Posts Tagged ‘Allyson Pollock’

Private Eye’s Demolition of Fraudulent New Labour Pro-NHS Privatisation Paper

August 5, 2020

This is another piece I found in an old issue of Private Eye, for 15th-28th October 2004. New Labour was as keen as the Tories to privatise the NHS, all in the name of introducing into it the supposedly greater efficiency and management skills of private enterprise. They were heavily influenced by the American private healthcare company, Kaiser Permanente, which was used as a model for their NHS reforms. But the report comparing the supposedly greater performance of Kaiser Permanente to the NHS was biased and fraudulent, as Private Eye’s article ‘NHS Privatisation – Kaiser bill’ revealed in that issue’s ‘In the Back’ section. The article runs

LAST WEEK’s NHS modernisation Agency conference on the much-hyped treatment centre programme – the mix of private and NHS one-stop units springing up around the country to offer quick and relatively easy diagnosis and surgery – struck a self-congratulatory note.

But a study published this summer suggests there is no evidence that bringing private companies into the NHS is increasing efficiency or reducing costs. Quite the opposite in fact.

This news will not please the government, which has always promoted health secretary John Reid’s favourite private US healthcare providers, Kaiser Permanente, citing a seven-page research paper in the British Medical Journal in 2002 which purported to show that Kaiser offered “better performance at roughly the same costs as the NHS”.

This conclusion, extolling the benefits of competition, was manna from heaven for health minister who had been criticised for closing 10,000 NHS beds since Labour came to power. But it seems it was all nonsense.

For a start, two of the report’s three authors,used to work for Kaiser; and their paper triggered a storm of protest in the US and from the medical and scientific community here, highlighting its flawed analysis and conclusions. It emerged that Kaiser’s costs were deflated while NHS costs were inflated; Kaiser patients were the “working well” but NHS patients included the poor, elderly and chronically ill; and individual Kaiser charges for visits and treatment were ignored.

Nevertheless, the protests were ignored and the paper – described by one leading academic as “not worthy of a first year student” – went on to form British government policy, featuring in the 2002 review of NHS funding by Derek Wanless and the subsequent white paper on how to deliver the NHS plan. The department of health even joined forces with Kaiser in “learning from Kaiser Permanente” projects managing chronic conditions and care.

In the summer, however, the scientific record was finally put straight with a paper in the British Journal of General Practice which comprehensively exposed that the Kaiser paper was propaganda masked as science. It detailed the way in which authors used counting tricks including a curious foreign exchange currency conversion which had the effect of almost doubling NHS costs. Despite this evidence the Kaiser paper has still not been officially withdrawn. Instead it is still promoted on health department websites.

Allyson Pollock, professor of health policy at University College London and one of the authors of the critical BJGP paper, said: “There is no evidence that introducing private companies increases efficiency or quality or reduces costs. Indeed all the evidence goes the other way. Markets – even those underwritten by the state – do not deliver comprehensive universal healthcare. Research in the US has shown how private health providers select the profitable patients, treatments and conditions and at a greater cost than public providers.”

Professor Pollock is a very long-time opponent of NHS privatisation. I think I put up another article from Private Eye from nearly 20 years or so ago, in which she led a campaign against the New Labour closure of a hospital in Wyre Forest. She’s also one of the contributors to Jacky Davis’ and Raymond Tallis’ book attacking the privatisation of the NHS, NHS – SOS.

But New Labour continued in their piecemeal privatisation of the NHS, and this has been followed by the Tories. Boris Johnson wants to include it in a trade deal with the US, but has kept it and the rest of the deal secret. Jeremy Corbyn revealed what the Tories were doing, and our mendacious, scumbag media howled that he was lying. But it’s the Tories who were.

Corbyn promised to renationalise and revitalise the NHS. That was one of the reasons the right-wing political and media establishment hated and reviled him and his supporters: he threatened to return the Labour party to its working class, socialist roots, empowering ordinary people and restoring the welfare state. And dismantling the zombie economics of Thatcherism. And that really couldn’t be tolerated. Hence the smears of him as a Communist, Trotskyite and anti-Semite.

Now we have Keir Starmer instead, another Blairite, who seems determined to restore the power of the Thatcherites in the Labour party. And carry on with their failed, destructive policy of NHS privatisation.

Private Eye on Successful Campaign against Blairite Hospital Privatisation by Pro-NHS Group

July 24, 2020

One of the political developments prompted by New Labour’s wholesale adoption of the Tory programme of the destruction of the welfare state and privatisation, including that of the NHS, is that opposition to these policies moved away from the party to popular organisations set up by concerned professionals, activists and members of the public. This was particularly true of organised opposition to the privatisation of the NHS, which led to the formation of the NHS Action Party. In the same issue of Private Eye which revealed how Blair and his cronies in private industry wished to force through even more privatisation, 15-28 June 2001) the very first article was about how a New Labour politico had suffered a series of humiliating defeats at the hands of opponents of plans for the closure of beds at Kidderminster Hospital and the transfer of services to a new, PFI-funded hospital at Worcester. The article, ‘Wyre, Oh Wyre’, ran

The best election result by far was at Wyre Forest, where the ambitious junior minister at the lord chancellor’s department, barrister David Lock (10,857 votes) was hammered out of sight by the Health Concern candidate, Richard Taylor (28,487 votes).

The Eye was one of the first to appreciate the challenge from Health Concern. Under the heading Wyres Crossed way back in June last year, we traced the the circuitous record of David Lock over the key local issue of the proposed closure of all acute services at Kidderminster Hospital (Eye 1007). Lock was against the proposals when he stood for the seat and won it unexpectedly in 1997. But his enthusiasm for the campaign against closure waned as he climbed into the government.

His ire was directed against those who opposed plans for the new hospital, especially professor Allyson Pollock of the University College of London’s school of public policy. Mr Lock complained not to Prof Pollock herself but to the chairman of the University College council, Lord Young of Graffham.

The Eye article drew a mocking reply from the MP who proclaimed himself a regular Eye reader and bitterly attacked Prof Pollock, who, he wrote, “didn’t bother to check her facts with the health authority before going to print”. This letter drew a furious and devastating response from Richard Taylor, a retired consultant, whose letter (Eye 1007) exposed Mr Lock as, well, having been economical with the truth.

This was followed the following issue (1008) by a letter from Allyson Pollock pointing out that her facts about the hospital were quite correct. The cost of new PFI facility at Worcester replacing the services at Kidderminster had risen from £49m to £108m, all to provide 44 percent fewer acute beds for more patients.

So besieged was Mr Lock by the campaigner for the hospital that he resorted to his lawyers. Eye 1023 reported that he had threatened to sue Frank Baillie, a vice-chairman of Health Concern, for telling the left-wing weekly Tribune that Lock “had gone for promotion instead of standing side by side with the people of Wyre Forest”. Lawyers for the local authority (where Health Concern was and is the largest party) told Mr Baillie that they would not meet the costs of a libel action, and Baillie was forced to issue a grovelling and humiliating apology to Lock for saying something that was demonstrably true.

Mr Lock had not finished yet and his next assault on his critics won him the much-coveted spot of Man In The Eye (1026). He had rung a small publisher of a local magazine called For You who had had the nerve to reprint the Eye’s reports of the above events and as usual threatened them with a libel writ and demanded and an apology and substantial damages. He objected in particular to the observation: “It is a racing certainty that an Independent MP who will truly represent the wishes of the people will be elected.” Somehow the litigious MP did not get his apology or his damages before the election, when the magazine’s prediction came so handsomely true.

There is talk up in Kidderminster of a amss phone-in to the former MP demanding an apology and even substantial damages for contest the now rather obvious fact that enormous majority of his constituents did not agree with him.

Professor Pollock is the author of a series of works attacking the privatisation of the NHS, and I think she’s also a contributor to Jacky Davis and Raymond Tallis superb NHS -SOS, which minutely describes and exposes it. I think Health Concerns victory at Wyre Forest may be exceptional, because of the difficulties in getting a small, independent party or organisation off the ground and gathering enough votes to challenge the big parties.

But unfortunately, as Starmer shows himself keen to push through the Blairite agenda of the early 21st century, this may be the only tactic available to people who really want to preserve the NHS, and the health, prosperity and welfare of their fellow citizens.

 

The Beeb’s Biased Reporting of NHS Privatisation

January 2, 2020

The Corporation’s General Right-wing Bias

The BBC is infamous for its flagrant right-wing bias. Writers and experts like Barry and Savile Kushner in their Who Needs the Cuts, academics at the media research centres of Glasgow, Edinburgh and Cardiff Universities, and ordinary left-wing bloggers like Mike and Zelo Street have pointed out time and again that the corporation massively prefers to have as commenters and guests on its show Conservative MPs and spokespeople for the financial sector on its news and political comment programmes, rather than Labour MPs and activists and trade unionists. The Corporation relentless pushed the anti-Semitism smears against Jeremy Corbyn and the Labour party. But it has also promoted the privatisation of the NHS too through its biased reporting.

Biased Towards NHS Privatisation

Jacky Davis and Raymond Tallis’ book on the privatisation of the NHS, NHS – SOS, has a chapter by Oliver Huitson, ‘Hidden in Plain Sight’, discussing the biased reporting of the NHS’s privatisation by the media in general. Here, however, I will just confine myself to describing the Corporation’s role. The Beeb was frequently silent and did not report vital pieces of information about successive privatisations, such as the involvement of private healthcare companies in demanding them and conflicts of interest. On occasion, this bias was actually worse than right-wing rags like the Daily Mail. Although these ardently supported the NHS’ privatisation, they frequently reported these cases while the Beeb did not. When the moves towards privatisation were reported, they were often given a positive spin. For example, the establishment of the Community Care Groups, groups of doctors who are supposed to commission medical services from the private sector as well as from within the NHS, and which are legally allowed to raise money from the private sector, were positively described by the Corporation as ‘giving doctors more control’.

Lack of Coverage of Private Healthcare Companies Role in Privatisation

David Cameron and Andrew Lansley did not include Lansley’s Health and Social Care Bill in the Tories’ 2010 manifesto, because they didn’t believe they’d win the election if they did. But in all the two years of debate about the bill, the Beeb only twice reported doubts about the bill’s democratic mandate. (p.152). In October 2010, Mark Britnell was invited to join Cameron’s ‘kitchen cabinet’. Britnell had worked with the Labour government and was a former head of commissioning for the NHS. But he was also former head of health for the accountancy firm, KPMG, which profits greatly from government privatisation and outsourcing. He declared that the NHS would be shown ‘no mercy’ and would become a ‘state insurance provider, not a state deliverer’. But the BBC decided not to report all this until four days after others had broken the story. And when they did, it was only to explain a comment by Nick Clegg about how people are confused when they hear politicians stating how much they love the NHS while at the same time demanding its privatisation. (pp.153-4).

On 21 November 2011 Channel 4 News reported that they had obtained a document which showed clearly that GP commissioning was intended to create a market for private corporations to come in and take over NHS services. But This was only reported by the Groaniad and the Torygraph. The rest of the media, including the Beeb, ignored it. (pp. 156-7).

Lansley was also revealed to have received donations from Andrew Nash, chairman of Care UK, another private healthcare firm hoping to profit from NHS privatisation. But this also was not reported by the Corporation. (pp. 157-8).

In January 2011 the Mirror reported that the Tories had been given over £750,000 from donors with major connections to private healthcare  interests since David Cameron had become their chief in 2005. But this was also not mentioned by the Beeb. (pp. 158).

The Mirror also found that 40 members of the House of Lords had interests in NHS privatisation, while the Social Investigations blog suggested that it might be as high as 142. The BBC, along with several papers, did not mention this. (pp. 158-9).

Sonia Poulton, a writer for the Heil, stated on her blog that 31 Lords and 18 MPs have very lucrative interests in the health industry. But this was also ignored by the Beeb, along with the rest of the media with the exception of the Guardian. (p. 159).

The Tory MP, Nick de Bois, was a fervent support of the Tories’ NHS privatisation. He is a majority shareholder in Rapier Design Group, which purchased Hampton Medical Conferences, a number of whose clients were ‘partners’ in the National Association of Primary Care, another group lobbying the Tories for NHS privatisation. This was also not reported by the Beeb. (pp. 159-60).

The Beeb also chose not to report how Lord Carter of Coles, the chair of the Co-operation and Competition Panel charged with ensuring fair access to the NHS for private healthcare companies, was also receiving £799,000 per year as chairman of McKesson Information Solutions, part of the massive American McKesson healthcare company. (p. 160).

There were other links between politicos, think tanks, lobby groups and private healthcare companies. The health regulator, Monitor, is dominated by staff from McKinsey and KPMG. But this also isn’t mentioned by the press. (pp. 160-1).

Beeb Falsely Presents Pro-Privatisation Think Tanks as ‘Independent

The BBC, along with much of the rest of the media, have also been responsible for misrepresenting spokespeople for pro-privatisation lobby groups as disinterested experts, and the organisations for which they speak as just independent think tanks. This was how the Beeb described 2020health.org, whose chief executive, Julia Manning, was twice invited onto the air to discuss the NHS, and an entire article was given over to one of her wretched organisation’s reports. However, SpinWatch reported that its chairman, former Tory minister Tom Sackville, was also CEO of the International Federation of Health Plans, representing of 100 private health insurance companies. Its advisory council includes representatives of AstraZeneca, NM Rothschild, the National Pharmaceutical Association, Nuffield private hospital group, and the Independent Healthcare Advisory Services. (p. 162).

Another lobby group whose deputy director, Nick Seddon, and other employees were invited onto the Beeb to discuss the proposals was Reform. Seddon was head of communications at Circle, the first private healthcare company to take over an NHS hospital. Seddon’s replacement at Circle was Christina Lineen, a former aide to Andrew Lansley. None of this was reported by the Beeb. Their corporate partners included companies like Citigroup, KPMG, GlaxoSmithKline and Serco. Huitson states ‘Through Seddon’s and other Reform Staffs’ appearances, the BBC may have facilitated private sector lobbying on a publicly funded platform without making relevant interests known’. (163).

Beeb Did Not Cover Protests and Opposition to Bill

Pages 164-5 also discusses the Beeb’s refusal, with few exceptions, to interview critics of Lansley’s Health and Social Care Bill, the rightwing bias of panels discussing it and how the Beeb did not cover protests against it or its discussion in parliament. Huitson writes

At the BBC opportunities were frequently missed to provide expert opposition to the bill on a consistent basis. the RCGP’s Clare Gerada was largely the exception to this rule. Many of the most well-known and authoritative critics of the bill – the likes of professors Allyson Pollock or Colin Leys, doctors Jacky Davis and Wendy Savage from Keep Our NHS Public – never appeared on the BBC to discuss the plans. Davis recalls being invited to appear on the BBC a number of times but the item was cancelled on every occasion. ‘Balance’ is supposedly one of the BBC’s primary objectives yet appearing on the Today programme of 1 February 2012 to discuss the bill, for instance, were Shirley Williams (who voted in favour of the bill, however reluctantly), Nick Seddon of ‘independent’ Reform (pro-Bill), Steve Field (pro-Bill) and Chris Ham (pro-Bill). It’s difficult to see how that is not a breach of BBC guidelines and a disservice to the public. One of the fundamental duties of an open media is to ensure that coverage is not skewed towards those with the deepest pockets. And on that issue the media often performed poorly.

Further criticism of the BBC stems from its curious lack of NHS coverage during the climactic final month before the bill was passed in the House of Lords on 19 March. One such complaint came from blogger and Oxford Professor of Developmental Neuropsychology Dorothy Bishop, who wrote to the BBC to ask why it had failed to cover a number of NHS stories in March, including an anti-bill petition that had been brought to the House by Lord Owen, carrying 486,000 signatures of support. In reply, the BBC confirmed that the bill had been mentioned on the Today programme in March prior to the bill’s passing, though just once. Bishop replied:’So, if I have understood this right, during March, the Today programme covered the story once, in an early two-minute slot, before the bill was passed. Other items that morning included four minutes on a French theme park based on Napoleon, six minutes on international bagpipe day and eight minutes on Jubilee celebrations.’

Other BBC omissions include Andrew Lansley being heckled by angry medical staff at a hospital in Hampstead, as reported by both the Mail and Sky News. On 17 March a peaceful anti-bill march took place in central London. Those out protesting for their national health service found themselves kettled by riot police despite being one of the most harmless-looking crowds you’re ever likely to see. The protest and the shameful police response were completely ignored by the media, except for a brief mention on a Guardian blog. On social media numerous examples have been reported of protests and actions opposing the bill that were entirely absent from national coverage.

Then, on 19 March, the day of the final vote on the bill, the BBC ran not a single article on the event, despite this being one of the most bitterly opposed pieces of legislation in recent history – it was as if the vote was not taking place. The next day, with the bill passed, they ran a full seven articles on the story. Three days after the bill passed, Radio 4 broadcast The Report: ‘Simon Cox asks: why is NHS reform mired in controversy?’ Why this was not broadcast before the Lords’ vote is a mystery. 

When the Bill was passed, the bill scrolling across the BBC News’ screen ran ‘Bill which gives power to GPs passes’. (166). Huitson remarks that when the Beeb and the other news networks reported that the Bill gave power to GPs and allowed a greater role for the private sector, it was little more than regurgitating government press releases. (p. 168).

Beeb Bias Problem Due to Corporation’s Importance and Domination of Broadcast News

Huitson also comments on the specific failure of the Beeb to provide adequate coverage of NHS privatisation in its role as one of the great British public institutions, the dominant role it has in British news reporting. On pages 169-70 he writes

Campaigners may not expect more from the Sun but they certainly do from the BBC, given its status as an impartial public service broadcaster whose news gathering is supported directly by licence fee payers. The BBC accounts for 70 per cent of news consumption on television. Further, the BBC accounts for 40 per cent of online news read by the public, three times that of its closes competitor, the Mail. Quite simply, the BBC dominates UK news. The weight given to the BBC here is not purely down to its dominance, however, but also because, along with the NHS, the BBC remains one of our great public institutions, an entity that is supposedly above commercial pressures. Many of the stories ignored by the BBC were covered by the for-profit, right-wing press, as well as the Guardian and Channel 4, so the concern is not that the organisation failed to ‘campaign’ for the NHS, but that it failed to report facts that other outlets found newsworthy.

The BBC’#s archive of TV and radio coverage is neither available for the public to research nor technically practical to research, but there are a number of reasons for confidence that their online content is highly indicative of their broader output. First, BBC online is a fully integrated part of the main newsroom rather than a separate operation. Consequently, TV and radio coverage that can be examined is largely indistinguishable from the related online content, as demonstrated in the examples given above. During the debate of Lansley’s bill, the BBC TV and radio were both subject to multiple complaints, the figures for which the BBC has declined to release.

Beeb’s Reporting of NHS Privatisation as Biased as Coverage of Miners’ Strike

He also compares the Beeb’s coverage of the bill, along with that of the rest of the media, to its similarly biased reporting of the miners’ strike.

The overall media coverage of the health bill brings to mind a quote from BBC radio correspondent Nicholas Jones, on the BBC’s coverage of the miners’ strike: ‘stories that gave prominence to the position of the National Union of Miners could simply be omitted, shortened or submerged into another report.’ (pp. 172-3).

Conclusion

The Beeb does produce some excellent programmes. I really enjoyed last night’s Dr. Who, for example. But the right-wing bias of its news reporting is now so extreme that in many cases it is fair to say that it is now a propaganda outlet for the Tory party and big business. It’s utterly indefensible, and in my view it will only be reformed if and when the newsroom and its managers are sacked in its entirety. In the meantime, Boris and the rest of the Tories are clamouring for its privatisation. Godfrey Bloom, one of the more prominent Kippers, has also put up a post or two in the past couple of days demanding precisely that.

If the Beeb was genuinely impartial, it would have defenders on the Left. But it is rapidly losing them thanks to its bias. And to the Tories, that’s also going to be a plus.

Thanks to the Beeb’s own Tory bias, it’s going to find it very hard to combat their privatisation.

And in the meantime they will have helped destroy the most valued of British institutions, the NHS, and free, universal healthcare to Britain’s citizens.

Vox Political on Private Healthcare Overcharging the NHS

January 27, 2015

Rapacious Quack

18th Century Satirical Print: The Rapacious Quack. It depicts a poor family at the mercy of a doctor, who has taken away a flitch of bacon in lieu of unpaid fees. Its caption reads
‘The Rapacious Quack quite vext to find,
His patient poor, and so forsaken
A thought soon sprung up in his mind
To take away a piece of bacon.’
Which just about describes the grasping attitude of the private healthcare firms mentioned in the report.

Earlier this evening I blogged a piece on Mike’s story over at Vox Political on Ed Miliband’s promise to rebuild and strengthen the NHS. The piece is Will voters support Labour’s vision for the NHS? and it’s at http://voxpoliticalonline.com/2015/01/27/will-voters-support-labours-vision-for-the-nhs/. It offers hope for an NHS decimated by the Tories, but also by Blair and Brown.

Mike also wonders in the piece whether Alan Milburn, Blair’s former health secretary, is really a member of the Labour party, or a Tory, who has worked his way into Labour to undermine it. He isn’t the only one. A few weeks ago, Johnny Void pointed out how one of the authors of the Archbishop of Canterbury’s report suggesting the establishment of a national network of food banks was Frank Field, and made the same comments about him. Field is notorious for recommending further cuts to the welfare state to encourage unemployed hoi polloi to find work. And it isn’t only his critics, who have suggested he should join the Tories. He also has admirers within that party, who’ve actually made the invitation. The politically Conservative Cranmer blog actually invited Field to cross the floor and join the Tories.

And the same comments could have been made about much of the New Labour leadership. Remember the computer programme back in the 1990s that made anagrams from politicians’ names, supposedly revealing their real character? Michael Portillo was ‘a cool, limp Hitler’. Blair came out as ‘I am Tory Plan B’. Lobster compared Blair to Ted Heath. Both were men leading the wrong parties. Giles Brandreth, who served on John Major’s Tory cabinet in the 1990s, on Have I Got News For You described the Blairs, both Tony and Cherie, as natural Tories. They were, and they similarly pursued a policy of privatising the NHS piecemeal.

In the first few years of this century Patricia Hewitt wanted to sell of the £64bn commissioning and supply arm of the NHS, but ended up having to reject the plan, claiming it was mistaken. She therefore just privatised hospital management. And one of the brilliant ideas of Blair’s administration was the inclusion of private healthcare companies to pick up work that could not be done by an overstretched NHS. Who was the brains behind this, ahem, operation?

Alan Milburn.

And in 2009 Private Eye carried a story about an independent report that concluded the private healthcare providers were overcharging the NHS, including billing for work they did not carry out. The article was in their edition for the 15th – 30th May. Here it is.

NHS Plc.
ISTCs: A Crying Sham

Another crumbling New Labour initiative, independent sector treatment centres (ISTCs) for NHS operations, has ben exposed as a shambolic waste of money.

ISTCs were supposed to provide low-cost operations to an overstretched NHS. But the have long been suspected of creaming off the most lucrative ones under favourable contracts without providing the quality to be found in the NHS.

A 2006 parliamentary report questioned their value for money and asked the National Audit Office to look into it. Several billions of pounds of public money were at stake, but the audit body has oddly shied away from the subject despite reportedly expressing some concern over the ISTCs’ performance and £100m+ procurement costs 18 months ago.

Now academics Allyson Pollock and Graham Kirkwood at Edinburgh University have obtained the contract for one ISTC under Scottish freedom of information laws (contracts in England remain confidential). This shows that the NHS in Tayside paid an ISTC run by Amicus Healthcare – a joint venture of private equity firm Apax and South Africa’s Netcare – for 90 percent of referrals even though the centre only performed 32 percent of them. The academics estimate that Tayside’s overpayments could be dwarfed by those across England, where the NHS could have been stung by up to £927m for operations not performed.

The £5bn ISTC programme was pushed through by the Department of Health’s commercial directorate, set up in 2003 by the then health secretary, Alan Milburn, now earning £30k a year from the private equity firm Bridgepoint that owns ISTCs through Alliance Medical. The directorate was run by American Ken Anderson (since decamped to Swiss bank UBS’s private health investments) and was exposed by the Eye two years ago as home to 220 consultants on an average £238k a year, much channelled through tax-efficient service companies. It has since been quietly disbanded without ever having faced the scrutiny it warranted.

This effectively explains why Milburn was so keen to pour scorn on Miliband’s plans for the NHS: he’s working for a private equity firm that will lose work in that area if Miliband starts to take seriously the NHS’ commitment to providing free state medicine.

It also shows how better governed Scotland is than England. The two academics are able to get details like this through the Scots freedom of information act, which is denied to citizens south of the Border.

As for Amicus Healthcare, I remember Amicus as the American rival to Hammer films way back in the 1970s. Although American, they used much of the same actors and production staff. Sadly, Hammer and Amicus passed away, though the horror continues under the Amicus name.

From 2011: Private Eye on Criticism of Tory Research Supporting Competition in the NHS

April 13, 2014

This is from Private Eye’s edition for 25th November – 8th December 2011.

NHS Reforms

Broken Heart Study

Malcolm Grant, newly appointed chair of the NHS Commissioning Board, recently described health secretary Andrew Lansley’s proposed health reforms as “completely unintelligible”. Now it seems the same applies to the only bit of research David Cameron could come up with to support the bill.

Back in June The PM said: “Put simply, competition is one way we can make things work better for patients. This isn’t ideological theory. A study published by the London School of Economics found hospitals in areas with more choice had lower death rates.”

Certainly the paper, published in the Economic Journal, was billed as showing that “hospital competition in the NHS saves lives”. It looked at the impact of patient choice and hospital competition in relation to elective surgery and concluded, according to lead author Dr Zack Cooper, that “competition in a market with fixed prices can lead to lower hospital death rates and improve patient outcomes.”

Death rates from heart attacks were apparently reduced by an impressive seven percent. There were, it claimed, 900 fewer deaths from heart attacks during the three-year period after the choice and competition reforms were introduced into NHS.

Er … but not according to 11 experts in public health, health economics, general practice and statistics from eight leading universities led by Allyson Pollock of Queen Mary, University of London. In a paper published in the Lancet last month, they argue that there is “no evidence that patient choice in the NHS saves lives” qand claim that the LSE study is daft, or as they put it “fundamentally flawed”.

Among a long list of criticisms, covering data, study design and methods, as well as the report’s analysis and conclusions, they said the LSE researchers had made three very basic mistakes.

Firstly they did not explain why the availability of choice for elective procedures should have any effect on whether heart attack patients survive. For heart attack victims, hospital choice and competition don’t come into it. As Sir Roger Boyle, the government’s former heart tsar who presided over a long-term decrease in heart attack and stroke deaths, told the Guardian, it’s down to the paramedic and ambulance drivers to get patients to the nearest specialist centre as fast as possible. People in acute pain and distress don’t choose.

Secondly, the LSE team didn’t look at whether the availability of choice had nay effect on where patients go for treatment – recent research indicates that most patients pick their nearest hospital.

Thirdly, LSE researchers ignored the effects of changes in prevention and treatment over which Boyle had presided. Heart attack patients tend to fare better when they’re treated in specialist centres in urban areas.

The authors concluded: “Our examination of this research reveals it to be fundamentally flawed, amounting to the conclusion that the paper simply doesn’t prove either cause or effect between patient choice and death rate from acute myocardial infarction.”

The LSE team is fighting back, accusing its accusers in the Lancet of misrepresenting the LSE research and being “politically motivated”. Not an accusation that could be levelled at Cooper and his pro-competition friends at the LSE surely

Others have also blogged on the criticisms of Cooper’s paper advocating greater competition in the NHS. In fact, Cameron’s NHS reforms are highly ideological. He and the other Tories are deliberately privatising the NHS through gradual, piecemeal measures. Furthermore, such privatisation directly enriches the Tories and Tory Democrats, who own and run companies involved in this privatisation. For further information, see the relevant blog posts over at Another Angry Voice, the Void, Vox Political, amongst many others.