Government Takes £20 Billion Out of NHS – and Puts Back £0.5 Billion – Sept 2013

BMI Hospitals Is Over £2.2 Billion In Debt and Unhappy with  Competition Commission’s Assertions of Exercising Market Power and Making Excess Profits at Patients’ Expense

‘The Times’ of 19 August 2013 reported on the financial and regulatory ‘health’ of BMI Hospitals, which owns and manages 69 private British hospitals. BMI’s property company has debts of over £2.1 billion on properties which have dropped in value to £1.45 billion from £1.8 billion. BMI’s operating company has debts of £145 million.

 

BMI was also investigated by the Competition Commission for allegedly carving up the country into local monopolies. The other companies also investigated were Spire, Ramsey, HCA and Nuffield. The investigation was sparked off, in part, by new private healthcare ‘player’ Circle Healthcare in effect complaining that established private healthcare ‘players’ were making it difficult for Circle to join the game.

 

The Commission published its report on 28 August 2013 and found that most patients in UK private hospitals are paying more than they should for treatment because of a lack of local competition. BMI, Spire and HCA have been ‘earning substantially and persistently in excess of the cost of capital’. 20 hospitals in 11 locations owned by these three private hospital groups will have to be sold by them. The Commission estimates patients were  being overcharged by these three companies by up to £193 each year between 2009 and 2011.

 

BMI Hospitals is the trading name of General Healthcare Group, itself owned by Netcare and private equity group Apax Partners. Netcare is an investment holding company which manages the largest private health hospital network in South Africa.

 

Government Takes £20 Billion Out of NHS – and Puts Back £0.5 Billion

Ostensibly to help A&Es which might still exist in the winters of 2013/4 and 2014/5, the Coalition Government – ever aware of the upcoming 2015 General Election – is boasting of giving £0.5 billion to the NHS. As the Coalition Government/NHS is in the process of taking £20 billion out of the NHS this PR farce is pure electioneering.

 

NHS has Spent £1.4 Billion on Redundancies Since 2010

‘The Daily Mail’ of 28 August 2013 revealed this staggering figure. Other jaw dropping figures are 2,299 staff have been handed six figure ‘golden goodbyes’ with some of them receiving more than £600,000. 20% percent of those made redundant walked straight back into the NHS to take up new positions! Altogether 32,000 managers have been made redundant since 2010. This data was obtained from the Department of Health and the National Audit Office.

 

With around 4,500 posts in the shiny new world of brand new NHS organisations yet to be filled many, many more millions will be paid out in redundances and recruitment costs.

 

Jeremy Hunt MP – No Longer Responsible for Supplying a Universal Healthcare Service – Wants GPs to be Responsible for Life and Health

 

Quoted in ‘The Sunday Times’ of 11 August 2013, Jeremy Hunt says he wants GPs to go back to the days when they checked on vulnerable patients. He clearly means a return to home visits. He also talks about transforming out-of-hospital care. I can’t imagine many existing GPs want the former and it’s unclear certainly in Ealing how and where the latter might be implemented.

 

GPs are private contractors and are clearly not all ‘biddable’ by the Government/NHS. In fact that has been the case since the NHS was founded 65 years ago.

 

I can’t find anyone who thinks this is a viable strategy. It will hardly persuade students at medical school to choose to be a General Practitioner in England.

 

As for hospital services, Hunt wants Consultants to work at night and at weekends. Again this won’t be popular at medical school and as private contractors (again for 65 years) many Consultants will plump for private practice in England or elsewhere. This consequence is probably what Hunt’s ‘handlers’ want anyway.

 

Hunt also bangs on about sustainability. There is rich irony in this here in West London when it’s his hand which is pushing for the closure of four major hospital A&E departments. Of all these A&E closures, the one at Ealing Hospital in densely populated, expanding and highly deprived Southall is the most unsustainable.

 

The old chestnut of electronic patient records is on his dance card too. Bill Gates persuaded Tony Blair in 2001 to begin the world’s largest IT screw-up to have online patient records in England by 2005.  This vastly overambitious project (‘NHS Connect’), costed at £12+ billion, was littered with very poor decisions and it petered into oblivion in 2011 having squandered and still squandering around £13 billion. McKinsey, Microsoft, Accenture, BT, CSC and Fujitsu all variously made and lost money in the fiasco. No doubt Hunt wants some other global players to have another go at this search for the unattainable Holy Grail of anywhere, anytime, access to 53.5 million patient records. His deadline for reaching this nirvana is 2018.

 

Hunt’s comments and ideas on the NHS are about as useful and credible as alleged war criminal Tony Blair’s comments and ideas about peace in the Middle East.

 

Ealing Council’s Request for a Judicial Review (JR) of NHS NW London’s Proposed Downsizing of Ealing Hospital is Denied

No details are seemingly available on why the JR was refused. Of course Justice Secretary Grayling said in April 2013 that many JRs were  ‘…needlessly holding up building projects’. So maybe it’s a political decision and the Government wants to crack on and demolish Ealing Hospital and get some luxury flats built on the site.

 

Independent Reconfiguration Panel Evidence Gathering Ends as Developer Announces Plans To Increase Southall’s Official Population by Some 10,000 Residents.

Clearly the biggest losers in the downgrading of Ealing Hospital will be Southall residents. And in the great big wonderful joined up world we live in Berkeley Group is trumpeting building 3,750 new homes in Southall. This development alone (on the old Gas Works site) will raise the official population in Southall by some 10,000 within 15 years. The 2011 population projections estimated that Southall’s population in 2015 would be 84,000. Add maybe 5,000 illegal residents living in sheds in Southall then a population in 2015 of 89,000 emerges. If we then add the new Gas Works site residents we begin to approach 100,000.

 

Parts of Southall are in the top 5% deprived areas in England in terms of income deprivation, crime and access to housing and services. The incidence of Chronic Heart Disease, Diabetes and Tuberculosis in Southall is very high.

 

For Ealing generally the semi-destruction of Ealing Hospital is a real backward step. Birth rate in Ealing in 2012 was 81.8 births/1,000 women (15 – 44 years of age) – well above the national average of 65.4 births/1,000. In 2012 there were 28,200 under fives. The loss of well performing Maternity and Paediatric units at Ealing Hospital will seriously adversely affect expectant mothers, babies, toddlers and nursery children in our town.

 

On the independence front I recently discovered that Chair of the Independent Reconfiguration Panel Lord Ribeiro is an advisor on hospital reorganisation to PriceWaterhouseCoopers. You just couldn’t make this stuff up.

 

Patricia Hewitt Wants the NHS to Operate in India

Australian born ex-MP Patricia Hewitt is Chair of the UK India Business Council. She told ‘Health Service Journal’ in August 2013 that she wanted many UK NHS, private health companies and charities to operate in India.  

 

As I understand it, Indian hospitals suffer from staff shortages. So….Indian students come to the highly rated UK medical schools to get qualified. (They have a good chance to gain entry as they pay higher fees than indigenous students). Once qualified some of them return home and treat UK patients who are flown over to India for treatment. It does sound nuts doesn’t it?

 

Dr Kailish Chard of the BMA told the ‘Daily Mirror’ that he thought the plans were ‘..a huge scandal’. He went on to say that the plans ‘..would mean losing manpower here – which could pose a serious threat to patient safety’.

 

Ms Hewitt had just a two year spell as Health Secretary but gained fame by being suspended from Parliament when caught asking for £5,000/day to advance commercial clients’ interests at Westminster. Her health sector clients include BUPA, Boots and Cinven the healthcare industry buyout specialists.

 

Anti-Depressant Prescriptions Reach New High in England in 2012 – Over 50 Million Issued

The Health and Social Care Information Centre has reported that anti-depressant prescription issuing was up 7.5% in 2012. In some towns and cities one adult in six was prescribed anti-depressants in an average month. The North features strongly in those places where medication for depression and anxiety was highest – namely Barnsley, Redcar, Durham, Middlesbrough, Salford and Sunderland.

 

Dr Mark Spencer of NHS England Attempts and Fails to Rubbish Residents’ Views on Closing Ealing Hospital

Ealing Gazette 16 August printed a letter from Dr Mark Spencer who is one of the leading Ealing Hospital closure protagonists. Dr Spencer attempted to belittle local residents’ letters in the previous week’s issue. Here’s the letter I wrote in response to this:

 

“Dr Mark Spencer of NHS NW London ‘Shaping a Healthier Future’ (SAHF) fame is somewhat selective with his facts in his 16 August 2013 Ealing Gazette letter.

 

What is beyond dispute is that A&E, Maternity and Paediatrics units at Ealing Hospital will be closed as part of SAHF. 104 beds will be eliminated 2012 – 2015. The Unite Union publicised the NHS NW London Ealing Hospital tower and three level podium demolition cost of £3 million and land sale value of £9.9 million in August 2012. The major hospital that is Ealing Hospital as we have known it since 1979 will soon close and be demolished.

 

Dr Spencer does not refute Arthur Breens’ 6,000 job losses – he just passes it off as not part of his bit of the NHS! He also writes about ‘employing more GPs. There are no GP employees in the NHS – they are all private contractors. And the additional weight that healthcare ‘promoter’ Jeremy Hunt MP wants GPs to carry – including night time and weekend working – is unlikely to persuade medical students to plump for General Practice in England.

 

What NHS NW London never did was engage with the local community. Engagement involves sitting down with residents/patients at the formative stage of plan making. Tell us that money has to be saved and discuss with us ways in which sustainable services can still be provided which will inflict the least damage on the vulnerable, sick, injured and disabled.

 

‘Ealing GPs are developing plans….’ No they are not. It’s clear from attending Ealing Clinical Commissioning Group public meetings that very few Ealing GPs are involved in local health service policy making or planning. A ‘….£83 million new hospital at Ealing…’ . This is a new figure. The new hospital at Barts in London cost £1 billion and the rebuilt and quite small West Middlesex Hospital cost £125 million in 2002. So £83 million won’t build us very much at all in terms of a major hospital.”

 

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Shortage of High Quality Doctors

NHS Consultant Surgeon J. Meirion Thomas writing in ‘The Spectator’ on 17 August 2013 pinpoints the shortage of British trained doctors as an urgent problem to be solved. Each year the General Medical Council registers some 13,000 new doctors.

Of these doctors only 6,071 will come from British medical schools in 2013/14. The other new doctors come from medical schools both inside and outside the EU. Recently many of our new doctors are arriving from Greece, Spain, Italy, Portugal and especially Eastern Europe.

 

The quality of British medical schools is recognised as being higher than those in many other countries. The advantages of native language skills allied to knowledge of British culture and the NHS itself really do matter. Foreign trained doctors, for example, are up to four times more likely to be suspended or struck off here rather than their UK colleagues.

 

Most applicants to UK medical schools are rejected despite having the required A Level grades. This is because we don’t have sufficient training places in British medical schools.

 

So stop spending £billions on complex IT health systems which will probably never work. Stop the planned spending of £billions on HS2 to get folks from Birmingham to London 35 minutes quicker and spend all these £billions on TRAINING MORE BRITISH DOCTORS HERE IN BRITAIN.

 

Some GPs Are seeing Up to 60 Patients in a Single Day

A poll of GPs carried out by the Royal College of General Practitioners (RCGP) revealed that 80% of GPs said that they had ‘insufficient resources’ to provide high quality patient care. 70% were concerned that patients could face longer waiting times. 47% admitted that they had cut back on the range of services they provide for patients.

 

Patients/Tax Payers Say ‘Raise Taxes to Fund NHS’

‘The Independent’ of 13 August 2013 reported that global tax and audit giant KPMG had carried out a survey of UK patients about the funding of long-term healthcare. 87% said that Government should pay for long-term healthcare. 82% said that social care should also be funded from the public purse. 54% said they were willing to pay more in tax to meet the cost of care. More than 50% said they had ‘no means of supporting’ their own long-term care.

 

It will be interesting to see if this issue becomes a battleground for votes in the 2015 General Election.

 

Facts and Statistics You Won’t Like

+ Number of Cancelled Operations

1998:  12,389

2013:  15,443

 

+ Number of General and Acute Hospital Beds in England

1997:  138,047

2012:  104,858

 

+Visits to A&E Lasting Over 4 Hours

Q2 2003:  87.3%

Q2 2011:  95.5%

 

+ Total Number of Visits to A&E

Q2 2003:  3.21 million

Q2 2011:  3.58 million

 

+ Shortage of Midwives

May 2010:   Cameron pledges to recruit 3,000 new midwives

April 2013:  Only 1,278 new midwives recruited

 

+ Shortage of at least 47,000 Nurses and Maybe up to 190,000 Nurses by 2016. (Government Report August 2013)

 

+ Shortage of 650 A&E consultants (College of Emergency Medicine)

 

+ Peers and MPs with Financial Interests in Private Healthcare

73 MPs and 147 Peers

(May 2013: www.socialinvestigations.blogspot.co.uk)

 

+ Since May 2010

4,000 fewer nurses in the NHS.

£2.6 billion taken out of adult social care spending.

£3 billion of NHS funds have been spent on ‘reconfigurations’ under the auspices of the Health & Social Care Act 2012.

500 GP practices have stopped opening in the evening and at weekends.

25% of all NHS Walk-in centres have been closed.

25% of Doctors in New Zealand were trained in the UK.

 

(Much of the above data has been sourced from ‘Hansard’ and ‘The Spectator’).