Jeffs posts
Visiting our local health centre the other day, my parents, along with the other local people enrolled there, were handed a letter, explaining that due to funding cuts the health centre was having to cut back on services. It also advised its patients that if they wanted to raise their concerns about the restriction in their service they could contact:-
1. NHS England at FAO Linda Prosser, Director of Assurance and Delivery, NHS England South West (BNSSG), 4th floor Plaza, Marlborough Street, Bristol BS1 3NX
2. your local MP at the House of Commons, Westminster, London SW1A 0AA
Unfortunately, this is happening to the NHS and GPs’ services all over the country. It is no accident, and it is certainly not the fault of the many dedicated doctors, nurses and other health professionals working in the NHS.
It is the result of over 30 years of privatisation begun with Margaret Thatcher. Thatcher and her former Chancellor, Nigel Lawson, denied that they wanted to privatise the NHS. They merely stated that they wanted to include more private provision in the NHS. This is a lie. Released cabinet minutes showed that Thatcher and Geoffrey Howe wanted to privatise the NHS along with abolishing the rest of the welfare state. They were only prevented from doing so because the rest of the cabinet realised that this would be the death knell for the Tory party. And a fact-finding mission to the US to see how their private healthcare system worked by Patrick Jenkin showed that it was massively inefficient.
Nevertheless, the amount of private healthcare in the NHS was expanded, and state provision duly cut by successive governments. It was Maggie’s government in 1989 that ended the state support for care for the elderly in nursing homes. As a result, the families of those, who need this kind of care, are forced to fund it themselves, often through selling or remortgaging their homes because of the immense expense. It was also Maggie’s government that ended free eye tests, and picked a feud with the doctors that saw the majority of them leave the NHS.
This privatisation has continued under Tony Blair, Gordon Brown and now David Cameron and Jeremy Hunt. Blair and Brown were deeply impressed with American private healthcare firms such as Kaiser Permanente, and wished to reform the NHS on their model. The ultimate intention was to replace the publicly owned and operated NHS with private healthcare funded by the state, but administered by private health insurance companies. As a result, NHS work has been given to private hospitals and clinics, and private healthcare companies have been given NHS hospitals to manage. Alan Milburn, Blair’s health secretary, wanted the NHS to become merely a kitemark – an advertising logo – on a system of private healthcare companies funded by the government.
This has been carried on the current Conservative government. And they have used the same tactics Margaret Thatcher did to force private healthcare on this nation. The dispute with the doctors over contracts a few years ago was part of this. It has left the majority of NHS GPs wishing to leave. Yet elements within the Conservative networks responsible for foisting these demands have seen this as an opportunity for forcing through further privatisation. Penny Dash, of the National Leadership Network, and one of those responsible for the NHS privatisation, has looked forward to the remaining GPs forming private healthcare companies. Furthermore, an report on the Care Commissioning Groups now in charge of arranging healthcare in the NHS by one of the private healthcare companies also suggested that they could form private healthcare companies, and float shares on the stockmarket.
Further privatisation has come with Andrew Lansley’s Health and Social Care bill of 2012. This exempts the state and the Secretary of State for Health from their statutory duty, as the ultimate leaders of the NHS, to provide state health care. It is carefully worded to disguise its true meaning, but that is what has been intended by the bill. Dr David Owen, one of the founders of the SDP, now part of the Lib Dems, has tabled amendments trying to reverse this despicable bill. He and many others have also written books on the privatisation of the NHS. One of the best of these is NHS SOS, by Jacky Davis and Raymond Tallis, published by Oneworld.
This process cannot be allowed to continue, and I strongly urge everyone to resist the creeping privatisation of the NHS, Britain’s greatest public institution.
In the last government, there were 92 Conservative and Lib Dem ministers, who advocated the privatisation of the Health Service, and who stood personally to gain from it. They included Iain Duncan Smith, the minister for culling the poor, the sick and the old. Andrew Lansley, the health minister, openly stated he is in favour of privatising it. So has Nigel Farage, and the Unterkippergruppenfuhrer, Paul Nuttall.
Farage in particular follows the Tory policy going all the way back to Thatcher of promising to defend it while secretly plotting how to sell it off. Thatcher 's review into the NHS and its funding in the 1980s. so alarmed Labour’s Robin Cook, that he wrote a Fabian pamphlet, Life Begins at 40: In Defence of the NHS, attacking possible proposals to privatise the Health Service.
Previous reviews had given the NHS a clean bill of health. The extremely high quality of the NHS and its doctors was recognised by the heads of American healthcare firms: Dr Marvin Goldberg, chief executive of the AMI health group, told a parliamentary select committee that the Health Service Provides ‘outstanding health care and British NHS hospitals are at least as good as those in America while British doctors are better.’
The then Conservative MP for Newbury, Michael McNair-Wilson, also testified to the effectiveness of the NHS. He had suffered kidney failure. He had private health insurance, but it did not cover operations such as the one he needed because of the expense. He said ‘I have cost the NHS tens of thousands of pounds – much more than I could have afforded privately … Had my treatment depended on my ability to pay, I would not be alive today.’
Pre-NHS Britain: Some Areas Completely Without Hospitals
Cook’s pamphlet also graphically described the patchwork state of healthcare in Britain before the NHS. In London, where there were plenty of paying customers, there could be hospitals in neighbouring streets. Out in the poorer British provinces, there were hardly any, and many operations were carried out not by surgeons but by GPs. He cites Julian Tudor Hart’s book, A New Kind of Doctor, to show how bad this could be. Hart described how he joined one of those practices in Kettering. One patient was left under anaesthetic as the London specialist operating on him was called away to continue a stomach operation on a London patient, which the operating GP had been unable to complete.
Cook was deeply concerned that the Tories’ review would not be at all interested in improving quality, only in opening up the NHS to the market and privatisation.
Cook on Private Health Insurance
One of the issues he tackled in the pamphlet was the possibility of the introduction of private health insurance. This covers two pages and a column and a bit in the original pamphlet. This is what he wrote, though emphases and paragraph titles are mine.
The mechanism proposed to square the incompatibility of health care with the market is insurance. All market approaches to the NHS submitted to the Review stress the case for much wider private insurance and almost as frequently propose subsidies to boost it.
Insurance-Based Systems Encourage Expensive Treatment
The first thing to be said is that private insurance does not offer
to health care the alleged benefits of the discipline of the market place. At the point when the individual requires treatment he or she has already paid the premiums and has no incentive not to consume as expensive a treatment as can be reconciled with the policy. The position of the doctor is even more prejudiced in that he or she has every incentive to obtain as much as possible from the insurance company by recommending the most expensive treatment. Both patient and the doctor are in a conspiracy to make the consultation as costly as possible, which is a perverse outcome for a proposal frequently floated by those who claim to be concerned about cost control.
Insurance-Based Systems Encourage Unnecessary Surgery
The compulsion in an insurance-based system to maximise the rate of return is the simple explanation why intervention surgery is so much more often recommended in the United States. For example, the incidence of hysterectomy there is four times the British rate. This is unlikely to reflect higher morbidity rates but much more likely to reflect the greater willingness of doctors on a piece-work basis to recommend it, despite the operative risks and in the case of this particular operation the documented psychological trauma. I can guarantee that an expansion of private insurance will certainly meet the objective on increasing expenditure on health care, but it is not equally clear that the money will be spent effectively.
Insurance-Based Systems Require Expensive bureaucracy to Check Costs
One direct diversion of resources imposed by any insurance-based scheme is the necessity for accountants and clerks and lawyers to assess costs and process claims. The NHS is routinely accused of excessive bureaucracy, frequently I regret to say by the very people who work within it and are in a position to know it is not true. Expenditure in the NHS is lower as a proportion of budget than the health system of any other nation, lower as a proportion of turnover
than the private health sector within Britain, and come to that, lower than the management costs of just about any other major enterprise inside or outside the public sector. I am not myself sure that this is a feature of which we should be proud. ON the contrary it is evidence of a persistent undermanaging of the NHS, which is largely responsible for its failure to exploit new developments in communication, cost control and personnel relations. Nevertheless, there is no more pointless expansion of administrative costs than the dead-weight of those required to police and process and insurance-based system. These costs would be considerable.
Forty per cent of personal bankruptcies in the US are attributable to debts for medical care
Part of this additional cost burden is incurred in the task of hunting down bad debts, which does not contribute in any way to the provision of health care. Forty per cent of personal bankruptcies in the US are attributable to debts for medical care, a salutary reminder of the limitations set to insurance cover. These limitations have three dimensions.
Insurance Cover Excludes Chronic and Long-Term Sick, and the Elderly
First, insurance cover generally excludes those conditions which are chronic and therefore expensive or complicated and therefore expensive. Standard exclusions in British insurance policies are arthritis, renal dialysis, multiple sclerosis or muscular dystrophy. Most people do not require substantial medical care until after retirement. Most insurance cover excludes the very conditions for which they are then most likely to require treatment. Short of retirement, the most expensive health care required by the majority of the population is maternity care, which is also excluded by the majority of insurance policies.
Private Healthcare Limits Amount of Care due to Cost, not Need
Secondly, insurance cover is generally restricted by upper limits which are arbitrary in every sense other than financial. I recently met a psychiatric consultant to a private clinic, who was prepared to discuss candidly the ethical dilemmas of treating patients whose financial cover is fixed at five weeks of residential care, but whose response to treatment may indicate that a longer period of hospitalisation is desirable.
Private Health Care Geared to Selling to Healthy not Sick
Thirdly, insurance cover is further limited by exclusion of those most likely to claim on it. I am often struck at the sheer healthiness of the patients who illustrate the promotional literature of BUPA and PPP who appear in such pink of good cheer and fitness that it is difficult to figure out why they are in a hospital bed. These models are though in a sense most suitable for the purpose as the objective of insurance companies is to attract the healthy. They therefore claim the right to screen for the unhealthy and reject them from cover. This discriminatory approach was defended earlier this month by the managing director of WPA, Britain’s third biggest health insurer, on the principled grounds that it meant ‘essentially healthy people are not penalised by unhealthy people.’ This statement has the advantage of originality in that it perceives healthy people as the vulnerable group and proposes a market remedy that protects them from the inconvenient costs of the unhealthy.
Given this limited character of health insurance in Britain, the private sector is patently not in a position to substitute for the NHS and to be fair most directors of BUPA or PPP would be horrified at the notion of accepting the comprehensive, open-ended liabilities of the NHS. It is therefore perplexing that so much effort in and around the Review appears to be addressed to the issue of how the private sector may be expanded rather than how the public sector may be improved. Two major devices are being canvassed to boost private cover-tax relief on private cover or opt-out from public cover, or for all I know both of them together. Both would be a major mistake.
Tax Relief on Private Healthcare
Tax relief is open to the obvious objection that it targets help most on those who need it least – the healthy who are most likely to be accepted for private cover and the wealthy whose higher tax rates make relief most vulnerable. These are curious priorities for additional health expenditure.
Tax Relief Does Not Create Higher Spending on Health Care
Moreover, even in its own terms of stimulating higher spending on health, tax relief is likely to prove an ineffective mechanism. If for example the average premium is £200 pa the cost of tax relief for 6 million insured persons will be £300 million. The numbers under insurance need to increase by a third before the increased spending on premiums matches the cost of the subsidy and provides any net increase in health spending. Up to that point it will always produce a larger rise in health spending to increase the budget of the NHS by a sum equivalent to the cost of tax relief.
It is apparently being mooted that these objections could be circumvented by limiting the tax relief to the elderly. At this point the proposal moves from the perverse to the eccentric. This restriction targets help for private insurance on the very group for whom private cover is most inappropriate as their most likely health needs are the ones most likely to be excluded from cover. Only a moment’s reflection is required on the multiple ways in which we need to expand our health provision for the elderly to expose the hopeless irrelevance of tax relief as the solution for them.
Opt-Out Penalises those who Remain in the System
Opt-out is even more objectionable. The basic problem with opt-out is that it requires the payment towards the NHS of every individual to be expressed in a manner that gives him or her something to opt-out from. The principal attraction to Leon Brittan of his proposal for an NHS insurance contribution appeared to be precisely that it paved the way for opting out (A New Deal for Health Care, Conservative Political Centre,, 1988). Nor is this inconvenience confined to the need for a whole new element in the tax system. If one in ten of the population chose to opt out, it would be remaining nine out of ten who would have to prove they were not opted-out when they went along to seek treatment. With the new contributions comes a requirement to maintain a record of payment of them, and presumably a mechanism for credits to those not in work but who do not wish to be counted has having opted out of the NHS.
Private Healthcare Undermine NHS as Universal System
The more fundamental objection both these proposals is they explicitly threaten the NHS as universal health service catering for everyone. Moreover, they threaten its universality in the worst possible way, by encouraging those with higher incomes and lower health needs to get out, leaving behind the less affluent and the less fit. In this respect such an approach to the NHS would be a piece with the Government’s strategy of erosion towards the rest of the social services-housing, pensions, and now education, where the Government has encouraged those who could afford it to opt-out of public provision, leaving behind the poor who could be expected to put6 up with a poor service.
This is the reality of the private healthcare system which Cameron, Clegg, Farage and the rest of the Right wish to introduce. It is expensive, bureaucratic, does not stimulating further spending, and excludes those with the most acute and expensive medical need, especially the elderly.
And the Tories and their counterparts in UKIP and the Lib Dems know it. Why else would the Tories spend their time trying to deny what they’re doing? Why does Farage appear to be advocating retaining the NHS, while arguing for an insurance based system, like America? It’s because they know that private medicine does not provide the solutions they claim. It is only source of further enrichment to them and their corporate donors.
And since Cook wrote that pamphlet, more than 20 per cent of all Americans can no longer afford their healthcare. It’s why the firms are trying to get their feet under the table over here. Don’t let them. Ed Miliband and now Jeremy Corbyn have promised to reverse the privatisation of the NHS. Please support them.
Posted by jeffrey davies [86.17.83.77] on 08 June 2017
reply | edit & publish | delete
torys
Everyone’s talking about terrorism and which party will defend our national security this week. For obvious reasons.
Here’s the thing: I’m not terrified of terrorists at all. What I am terrified of, is Tories.
So far in 2017, just over 30 people have been killed by terrorists in Britain. It’s 30-odd people too many of course, but the number is reasonably small compared to this next figure.
In 2015, 30,000 people were killed by austerity (Oxford University, 2017). That’s not the total number who’ve died since the Conservatives came to power; that’s just for one year: 2015.
That’s a thousand times as many deaths.
You are far more likely to be killed by cuts to health and social care than you are by terrorists. It’s this government you should be terrified of.
Over the next five years, it could be someone you love who dies because they couldn’t get their medical treatment in time. It could even be you.
Remember this isn’t some dodgy thinktank or an unreliable blogger who did this research: It was Oxford University.
30000 x 7 yrs 210000 killed by government under their austerity measures makes you think
Posted by jeffrey davies on 08 June 2017
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nhs and the torys
/stop-the-plans-to-dismantle-our-nhs
This is a really important thing to do, because the stakes have never been higher.
Following the financial crash caused by the irresponsibility of the banks, governments were wanting to cut spending. They discussed the issue at the World Economic Forum (WEF) in Davos in 2012.
I remember the TV coverage of people gliding in on their own private jets.The WEF comprises Governments, the top 1000 Transnational Companies and Media owners. This is where the transnational capitalist class does its work
of extending the influence of global corporations. At that time Simon Stevens, now the boss of the NHS, worked for the biggest US health multinational insurance company UnitedHealth. Two WEF reports were written. The second
report, entitled 'Sustainable Health Systems: Visions, Strategies, Critical Uncertainties and Scenarios(2)', examined "structural scenarios of the future which could be used to inform present-day thinking*". 'Sustainability', code for
cuts, must be achieved through transforming supply. The report went on to outline exactly the type of changes we see in the Five Year Forward View, of which the STPs are a huge element. At that time Simon Stevens himself, was
head of UnitedHealth’s Global Division, and acted as Project Steward of the Steering Board for the first World Economic Forum report. So he stewarded the first report and is implementing proposals from the second, in England.
Not only that but West Yorkshire STP lead Rob Webster was a workshop participant there. Amanda Doyle, STP lead for Cumbria was another.
Simon Stevens was recruited by the Coalition, directly from United Health in 2013 to dismantle the English health service. United Health has been aquiring contracts under the NHS logo with its English name Optum. Already one
area has Optum as both Commissioning Support and 'provider of services.' What conflicts of interest are there? The councils do not have a veto, whether they subscribe to the STP plans or not. This was revealed in the House in
response to a question by Jusitn Madders MP. The public have not been consulted, nor have they voted on any of this. Please share the petition, in whatever way you can.
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fracking
Fracking in America generated 280bn US gallons of toxic waste water last year – enough to flood all of Washington DC beneath a 22ft deep toxic lagoon, a new report out on Thursday found.
The report from campaign group Environment America said America's transformation into an energy superpower was exacting growing costs on the environment.
"Our analysis shows that damage from fracking is widespread and occurs on a scale unimagined just a few years ago," the report, Fracking by the Numbers, said.
The full extent of the damage posed by fracking to air and water quality had yet to emerge, the report said.
But it concluded: "Even the limited data that are currently available, however, paint an increasingly clear picture of the damage that fracking has done to our environment and health."
A number of recent studies have highlighted the negative consequences of horizontal drilling and hydraulic fracturing, which have unlocked vast reservoirs of oil and natural gas from rock formations.
There have been instances of contaminated wells and streams, as well as evidence of methane releases along the production chain.
The Environment America report highlights another growing area of concern – the safe disposal of the billions of gallons of waste water that are returned to the surface along with oil and gas when walls are fracked.
The authors said they relied on data from industry and state environmental regulators to compile their report.
More than 80,000 wells have been drilled or permitted in 17 states since 2005.
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It can take 2m to 9m gallons of water mixed with sand and chemicals to frack a single well. The report said the drilling industry had used 250bn gallons of fresh water since 2005. Much of that returns to the surface, however, along with naturally occurring radium and bromides, and concerns are growing about those effects on the environment.
A study published this week by researchers at Duke University found new evidence of radiation risks from drilling waste water. The researchers said sediment samples collected downstream from a treatment plant in western Pennsylvania showed radium concentrations 200 times above normal.
The Environment America study said waste water pits have been known to fail, such as in New Mexico where there were more than 420 instances of contamination, and that treatment plants were not entirely effective.
"Fracking waste-water discharged at treatment plants can cause a different problem for drinking water: when bromide in the wastewater mixes with chlorine (often used at drinking water treatment plants), it produces trihalomethanes, chemicals that cause cancer and increase the risk of reproductive or developmental health problems," the report said.
About 260bn US gallons of the 280bn US gallons of toxic waste water were from Texas, a state that has undergone three years of severe drought and where there is fierce competition for water between the oil industry and farmers and ranchers.
Environment America said that water was now taken out of the supply and that storing, transporting and even recycling the toxic waste carried environmental risks. ""They say a lot of it is recycled. It is still 280bn gallons of toxic waste generated that is running through our communities," said John Rumpler, author of the report.
Spokespersons for Energy in Depth, the industry lobby group, disputed the findings as "alarmist:" and "meaningless".
"Number is meaningless unless they're alleging something is happening with it, ie ending up in tap water," Steve Everley, the lead spokesman for the lobby group said on Twitter.
Other consequences of fracking highlighted in the report included: 450,000 tons of air pollution a year and 100m metric tons of global warming pollution since 2005.
Posted by jeffrey davies on 05 June 2017
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The SKWAWKBOX wanted to remain silent until this evening out of respect for the victims of last night’s terror atrocity and our hearts go out to those affected and their families.
But information that has come to light – and Theresa May’s clear attempt to politicise events – mean that it would be a dereliction of this blog’s purpose and duty to wait.
Theresa May this morning attempted to blame ‘too much tolerance’ for the attacks last night, in Manchester and on Westminster Bridge and is clearly positioning herself to exploit them in order to restrict civil liberties. A separate article will address her speech in detail.
But as broadcaster Paul Lewis highlighted this morning, May has blocked publication of a report into the funding of terrorism until at least after the election and possibly permanently – because it allegedly focuses on the central role of Saudi Arabia:
Yesterday, before the terror attacks, Home Secretary Amber Rudd appeared at a hustings in Rye with other candidates as part of the contest for the Hastings and Rye seat she occupied as Tory MP until Parliament was dissolved. Rudd faces a challenge by Nicholas Wilson, a man who has spent over a decade campaigning on the issue of alleged corruption involvement banks and the Tories.
Shockingly, Rudd – who, along with May, talks freely of the hatred terrorists hold for Western democracy – attempted to block democratic processes during the hustings by asking the chair to censor her opponents comments about her alleged political and financial links and actions in Saudi Arabia.
And the whole thing was captured on video:
Rudd can clearly be seen scribbling a note as the allegations come out and passing it to the chair, who rings a bell to interrupt and then even attempts to take the microphone away from Wilson – to outrage from the crowd.
The Tories are firm supporters of Saudi Arabia and of Britain’s financial and trade links with that Kingdom. They are very keen to prevent the public hearing about Saudi Arabia’s reported links to ISIS.
And Ms Rudd is clearly very keen to prevent voters in Hastings and Rye hearing about them.
All while Theresa May positions for an assault on our civil liberties, using as a reason attacks by terrorists connected to the same group a report claims the Saudis support.
Posted by jeffrey davies on 05 June 2017
