By Kam Sandhu @KamBass
As part of the ‘Five Year Forward Plan’ being implemented by Simon Stevens, Head of NHS England, the health service is being split into 44 regions. Sustainability and Transformation Plans (STPs) are bringing in covert and controversial cuts through their framework according to researchers and campaigners. How are they being implemented? What changes are taking place at a local level?
We spoke to Madeleine Dickens, Sussex Defends the NHS, about unaccountable boards, secrecy and the coming effects of the plans in Part One of our interview which you can read here.
Now we talk about the presence of US companies, Data capture and the media.
It was the appointment of Simon Stevens to head of NHS England which really set things in motion. Simon Stevens was a senior manager at United Health in the states, and his appointment clearly indicated the direction of travel that they wanted to go. NHS England has been driving the whole thing on the instruction of the government.
United Health has been sued countless times, and yet these are the companies we are using to put our NHS into a US style system.
There was a flurry a few weeks ago and the NHS was never out of the news. It was absolutely everywhere, and we thought this won’t last. They were addressing some of the issues, and they were rightly outraged, and right to generate outrage, but then it disappeared. It was no longer flavour of the month.
Everyone is banging on about funding, and that is important – the NHS underwent £20bn in cuts up to 2015 when lots of hospital beds were taken away. We’re now into another round of cuts which STPs aim to implement and we’re talking about £22bn more in cuts. I am not saying funding is not important, we are the second lowest in the G7 countries for expenditure on healthcare and it’s going down in terms of international comparison.
But no one talks about privatisation which is a much bigger danger. No one talk about the involvement of all the US companies, which is again the bigger danger. No one talks about the utter fragmentation of services or the fact that health workers wages are being held down by 15% and health workers are using food banks – no one is talking about any of those issues which is as serious as lack of funding.
In our recent investigation we talked about United Health and Optum, and their presence here in the UK. What kind of experiences have you had with them locally?
Optum were brought in under Brighton integrated services, so again appeared out of nowhere, they came in about a year ago. There was a meeting which was so explosive it was reported on in the local press and GPs were absolutely disgusted with the chaos being generated when Optum came in; people not getting appointments, people getting dropped off lists, people being called by private companies and all those sorts of issues and the GPs were absolutely furious.
Since then, everything has gone quiet, and things have settled down but anecdotally we know people are still being phoned by private companies, we know people are being dropped off lists – it happened to someone in our group, that was for cancer. She was dropped off the list and she had to fight to get back on it.
We’ve just done a survey to all local GP surgeries. We have had 56 responses which is staggering out of about 120 – we haven’t yet processed those but I suspect there will be a lot about Optum – we asked about private sector companies and their experiences of them. That’s coming.
How do you feel about Simon Stevens, his appointment and the potential conflicts of interest?
I have always been sceptical but this government is riding coach and horses through our democracy. On so many levels. The vast majority of MPs know nothing about any of this.
Sarah Wallaston MP did her utmost to get the issues raised. She is a passionate and committed woman I think but there are limitations to how much she is going to be able to do. No one seems to care.
The reason for that is it’s such a toxic issue. There was a survey and it proved it was well over 200 MPs had interests in private healthcare companies. And it included Labour, prominent labour figures like Alan Milburn and Patricia Hewitt and a few others. Right across the board and in the House of Lords too. That is an indication of the extent of collusion with MPs as to what’s happening.
Until Corbyn came in there was virtually no support at all, since then it has got a bit better. Their policy on the NHS is not ideal, but at least it’s there and they would take action against privatisation. They acknowledge privatisation which is a first for Labour.
Things are looking a bit hopeful, but if they do get into government, and that’s a big if, who knows what will happen.
In our investigation we also talked about data capture, what have been your local experiences of this?
As far as I know there’s been quite a lot of staff resistance to data collection, and we have no reports of anyone being charged. Docs Not Cops have been very active in our area.
What do you think the data capture is for?
A couple of years ago there was a whole thing about patient confidentiality and the government was proposing that all patient data should be made available on request and that’s important for sharing information between hospitals. But patients were required to opt out of their data being transferred. Loads of people did that but then found their data had been transferred. Now obviously in the NHS, the intention is to make that data available to private healthcare companies. The more private involvement you have, and we’re looking at £16bn worth of NHS services which have been privatised and more is being privatised all the time, the easier this is. Just in Manchester they put out £6bn worth of contracts to tender.
So you’re talking about rapidly accelerating privatisation of the NHS anyway. Once the private sector get their hands on this data, God knows what will happen to it. And they are getting their hands on it. We don’t know yet about the specifics of it, but you’re talking about massive abuses of citizen rights and all this again completely under the radar.
Are we moving towards a US style healthcare insurance system?
Course we are. There’s absolutely not one iota of doubt about that.
The key organisations are the Accountable Care Organisations (ACOs). The big companies involved in US healthcare, they use Accountable Care organisations. Now those are private health insurance based set-ups to deliver care.
There are various types of ACO but we know they will be delivering, as it states clearly in the STP, the healthcare in these footprints. The good news is that ACOs are proving unworkable in this country. There was meant to be flagship ACO in Northumberland – the government’s leading light. Everyone was banging on about how wonderful it would be. That’s been withdrawn as unworkable. There was one in Torbay, Devon and people are pulling out if right, left and centre. The reason being, is the government is ramming STPs through and all the changes they propose. There’s been no testing, no attempts to find how workable these are. They are bringing in a one size fits all policy to cut costs and bring in a US style health system. But they are doing this in a context where most people don’t know this is happening. Most of the population are opposed to charging and to private health insurance. Because they are trying to force through ACOs in this context – ACOs rely on the fact they charge massive amounts for services. So they are trying to impose a US style system in a context where people don’t know and are opposed – and they aren’t working.
The data links into the data capture – the technology they are using to charge migrants will be used for everyone.
A lot of what they are doing is chipping away at people’s reluctance about charging and the private sector.
We know GPs are introducing charges for more and more services. There’s a whole softening up happening. And the talk of private health plans where people are given a budget to buy their own healthcare – people who have chronic conditions. I don’t know if you’ve noticed there are more health insurance adverts on the TV. This is a softening up process to lull people into thinking maybe private healthcare isn’t so bad. And that’s so insidious. Their nudge unit is working overtime.
People won’t be noticing yet what they’re doing. We’ve had 7 GP practices closing in Brighton and Hove and quite a few thousand people who don’t have a GP. We have 2 GP practices in a city of 300,000 people taking on patients. There’s a breakdown happening here anyway and STPs are being imposed on that.
All people will notice so far with hospitals is waiting lists, queues – the changes from STPs haven’t come in. We know hospitals will close. Already our hospital trust has been merged with one in west Sussex.
We were given the information by the outgoing head of the CCG who said only 50% of Brighton residents are seen in the Royal Sussex. 50%. Everyone else is sent here, there and everywhere – Private hospitals 12, 15, 20 miles away. I spoke to someone who said I tried to get into Royal Sussex and they sent them 16 miles away. So people will notice that, and they haven’t started closing hospitals but we are a strong campaign they are worried about starting that process.
They are building up for it because they know it will be bedlam. As soon as the government or anyone threatens hospitals that is a touchstone.
You need to say no more than the government is destroying the NHS. They are mutating it to a US style insurance system. There is so much evidence of that it can no longer be misconstrued as a conspiracy theory – it’s happening. They are wrecking the NHS.
It is an engineered shock doctrine – reduce the NHS to chaos, staff are leaving in absolute droves. They are creating chaos and driving NHS workers to despair. Then of course they can say things have to change and we have to get the private sector in to continue.
The trouble is for a lot of people they are not yet seeing it. There’s been massive outcries where they have announced hospital closures. And in Cornwall a few weeks ago, 700 people stormed a building and held the NHS rep hostage until they told them the truth.
It is happening selectively and because they divided it all up, it’s happening in different regions.
It’s a complete and utter stitch up.