‘I’ Newspaper: Tories Selling Off Mental Health care to Americans

And it’s a disaster.

This is another story from yesterday’s I, this time written by Ian Birrell. It’s titled ‘NHYS for sale? Our mental health services are’ with the subtitle ‘Fatcat US operators already have their claws into our psychiatric services’. It’s a comprehensive discussion how big American private medical companies are acquiring British healthcare companies and NHS contracts, and how patients are suffering through the deplorably bad care they provide.

Birrell begins with Jeremy Corbyn’s statement last week that the documents of the negotiations between Trump and Johnson showed that the NHS were being sold off to private American companies. Birrell denied this, and instead stated that not even Boris would dare sell off the NHS went it is so highly valued by the British public. He then moved on to the strenuous denials by the Tories that they were planning any such thing, before attacking them in turn as lies when it came to mental health. He wrote

Yet hang on a second. One key slice of the NHS is already lying in a distressed state on the operating table, where it has been chopped up for profit-hungry private firms. And giant US health corporations, along with hedge funds and private equity firms, are already here and bleeding dry this profitable of the corner of the NHS – with often disastrous consequences for some of our most desperate patients. Sadly, no one seems to care much since it is “only” the mental health sector – for so long the neglected Cinderella service.

Yet in recent years a small cluster of fatcats have got their claws into Britain’s psychiatric services, exploiting the struggles of the health service to cope with surging demand. These operators have grabbed nearly £2bn of business, providing almost one quarter of NHS mental health beds and soaking up close to half the total spend on child and adolescent mental health services.

This means they own many NHS-funded units holding people, such as teenage girls who self-harm and adults with suicidal thoughts, along with hundreds of people with autism and learning disabilities scandalously locked up due to lack of support in their local communities. These firms benefit as overloaded mental health services and risk-averse officials send more and more troubled citizens into secure units. It is a lucrative business when it costs up to £730,000 per patient a year. Bosses can pocket millions – but many frontline workers earn little more than minimum wage and the use of agency staff is routine, despite the need to develop patient relationships.

Acadia, a Tennessee-based health giant, spent £1.3bn buying the Priory Group and now boasts of earning more than £188m in just three months from British public services. “Demand for independent-sector beds has grown significantly as a result of the NHS reducing its bed capacity and increasing hospitalisation rates,” said its last annual report.

Operating profits at Cygnet, owned by another huge US firm, have surged to £45.2m due to deals with 228 NHS purchasing bodies after it bought a rival group last year. Another outfit called Elysium, backed by private equity through a Luxembourg firm, only launched three years ago, but is already earning revenues of £62.2m from at least 55 units.

But a study by the Rightful Lives campaign group has found these three firms alone own 13 of the 16 mental health settings judged “inadequate” by the Care Quality Commission watchdog, since it found some teeth after the furore over abusive detention of people with autism and learning disabilities exploded a year ago. Cygnet runs eight of these “inadequate” units, although its US boss is reportedly the richest chief executive in the hospital industry, who collected more than £39m in one year from pay, bonuses and stock. Priory and Cygnet also owned hospitals exposed by disturbing undercover television documentaries over the past year.

I have heard a stream of horror stories from despairing families and former patients involving solitary confinement, forcible injections, abuse and overuse of restraint, during investigations into this area. Some were detained in NHS psychiatric units. But most involve privately run units. People such as Megan, who was sectioned for self-harm, suicidal thoughts and later found to be suffering post-traumatic stress from childhood traumas. She was in four clinics – but in one run by the Priory, aged just 16, she was even held stark naked for one month to prevent self-harm until her parents delivered a “safe suit”. “It was the most degrading time of my life,” she told me. The firm was fined £300,000 earlier this year for failings after the suicide of a 14-year-old girl at the same unit.

Despite the ample demonstration that private healthcare doesn’t work and is just simple profiteering, Birrell is at pains to say that he has nothing against the involvement of the private sector in state healthcare. He just wants it to be better regulated. He ends his piece with these two paragraphs

Unlike many voters, I have no problems with private providers in healthcare if the service remains free at the point of use, especially after seeing their role in European systems with superior patient outcomes to our own health service. But seeing these mental-health firms has shaken my faith.

Clearly all private operators need to be effectively regulated, especially when providing sensitive frontline services. Sadly, it seems our politicians on all sides prefer to posture over whether the NHS is really for sale to “mega-corporations” while ignoring those that have already arrived and are pocketing vast sums while offering inadequate services to so many despairing citizens. Once again, we see how little Westminster really cares.

Actually, I think these paragraphs say much about the I and the political ‘centrism’ it supports. The NHS has been privatised piecemeal since the days of Thatcher, who was prevented from privatising it outright by a cabinet revolt. Blair’s government did much to hand it over to private firms, though much had already been done in this direction by the Private Finance Initiative introduced by the Tories and Peter Lilley. The Conservatives haven’t reversed the policy of privatisation, and are instead ramping it up even further.

The result is massively poor performance. Jacky Davis and Ray Tallis argue very strongly in their book on the privatisation of the NHS, NHS-SOS, that on their own private healthcare can’t compete with state. The service provided will always be inferior, as the profit-motive doesn’t work when it comes to the long-term sick or those with acute conditions. Private hospitals have fewer beds than state hospitals. And those who cannot afford healthcare are simply left to sicken and die. A few years ago the private healthcare system in America nearly collapsed. It’s why the American healthcare giants are so keen to acquire pieces of ours.

Yes, continental healthcare which often does involve the private sector can perform better than ours. But that’s because our National Health Service has always received comparatively less funding than theirs. It’s been the case, sadly, since the NHS was set up. On the other hand, our healthcare results are far, far better than Americas and were comparable to those on the continent. Until the Tories took over, and decided to cut things back and privatise even more.

But Birrell cannot criticise private medicine, because privatisation is still part of ‘Centrist’ political dogma. Moreover, the press is now owned by immensely rich men, often with commercial interests in other sectors of the economy. As a result, the supposedly liberal I and Guardian continue to flog Centrist economics even though these are so well-past their sale-by date that they’ve been dubbed ‘zombie economics’.

As for Corbyn, I believe very strong that rather than playing political football with the issue of NHS privatisation, he’s very aware of what’s going on and how it is failing Britain’s sick and ill. That’s why he wants to end it and renationalise the NHS. Birrell tries desperately to avoid that conclusion, because like all Centrists he wants the NHS privatisation to continue thanks to the Thatcherite dogma he’s imbibed and promotes.

But Thatcherism has had its day. It is bringing nothing but misery, deprivation and death. It’s time the Tories were out, Jeremy Corbyn was in, and the NHS renationalised. 

Now!

The I: ‘Private Hospitals ‘Put Patients at Risk’

I just found this article in today’s ‘I’ newspaper for 30th November 2015, reporting the findings of the Centre for Health and the Public Interest that poor standards at smaller private hospitals are a risk to patients’ health. The article by Paul Gallagher states

‘NHS patients sent for treatment at smaller private hospitals are being put at risk because of unsafe staffing and facilities, according to a report by an anti-privatisation think-tank.

Nurses without specialist training, high levels of agency staff on post-operative wards and hygiene weaknesses were also among the patient safety risk identified by the Centre for Health and Public Interest (CHPI).

Analysis of 15 Care Quality Commission (CQC) investigations into hospitals from each of England’s six main private hospital chains found serious problems even in hospitals rate “good” by the regulator. Care UK’s Barlborough NYHS Treatment Centre in Chesterfield was given an overall rating of “good” and a rating of “good” specifically for surgery. Yet in the previous 12 months there had been four “never events”, defined as “serious, largely preventable, patient safety incidents that should not occur”.

Dr Howard Freeman, of the NHS Partners Network, said: “The overwhelming majority of NHS care delivered by independent sector hospitals is safe”.’

I dare say the treatment at most private hospitals is safe, but that does not mean that it is necessarily particularly high or of the same quality as that supplied by the NHS. In America, there is a very high incidence of iatrogenic disease. In the case of surgery, this is built into the system through the profit motive. Doctors and surgeons get paid if they treat. Therefore, they will offer or suggest treatment, even if its unnecessary. Way back in the 1980s Panorama did an edition on medicine in America, at the time when Maggie was considering its privatisation, and revealed the very high rates of unnecessary operations in the Land of the Free. This adds further evidence to corroborate existing information on the detrimental effects of private healthcare, no matter what Bliar and Cameron have told and are telling everyone.

From 2012: Serco Sacks 140 Medical Staff in Suffolk

This is another article from Private Eye. In their issue for 16th-29th November 2012 the Eye covered the way SERCO were going to shed 140 jobs after taking over the management of the NHS community services in Suffolk, similar to what the company had previously done when it took over the out-of-hours GP service in Cornwall.

SERCO

Suffolk Punch

No sooner does outsourcing giant Serco take over NHS community services in Suffolk, including nursing and community hospitals, than nearly 140 jobs are to be axed.

It’s little consolation for front-line clinical staff, such as health visitors, that they won’t have to face compulsory redundancy. They can volunteer, be redeployed or wait to be “phased out” – unlike their colleagues in HR, finance and admin who will be swiftly shown the door as the “Serco Global Business Division”, backed by a “dedicated qualified accountant in India”, takes over.

When Serco won the £140m three-year contract NHS Suffolk – which includes specialist services such as cardiac rehabilitation, neurological services and speech and language therapy – the company pledged that patients would not notice any changes and would be able to access NHS services in the same way as before.

So how will it fulfil that role with fewer front-line health workers, who are already stretched caring for the growing numbers of people who are being cared for and treated in the community, rather than hospitals?

The company says clinical staff will be freed up by extra administrative backup, reduced bureaucracy, changes to the way people work and increased use of mobile and other technology.

This all sounds very similar to the Serco service model for the out-of-hours GP service that it runs in Cornwall – which in the summer was criticised by the Care Quality Commission for, among other things, not employing enough “qualified, skilled and experienced staff to meet people’s needs”.

In short, it’s another example of how local NHS services have been cut under the piecemeal privatisation of the NHS in order to maximise the profits of yet another multinational.

Private Eye on Abuse and Neglect at Beech House Private Care Home

After covering several stories of abuse and neglect at private care homes, Private Eye ran another story about the poor care given to adults suffering from learning difficulties and ‘challenging behaviour’ at the private Beech House hospital in Newmarket in their 24th August -6th September 2012 edition. Here it is.

‘Care Homes

A Private Concern

More evidence emerges that big business and private-equity firms are among the worst offenders when it comes to running poor care homes.

Last month Eye 1319 revealed how the ever-expanding Priory Group and Craegmoor-owned by the American private-equity firm Advent International – were the owners of two of the 18 homes and hospitals found to be failing to protect its young disabled residents during Care Quality Commission inspections.

Another found by the care watchdog to have “major concerns” was Beech House in Newmarket, an independent hospital that houses 30 adults with learning difficulties and challenging behaviour. Inspectors found residents were “being restrained unnecessarily ” by staff who were “authoritarian” and “very controlling”. All external and internal doors were locked, even though this was a “low secure hospital”.

Issuing enforcement notices against the hospital, inspectors concluded that patients were “not being protected from abuse, or the risk of abuse”.

Beech House is part of the Four Seasons group, which also owns six homes listed as “moderate concern” by the inspectors. Four Seasons has been bought and sold by private-equity firms for years: Terra Firma, the private-equity outfit run by Guy Hands, was the latest to buy it, for £800m in April.

Another of the 18 presenting “major concerns” was Elmsmead in Taunton, a home for a dozen young adults with learning difficulties, where inspectors found poor care planning and a “strong small of urine” in the lounge, suggesting poor continence care. Elmstead is part of the Voyage Care chaine of homes, which also runs the Rhodelands home in Devon, where inspectors recorded “moderate” concerns-and Voyage Care is owned by private-equity firm HG Capital.

Overall in its inspection of 150 institutions, the CQC found that privately owned “independent” homes were twice as likely to fail at both care and safeguarding as those run by the NHS. Eye readers know well the debacle surrounding the collapse of Southern Cross (private-equity owner, Blackstone), the largest provider of care for the elderly – much of it poor.

But the government remains ideologically wedded to greater private investment in health and social care from its business mates and associates. Guy Hands is a close friend of William Hague, and Ian Armitage, chair of HG Capital, gave £30,500 to David Willetts “research fund” and the Tory party between 2007 and 2010.

* Now taxpayers’ money is also being handed over to private enterprise from the care watchdog itself. For the past two years the CQC has been handing monthly sums, in the region of £500,000 or above, to Carlisle Managed Solutions, for staff and services to just about every division of the commission, from registration to regulation, from finance to intelligence – and even to the chair and chief executive’s office. So far Carlisle Managed Solutions has pocketed some £13.66m. It just happened to be owned by Impellam, the so-called global “human capital services company”-owned by the family trust of none other than tax-haven enthusiast and Tory party benefactor Lord Ashcroft.’

So there it is in black and white: privately run hospitals are more inefficient, and offer worse care than the NHS. But thanks to their connections to Tory leaders like Hague and Ashcroft, they’re set to be give more of the NHS.

Private Eye on Failure of Care at More Care Hospitals owned by American Private Equity Firms

I blogged yesterday on the scandalous conditions and abuse of patients at Winterbourne View, a residential hospital run by a private equity firm. Looking back through Private Eye I found more cases of neglect and abuse of people with learning difficulties in care homes run by the Priory Group, owned by Advent International, another private equity firm. This article was published in their 27th July-12th August edition last year.

‘Care Homes

Priory Engagement

The Priory group and its Craegmoor subsidiary boast that they “transform lives”. but they seem less happy to see their brand on their ever expanding care home portfolio when things go wrong.

When the Care Quality Commission’s unannounced checks revealed shortcomings in facilities for the learning disabled, no criticism was levelled at “Europe’s leading specialist care provider” to tarnish its self-proclaimed “unrivalled reputation”. That is because two of the group’s homes criticised by the CQC for failing to protect the safety and welfare of its young residents, Lammas Lodge in Hereford and Melling Acres in Liverpool, are registered in the name of Parkcare Homes, which took all the blame and bad publicity in the specialist media.

In September last year, following an anonymous tip, inspectors found residents at risk of abuse in Lammas Lodge, a home for young adults. There were not enough staff and what staff there were, inspectors found, were not properly trained to meet residents’ complex needs. There were six major areas of concern, including care and welfare, medication and safeguarding. The home, which was warned it must improve or face closure, has since been given a clean bill of health by the regulators.

Not so Melling Acres, where inspectors reported major concerns in May about the care and welfare of its seven residents – care plans were poor, with scant information about physical health needs, there were limited activities and a lack of advocacy to enable people to express concerns about their care.

The Priory Group and Craegmoor are owned by the American private equity firm Advent International, whose continuing expansion into the industry (it has recently acquired 11 Harbour Care homes on the south coast) is causing some concern.

The collapse last year of Southern Cross showed that care homes, private equity and poor financial and care regulation can lead to a toxic cocktail for the people in care. Sale and leaseback deals on the care home property portfolio itself enabled profits to be creamed off by Southern Cross’s private equity owner, Blackstone, before the credit crunch meant Southern Cross could no longer afford its landlords’ rising rents.

As Eye readers may recall, Philip Scott – the former Southern Cross chief executive who was in charge during the boom years but bailed out, selling his personal stake for £11m just before sales started to plunge-went on to become CEO at the Priory Group. Interestingly, he has this month announced he is to quit.

Is history about to repeat itself? The group has recently reduced its earnings forecast by 7 per cent, blaming the squeeze on NHS budges for a fall in patients. Will Scott retain his equity stake in the group-and will he continue to rent various care properties back to the Priory Group via his property companies? Watch this space.’

I’ve no doubt that there are care homes excellently run, where their patients are comfortable and well-looked after. The combination of private equity firms, which are primarily interested in making a quick, big buck, and residential and care homes is too vulnerable to exploitation and abuse, however.