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KEEP OUR NHS PUBLIC Fight the White Paper

KEEP OUR NHS PUBLIC Fight the White Paper. Wendy Savage MBBCh(Cantab) FRCOG MSc (Public Health) Hon DSc Co-chair KONP Haringey 22.11.10. Keep Our NHS Public. Launched September 2005 by NHS Consultants Association NHS Support Federation and Health Emergency Website

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KEEP OUR NHS PUBLIC Fight the White Paper

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  1. KEEP OUR NHS PUBLICFight the White Paper Wendy Savage MBBCh(Cantab) FRCOG MSc (Public Health) Hon DSc Co-chair KONP Haringey 22.11.10

  2. KeepOurNHS Public Launched September 2005 by NHS Consultants Association NHS Support Federation and Health Emergency Website www.keepournhspublic.com

  3. Aims of KONP • To build a broad non-party political coalition which will campaign to protect the NHS from further privatisation and fragmentation • To inform the media, public and MPs about the government ‘reforms’ • To keep our NHS public which means publicly provided as well as funded

  4. ‘Equity and Excellence: Liberating the NHS’ ? • Transfer the responsibility for the NHS from the Secretary of State for Health to a new NHS Commissioning Board • Abolish Strategic Health Authorities (SHAs) • Abolish PCTs • Create 500-600 groups of GPs called consortia which would take on the commissioning (purchasing) of services. • They would replace 152 PCTs. They would be responsible for 80% of NHS budget – and have not been trained for this job ?half don’t want it

  5. ‘Liberating the NHS’ ?? • Force all hospitals to become Foundation Trusts (FTs) and encourage them to become employee led social enterprises. • Encourage ‘any willing provider’ • Increase the powers of Monitor (who oversees FTs) as sole economic regulator • Reduce NHS management costs by 45% over the next 4 years. • Estimated cost of re-organisation is £1.7bn in the first year alone (government figures ) up to £3bn (Kings Fund)

  6. ‘Liberating the NHS’ ??? • Strengthen CQC -become effective regulator • ‘We will give every patient the power to choose any health care provider that meets NHS standards withiin NHS prices. This includes independent, voluntary and community sector providers’ Comment from Tribal a private health care firm ‘This white paper could amount to the denationalisation of healthcare services in England and is the most important redirection of the NHS in more than a generation, going further than any Secretary of State has gone before

  7. The effect of the White Paper • Managers will be demoralized, lose their jobs and some, after hefty redundancy, are likely to be re-hired to work for consortia • Consortia must use any willing provider so private companies bid for services cheaply • Consortia fail, taken over by private companies • NHS fragmented reduced to basic backup

  8. Government tactics • Reassuring language-ie liberating, clinicians in charge, patient choice, positive spin • ‘Consultation’ is about ‘how ‘not ‘what’ • Directing PCTs and SHAs to start process of getting rid of managers • Getting their message across as if changes have already happened although no electoral mandate or debate in Parliament

  9. Useful points to remember & use • Remember that FT survey found that 75% of population did not want private sector in NHS • Private companies primary duty is to their shareholders • Cooperation not competition needed in health care • Market costs at least 10 bn a year to operate • Exploit differences between Con Dems

  10. The fight must continue • Efficiency savings can be made by abolishing the market • Evidence is that health care is an unsuitable service for market mechanisms • Increases inequity • Affects the elderly and other most vulnerable • Why should ordinary people pay for the bankers excesses and failure of government regulation of the financial markets?

  11. Lansley’s stated aims • Patient centred approach ‘no decision about me without me’ • Clinicians in charge not managers • Reduced bureaucracy • Improved outcomes measure by PROMs not targets All could be achieved without this massive upheaval

  12. What can we do? • Let MPs know in every constituency that another ‘re-disorganisation’ is the last thing we as citizens or the NHS staff want • Point out that abolishing the market and the purchaser-provider split introduced in 1989 by Kenneth Clarke would save at least £10 billion a year • Join &/or donate to KONP so we can mobilize people via meetings website etc

  13. Market-driven politics • Real markets are deeply political-state omnipresent-national politics and the state always targets-businesses want to enter NHS • Convert services into commodities and workforce into one orientated to profit and get government to underwrite risk. • Market competition transforms commodities • Consequences, inequality of provision, high costs and corruption (eg US health system)

  14. Further reading • Colin Leys Market-driven politics (2001) Verso • Allyson Pollock NHS-plc (2005) Verso • John Lister Health Policy Reform (2005) The NHS after 60:for patients or profits? (2008) • Stewart Player & Colin Leys Confuse and Conceal Merlin Press 2008 • On the Brink Report for BMA London Regional Council by John Lister January 2009 • House of Commons Health Committee (2010) Commissioning. Fourth Report of session 2009-10 • An NHS beyond the Market report of a round table discussion download from www.bma.org.uk

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