Posts Tagged ‘GPS’

Don’t Let Theresa May Privatise the NHS

June 8, 2017

This is the text of one of the self-published, table-top produced pamphlets I created a few years ago, and which are advertised on one of the other pages of this blog.

As you can see, it was written a year or so ago when David Cameron was in power. Nevertheless, it is still as valid now as it was then. Theresa May has not changed the Tory policy of privatising the NHS one whit.

So, please, read this article, and then vote for Jeremy Corbyn to preserve this most precious of British institutions.

Don’t Let Cameron Privatise the NHS
David Sivier

Visiting our local health centre the other day, my parents, along with the other local people enrolled there, were handed a letter, explaining that due to funding cuts the health centre was having to cut back on services. It also advised its patients that if they wanted to raise their concerns about the restriction in their service they could contact:-

1. NHS England at FAO Linda Prosser, Director of Assurance and Delivery, NHS England South West (BNSSG), 4th floor Plaza, Marlborough Street, Bristol BS1 3NX
2. your local MP at the House of Commons, Westminster, London SW1A 0AA

Unfortunately, this is happening to the NHS and GPs’ services all over the country. It is no accident, and it is certainly not the fault of the many dedicated doctors, nurses and other health professionals working in the NHS.
It is the result of over 30 years of privatisation begun with Margaret Thatcher. Thatcher and her former Chancellor, Nigel Lawson, denied that they wanted to privatise the NHS. They merely stated that they wanted to include more private provision in the NHS. This is a lie. Released cabinet minutes showed that Thatcher and Geoffrey Howe wanted to privatise the NHS along with abolishing the rest of the welfare state. They were only prevented from doing so because the rest of the cabinet realised that this would be the death knell for the Tory party. And a fact-finding mission to the US to see how their private healthcare system worked by Patrick Jenkin showed that it was massively inefficient.

Nevertheless, the amount of private healthcare in the NHS was expanded, and state provision duly cut by successive governments. It was Maggie’s government in 1989 that ended the state support for care for the elderly in nursing homes. As a result, the families of those, who need this kind of care, are forced to fund it themselves, often through selling or remortgaging their homes because of the immense expense. It was also Maggie’s government that ended free eye tests, and picked a feud with the doctors that saw the majority of them leave the NHS.

This privatisation has continued under Tony Blair, Gordon Brown and now David Cameron and Jeremy Hunt. Blair and Brown were deeply impressed with American private healthcare firms such as Kaiser Permanente, and wished to reform the NHS on their model. The ultimate intention was to replace the publicly owned and operated NHS with private healthcare funded by the state, but administered by private health insurance companies. As a result, NHS work has been given to private hospitals and clinics, and private healthcare companies have been given NHS hospitals to manage. Alan Milburn, Blair’s health secretary, wanted the NHS to become merely a kitemark – an advertising logo – on a system of private healthcare companies funded by the government.

This has been carried on the current Conservative government. And they have used the same tactics Margaret Thatcher did to force private healthcare on this nation. The dispute with the doctors over contracts a few years ago was part of this. It has left the majority of NHS GPs wishing to leave. Yet elements within the Conservative networks responsible for foisting these demands have seen this as an opportunity for forcing through further privatisation. Penny Dash, of the National Leadership Network, and one of those responsible for the NHS privatisation, has looked forward to the remaining GPs forming private healthcare companies. Furthermore, an report on the Care Commissioning Groups now in charge of arranging healthcare in the NHS by one of the private healthcare companies also suggested that they could form private healthcare companies, and float shares on the stockmarket.

Further privatisation has come with Andrew Lansley’s Health and Social Care bill of 2012. This exempts the state and the Secretary of State for Health from their statutory duty, as the ultimate leaders of the NHS, to provide state health care. It is carefully worded to disguise its true meaning, but that is what has been intended by the bill. Dr David Owen, one of the founders of the SDP, now part of the Lib Dems, has tabled amendments trying to reverse this despicable bill. He and many others have also written books on the privatisation of the NHS. One of the best of these is NHS SOS, by Jacky Davis and Raymond Tallis, published by Oneworld.
This process cannot be allowed to continue, and I strongly urge everyone to resist the creeping privatisation of the NHS, Britain’s greatest public institution.

In the last government, there were 92 Conservative and Lib Dem ministers, who advocated the privatisation of the Health Service, and who stood personally to gain from it. They included Iain Duncan Smith, the minister for culling the poor, the sick and the old. Andrew Lansley, the health minister, openly stated he is in favour of privatising it. So has Nigel Farage, and the Unterkippergruppenfuhrer, Paul Nuttall.

Farage in particular follows the Tory policy going all the way back to Thatcher of promising to defend it while secretly plotting how to sell it off. Thatcher ‘s review into the NHS and its funding in the 1980s. so alarmed Labour’s Robin Cook, that he wrote a Fabian pamphlet, Life Begins at 40: In Defence of the NHS, attacking possible proposals to privatise the Health Service.

Previous reviews had given the NHS a clean bill of health. The extremely high quality of the NHS and its doctors was recognised by the heads of American healthcare firms: Dr Marvin Goldberg, chief executive of the AMI health group, told a parliamentary select committee that the Health Service Provides ‘outstanding health care and British NHS hospitals are at least as good as those in America while British doctors are better.’

The then Conservative MP for Newbury, Michael McNair-Wilson, also testified to the effectiveness of the NHS. He had suffered kidney failure. He had private health insurance, but it did not cover operations such as the one he needed because of the expense. He said ‘I have cost the NHS tens of thousands of pounds – much more than I could have afforded privately … Had my treatment depended on my ability to pay, I would not be alive today.’

Pre-NHS Britain: Some Areas Completely Without Hospitals

Cook’s pamphlet also graphically described the patchwork state of healthcare in Britain before the NHS. In London, where there were plenty of paying customers, there could be hospitals in neighbouring streets. Out in the poorer British provinces, there were hardly any, and many operations were carried out not by surgeons but by GPs. He cites Julian Tudor Hart’s book, A New Kind of Doctor, to show how bad this could be. Hart described how he joined one of those practices in Kettering. One patient was left under anaesthetic as the London specialist operating on him was called away to continue a stomach operation on a London patient, which the operating GP had been unable to complete.
Cook was deeply concerned that the Tories’ review would not be at all interested in improving quality, only in opening up the NHS to the market and privatisation.

Cook on Private Health Insurance

One of the issues he tackled in the pamphlet was the possibility of the introduction of private health insurance. This covers two pages and a column and a bit in the original pamphlet. This is what he wrote, though emphases and paragraph titles are mine.

The mechanism proposed to square the incompatibility of health care with the market is insurance. All market approaches to the NHS submitted to the Review stress the case for much wider private insurance and almost as frequently propose subsidies to boost it.

Insurance-Based Systems Encourage Expensive Treatment

The first thing to be said is that private insurance does not offer
to health care the alleged benefits of the discipline of the market place. At the point when the individual requires treatment he or she has already paid the premiums and has no incentive not to consume as expensive a treatment as can be reconciled with the policy. The position of the doctor is even more prejudiced in that he or she has every incentive to obtain as much as possible from the insurance company by recommending the most expensive treatment. Both patient and the doctor are in a conspiracy to make the consultation as costly as possible, which is a perverse outcome for a proposal frequently floated by those who claim to be concerned about cost control.

Insurance-Based Systems Encourage Unnecessary Surgery

The compulsion in an insurance-based system to maximise the rate of return is the simple explanation why intervention surgery is so much more often recommended in the United States. For example, the incidence of hysterectomy there is four times the British rate. This is unlikely to reflect higher morbidity rates but much more likely to reflect the greater willingness of doctors on a piece-work basis to recommend it, despite the operative risks and in the case of this particular operation the documented psychological trauma. I can guarantee that an expansion of private insurance will certainly meet the objective on increasing expenditure on health care, but it is not equally clear that the money will be spent effectively.

Insurance-Based Systems Require Expensive bureaucracy to Check Costs

One direct diversion of resources imposed by any insurance-based scheme is the necessity for accountants and clerks and lawyers to assess costs and process claims. The NHS is routinely accused of excessive bureaucracy, frequently I regret to say by the very people who work within it and are in a position to know it is not true. Expenditure in the NHS is lower as a proportion of budget than the health system of any other nation, lower as a proportion of turnover
than the private health sector within Britain, and come to that, lower than the management costs of just about any other major enterprise inside or outside the public sector. I am not myself sure that this is a feature of which we should be proud. ON the contrary it is evidence of a persistent undermanaging of the NHS, which is largely responsible for its failure to exploit new developments in communication, cost control and personnel relations. Nevertheless, there is no more pointless expansion of administrative costs than the dead-weight of those required to police and process and insurance-based system. These costs would be considerable.

Forty per cent of personal bankruptcies in the US are attributable to debts for medical care

Part of this additional cost burden is incurred in the task of hunting down bad debts, which does not contribute in any way to the provision of health care. Forty per cent of personal bankruptcies in the US are attributable to debts for medical care, a salutary reminder of the limitations set to insurance cover. These limitations have three dimensions.

Insurance Cover Excludes Chronic and Long-Term Sick, and the Elderly

First, insurance cover generally excludes those conditions which are chronic and therefore expensive or complicated and therefore expensive. Standard exclusions in British insurance policies are arthritis, renal dialysis, multiple sclerosis or muscular dystrophy. Most people do not require substantial medical care until after retirement. Most insurance cover excludes the very conditions for which they are then most likely to require treatment. Short of retirement, the most expensive health care required by the majority of the population is maternity care, which is also excluded by the majority of insurance policies.

Private Healthcare Limits Amount of Care due to Cost, not Need

Secondly, insurance cover is generally restricted by upper limits which are arbitrary in every sense other than financial. I recently met a psychiatric consultant to a private clinic, who was prepared to discuss candidly the ethical dilemmas of treating patients whose financial cover is fixed at five weeks of residential care, but whose response to treatment may indicate that a longer period of hospitalisation is desirable.

Private Health Care Geared to Selling to Healthy not Sick

Thirdly, insurance cover is further limited by exclusion of those most likely to claim on it. I am often struck at the sheer healthiness of the patients who illustrate the promotional literature of BUPA and PPP who appear in such pink of good cheer and fitness that it is difficult to figure out why they are in a hospital bed. These models are though in a sense most suitable for the purpose as the objective of insurance companies is to attract the healthy. They therefore claim the right to screen for the unhealthy and reject them from cover. This discriminatory approach was defended earlier this month by the managing director of WPA, Britain’s third biggest health insurer, on the principled grounds that it meant ‘essentially healthy people are not penalised by unhealthy people.’ This statement has the advantage of originality in that it perceives healthy people as the vulnerable group and proposes a market remedy that protects them from the inconvenient costs of the unhealthy.
Given this limited character of health insurance in Britain, the private sector is patently not in a position to substitute for the NHS and to be fair most directors of BUPA or PPP would be horrified at the notion of accepting the comprehensive, open-ended liabilities of the NHS. It is therefore perplexing that so much effort in and around the Review appears to be addressed to the issue of how the private sector may be expanded rather than how the public sector may be improved. Two major devices are being canvassed to boost private cover-tax relief on private cover or opt-out from public cover, or for all I know both of them together. Both would be a major mistake.

Tax Relief on Private Healthcare

Tax relief is open to the obvious objection that it targets help most on those who need it least – the healthy who are most likely to be accepted for private cover and the wealthy whose higher tax rates make relief most vulnerable. These are curious priorities for additional health expenditure.

Tax Relief Does Not Create Higher Spending on Health Care

Moreover, even in its own terms of stimulating higher spending on health, tax relief is likely to prove an ineffective mechanism. If for example the average premium is £200 pa the cost of tax relief for 6 million insured persons will be £300 million. The numbers under insurance need to increase by a third before the increased spending on premiums matches the cost of the subsidy and provides any net increase in health spending. Up to that point it will always produce a larger rise in health spending to increase the budget of the NHS by a sum equivalent to the cost of tax relief.

It is apparently being mooted that these objections could be circumvented by limiting the tax relief to the elderly. At this point the proposal moves from the perverse to the eccentric. This restriction targets help for private insurance on the very group for whom private cover is most inappropriate as their most likely health needs are the ones most likely to be excluded from cover. Only a moment’s reflection is required on the multiple ways in which we need to expand our health provision for the elderly to expose the hopeless irrelevance of tax relief as the solution for them.

Opt-Out Penalises those who Remain in the System

Opt-out is even more objectionable. The basic problem with opt-out is that it requires the payment towards the NHS of every individual to be expressed in a manner that gives him or her something to opt-out from. The principal attraction to Leon Brittan of his proposal for an NHS insurance contribution appeared to be precisely that it paved the way for opting out (A New Deal for Health Care, Conservative Political Centre,, 1988). Nor is this inconvenience confined to the need for a whole new element in the tax system. If one in ten of the population chose to opt out, it would be remaining nine out of ten who would have to prove they were not opted-out when they went along to seek treatment. With the new contributions comes a requirement to maintain a record of payment of them, and presumably a mechanism for credits to those not in work but who do not wish to be counted has having opted out of the NHS.

Private Healthcare Undermine NHS as Universal System

The more fundamental objection both these proposals is they explicitly threaten the NHS as universal health service catering for everyone. Moreover, they threaten its universality in the worst possible way, by encouraging those with higher incomes and lower health needs to get out, leaving behind the less affluent and the less fit. In this respect such an approach to the NHS would be a piece with the Government’s strategy of erosion towards the rest of the social services-housing, pensions, and now education, where the Government has encouraged those who could afford it to opt-out of public provision, leaving behind the poor who could be expected to put6 up with a poor service.

This is the reality of the private healthcare system which Cameron, Clegg, Farage and the rest of the Right wish to introduce. It is expensive, bureaucratic, does not stimulating further spending, and excludes those with the most acute and expensive medical need, especially the elderly.
And the Tories and their counterparts in UKIP and the Lib Dems know it. Why else would the Tories spend their time trying to deny what they’re doing? Why does Farage appear to be advocating retaining the NHS, while arguing for an insurance based system, like America? It’s because they know that private medicine does not provide the solutions they claim. It is only source of further enrichment to them and their corporate donors.

And since Cook wrote that pamphlet, more than 20 per cent of all Americans can no longer afford their healthcare. It’s why the firms are trying to get their feet under the table over here. Don’t let them. Ed Miliband and now Jeremy Corbyn have promised to reverse the privatisation of the NHS. Please support them.

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Healthcare in America: Republican Politico Urges People to Save Money by Not Taking Children to Hospital

January 7, 2017

Since Maggie Thatcher, the privatisers and Neoliberals in all three parties have been keen to privatise and remodel the NHS at least partly on the American private healthcare model. This clip from Sam Seder’s Majority Report shows just how pernicious this model, and the politicians who defend and promote it, are. Seder here comments on a speech by a Republican member of the House of Representatives, Bill Huizinga, in which he recommended that people worried about their healthcare costs could cut down on them by not seeking medical help immediately until after they were sure it was necessary. Representative Huizinga tells the story about how he waited until the next day to take his son to the A&E department of his local hospital, after the lad broke his arm falling off a trampoline.

Seder rips into this stupid attitude by making it very plain how dangerous it is. Huizinga seems to regard patients as ‘customers’. They aren’t. They are people who require medical care, and in many cases don’t have the luxury of shopping around for the lowest price. The time taken to do this, instead of getting the patient treated, could be decisive, such as in cases of head injury and concussion.

Seder also makes the point about the racism in the way Huizinga’s story was blandly accepted. If a Black parent had said that they hadn’t taken their child to the hospital, because they didn’t know if they could afford it, it’s very likely that social services would intervene. They’d have their child taken into care and be denounced as bad parents. But Huizinga has got away with this, ’cause he’s White and middle class.

However grotesque this, it is the choice faced by millions of Americans. About 20 per cent of the US population cannot afford their healthcare. And I was told by a friend that it’s not uncommon for elderly citizens suffering terminal illness to forgo palliative care in order to save money to pass on to their families.

This is what’s coming to Britain if and when May and Hunt have their way and sell off the NHS. And it did happen here before the establishment of the National Health Service. GPs were in private practice, and although successive Liberal governments introduced some state insurance coverage, this only covered the wage earner. And so many people, particularly women, did not go to the doctor except when they were seriously ill, as they could not afford it.

This is another instance where women are going to be particularly hard hit by the government’s attacks on the welfare state. Despite all the verbiage about making politics and industry more representative, with more women and people from ethnic minorities, and opening up more jobs to women and girls, it has been traditionally female jobs that have been the hardest hit by the Tories’ austerity campaign. And there is the pay gap between women and men, so that if the Tories bring in private insurance contributions into the NHS, as they and the Blairites would like, it will be women who’ll have the least insurance coverage.

Get them and their Lib Dem enablers out. Only Jeremy Corbyn has made it clear that he will protect the NHS from further privatisation.

NHS Privatisation: Cuts to My Local Health Centre

June 19, 2016

NHS SOS pic

Visiting our local health centre the other day, my parents, along with the other local people enrolled there, were handed a letter, explaining that due to funding cuts the health centre was having to cut back on services. It also advised its patients that if they wanted to raise their concerns about the restriction in their service they could contact:-

1. NHS England at FAO Linda Prosser, Director of Assurance and Delivery, NHS England South West (BNSSG), 4th floor Plaza, Marlborough Street, Bristol BS1 3NX
2. your local MP at the House of Commons, Westminster, London SW1A 0AA
3. Jeremy Hunt, Secretary of State for Health, via his website http://www.jeremyhunt.org

Unfortunately, this is happening to the NHS and GPs’ services all the country. It is no accident, and it is certainly not the fault of the many dedicated doctors, nurses and other health professionals working in the NHS.

It is the result of over 30 years of privatisation begun with Margaret Thatcher. Thatcher and her former Chancellor, Nigel Lawson, denied that they wanted to privatise the NHS. They merely stated that they wanted to include more private provision in the NHS. This is a lie. Released cabinet minutes showed that Thatcher and Geoffrey Howe wanted to privatise the NHS along with abolishing the rest of the welfare state. They were only prevented from doing so because the rest of the cabinet realised that this would be the death knell for the Tory party. And a fact-finding mission to the US to see how their private healthcare system worked by Patrick Jenkin showed that it was massively inefficient.

Nevertheless, the amount of private healthcare in the NHS was expanded, and state provision duly cut by successive governments. It was Maggie’s government in 1989 that ended the state support for care for the elderly in nursing homes. As a result, the families of those, who need this kind of care, are forced to fund it themselves, often through selling or remortgaging their homes because of the immense expense. It was also Maggie’s government that ended free eye tests, and picked a feud with the doctors that saw the majority of them leave the NHS.

This privatisation has continued under Tony Blair, Gordon Brown and now David Cameron and Jeremy Hunt. Blair and Brown were deeply impressed with American private healthcare firms such as Kaiser Permanente, and wished to reform the NHS on their model. The ultimate intention was to replace the publicly owned and operated NHS with private healthcare funded by the state, but administered by private health insurance companies. As a result, NHS work has been given to private hospitals and clinics, and private healthcare companies have been given NHS hospitals to manage. Alan Milburn, Blair’s health secretary, wanted the NHS to become merely a kitemark – an advertising logo – on a system of private healthcare companies funded by the government.

This has been carried on the current Conservative government. And they have used the same tactics Margaret Thatcher did to force private healthcare on this nation. The dispute with the doctors over contracts a few years ago was part of this. It has left the majority of NHS GPs wishing to leave. Yet elements within the Conservative networks responsible for foisting these demands have seen this as an opportunity for forcing through further privatisation. Penny Dash, of the National Leadership Network, and one of those responsible for the NHS privatisation, has looked forward to the remaining GPs forming private healthcare companies. Furthermore, an report on the Care Commissioning Groups now in charge of arranging healthcare in the NHS by one of the private healthcare companies also suggested that they could form private healthcare companies, and float shares on the stockmarket.

Further privatisation has come with Andrew Lansley’s Health and Social Care bill of 2012. This exempts the state and the Secretary of State for Health from their statutory duty, as the ultimate leaders of the NHS, to provide state health care. It is carefully worded to disguise its true meaning, but that is what has been intended by the bill. Dr David Owen, one of the founders of the SDP, now part of the Lib Dems, has tabled amendments trying to reverse this despicable bill. He and many others have also written books on the privatisation of the NHS. One of the best of these is NHS SOS, by Jacky Davis and Raymond Tallis, published by Oneworld.

This process cannot be allowed to continue, and I strongly urge everyone to resist the creeping privatisation of the NHS, Britain’s greatest public institution.

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.

Nye Bevan and Nostalgia for the Era Before the NHS: My Response to a Critic

February 15, 2016

Last week I received a comment from Billellson criticising me for stating that Aneurin Bevan was the architect of the NHS. He also stated that we did not have a private healthcare system before the NHS, and although some charges were made, they were in his words, not so much that people would lose their house.

Here’s what he wrote.

“Nye Bevan, the architect of the NHS, was also acutely aware of the way ordinary women suffered under the private health care system that put medicine out of the reach of the poor.”
Aneurin Bevan was not the architect of the National Health Service. The NHS was a wartime coalition policy, for the end of hostilities, agreed across parties. The concept was set out in the Beveridge Report published in December 1942, endorsed by Winston Churchill in a national broadcast in 1943 and practical proposals, including those the things the public value re the NHS today, set out in a white paper by Minister of Health Conservative Henry Willink in March 1944. It would have been established whoever was Minister of Health after the war / whichever party won the 1945 general election. The UK did not have a ‘private health care system’ before the NHS. Most hospitals in England and Wales were local government owned and run, the remainder voluntary (charitable). Those who could afford to pay for treatment were required to do so, or at least make a contribution, but nobody was expected to sell their house. The poor were treated in hospitals free of charge. c11 million workers were covered for GP consultations by the National Health Insurance Scheme which had been established in 1911. In many places, particularly mining areas, there were mutual aid societies that established health facilities including dispensaries. Scotland had a greater degree of state health provision and Northern Ireland had greater faith based provision before their NHSs were established, starting on the same day as Bevan’s English and Welsh service, but always separate established under separate legislation.

So I checked this with what Pauline Gregg says about the creation of the NHS in her The Welfare State: An Economic and Social History of Great Britain from 1945 to the Present Day (London: George G. Harrap & Co 1967).

She states

In 1942, during the War, the scope of health insurance had been considerably widened by the raising of the income limit for participation to £420 a year. But it still covered only about half the population and included neither specialist nor hospital service, neither dental, optical, nor hearing aid. Mental deficiency was isolated from other forms of illness. Medical practitioners were unevenly spread over the country – they had been before the War, but now their war-time service had too often disrupted their practices and left their surgeries to run down or suffer bomb damage.

Hospitals were at all stages of development. There were more than a thousand voluntary hospitals in England and Wales, varying from large general or specialist hospitals with first-class modern equipment and with medical schools attended by distinguished consultants, down to small local cottage hospitals. There were some 2000 more which had been founded by the local authorities or had developed from the sick ward of the old workhouse, ranging again through all types and degrees of excellence. Waiting-lists were long; most hospitals came out of the War under-equipped with staff and resources of all kinds; all needed painting, repairing, reorganising; some were cleaning up after bomb damage; most needed to reorient themselves before they turned from war casualties to peace-time commitments; all needed new equipment and new buildings. Other medical services were only too clearly the result of haphazard development. There were Medical Officers of Health employed by the local authorities, sanitary inspectors concerned with environmental health, medical inspectors of factories, nearly 2000 doctors on call to industry, as well as doctors privately appointed by firms to treat their staff. A school medical service provided for regular inspection of all children in public elementary and secondary schools; local authorities provided maternity and child care, health visiting, tuberculosis treatment, and other services for the poor, which varied widely from district to district. How many people there were of all ages and classes who were needing treatment but not getting it could only be guessed at.

Since it was clear that ad hoc improvement would no longer serve, a complete reshaping of the health and medical service marked the only line of advance. The general pattern it would take was indicated by Sir William Beveridge, who laid down his Report in 1942 the axiom that a health service must be universal, that the needs of the rich and poor are alike and should be met by the same means: ” restoration of a sick person to health is a duty of the state … prior to any other,” a “comprehensive national health service will ensure that for every citizen there is available whatever medical treatment he requires, in whatever form he requires it, domiciliary or institutional, general, specialist or consultant, and will ensure also the provision of dental, ophthalmic and surgical appliances, nursing and midwifery and rehabilitation after accidents.”

The Coalition Government accepted the Health Service Proposals of the Beveridge Report and prepared a White Paper, which it presented to Parliament in February 1944, saying the same thing as Beveridge in different words: “The government .. intend to establish a comprehensive health service for everybody in this country. They want to ensure that in future every man and woman and child can rely on getting all the advice and treatment and care which they may need in matters of personal health; that what they get shall be the best medical and other facilities available; that their getting these shall not depend on whether they can pay for them, or any other factor irrelevant to the real need – the real need being to bring the country’s full resources to bear upon reducing ill-health and promoting good health in all its citizens.” The Health Service, it said, should be a water, as the highways, available to all and all should pay through rates, taxes and social insurance.

Ernest Brown, a Liberal National, Minister of Health in the Coalition Government, was responsible for a first plan for a National Health Service which subordinated the general practitioner to the Medical Officer of Health and the local authorities, It was abandoned amid a professional storm. The scheme of Henry Willink, a later Minister of Health, was modelled on the White Paper, but was set aside with the defeat of Churchill’s Government in the 1945 Election. In the Labour Government the role of Minister of Health fell to Aneurin Bevan, who produced a scheme within a few months of Labour’s victory.

Pp. 39-51.

Churchill’s own attitude to the nascent NHS and the emergence of the later welfare state was ambivalent. In March 1943, for example, he gave a speech endorsing it. Gregg again says

He was “very much attracted to the idea” of a Four Year Plan of his own which included “national compulsory insurance for all classes for all purposes from the cradle to the grave”, a national health service, a policy for full employment in which private and public enterprise both had a part to play, the rebuilding of towns and a housing programme, and a new Education Act. He envisaged “five or six large measures of a practical character”, but did not specify them, … (p. 25).

However, two years later after the Beveridge Report had become the official policy of the Labour party, Churchill’s tone was markedly hostile.

Coming to the microphone on June 4, 1945, he said: “My friends, I must tell you that a Socialist policy is abhorrent to British ideas of freedom … Socialism is in its essence an attack not only upon British enterprise, but upon the right of an ordinary man or woman to breathe freely without having a harsh, clumsy, tyrannical hand clapped across their mouths and nostrils. A free Parliament – look at that – a free Parliament is odious to the Socialist doctrinaire.” The Daily Express followed the next day with banner headlines: “Gestapo in Britain if Socialists Win”. (pp. 32-3)

So Mr Ellson is partly right, but only partly. There was some state and municipal healthcare provision, but it was a patchy and did not cover about half the population. It was a Coalition policy, which was sort of endorse by Churchill. However, its wholehearted embrace and execution was by the Labour party under Aneurin Bevan.

And its immense benefit and desirability was recognised by many traditionally staunch Tories at the time. One of my mother’s friends was herself a pillar of the local Conservative party, and the daughter of a pharmacist. She told my mother that at the 1945 elections her father gather his family together and told them that he had always voted Tory, but this time he was going to vote Labour, because the country needed the NHS. He explained that he served too many people, giving them their drugs on credit, because they couldn’t pay, not to vote for Labour and the NHS.

Now I think the Tories would like to roll state healthcare provision back to that of the pre-NHS level, where there is some minimal state provision, but much is carried out by private industry. The Daily Heil a few years ago was moaning about how the friendly societies were excluded from a role in the NHS. Like them, I think Mr Ellson has far too rosy a view of the situation before the NHS. I’ve blogged on here already accounts from doctors of that period on how badly much of the population were served before the NHS, especially those without health insurance.

Britain needed the NHS, and the party that was most passionately in favour of it was Labour. That some Tories were in favour of it, including Churchill on occasions, is true. But there were others in the party that were very firmly against, and it was ultimately Rab Butler in the Tories who reconciled them to the NHS. But that reconciliation is breaking down, and they are determined to privatise it anyway they can.

Independent: State GPs Better than Private Enterprise, Report Shows

April 26, 2015

NHS-privatisation

Friday’s Independent carried news of research by Imperial College London that that the private and voluntary healthcare organisations that have bought into the NHS perform worse than the traditional GP system. New Labour in 2004 opened up the NHS to private healthcare firms like Virgin Healthcare and Care UK, and also social enterprises and voluntary organisations. At the moment, these organisations provide 347 GP surgeries out of the total 8,300 in England. The Indie noted that these firms typically served more deprived, younger and diverse populations than normal, state-run surgeries.

The study, published in the Journal of the Royal Society of Medicine, found that these private, voluntary and social organisations provided worse service than the state in 15 out of 17 key areas. These included patient satisfaction, diabetes control and keeping patients out of hospital.

Supporters of these private GP services criticised the study’s findings on the grounds that like was not compared with like.

This is, nevertheless, a blow to the supporters of the piecemeal privatisation of the NHS under the Tories and Lib Dems. There are 92 MPs in the coalition parties, who either own, or have senior positions in the private healthcare firms seeking to profit from the NHS, including the minister for chequebook genocide, Iain Duncan Smith. Andrew Lansley and Jeremy Hunt have both spoken out in favour of the privatisation of the NHS. One Tory politico even stated that it wouldn’t exist if the Tories won a second term. When this was reported, Tory Central Office immediately went into emergency spin mode, and claimed he’d been misreported. They said instead that what he meant was that the NHS would be transformed by the removal of all the bureaucracy.

And the Kippers have been very outspoken in their desire to privatise the NHS. The Purple Duce, Nigel Farage, claims he doesn’t want to privatise it, but has said that he wants state funding to be replace by private insurance. Which means privatisation. His deputy, Paul Nuttall, has stated very clearly that he wants it privatised. I can’t remember if it was Nuttall, or one of the other Kippers, who went off and compared the NHS to Nazi Germany. This says much about the extreme Right-wing hysteria running through UKIP. They really believe that any kind of state intervention = Nazism. Because the Nazis put ‘Socialist’ in their name.

As for the Tories’ claim that their people don’t advocate the privatisation of the NHS: they’re lying. The bureaucracy has actually increased in the NHS due to the introduction of privatisation, PFI and the internal market, the basis of which was introduced by Peter ‘I’ve got a little list’ Lilley’ in the 1990s under John Major.

As for not keeping people out of hospital, from the point of view of private medicine this is just good, profit-making sense. Private hospitals make their money from treating people. Therefore, they have a vested interest in making sure as many people are sent to them as possible. It’s why the private healthcare system of the US is riddled with cases where people have undergone unnecessary surgery.

Earlier today I reblogged a video that has been sent out by 38 Degrees, asking people to use their vote to defend and protect the NHS. I notice that a number of my readers here have already reblogged in their turn. Thanks! We’ve got to do all we can to stop the privatisation of the NHS.

And that means definitely not voting for the Tories, the Lib Dems and very definitely not the Kippers.

Vox Political Defends Piece Attacking Labour for Allowing WCA Deaths

March 12, 2015

Earlier this week I reblogged a piece by Mike, in which he attacked the Labour party for continuing to allow disabled people to die due to the Work Capability Test. He was incensed at what Liza van Zyl, a fellow campaigner against the WCA, had been told by the Labour MP Owen Smith. Smith stated that Labour would not consider scrapping the WCA before the election, because of the fear that the right-wing press would torpedo their chances of getting elected with the charge that Labour were ‘soft on welfare’. They might, however, review the situation after the election.

Mike criticised this policy on the grounds that it was absolutely immoral and unjust for disabled people to continue to die because of the test just so that Labour could get elected. He pointed out that the party would get far more support by openly appealing to disabled people, their relatives, friends and supporters, by openly opposing the test. He also makes the point that if Labour did scrap or modify the test after the election, without any previous announcement that they would do so, they would be guilty of the same deception and mendacity as the Tories and Lib Dems, a cynical attitude that has done so much to put people off politics and politicians.

In order to encourage the party to do the right thing and scrap the test, Mike offered to write a letter to one of the right wing papers making the above arguments.

The piece was immensely controversial, garnering 92 comments. Mike says that most were supportive, but he also received some criticism. Amongst other accusations, he was told that he was working for the Tories in order to destroy Labour’s chances at the election. Mike here defends his comments, stating clearly that the purpose of the WCA is to give money to the private firms that administer it while throwing the disabled themselves off benefit. Many of these have consequently died of starvation and despair. As he says, ‘death surrounds the process’.

Mike also attacks the way Liza van Zyl has been hounded off Facebook and Twitter because of her piece reporting what she had been told by Owen Smith. Mike states that Smith’s comments could be a fudge, or he might be serious about Labour reviewing the situation after the election. Either way, it’s the kind of deception practised by the Tories and their Lib Dem lackeys, of which the public are well and truly sick.

He provides further proof just how mendacious and duplicitous this government is by repeating, once again, how the DWP is refusing to release the figures showing how many people have died due to the WCA. He then argues that there is a desperate need for Labour to scrap the wretched test, because Labour is the only party that stands any chance of getting the Tories out.

Mike’s article’s entitled Work Capability Assessment fuss shows Labour must change its ways. It begins

Yesterday’s article on Labour’s attitude to the Work Capability Assessment (WCA), used on people applying for incapacity or disability benefits, was probably the most controversial to be published by this site.

Look at the article‘s comment column and you will see the strength of support for this writer’s planned open letter. It calls for Labour to accept that the public opposes the continued use of a system that is responsible for as much death as the WCA undoubtedly is.

You will also see a few critical comments, and it is fair to say that there have been quite vicious attacks on the other social media, including Facebook and Twitter. Let’s try to address some of those.

Some claimed this writer was some kind of agent provocateur who had timed an attack on Labour to ruin its chances – a curious suggestion, considering the report was about someone else’s response to the ill-considered comments of a Labour shadow cabinet member, over which Yr Obdt Srvt could not have had any control.

Some claimed that Labour’s attitude to the WCA has already been addressed by Rachel Reeves’ promise to reform it – even though it cannot be reformed. It is beyond rehabilitation. The Work Capability Assessment serves a twofold purpose: It shovels taxpayers’ money into the hands of private, profit-making firms, and in return those firms do their best to disqualify claimants from receiving payments. If there was no intention to pervert the benefit system, governments would rely on the word of claimants’ GPs and the specialists working on their case. The responsible course of action is to get rid of it – before it kills anyone else.

It’s at http://voxpoliticalonline.com/2015/03/11/work-capability-assessment-fuss-shows-labour-must-change-its-ways/. Go and read it. It makes sense, which is more than the WCA ever has.

Vox Political: Milliband’s 10 Point Plan to Strengthen the NHS

January 27, 2015

milburnmiliband

Milburn vs Miliband: The Scowl of the past vs the promise of the future

Mike over at Vox Political has published a piece reporting on Miliband’s 10 point plan to improve and expand the NHS. Entitled Will voters support Labour’s vision for the NHS?, it describes the Labour leader’s speech today at Trafford, near the very first NHS hospital founded in 1948. Miliband stated that his ‘central idea is this: that we must both invest in the NHS so it has time to care and join up services at every stage from home to hospital, so you can get the care you need, where you need it.

“We will… train and hire more doctors, nurses, care-workers and midwives – so that they all have the one thing that patients need most: an NHS with time to care.

Miliband then went on to promise that Labour would hire 5,000 more care workers, 20,000 more nurses and 8,000 more GPs. He also pledged that Labour would guarantee a doctor’s appointment within 48 hours and cancer tests within a week.

Cameron apparently didn’t say anything. It was left to the former Health Minister under Tony Blair, Alan Milburn, to do it for him. He claimed on the BBC’s World at One that Labour was badly prepared to carry out these plans, and that they would lead to electoral defeat like that of 1992. Milburn was notorious under Blair for promoting the creeping privatisation of the NHS and the public sector generally. Mike suggests that in Milburn’s case, it looks like a bit of entryism. Just like extremist parties try to infiltrate more respectable, moderate parties, so in Milburn’s case he looks like a Tory, who has somehow found his way into Labour.

Blair and Brown’s privatisation of the NHS and their introduction of the Work Capability Test and Atos were a disgrace. Miliband hasn’t promised to end the Work Capability Test, but his policies today do indicate that he is serious about reversing the damage done to the NHS. For that reason he deserves our support.

Vox Political on Tories Trying to Bribe Doctors to Sign the Sick Back to Work Early

November 11, 2014

Mike over at Vox Political has this article, Will GPs be bribed to put you back to work?. It begins

Doctors could ask for funding from the Department of Work and Pensions (DWP) to ensure patients go back to work quickly, a top NHS England official has suggested, according to GP Online. Is this the next stage in Iain Duncan Smith’s war on the sick?

Addressing the annual conference of the out-of-hours provider body Urgent Health UK, Professor Keith Willett, national director for acute episodes of care, said getting a patient in to see a GP quickly and issued with a return to work certificate could save the government two weeks of benefits payments. Oh really? And what if the patient isn’t better by then?

This seems to be a massively bad idea, as it encourages doctors to try to get their patients back to work regardless of whether they are truly well. One of the complaints I heard about a local GP, who was less than popular with many of the patients at the local practice, was that he had this attitude. People felt that he was less concerned with actually curing them, than in simply getting them back to work as quickly as possible. Willetts clearly seems to think it would be a good idea, as GPs would get to make more money. It’s notable that he was addressing a conference for one of the private medical contractors the Tories have brought in, so obviously he sees the marketisation of the health service and dismantlement of the NHS as an opportunity for personal enrichment. The Tories have also attempted to sweeten this very bitter pill by saying that it would allow some patients to see their doctors quicker. It seems to me that this will simply result in more sick people denied the time and treatment they need to properly get well, and a further breakdown in the relationship between patient and doctor. If this comes in, patients will believe, quite rightly, that they are being denied proper care by their doctors just to make the GP himself richer.

From 2011: Private Eye on Atos Throwing the Severely Disabled Off Benefits

April 11, 2014

This is from Private Eye’s edition for the 9th – 22nd December 2011.

ATOS

Unfit For Purpose

The government’s proposal to stop GPs writing sick notes for long-term illness and hand the work to “independent assessors” has private companies rubbing their hands. Bit it has alarmed those who far that patients will have to endure the same type of tick-box assessments as those needing benefits, as carried out by Atos.

The huge French service company has been slated by MPs and charities over its health and capability assessments on behalf of the Department for Work and Pensions, leading to wrong decisions in up to 40 percent of cases and causing “fear, anxiety and distress” to many disabled people.

Now an Atos insider tells the Eye that, under pressure from government to produce figures showing the number of claimants coming off benefits, coupled with competition to run the multi-million-pound contract, the situation may get worse. In the past 12 months a number of experienced doctors have left the company because they no longer want to part of a “target-driven” system that they say is unfair to the claimants and compromises their professionalism. One said it was “immoral”.

They have not apparently been replaced, and most medical assessments are now carried out by n8urses, who are less expensive – but would have fewer skills in musculo-skeletal disorders or mental illness, two of the main causes of disability.

For those who have been assessed by Atos, the result can be devastating. Secretary Debbie, 44, has been unable to work since a brain haemorrhage 14 years ago left her needing regular nerve-blocking injections into the head and intravenous drug treatment. She suffers from excruciating headaches and is partially sighted.

Her consultant detailed in a letter how her “excruciating” chronic cluster headaches and migraine were rated by the World Health Organisation as “one of the most disabling chronic disorders”. In August she saw an Atos assessor – a doctor, not a nurse – who appeared sympathetic. However, Debbie and her partner say the assessor then made false statements about the examination, saying an eye had been carried out when it hadn’t and bizarrely alleging that she self-harms, which she says she has never done.

The DWP then told Debbie her incapacity benefit would be replaced by employment support allowance (ESA) and that she must attend work-related activity group meetings (WRAG) seven miles from her home. If she fails to attend she will lose her benefits. She told the Eye: “my consultant, my GP, everyone says there’s no way I can work. I can’t see very well, I bang into things, I can’t even make a cup of tea without spilling boiling water. I can’t travel unattended … Yet according to Atos I’m able to work.” Having lost her appeal against having to attend the activity group, Debbie is to file a formal complaint about the Atos doctor to the General Medical Council.

Similarly, in April 2009, Mike, a 52-year-old academic, was found to have a brain tumour the size of a squash ball after he collapsed and had a massive seizure. Six weeks of radiotherapy reduced its size, and Mike has remained stable – although he relies on strong anti-convulsants to keep epilepsy, seizures and focal fits at bay – and is exhausted after short periods of mental or physical activity. Two months after the diagnosis he was ordered to attend an Atos assessment and was found to be capable of work.

Mike has found that the DWP had hidden information showing that people with terminal illness, like him, should not have had to undergo such an assessment, and that any assessment that does take place should be by an expert. But it took him two years of appeals to obtain his entitlements. His battle for compensation continues.

This confirms the other reports that Atos are instructed to find a certain percentage as fit for work, in order for them to be thrown off benefits. I’d also come across elsewhere the information that some of the doctors initially involved in the assessments had left because of its immorality and unprofessionalism. And from my own experience and those of some of the commenters here, and the reports of other bloggers like Jayne Linney I know that Atos lies and falsifies its medical reports to get the results it desires.

There is some useful information here for those seeking to challenge Atos. The article’s statement that terminally ill people should not have to undergo assessment may be of some help to some of the others challenging their assessments. Atos has a long history of declaring medically capable of finding work people so tragically afflicted. Jayne Linney has suggested that as many as 55,000 people a year may have died after being assessed by Atos. If only a small proportion of these were diagnosed as terminally ill by their doctors, then it means that Atos has been massively in breach of regulations. Which is probably why bloggers such as Mike over at Vox Political have been refused this information, and denounced as ‘vexatious’ by the DWP for daring to do so.