Posts Tagged ‘BMA’

Vox Political: It’s Not GPs Who Should Resign, It’s May and the Tories

January 15, 2017

Mike yesterday put up a piece reporting a statement by a deputy head of the British Medical Association, Dr. Kailash Chand, that many senior doctors were considering leaving the NHS thanks to being made scapegoats by the Tories for the current NHS crisis in England.

Mike makes the point that it is indeed the Conservative government that is responsible for the crisis. They aren’t responsible for the NHS in Ulster, Scotland or Wales, and so those nations haven’t suffered a similar crisis in their health services. May and Hunt have further tried to blame everyone but themselves for the crisis, including pensioners, who they were claiming were filling up needed seats and beds.

Mike states that this time it has gone far enough, and we should be demanding their resignation. His article concludes

Theresa May seems keen to blame anybody but herself – she tried to pin the crisis on the elderly before claiming that A&E departments are buckling because she thinks GPs are lazy.

Enough is enough.

Whenever Mrs May, Mr Hunt or any other Tory (with the exception of Dr Sarah Wollaston, who has spoken up for the NHS, thereby proving she is in the wrong political party altogether) tries to run down the NHS, its doctors, nurses, specialists, workers or users, let’s just tell them:

“No. You are to blame. Resign.”

It’s a simple message, and easy to repeat.

Put it out there a few times and even our Tory-loving mass media might get the hang of it.

http://voxpoliticalonline.com/2017/01/14/why-should-doctors-resign-because-of-the-nhscrisis-caused-by-theresa-may-and-jeremy-hunt/

Mike also asks why high profile medical leaders and politicians are not demanding May’s and Hunt’s heads. Jacky Davis and Raymond Tallis have a whole chapter on the failure of the medical profession to challenge the government over their piecemeal dismantlement of the NHS in their book, NHS-SOS. This topic may well deserve a blog post to itself to examine and explain it.

But for now, I completely agree with Mike. May, Hunt, Andrew Lansley and every other Tory, who has worked to undermine and destroy the Health Service from within, should resign. Now.

And why not also politicos from New Labour and the Lib Dems, who were also so keen to destroy the NHS in the interests of their corporate paymasters? They should go too.

And the same pressure should be kept on their replacements until the political class gets the message:

Restore the NHS.

Fund it properly.

Support NHS staff properly.

Or go.

These points are not negotiable.

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Vox Political on the Lies and Pro-Privatisation NHS Policies of Heidi Alexander

August 21, 2016

Mike also put up a couple of pieces yesterday critiquing and criticising a piece by Heidi Alexander in Friday’s Graun claiming that she resigned from her post as Shadow Health Secretary because Jeremy Corbyn was constantly undermining her and going behind her back. He does so by pointing out the inconsistencies between her tale, and what she actually said at the time.

For example, in her article she talks about how delighted she was to receive Corbyn’s invitation to take the post. Yet at the time, he was also in the Daily Mail saying she would not back Corbyn, because he was ‘unelectable’. She then claims that she left the Shadow Cabinet because it was ‘chaotic’ and ‘entirely dysfunctional’. But the real reason was that she was profoundly ideologically opposed, no matter what she says about interesting bright people committed to the NHS and giving Jeremy Hunt a run for his money.

John McDonnell was suspicious of her. She wasn’t doing enough to support the junior doctors, nor to combat Jeremy Hunt’s Seven Day NHS policy. So he set up an advisory panel to look into her work. She claimed that she supported this, but wasn’t informed about it. When she found out, she quit. Others involved in the affair have quite different versions of events. Mike makes the point that it’s not pleasant having someone else scrutinise your work, but we’ve all had it done to us. It’s part of business. You also have it in academia and in publishing. If publishers think a book you’ve written needs some alterations, they tell you. This includes tenured academics writing technical papers for academic publications. Mike states that it’s significant that the advisory panel hadn’t met before she left.

Mike also makes the point that she was among the first to resign following Hilary ‘Bomber’ Benn. He also points out that it’s hard to take her complaints seriously when she starts claiming that she wasn’t part of a coup, nor a plotter. She clearly was. As for her claim that Corbyn’s election would cause division, that’s exactly what she and the other Blairites have done. She states that when Labour members receive their ballot papers on Monday, they should carefully consider who would best lead the party. She now supports Owen Smith, yet Smudger had not put himself forward when she walked out.

Mike concludes that she’s simply a two-faced co-conspirator, who simply wanted Corbyn out so that she could further her own ambitions.

See: http://voxpoliticalonline.com/2016/08/20/lets-stop-heidi-alexanders-latest-silliness-right-now/

Following Heidi Alexander’s self-pitying moan in the Groaniad, the NHA – the National Health Action party put up a piece, ‘Bye Bye Heidi’, welcoming her resignation.

They state that they were hoping she’d resign, as she fully supported Simon Steven’s 5 Year Forward Plan for the privatisation of the NHS. The article quotes Dr Bob Gill, one of the executives of the National Health Action party, who met her twice. She said to him I believe Stevens has the best interests of the NHS at heart’. He goes on ‘A former UnitedHealth president here to complete the transition to an American style insurance system has her confidence. That says it all.’ She did not appear on junior doctor picket lines, nor even wear a BMA badge. He hopes that now that Blairites like Alexander are leaving the cabinet, Corbyn can appoint people, who actually want to renationalise the NHS and fully understand that it doesn’t have to be the private industry Hunt and Stevens want.

He states that the hospital closure plan is ready to be implemented. Hospitals and Accident and Emergency services are ready to be closed to pay off NHS debts. Dr. Gill states that Labour ought to be shouting from the roof tops about this. And with the right MPs in charge, may be they will.

See Mike’s article at:http://voxpoliticalonline.com/2016/08/20/bye-bye-heidi-nhaspace/

I think the National Health Action party has more than a little experience of dealing with privatising Blairites. I’ve got a feeling it was begun, at least according to Private Eye, when Blair tried to close a popular local hospital in the Midlands – I think it might have been Warwickshire, but I can’t be sure – in favour of a PFI deal. Local people and medical professionals tried to get their local councillor or MP to challenge the policy. They didn’t get very far, so one of the doctors stood as the party’s candidate. He won, defeated the Labour incumbent, and Tony got very cross.

In fact, much of the legislation the Tories have taken over and built on as part of their plan to privatise the NHS was started by Tony Blair, who wanted to remodel the Health Service on the type of ‘managed care’ practised by Kaiser Permanente and other American medical insurance companies. Hence I’m not remotely surprised by her comments about Stevens, an officer from an American insurance company, being placed in charge of the NHS’ privatisation.

The Blairites are disgusting, and the support of the supposedly left-leaning Groaniad for them, and by extension the privatisation of the NHS, is equally revolting. The time’s long past they were banished from the Labour party and national politics for good.

The War and Socialist Demands for a National Health Service before the Beveridge Report

February 18, 2016

This is following a debate I’ve recently had with a critic, who stated that the National Health Service had its origins in the Beveridge Report of 1942, and was endorsed by Winston Churchill and the Conservatives. This is true, up to a point, though Churchill was initially very cautious about the foundation of a National Health Service. After the War he made a radio speech denouncing the Labour party’s plans for a complete reconstruction of Britain as ‘a Gestapo for England’. However, Michael Sullivan in his book, The Development of the British Welfare State (Hemel Hempstead: Prentice Hall/Harvester Wheatsheaf 1996) also points out that before the publication of the Beveridge, there had been a long process of negotiation and demand for some kind of comprehensive, free healthcare for working people, and that this had become official Labour party policy in the 1934. He writes

Discussions about the reform of British health care had, in fact, occurred between the National Government and interested parties during the 1930s (Abel-Smith, 1984, pp. 424-7). The starting point for these discussions was the extension of health insurance rather than the position adopted by the Socialist Medical Association in the early 1930s. These latter proposals, which became Labour party policy in 1934, included the provision of free services to patients, the establishment of a corps of full-time salaried doctors and the introduction of local health centres which would be the hubs of the health care system. The discussions between doctors and government had emphasised the need to cater for the British Medical Association’s preference for the retention of a large private sector in health and the extension of health insurance to cover hitherto uninsured groups. (Leathard, 1991, p. 24).

During the early war years the departmental civil service encouraged the continuation of these discussions and received deputations from the medical profession and the Trades Union Congress. Events, however, overtook these discussions. The formation of the Emergency Hospital Service had, as we have noted earlier, the effect of providing a planned health service, albeit in the conditions of war.

By 1941, civil servants in the ministry of health, perhaps influenced by the running of the EHS, suggested a comprehensive national health system in which general practitioners would be grouped in health centres associated with local hospitals. In October of the same year, the Minister of Health, the Liberal, Ernest Brown, announced that some sort of comprehensive service would be introduced after the war. The organisational and funding arrangements of the service remained unclear, though the minister did suggest that patients ‘would be called on to make a reasonable payment towards cost, whether through contributory schemes or otherwise (Hansard, 10 October 1941). At this time, a survey of hospital provision was also set under way.

At the same time, professional interests were attempting to influence the shape of any future national health system. First, the voluntary hospitals, which had been in financial difficulties before the war, started to plan to avoid the return of financial ill-health after the war. Their suggested framework for a national health system included a closer co-operation between the two existing hospital systems in which local authority hospitals might buy service from the voluntary sector, a call echoed of course in the 1980s, if in a slightly different form and from a different source!

The British Medical Association and the Royall Colleges were also active. Charles Hill, better Known to a generation earlier than that of the author’s as ‘the radio doctor’, and later to become a Conservative Minister of Health, argued that those who planned first would be more likely to influence the final form [of the health service].’ That planning initially included an acceptance of the ideas emerging about General Practitioner (GP) health centres, as well as those of central planning and of a universal and free service. (Pp. 40-1)

He then describes how the BMA later changed its opinion, and became resolutely opposed to the idea of socialised medicine.

Of the contribution of the Conservative Health Minister, Henry Willink, he says

The White Paper, introduced by the then (Conservative) health minister, Henry Willink, conceded very little to the doctors and the voluntary hospitals. Indeed it was, at first sight, almost as radical in intent as the National Health Service came to be seen. Under this plan, a national health service was to be comprehensive and free and financed out of general taxation and local rates. A closer look at the White Paper reveals acknowledgement of some of the doctors’ concerns, however. The planned service would, as far as the ministry was concerned, be free and comprehensive. There would, nonetheless, be no compulsion for doctors or patients to use the planned public service but doctors who opted into the system would be offered the opportunity to become salaried employees of the central or local state. This latter offer, of course, flew in the face of the formal position adopted by the BMA. (p. 41).

He also points out that Willink appears to have retreated from several of his initial positions due to lobbying from the BMA:

In the succeeding months, political lobbying was intense. BMA leaders engaged in secret negotiations with Willink and appeared to have achieved a large degree of success. It seems that the minister colluded with the BMA in dismembering the proposals contained in the White Paper. First the idea of Central Medical Board was dropped to be followed by the demise of plans for a salaried service organised around health centres. Local authorities, it was now decided, would build health centres, but not control them. Instead GPs would rent the buildings, would be remunerated by capitation fee and be entirely free to engage in private practice. (p. 42).

He also argues against the view that the War was ultimately responsible for the creation of the NHS, and that it was the result of an overall consensus in which there was little left for Labour to do but decide the final details. He writes

The war cannot sensibly be regarded as the midwife of the NHS. Some account must also be taken of pressure for change in health policy during the inter-war years.

As we have already seen, the SMA were successful in placing these recommendations for a national health service on the political agenda during the 1930s. These proposals for a free and comprehensive service with a salaried staff formed the basis of Labour party policy as early as 1934. The proposals put forward during this decade by the BMA were, of course, less radical but acknowledged that there were fundamental weaknesses in available medical cover. On two occasions in the 1930s, it published reports which recommended that each citizen should have access to a family doctor and to the services of appropriate specialists. These recommendation, like later proposals from the BMA, fell far short of a national, or nationalised, health service; the financing of the service was seen as best achieved through a system of health insurance. The BMA were even unwilling to accept the recommendations of its own Medical Planning Commission about the scope of a health insurance scheme (Sullivan, 1992). Nonetheless, the BMA during the 1930sa was ready to concede that co-ordination of any post-war service was most satisfactorily located at the national level. (pp. 42-3).

He also notes that even in the 1920s there were calls for some kind of national health service.

There had, of course, been an even earlier call for a national health service. In fact in 1926 the Report of the Royal Commission on National Health Insurance was published. It acknowledged that the insurance system established in 1911 by a reforming Liberal government had become an accepted part of national life. It suggested, however, that ‘… the ultimate solution will lie we think in the direction of divorcing the medical service entirely from the insurance system and recognising it, along with all other public health activities, as a service to be supplied from the general public funds (HMSO, 1926). (p. 43).

Of the supposed consensus produced by the War in favour of an NHS, he says

While it is undoubtedly the case that the experience of war played some part in promoting ideas about changes in the principles and practices of health care (ultimately represented in the 1944 White Paper), it is far from clear that this process represented a new beginning. War may simply have achieved the acceleration of an already established process of policy movement.

Nor should we fall into the trap of seeing the development of war-time health policy as consensual, leaving a Labour government only to decide on the best way to implement agreed policy frameworks. Though many doctors, even in war time, supported the idea of a health system funded from general funds and including a salaried service, there was critical resistance to some of the measures outlined in Willink’s White Paper. that resistance, from the BMA leaderships and, it must be said, from a small majority of doctors responding to the BMA survey, included resistance to the idea of doctors as public servants and, sometimes, to the idea of comprehensive health system itself.

Even among those medical and other interests favouring the establishment of a comprehensives system, there were conflicts about other issues. While the SMA and the Labour Party and Service doctors supported the idea of financing the service from the national Exchequer, most other doctors and certain elements in the Conservative Party favoured a system of health insurance, either publicly or privately administered. While the former grouping favoured control of the health service by central or local government, many doctors opposed government activity that went beyond central planning functions. While the SMA, Service doctors and local medical officers, the Labour Party and some ministers in the Coalition government favoured a salaried service, this found very little support in the wider ranks of the medical profession.

By the end of the war there was agreement of only a limited nature, which masked a wide divergence of opinion amongst interested parties in the health field and in the wider social politics of health. (P. 44).

He concludes

War-time health policy seems, then, to be of less significance than some claim in defining post-war health policy. Though limited agreement on the need for a comprehensive system had emerged, conflict remained over the nature of that system. More than this, inter-war factors seem to be not insignificant in the growth of pressure for a comprehensive health system. War undoubtedly accelerated the acceptance as orthodoxy hitherto contested arguments. Nevertheless, as Aneurin Bevan was to find out, that orthodoxy was still some way short of a national health service.

It’s therefore clear then that sections of the civil service was aware of the defects in existing health provision in the 1920s, and that the Labour Party was demanding something like an NHS from 1934 onwards. The proximate cause of the emergence of the NHS was indeed the emergency health care system set up in the war to treat victims of bombing and evacuees. I concede to my critic the fact that Churchill was, at times, cautiously in favour of an NHS, and that Henry Willink did advocate a free health care system, although his was not ultimately as radical as that set by Bevan.

Nevertheless, ultimately it was Bevan and the Labour party that set up the NHS in 1946. Furthermore, even though there were elements in the Tory party that certainly supported the creation of the NHS and welfare state, there were still many others that opposed it.

Furthermore, the origins of the National Health Service in a fragile war-time and post-war consensus does not, unfortunately, alter the situation today. The Tory party is determined to privatise the NHS by stealth. Jeremy Hunt has said that he wants the NHS broken up and replaced with private health care. Another Tory apparatchik stated that by 2020, if his party had its way, the NHS wouldn’t exist except as a clearing house for health insurance. This was later denied by the Tory spin machine, would claimed that he instead said that the Tories would succeeded in removing unnecessary health regulations and bureaucracy. In the last government, there were 95 Tory and Lib Dem MPs with interests in private health firms, hoping to profit from the NHS’ privatisation.

The only remaining clear champions of the National Health Service as national, free, universal system are the anti-Blairite wing of the Labour party under Jeremy Corbyn.

And that’s my last word on this issue. At least for now.

From 2000: SEMA – the Atos of its Day

January 31, 2015

Private Eye in its issue for Friday, 19th May 2000, carried the story below on the establishment of the Work Capability Tests. These were originally a Tory idea, but where put into practice by Blair’s Labour after their election victory in 1997. The contract to administer the tests were awarded to Sema. Their conduct of them was so appalling that it was the subject of a report by the House of Commons social services committee.

Cringe Benefits

It was a Tory idea to begin with: how to make more money out of the disabled for a big private company.

After a “study of options” about what to do with the rather expensive government system for examining disabled people to see if they were entitled to benefit, the Tory government concluded that contracting out to the private sector was “most likely to deliver the improvements sought”.

Tory ministers agreed and the publicly-owned Benefits Agency Medical Services was divided into three areas “to encourage competition in terms of bids”. the Tory government fell in the spring of 1997, to be replaced by Labour with a huge majority and a secretary of state for social services, Harriet Harman, who had been eloquent in her condemnation of privatisation.

Ms Harman, however, was at once convinced of the case for privatising the testing of the disabled, and in February 1998 (in the interests of competition) she awarded the contracts for all three areas to one company, SEMA.

It was a juicy contract too. A government memorandum at the time announced that the three contracts would cost the government £305m, a figure, which the memo announced, “represented savings of £62m” compared with what the service used to cost the taxpayer.

One problem which soon became clear was that SEMA had no medical experience whatever. The British Medical Association, disgusted by the company’s treatment of doctors and patients, complained officially that SEMA executives “did not understand the complexities, having had no experience of employing doctors”. This obviously worried the company so much that when the five original bidders were invited to discuss the complexities of their new contract with the BMA, which represents most British doctors, two declined, including SEMA.

If it didn’t have any doctors or medically qualified staff, SEMA made sure it was well-stocked with “new” Labour lobbyists. It hired Westminster Strategy, which had a batch of such lobbyists on tap: Jo Moore, former Labour press officer; Mike Lee, who used to work for David Blunkett; and former chair of the Fabian Society and wanabee Labour candidate Mike Dauber. To clinch the business, SEMA acquired the then employment minister Andrew Smith as a speaker at its glittering conferences (see Eye 955).

Partly to make up for this lack of experience, SEMA engaged two companies as sub-contractors to do the new work, Nestor Healthcare Group and Nestor Disability Analysts. The board of the former was graced by a former Tory MP, Charles Goodison-Wickes, who quickly made way for the more acceptable Anne Parker, who chairs the Carers Association and is an examiner for the Child Support Agency. Nestor Healthcare has just branched into prisons, explaining in true “new” Labour tradition that “prisoner numbers are steadily growing”.

The performance of these SEMA subsidiaries and of privatisation in general, has recently been examined in detail by the House of Commons social services committee, whose shocking report has just been published. “To often”, says the report, “the organisation fails to deliver an adequate service … at its worst it puts claimants through examinations which are painful and distressing and gives poor advice.”

Bizarre examples of the doctors’ hostility to the people they are examining are provided by the report. In one case a patient was described as healthy because she could sit up watching television for up to two hours. In fact this patient could only watch television lying down. In another case a patient’s dirty fingernails were submitted as evidence of his ability to work in the garden – whereas in fact he could not even wash himself.

The conclusion makes sad reading for the “new” Labour lobbyists and privatisers of past years. There has been no improvement whatever. “Our inquiry has led us to conclude that, so far, the primary focus of SEMA has been on operational efficiency to achieve value for money rather than the delivery of a quality service.”

How has Labour responded so far to these devastating allegations? It has handed over a confidential contract for running the Labour party’s own membership records to … SEMA. And SEMA’s subsidiary Nestor has won a contract for the provision of an immigration centre for Group 4.

Since then, SEMA has been replaced by ATOS, who have now been replaced by Maximus, but still have the contract for administering the test for the Personal Independence Payments. ATOS made sure it avoided one of the criticisms of SEMA – that it didn’t have enough doctors or medically qualified staff. For patients and claimants, however, this has made absolutely no difference. The administrators of the Work Capability Test are still hostile towards those whom they are examining. Subsequent Tory policies, like those of Iain Duncan ‘Tosser’ Smith, have made this even worse. Maximus are going to be no different. Given the previous performance of the companies administering the test, they are likely to be worse.

There is even a lesson here for the recent recruitment of Sue Marsh, a disability campaigner, by Maximus. SEMA’s subsidiary, Nestor Healthcare, had on its board Anne Parker. As well as being an examiner for the Child Support Agency, she was also the chair of the Carers Association. This was doubtless to give the impression that the tests were to be fair, with the object of helping the disabled and their carers. It wasn’t, and isn’t.

This is the policy the Tories produced and are developing. It becomes nastier, more vindictive and humiliating every day. It’s high time the Tories were kicked out of office.