floated the idea of using depositors’ cash to prop up failed banks.   The EU has just done that in Cyprus. The original proposal included making use of insured deposits.  Coming to a country near you soon!
Say it rabb  “Independence or bust”  
 

molly

Les Wilson its happening already,why do you think Prince Philip was in Aberdeen Royal last year- no seriously, choose it  or lose it

Chic McGregor

“I’m not entirely sure there would be a “mass influx” of people from rUK anyway unless you know of some unionist plans for a national plague of some sort??”
 
Don’t go giving them ideas.

Stevie Cosmic

@Sneekyboy
 
I think an investigation into these cushy directorships of health companies is long long overdue. Sadly, it will be down to sites like this one to do the dirty work,
 

rabb

bc says:
1 April, 2013 at 10:35 am

Why would privatisation of the NHS have barnett implications? Just because NHS provision in many areas is to be privatised, it does not follow that NHS funding is going to be privatised. In fact, the entire NHS south of the border will remain free at point of use and publically funded.
 
Come on bc, are you seriously suggesting these changes have been made for no financial reason? Get real! It’s to cut public funding and place provision into the private sector for the least financial outlay possible (That’s how tendering works). You can put lipstick on the pig all you like but it’s still a pig!!

The cuts in NHS public funding brought about by privatisation will be reciprocated in a cut to the Scottish block grant. That’s how it works.
That in turn puts enormous strain on the Scottish government (regardless of which party is in power in Holyrood) to balance the books whilst sheilding our NHS.

We can only hold back the tide for so long before the damn bursts and we are forced into privatiation of the Scottish NHS.

It really is independence or bust!

Scott Minto (Aka Sneekyboy)

@Stevie Cosmic
 
·         206 parliamentarians have recent or present financial private healthcare connections
·         142 Lords have recent or present financial connections to companies involved in healthcare
·         124 Peers benefit from the financial services sector
·         1 in 4 Conservative Peers have recent or present financial connections to companies involved in healthcare
·         1 in 6 Labour Peers have recent or present financial connections to companies involved in healthcare
·         1 in 6 Crossbench Peers have recent or present financial connections to companies involved in healthcare
·         1 in 10 Liberal Democrat Peers have recent or present financial connections to companies involved in healthcare
·         64 MPs have recent or present financial links to companies involved in private healthcare
·         79% of these are Conservative
·         4 Key members of the Associate Parliamentary Health Group have parliamentarians with financial connections to companies involved in healthcare
·         4 Patrons of the pro-reform think tank 2020health have Peers with private healthcare links
·         Nearly 40% of the most powerful individuals in healthcare are from companies with links to Lords and MPs.
·         333 donations from private healthcare sources totalling £8.3 million has been gifted to the Tories.
·         4 MPs and 1 Lord have worked for Huntsworth Health, run by a Peer who gave money to Cameron’s leadership campaign
·         25 of the Finalists in the HealthInvestors Awards 2012 have parliamentarians connected to them
·         2 companies, DACBeachcroft, Cumberlege Connections., which have Lords as a partner and as an owner respectively, moved themselves into a position to make money from the reforms as the Lords voted on the bill, and before the bill became Act
·         5 organisations link to Baroness Cumberlege: Her company, Cumberlege Connections, Associate Parliamentary Health Group, 2020health, Huntsworth plc, MJM, healthcare solutions
·         19 Lords and MPs have financial links to Pharmaceutical giant GlaxoSmithKline
·         9 Lords and MPs have received payment from a company run by Baroness Cumberlege, called Cumberlege Connections, which is a healthcare training and political networking company
·         1 – the amount of times the BBC challenged Andrew Lansley in the last three years on his donation received to fund his private office when shadow health minister from John Nash the chairman of Care UK
·         All were able to vote on the Health and Social Care bill (now Act), despite having a prejudicial interest, which would not have been allowed at local council level
 

Scott Minto (Aka Sneekyboy)

@ Stevie Cosmic
 
THIS is a list of Conservative Lords who all have financial links to companies involved in the private healthcare industry. There are 62 of them out of a total of 217 peers who have these interests, which amounts to 28%.
 
There is LOTS of other information out there already too… HERE IS SOME:
 
·         206 parliamentarians have recent or present financial private healthcare connections
·         142 Lords have recent or present financial connections to companies involved in healthcare
·         124 Peers benefit from the financial services sector
·         1 in 4 Conservative Peers have recent or present financial connections to companies involved in healthcare
·         1 in 6 Labour Peers have recent or present financial connections to companies involved in healthcare
·         1 in 6 Crossbench Peers have recent or present financial connections to companies involved in healthcare
·         1 in 10 Liberal Democrat Peers have recent or present financial connections to companies involved in healthcare
·         64 MPs have recent or present financial links to companies involved in private healthcare
·         79% of these are Conservative
·         4 Key members of the Associate Parliamentary Health Group have parliamentarians with financial connections to companies involved in healthcare
·         4 Patrons of the pro-reform think tank 2020health have Peers with private healthcare links
·         Nearly 40% of the most powerful individuals in healthcare are from companies with links to Lords and MPs.
·         333 donations from private healthcare sources totalling £8.3 million has been gifted to the Tories.
·         4 MPs and 1 Lord have worked for Huntsworth Health, run by a Peer who gave money to Cameron’s leadership campaign
·         25 of the Finalists in the HealthInvestors Awards 2012 have parliamentarians connected to them
·         2 companies, DACBeachcroft, Cumberlege Connections., which have Lords as a partner and as an owner respectively, moved themselves into a position to make money from the reforms as the Lords voted on the bill, and before the bill became Act
·         5 organisations link to Baroness Cumberlege: Her company, Cumberlege Connections, Associate Parliamentary Health Group, 2020health, Huntsworth plc, MJM, healthcare solutions
·         19 Lords and MPs have financial links to Pharmaceutical giant GlaxoSmithKline
·         9 Lords and MPs have received payment from a company run by Baroness Cumberlege, called Cumberlege Connections, which is a healthcare training and political networking company
·         1 – the amount of times the BBC challenged Andrew Lansley in the last three years on his donation received to fund his private office when shadow health minister from John Nash the chairman of Care UK
·         All were able to vote on the Health and Social Care bill (now Act), despite having a prejudicial interest, which would not have been allowed at local council level
 

bc

Everybody is responding to me, that the reason for privatisation is as a smokescreen for cuts. Except that, really, the matter of cuts (which is a question of funding) is completely orthogonal to the matter of privatisation (which is a matter of how services are provided).
 
If they implement cuts, then they get the bad press and all the rest of it that entails regardless of how the NHS happens to be organised. It isn’t really a “smokescreen” at all. People don’t magically lose track of what the health budget is because the NHS is organised in a franco-german style rather than the old UK style.
 
The reasoning seems to be simple. According to tory ideology, the private sector is more efficient than the public, and yadda yadda. Therefore it makes complete sense to move to private provision, to get the best possible value for money – according to that ideology. It would seem to be trivially verifiable how most European health care systems stack up in terms of value for money – perhaps some movement from a monolithic state system to a more mainstream European style of health care is to be expected.
 
 
Finally, rev: what doctors say is not of much consequence. They opposed, in large part, the creation of the NHS in the first place – until their mouths were “stuffed with gold” anyway. They are inherently reactionary like most any profession, when it comes to radical change. They oppose open patient records, accountability, management of any sort, you name it.
 

tartanfever

Brilliant bc, what about the thousands that currently work for the NHS that will lose their jobs because of private sector reform and then have to go on the dole and then start claiming benefits – if there are any benefits left by then. How does that work in with your great streamlining process ? Great business model that.
It’s simple, you introduce privatisation – you introduce profit. They go hand in hand. You only have to look at the every single public body that has now been sold off to see what a complete shambles the country is in – and  the politicians are completely unaccountable and in the pockets of these companies.
Look at education, do you ever think university tuition fees will be dropped in England ? Of course they won’t, not ever, regardless of how well the economy is doing. The’ve been introduced and accepted, they’re now part of life – that will never change.
There’s a lot to be said in praise of inefficient public / nationalised infrastructure, not least the idea of community, identity and sharing and having a bloody job. This of course, does not figure in your argument though, so I can only presume you don’t care about such matters.

Ghengis

List of countries by total health expenditure (PPP) per capita 2010, 2009
UK spends less
So you spend more you might get a better service, unless it’s privatised, because private provision always ends up costing more for less
 
 
 
 

Patrick Roden

I work for the NHS (in the field of Mental Health) ‘seconded’ to Social Services in a large English city. I looked into starting my own business as It was being promoted within the NHS. I had a number of meetings with various people, all paid for by the government.
it quickly became clear that listening to people who were already running these businesses that the cheaper option, was the desired option.
One unreported fact is this: each disabled person would be offered a ‘personal budget’ instead of being refered to existing NHS / Social Services providers. This is promoted as giving the individual personal choice and independance. So what is accually happening is disabled people are being given say £25 an hour and offered say 4 hours worth of service per week. they can use this money to purchase any service from any provider they choose, (sounds good) So perhaps this disabled person needs help to go shoping for an hour per week, they also need someone to come to their house and help with medication bathing etc for another two hours, the other hour they may get taken to hospital/doctor appointments or other treatment, (so far so good) so along comes the service provider who gets £25 per hour, but another provider offers the same service to the fundholder for say £15 per hour, great you may say this means that instead of only having 4 hours support at £25 per hour the disabled person cab enjoy 7 hours of support at £15 per hour (this is working great, isn’t it ?)
I’m afraid not, what is happening is when the person offers to do the work for £15 the disabled persond budget gets cut to 4 x £15 and what has happend is that most ‘Micro Services’ are now working for £10 per hour.
Guess how good a service you get for £10 per hour ?
They are serious about privatisation folks, have no doubts about that !

bc

@tartanhero That’s an ideological response on the “privatisation = bad, public = good” side. Why don’t you go to continental europe and ask them if they like their health care systems?
 
It is to be regretted that “efficiency” usually means people losing their jobs, but you can use that argument against any change at all, including the institution of the NHS itself in the first place.
 
Anyway, things are getting a bit derailed here. I don’t recall hanging up a sign saying “Conservative Health Policy Defence” – I am rather sceptical of the policy myself for any number of reasons – but those reasons just don’t reach the hysterical and self serving heights of “oh no, we’re totally going to have a US style health care system and the poors will be dying if they don’t have insurance within the decade” or “If Scotland doesn’t vote for independence, the NHS will completely die!!!”
 
@rev The Telegraph article says there will be Barnett consequentials because of cuts. It doesn’t say there will be Barnett consequentials because of privatisation. If privatisation as not happening down south, the cuts would be happening anyway.
 
While it is certainly true to say that the Scottish NHS will be affected by budget decisions down south, and have funding problems, and yes that this is one argument for higher taxes whether delivered in or out of the union – it is hyperbole to state that the NHS in Scotland is facing an existential crisis because of privatisation directly. Privatisation is neither here nor there. It is the actual funding that matters.
 
Incidentally, I rather think this privatisation down south will be interesting. In ten years time, we will know whether moving the NHS to a franco-german model is worth it – if it delivers better patient outcomes and value for money. If politicians in Scotland are open minded, they can then choose whether to follow suit or not, with the unusual advantage of solid data. It is rare that two closely similar, huge public systems move in different directions – something of an empirical laboratory experiment is taking place, which is strange in public policy.

muttley79

We will not have a chance to wait ten years though.  The Barnett formula means this is not possible.

pmcrek

bc,
We actually spend markedly less per capita on healthcare than either France or Germany do.
 
link to en.wikipedia.org
 
 
 
 

bc

@pmcrek It is very intereresting – the NHS does seem to be very efficient. Of course, it may be that they spend more money and get better health care as a result in France and Germany, rather than the excess being wasted.
 
But I certainly get the impression that the tory government is coming up with this policy based on pure ideology – that the private sector is always better and more efficient, end of. To venture into paranoid territory, I also wonder about tory connections to big businesses that will benefit from this change.
 
 

Scott Minto (Aka Sneekyboy)

@Bc
“In ten years time, we will know whether moving the NHS to a franco-german model is worth it”
 
AND IF ITS NOT… THERE WILL BE NO GOING BACK!
 
The NHS is a superb service and deserves better than being a 10 year experiment that results in the changes made being PERMANENT regardless of whether or not they are far worse than what we currently have!
 
If you believe that opening up the NHS ot private providers and structuring it in such a way (deliberately) that coincides with how insurance systems are set up then you are blind, ignorant or willfully wishing the demise of this institution.

Scott Minto (Aka Sneekyboy)

@Bc
“this is one argument for higher taxes whether delivered in or out of the union”
 
We already looked at this. There are only so many ways that a Scottish government could find for ‘Bridging the Funding Gap’ if we stay in the UK.

Morag

pmcrek said:
We actually spend markedly less per capita on healthcare than either France or Germany do.

That’s just the point, isn’t it?  The NHS is already one of the less costly systems.  France and Germany already cost more, so if they are better that may be why.  Is Cameron planning to spend more to bring England up to their standards?  I don’t think so!

The US system is the most costly of any in the world – twice the cost of the NHS.  And yet outcomes are slightly poorer than in Britain.  The bulk of the effect of the US system is to pump money into the pockets of people running healthcare-related businesses, and pay for the hugely inefficient paper-pushing bureaucracy involved.

Is that what we want?

Malcolm

There is nothing paranoid about wondering about MP and Lord connections to healthcare business. That is what it is all about.

pmcrek

@bc
It is certainly hard to measure accurately, both Germany and France for example do have slightly higher life expectancy than the UK, however, considering the UK is also the fourth most unequal democracy in the world its not much of a leap of faith to consider that it is the efficiency of the NHS which is keeping the difference down to only a year or two.

rabb

bc,
You really are quite short sighted.
 
Before I proceed it is worth noting that the NHS is THE biggest healthcare provider in the UK bar none. It has almost the same amount of employees in the UK as McDonalds has on the entire planet (source).
 
One of the reasons i read for the changes was to allow the NHS to leverage on efficiencies in the private sector.
 
The private sector is in the game to make money. That’s why they exist. They aren’t ‘Not for profit’ or charitable organistations. They are they’re to turn a profit.

This is where it all goes south for me. In order to maximise revenue, these companies will inevitably cut corners in order to be competitive and retain profit. That’s what they do.
 
Mark my words everyone. The horrors in Staffordshire will spread accross the English NHS as the private sector gets hold of services and cuts service for profit and competitive edge.

The hardworking doctors, nurses, and other healthcare professionals in the NHS will be wrongly tagged with the blame and villified when tory tinkering goes tits up!
 
I will repeat it again. You can put lipstick on this pig but it’s still a pig!

The NHS down south is being put into the hands of private enterprise. This is THE REAL race to the bottom so trumpeted by politicians.
 
As these savings feed back in to Westminster the Barnett formula will dictate simillar cuts to Scotland’s block grant. FACT!
 
Again to the undecided’s. It’s independence or bust!!
 
And in response to another point made by bc. I have no source (I think it may have been the BBC surprisingly) but I heard a German politician saying that the NHS in the UK was the envy of his people. Unfortunately for them he said that they had missed the opportunity to model theirs on it. It is a regret now.
Like I say I heard it mentioned but have no concrete source.
 
 

Scott Minto (Aka Sneekyboy)

@Bc
 
You say that there is no proof that the Tories intend to fully privatise the NHS, that what they privatise will still be state funded and that worrying that they intend to charge the public directly is “hysterical and self serving heights“.
 
But lets look at another situation where you can judge a LIKELY outcome based on what evidence is there beforehand. For instance, if the police were to find someone loitering in the bushes outside a womans house with house breaking kit, rope, duct tape, chloroform, a picture of the woman, and a knife. Would they conclude that he was up to no good or would that also be a “hysterical” reaction on their part since he would have at that point have done nothing wrong?
 
Its not really a theoretical question since thats essentially what happened to the men plotting to kill Joss Stone… You dont wait for them to do it if you can see what they are up to!
 
The NHS is no different. They are forcing privatisation into the NHS against the wishes of patients, doctors and experts in not only healthcare but public finance.
 
The Health Secretary Jeremy Hunt (the man in charge of these “reforms”) co-authored a book in which he called for the de-nationalisation of the NHS and the creation of a USA style insurance scheme where ‘patients pay into their individual pots and decide how to spend it’
 
So given that they are setting up the NHS in England to be compatible with an insurance style system, and the man making the changes has said he wants to privatise the NHS and move it to a USA style insurance system does that not make you think that maybe they are putting in the groundwork for ending the NHS free at the point of need???
 
 

muttley79
BillyBigbaws

bc said : “In ten years time, we will know whether moving the NHS to a franco-german model is worth it”

It’s going to cost us a lot. Germany in particular spends a much larger slice of it’s GDP on healthcare than the UK does – because private provision is more expensive. we know it’s not about saving money, it’s about moving large amounts of public money into private hands.

Th major shareholders in Circle Health donated hundreds of thousands of pounds between them to the Conservative Party. Then their company was awarded a 10 billion pound contract by the Conservative govermnment, and we can’t get rid of them for fifteen years. It’s not even complicated, or hidden.

pmcrek

Morag
Certainly agree, even sub contracting to the private sector something seemingly innocious as janitorial services ended up costing lives. While healthcare provision in France and Germany is certainly efficient and effective (especially France) there are half the number of people living below the national poverty line in France than the UK, I think its clear that the NHS does an exceptional job in comparison.
I would also propose that what Tory and Labour are currently doing in England has very little to do with providing French style healthcare and more to do with making money like US style healthcare.

beachthistle

The BBC’s complicity in keeping the public in England and Wales in the dark about the NHS changes (until it was too late, after all had been decided when they reported tokenistically re criticism and opposition so that if they are audited in the future they can point to the number of time they were honest/critical about it) is part of the BBC’s great plan/mission/mandate to deliver a 2 (to the right of centre) party ‘UK’  to the London City State Establishment. Look at where Blair, (ex-BBC DG) Thompson, Milliband et al have ended up…in the 2 pro-corporate party motherland, the US.
The ONLY political threat to this ‘project’ is Scottish Independence – risking both the diminutionof the size of the ‘UK’/London City State hinterland (including the loss of vital oil revenue) plus the (perhaps more important for them) addition of another political party/entity (which to add to their chagrin is unlikely to be right of centre).
That this tame 2 party state is what the BBC has been mandated and is funded to deliver is the main reason the IndyRef  ‘balance’ gloves are off and why BBC Scotland is being allowed ‘untouchable’ status – and also why it is chronically and painfully pro-Labour. So its not just an anti-Scottish thing – so we should not take it personally – but we should certainly take it on politically – for instance inviting neutral international media monitors as Craig Murray suggested a few weeks ago…

CameronB

@ bc
Sorry to go on at you, but how is this for an argument against privatisation of the NHS, as with any public utility? DEMOCRATIC ACCOUNTABILITY & PUBLIC BENEFIT.
 
These may seem like abstract luxuries in these austere times, though hopefully not. It may be argued that the NHS will retain budgetary control over the conduct of care providers, though I do not see how this is at all possible. Herding cats would appear a more realistic task. It is, however, something the NHS already does with regard to itself. A different herd of cats, but in a sack this time. Why impose outside contracting, which can not hope to avoid incurring unnecessary additional bureaucracy and cost? How is this efficient?
 
As has been said previously, the NHS does appear to deliver remarkable results for the meager funding provided. Hopefully Scotland’s future NHS will continue to deliver a high quality service, under the democratically accountable supervision of the Scottish government. As such, control over this enormous public budget is retained by the Scottish public, for the public benefit. Imagination is our only limit to what mechanisms we might employ and how well we might choose to fund it.
 
As you say, the Tory ideology is to ensure the transfer of public funds to benefit private business. This is not the function of government, it is the action of crooks…..oh, and blue Labour.
 
Vote Yes in 2014.
 

thejourneyman

Thank goodness for WOS. Having just read the article, comments and explored many of the links I am not only more informed but have also had an education in the health service of Scotland in the process. The piece in early December was very informative and liberating. (Also very interesting that in one of the comments to that piece one reader shared their experience of reading comments from local coucillors / MSps /MP in the free local newsletter. The jist was that only the SNP representative used the opportunity to warn of cuts coming in April 2013, particularly the Bedroom Tax). It does give me the feeling that history will tell a very powerful story about how Scotland won back it’s Independence and in the longer term the good it did for an even bigger cause!
VOTE YES!


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