Though Cowards Flinch

David Cameron is playing an interesting game at the moment. After promising to “cut the deficit, not the NHS” he went and did both anyway. In fact he went further still: NHS reforms include abolishing Primary Care Trusts and handing 60% of the NHS budget to new GP-led consortia.

Under Cameron’s watch, health secretary Andrew Lansley has done nothing else but implement the very measures the Tories have always wanted to do to the NHS, but never before being so stupid as to.

In return for Lansley’s loyalty to the cause, Cameron has given the minister a cold shoulder.

Nicholas Watt put it this way:

In public the prime minister expresses support for the hapless minister. In private few are left in doubt that the minister has been placed on the naughty step or, in the case of Andrew Lansley, on the you-have-had-the-political-stuffing-knocked-out-of-you step.

The BMA stopped short recently of delivering Lansley a vote of no confidence, concentrating on his poor reforms only, but that’s not the message put out today by nurses who will debate a motion of “no confidence” – informed in part by Lansley’s refusal to address the Royal College of Nursing conference in Liverpool, instead limiting himself to a 45-minute Q&A with 50 select nurses.

If that wasn’t bad enough for the minister, his spats with Lord Owen – who has called on Cameron to “replace existing health ministers” – and Norman Lamb have caused a public embarrassment.

The influential Lamb, who has threatened to resign unless the government acts favourably upon a series of demands on the NHS reforms, joins a number of rebel Lib Dem figures who have proposed changes to Lansley’s plans.

Cameron has responded by saying he regrets “charging ahead” on reform without support – a change of heart which will not bode well for the health minister, who will be first in the firing line if Cameron wants to save face.

Clearly Lansley should be sacked on merit of his terrible reforms, which threaten the very heart and soul of the NHS, and aims only to swamp the service with pro-privatisation measures.

But we should remember the minister is merely the architect of the plans. The Tories under Cameron are only delivering the destructive ethos they know and love.

In a thinly veiled attempt to rock the boat a bit, Rawnsley asked on Sunday:

Andrew Lansley is clearly in trouble … Does Mr Cameron need to find himself a new health secretary?

This morning I read in the FT:

Andrew Lansley, health secretary, has opened the door to further concessions on the NHS bill, as the Liberal Democrat party overwhelmingly rejected his sweeping reform plans

This pertains to the decision by a majority of Liberal Democrats over the weekend, at their Sheffield conference, to vote for an “extensive and radical re-write of the government’s NHS bill”.

After this, the health secretary suggested he could “amend” his reforms.

Already a bad day for the UK health minister.

Then at around 11.45am, 15 March, the British Medical Association (BMA) “voted to call upon Andrew Lansley to withdraw the bill” adding that “any willing provider will hurt the provision of healthcare in the NHS in favour of private industry“.

Paul, in the comments thread of my last entry said: “Any resistance [re the health bill] will have to be from outside”. This is to suggest that the LibDem rebels will only manage to frame the ground with which they intend to rub up the coalition, which is not likely to bring it down. However, as acknowledged, this doesn’t preclude damage being made by the BMA.

Richard Blogger, who I owe a word of thanks to for pointing out the errors in my previous entry, also said in the comments thread:

The BMA SRM [Special Representative Meeting] is very interesting. This meeting will let off a lot of steam, but more important is what the BMA council will decide to do afterwards. If there is a decision not to take part in AWP [Any Willing Provider] then Lansley will be stuffed.

Today has shown that the BMA has little trust in AWP – it is possible, by Richard’s reckoning, that Lansley could be stuffed by this (if the BMA do stick to their guns with their opposition). However, Richard goes on:

is he likely to kill the Bill? I suspect not. He’s very much a bludgeon, he believes in AWP and so he will not remove it from the Bill.

[...]

If we (“the opposition” whatever that is) are to oppose Lansley, we have to attack and bring down his argument of “patient choice”. Either prove that patients do not want it (some do, many don’t care) or that it is ineffectual in delivering better healthcare (there is some evidence that shows this), or that it is more costly (IMO this would be quite a powerful argument if constructed properly).

The general attitude here is that though Lansley will find little confidence in his health bill, he is a firm believer in opening out provision to more private companies and may press on with that regardless. But moreover to what Richard suggests, a recent report by an organisation called Patient Opinion, found that provider choice was not part of a patients’ top priorities. I wrote regarding that report:

Ever since Andrew Lansley signed off the soundbite “no decision about me without me” journalists and bloggers have questioned whether it really is this vague notion of choice that could drive NHS improvement, or whether this is just another cover over our eyes, while slowly the national health system is privatised.

A recent report carried out by Patient Opinion (pdf file) – an online service to collate local concerns and praises of service – has added further doubt that Lansley’s line is a winner. The findings show that provider choice and inclusivity feature low in patients’ opinion, being trumped instead by concerns of care and staff attitudes.

[...]

Though it is vital people feel their wants and needs are being responded to, what is most important to the NHS is knowledge and quality provision. By focusing on something that it would seem patients feel less worried about, the health department have shown themselves to be out of touch on the issues, instead just pushing through ideology.

*

To add insult to injury, it has been reported by the BBC (at 12.06pm) that the “BMA is calling for Lansley to resign”.

In a case that could have philosophical idealists wetting themselves for decades to come, by naming something before the fact of it, we should adapt to the Conservative attempt at framing inheritance tax as a ‘death tax’. Here’s my proposal:

Step 1. We suspend habeas corpus for those who use the phrase ‘death tax’, or any other such attempts to name a fairly banal law so as to inspire fevered opposition to it. So the entire Tory Party, to begin with, starting with Lansley.

Step 2. We execute all the aforesaid and confiscate all their property, to be liquidated and used to fund universal comprehensive, elderly care. This programme will be called the “Live Long and Prosper Tax”.

Step 3. We collect the votes of elderly people and Trekkies everywhere and guarantee victory at the next general election.

Step 4. (Optional) We liquify the remains of all those who have died (or committed suicide through stupid political posturing) and use this to feed the living, who we will connect to a giant virtual reality machine in which Gore was elected President, communism works and nobody is offended ever.

We will call this the “Matrix Tax”.

Simple.

"You're all going to die. Howwibly."

The case of Hoon, Hewitt, Moran and the execrable Stephen Byers in the journalistic sting operation around “cash for influence” is being used as a stick with which to beat Labour. Probably something to do with the seven Tories who steered well clear of the operation. What strikes me, however, is that surprise in any form just demonstrates ignorance.

If we look at the Tory Shadow Cabinet for a moment, Andrew Lansley, in charge of the Tory drive to increase privatised healthcare provision, accepts donations from the chairman of Care UK. Alan Duncan, one-time energy spokesman, took money from the chairman of oil traders Vitol. Osborne is in it up to his neck with hedge funds.

Grant Shapps, housing spokesman, was funded by mortgage brokers. Theresa Villiers, once shadow Chief Treasury Secretary, was backed by investment banks.

And, when they leave office, after a term of government, they’ll be rewarded with positions on the boards of various companies. More dignified than Hoon etc trying to pimp their ‘achievements’ for money, certainly, but no different in principle at all. These companies aren’t recruiting parliamentarians for philanthropic reasons.

Both parties are in this up to their necks. There’s no use the Tories using the opportunity to make a partisan point – there’s no partisan point to be made. Ex-politicians go to work for private industry. From shadow cabinet to cabinet to PM to the President of the United States himself. It just turns out that Labour hacks are a little more gullible.

I’m just shocked Hoon hasn’t pulled out the “patriotic duty” card.

On Radio 4 this morning, Hoon was queried as to his use of “inside information” to help American arms manufacturers take over European companies that would be made vulnerable by a reduction in EU defence spending.

It seems like there’s an easy answer to that: European jobs and security depend on this American “investment” and “research expertise” if European governments decrease spending, don’tchaknow!

As for Stephen Byers helping price fixing companies to “get around the law”, well there’s two options. On the one hand, he could claim that his is a revolutionary exposition of the basic monopolistic drive of capitalism.

Or he could attack “meaningless regulations” for holding back the spirit of British enterprise and causing British business to fall behind the rest of the world. There’s perfectly acceptable corporate guff public policy narratives for all situations.

Words can’t describe how horrified I was when I picked up on this story through the BBC last night.

Hinchingbrooke District Hospital in Cambridgeshire is struggling with its budget, having to take a £40m loan from the NHS to stay in the black. The hospital is now being eyed up by 5 different Private firms, that want to take total control over the management on a for-profit basis. Interest arose in the hospital after the strategic health authority put the management responsibilities out for open tender due to the financial issues at the trust. If the deal goes through it will become the first NHS hospital in Britain to be operated by a private company!

In my opinion, private companies have no place in the NHS, profit should not factor into the health service full stop! The primary, and indeed, only objective of a hospital should be to provide high quality healthcare to its patients, not make profits for private investors. These companies don’t want to run a hospital due to some altruistic feeling of duty towards the community, they want to do what all private companies do, make money. As a spokesperson for one of the firms involved said, “this is a very attractive business opportunity.”

There is no doubt that the trust have made some serious errors with their financial management, but what they need is some expert assistance to get past this, not to let the private sector loose on it!

Despite some troubles with the finances, the trusts Chief Executive Mark Millar, has been praised in the local press. A survey by the NHS Institute for Innovation and Improvement rated the trust second in the country for reducing waiting times and received praise for improving a number of other standards of care.

It’s clear that the problems within Hinchingbrooke are solely financial and nothing to do with the quality of care it provides. Now I’m not saying that this isn’t a problem, it clearly is, but this is a problem that the Strategic Health Authority and the Department of Health should be dealing with in conjunction with the hospital staff, not the market.

Allowing private control in this hospital would set a worrying precedent. How long before media-ridiculed hospitals are being lined up for private takeover? As a spokesperson for Unison said yesterday, “this is a dangerous experiment”.

If the Tories win the election, on the back of Labour’s perceived corruption, how are we to regard Conservative Health spokesman Andrew Lansley? Lansley has received £21,000 in donations from the wife of the Chairman of Care UK, one of the firms bidding for control of the hospital. But of course his decisions will be entirely impartial. Gordon Brown himself received £5,000 from the chair of BUPA, and the links between both parties and private healthcare stretch beyond this.

At the moment we have a system of profit-making Independent Sector Treatment Centres, to which the NHS contracts out operations and which are anything but value for money. American private health insurers are already looking for a cut of the pie; how long before they’re bankrolling a selection of politicians to get it for them?

Letting private companies run our hospitals is totally contrary to the principles of the NHS. I bet Nye Bevan must be spinning in his grave! Sadly this is just the next step in the policy of marketisation and private procurement within the NHS, which has flourished since ’97. Numerous organisations such as the LRC, the Socialist Party, Keep the NHS Public, several Unions and Compass, have all been warning against this course of action for some time, and it unfortunately seems that they all might be right.

The government needs to take action now! The Department of Health should step in to prevent private acquisition and help Hinchingbrooke solve its budget issues. The NHS is a public service, probably the most cherished public service. No matter how far privatisation has been allowed to creep into other aspects of our society we cannot allow it here. It is up to those of us who believe in a publicly funded, publicly operated NHS, to resist these attempts at privatisation. It is unclear so far what kind of opposition is being organised, but as soon as it is, we will cover it here.

Lets hope that no campaign is necessary, and that the Department of Health will resolve this issue swiftly and come to a reasonable solution. Unfortunately such intervention doesn’t seem to be forthcoming so I would advise anyone reading this to follow the situation closely. This is not just a problem for the people who rely on Hinchingbrooke, if this is allowed to continue, then one day soon, it could be coming to a hospital near you!