Posts Tagged ‘Allyson Pollock’

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.

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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.