'No NHS in England from 2013'. Is there anything we can do to save it?

[Solopower]

'In 2012, parliament in England passed a law effectively ending the NHS by abolishing the 60-year duty on the government to secure and provide healthcare for all. From 2013, there will be no National Health Service in England, and tax funding will increasingly flow to global healthcare corporations. In contrast, Scotland and Wales will continue to have a publicly accountable national health service.

NHS hospitals and services are being sold off or incorporated; land and buildings are being turned over to bankers and equity investors. RBS, Assura, Serco and Carillion, to name but a few, are raking in billions in taxpayer funds for leasing out and part-operating PFI hospitals, community clinics and GP surgeries that we once owned.'

Allyson Pollock in The Guardian.

Well I'm scared. Life is going to get so much harder for the vast majority of us. I'm grateful to people like Pollock and Dr Mark Porter for trying to alert us to what is happening, but what can we do about it?

www.guardian.co.uk/commentisfree/2012/aug/27/nhs-privatisation-toxic-world-healthcare

Cogito, the privatisation lobby won't admit what they are up to. They mouth platitudes about free at the point of use - at the same time as deciding that the NHS is merely a brand and that it doesn't matter who provides the service.

Meanwhile the government are attacking doctors' pensions. Few people are bothered, because doctors earn lots of money (although junior doctors don't). But the big picture is that they are attacking pensions because that will make it easier to hand hospitals over to private companies. The pension obligations are a barrier to a new employer moving in.

At the same time, they have made a law that gives local commissioning groups the right to refuse to provide whatever services they deem are not NHS. A commissioning group in Stoke may arbitrarily decide speech and language therapy is not part of the NHS - and there's no appeal to the Secretary of State, because he will say it's down to the local commissioning group.

Then you have the transaction costs of the NHS being fragmented into different business units, all charging each other for every lightbulb or telephone call. Waste of millions of pounds on bureaucracy - but the kind of bureaucracy that earns money for companies such as United Health or McKinsey's, so it's good bureaucracy in the government's eyes.

How can they be clawing back so much money on so much stuff and still be needing more?

I'm a HA resident and part of the Strategy and Scrutiny Panel, each HA has to have one now, it's all residents so we don't get paid for it (so far it's cost them a small buffet each time and they took us away at the start of the panel for training and team building) because they've scrapped the body that does this job, we're doing the job of a flippin' government body for free! It's great fun and very exciting, we're at the start of our first project but it's ridiculous that they're expecting volunteers (who are usually unemployed/ sick/ SAHM and not necessarily trained in this sort of thing) to be doing it. Maybe they could get in patients to run the hospitals next?

"Then you have the transaction costs of the NHS being fragmented into different business units, all charging each other for every lightbulb or telephone call. Waste of millions of pounds on bureaucracy - but the kind of bureaucracy that earns money for companies such as United Health or McKinsey's, so it's good bureaucracy in the government's eyes."

This makes my head hurt. Can someone explain to me how this ultimately saves money? Like so much else that has been privatised, does it not ultimately always end up costing the taxpayer more because it is then profit driven?

Does this happen before or after the world ends in 2012.

The reason vouchers are significant is because they allow a seamless mechanism for integrating paid-for treatment. Run out of your vouchers? Just buy more.

And you can reduce the voucher allocation slowly over time, without the sort of "big bang" that gets people marching in the streets.

It's happening right now with social care of the disabled. Residential homes were closed with the claim that "care in the community" would be paid for. Now community services, Carers Allowance and Disability Living Allowance are being reduced and in many cases completely withdrawn. Means-testing is being extended. All to the rhetoric of "help should go to those who need it most." Which translates as "the squeezed middle get fucked again."

edam yes... local commission groups get to decide what the NHS provides or doesn't.

I work in a mental health trust that turns away ADHD referrals because we are 'not commissioned' to provide this service.

We dont even have to tell poor bloody patients where to turn to.

GP's have never been NHS, self-employed private practices. Hinchinbrooke seems to have done very well.

What is the problem?

Can I chip in, as someone who has spent two years living in Australia? I don't know the system here all that well yet but after the NHS I am in a state of shock. Basically for almost anything - basic GP appointment, specialist service - you have to pay a massive chunk yourself - maybe 60 per cent. Prescriptions are expensive. For the first time ever I have found myself hesitating to take DD to the doctor because of the cost and we have two incomes. The tax system pushes you in to having private health cover - which makes a big show of covering physio, dental (no govt dental here) etc but in reality we can't afford to access these because it pays a fraction. And the insurers are utter slime balls who whittle away entitlements and try to get out of all sorts - so are trying to get out of paying for an endoscopy and treatment for DH because he had an unrelated stomach problem 20 years ago - which he declared - and he is having to pay himself for Doctors' reports to prove this. We have paid to have pregnancy and birth cover but can't use it, because we can't afford the $3000 or so top up fees ... Meanwhile under the public health system we have to pay $120 out of $180 for routine pregnancy scans. I see my mum, on a pension, paying a third of her income for private health insurance - but that just covers a small percentage of any costs she incurs. If we drop out of private cover for any period because we can't afford it, we will be massively slugged with higher premiums when we go back on because we no longer have the protection of having had lifetime cover.

What can I say? I am not an expert on the system here but it feels hideously American. I am appalled that the government has instituted and nurtured this system. What is the point of living in an affluent country if it can't provide reliable, affordable healthcare - and what kind of government would allow corporations to exploit people in this way, with no guarantee of the care you need, when you need it.

The NHS is the thing I miss most about the UK. It is a triumph of civilsation, seriously. I am devastated what these bastards are doing to it.

Sorry for the long post - guess I am
Just saying that it doesn't take long for a decent system to be destroyed

I think its discusting what the goverment are doing and the way its heading we will end up like america. The conservitives only care about the rich, not the poor and that shows in all that they are doing.
They are running this country into the ground.
Why should we pay high taxes if the Nhs is not available to all, after all the N stands for National. I cant believe people were stupid enough to vote for them and believe all the lies/promises they made

Without the Nhs a lot of really sick people will go without treatment.
I just hope that this is stopped before it is too late

Thanks for that link younger, it was an interesting read. Hinchingbrooke is our local hospital.

I've had recent experience of being there as a family with DD and also have close friends/family working there. From our experience and the odd comment from those that I know working there Circle seem to be going in the right direction in many ways.

OK, at the moment everyone in work pays national insurance which means that everyone who needs it gets healthcare free at the point of use. This will not change.

At the moment, you go to a hospital or surgery, you have your treatment and (prescriptions and dentistry aside) all treatment is free. This will not change.

At the moment, you go into an NHS owned and run hospital with NHS doctors, nurses and administrators. In future it may be a Serco (or A.N. Other) owned and run hospital with Serco (or A.N. Other) doctors, nurses and administrators. The range of treatments it provides will be exactly the same and, just as always, there will be no direct financial charge to the patient. The hope is that private companies, being in competition with one another, will raise standards so that patients choose to go to their hospital rather than one run by their competitors.

I really can't see what there is to get het up about.

"Serco out of hours service in Cornwall was understaffed, finds watchdog", BMJ.

"Serco out-of-hours GP service failures create spike in Cornwall A&E use", Guardian

Of course poorly run services can happen, but for-profit contracts create an incentive to understaff. And fragmentation creates an incentive to make false economies.

Another private contract that didn't go sunnily and fell back on the (thankfully still existing) NHS proper to fill the gap in Tower Hamlets.

"Atos Healthcare pulls out of NHS contract", Guardian.

[[http://www.pulsetoday.co.uk/newsarticle-content/-/article_display_list/12199065/local-gps-drafted-in-to-run-apms-practice-after-private-company-fails-to-improve-access "
Local GPs drafted in to run APMS practice after private company fails to improve access"]], Pulse

Second link makes clear ATOS were pushed rather than jumped, but at least went quietly. Still, the lawyers will have made their money from the original tender process.

Notice that the ATOS contract was put in place by LABOUR in 2007 although the Guardian fails to mention that don't they, as it doesn't suit their it's the tories wot done it agenda,

I live in a country with private healthcare. We pay insurance. But the level of care and treatment is above and beyond the NHS. It can work. The US model is outdated even for them, probably not what the UK government is modelling itself on. Don't panic, your healthcare won't be taken away, just the more able to afford it will have to start paying for it.

"just the more able to afford it will have to start paying for it."

But we already pay for it, through progressive taxation and NI.

Which combines the best elements of insurance (cost spread across large number of people, if you never need to claim then lucky you) with the best elements of taxation (payment according to means spread across your whole adult life, so you can be sick when young then high earner later or vice versa, and don't get the catch-22 of big medical bills while being unable to earn).

OrangeKipper I entirely agree, except the level of the NHS has shrunk to what is affordable/what meets NICE standards, and that may not be the best care available to patients. If you have ever watched a loved one be denied treatment because of NICE then I guess you understand why I like the insurance led model of western Europe, where the best treatment is given regardless of cost.

I think people are going a bit over the top about this. The NHS needed to be reformed as it had become a giant money pit. You can't run a health service in 2012 the same way it was run in the the 1950s, for a multitude of reasons. A lot of the bleating about it is coming from people with vested interests, Labour allowed salaries for doctors especially to rise ridiculously high. The Guardian can never be trusted on issues such as this.

and another question is why has this received so little media coverage?

'snowball effect' being code for 'scare-mongering speculation'. There are many excellent universal health systems in operation round Europe. The French system is often held up as excellent, for example, and operates nothing like the NHS. Private and state hospitals exist side by side. The government manages health insurance and sets premium levels. Patients pay for care and are reimbursed anything between 70% and 100%

"and another question is why has this received so little media coverage? "

Because the article is private opinion based on speculation rather than reporting something that is actually going to happen.

Don't believe everything you read in the Guardian. They have an agenda, just like everyone else. This article is not fact.

GreenD - I disagree that Drs salaries were allowed to rise too high, they have fallen way behind other comparable professions over the last generation. No-one goes into medicine for the money any longer, which undoubtedly used to happen.

I actually think it was quite irresponsible to take excerpts from an opinion piece - written by someone with a related book to flog - and present it as a newspaper article or similar.

It is quite obvious from some of the comments that several posters did not realise the nature of the piece.

Thank goodness we have posters like Cogito who are willing to wade in to provide balance.

Einsty I am also in Australia & did not pay for anything pregnancy related.

Drs will bilk bill, you just have to find the practice that do so. Under 16 don't pay for appts in our practice & my dr bulk bills me & dh because he knows our entire family.