ME and the new corporate controlled NHS

Discussion in 'Fibromyalgia Main Forum' started by tansy, Sep 10, 2008.

  1. tansy

    tansy New Member

    by Greg Crowhurst

    02 September 2008

    Be aware that corporate-controlled service delivery and commissioning
    governed by the principles of the health insurance industry is being rolled
    out across the UK at something approaching lightening speed . For Myalgic
    Encephalomyelitis (ME) patients it does not get worse than this.

    Take APMS Contracting for example.

    * Alternative Provider Medical Services* (APMS) is a contractual arrangement
    which allows for Primary Care Trusts (PCTs) to commission GP services from
    a range of providers, including the private sector. This means that
    neighbourhood GP surgeries are now forced to compete for business up against
    the multinationals.

    GP's simply cannot compete , not even it seems for the smallest practices.
    In January this year , the GP contract in Camden and Tower Hamlets were
    awarded to the huge US company United Health and the multinational software
    firm Atos Origin, after local GP's were outbid, despite scoring higher on
    their service quality proposals.

    *Pulse* magazine , the doctor's journal has highlighted a dramatic rise in
    the number of PCT's in 2008 inviting bids for APMS contracts. Up and down
    the country GP practices are passing into the hands of companies like
    Virgin, Boots, United Health, with fewer controls over the quality and
    amount of care that is provided. Monitoring is "light touch" and clinical
    information is likely to be "commercially confidential".

    Privately run Health Centres are set to open up in every town in the
    country, vaguely financed by a combination of Private Finance Initiatives
    (PFI) and a kind of PFI called NHS LIFT.

    PFIs have attracted much criticism for their drain upon the public purse as
    Allyson Pollack (Guardian June 11 2008) reveals : "*until recently the true
    scale of the profits has been hidden from view with "commercial
    confidentiality" exemptions being invoked in response to freedom of
    information requests. The recent release of the Royal Infirmary Edinburgh
    and Hairmyres hospital contracts in Scotland and their analysis by Jim and
    Margaret Cuthbert show shareholders will reap dividends of £168m on an
    equity stake of £500,000 for the infirmary, and £89m on an equity stake of
    £100 for Hairmyres hospital - rich rewards for so little risk*."

    Of major concern to ME sufferers in the UK is the fact that a private
    LIFT company could well be responsible for their clinical services ; the
    outlook is grim :

    GP's, employed on short-tern contracts by a large corporation are unlikely
    to have the same commitment or knowledge of their patients that a
    traditional GP working in a local practice presently does.

    Private companies are concerned with making a profit; people with a long
    term chronic disease like ME, those who are housebound, may find that they
    receive no service , as Alysson Pollack explains : "*The commercialisation
    of services leads to the blurring of boundaries about the funding and
    responsibilities of care; once NHS services have moved into the commercial
    sector there will be no limits on what the private sector can charge for:
    boutique care for those who can pay, and small-print restrictions for those
    who cannot.* " Dr Kalish Chand (The Guardian Aug 28 2008) warns : "*A
    practice with the shareholders' interests at the fore may be tempted to
    cream off the fit and well from their patient list, leaving the vulnerable
    and chronically ill with their loyal, less well-resourced practice. As that
    practice is squeezed by falling resources and rising care demands, they may
    ultimately have to rely on health professionals recruited from abroad on
    short-term contracts. So continuity of care, which patients value most, will
    be lost*."

    Private companies are already cutting back on GP input, by employing nurses,
    healthcare assistants and even receptionists to do some of their work.

    These developments are taking place within the context of a stripping away
    of mechanisms for public accountability as Pollack explains "*public and
    staff protests have gone unheeded, and judicial reviews have merely delayed
    the market process. …. Voters face a dilemma: the temptation is to punish
    Labour at the ballot box, yet the Conservatives' health proposals, published
    last October, advocate the abolition of the secretary of state's unqualified
    duty to provide a universal health service."*

    * *Meanwhile under the "*Framework for Procuring External Support for
    Commissioners"* (FESC); PCT's are being "encouraged" to buy advice from 14
    selected private companies : these are : Aetna; Axa PPP; BUPA; CHKS; Dr
    Foster; Health Dialog Services Corporation; Humana; KPMG LLP; McKesson;
    McKinsey; Navigant Consulting; Tribal; UnitedHealth Europe; and WG
    Consulting; these FESC commissioners look set to award lucrative contracts
    to each other, a process known in industry circles as "co-opetition", states
    Stewart Player (Access to NHS Primary Care – for Patients or Business?

    It adds up to patchwork privatisation of the NHS on an unprecedented scale.
    This "*is deeply worrying because privatised healthcare tends to cost more;
    accountability suffers; the fog of 'commercial confidentiality' makes
    scrutinising public spending impossible; the profit motive encourages
    'cherry-picking' of thelucrative work, ultimately leading to NHS services
    being cut*."(The 'patchwork privatisation of our health service : a users's
    guide" Keep our NHS Public) **

    Allyson Pollack adds : "*We are never told about the impact of the market
    or how the huge injection of cash into the NHS is being diverted into
    marketing, billing, invoicing, chief executive-level salaries, profits,
    shareholders' returns and bank dividends. Nor is the public told how
    budgetary controls that made the NHS the most cost-efficient health system
    in the world are being dismantled in the rush to market."*

    Having suffered so much at the hands of the medical insurance industry
    already , the ME community perhaps know better than most what to expect from
    uninhibited corporate interest, where would we be today is we had not
    fought back so
    hard all these years?

    It is time to ratchet up the pressure.

    These developments are by no means inevitable – yet. Lobby PCT s not to go
    down this route, organise petitions, use the local press, above all, as
    Keep Our NHS Public urge : "*Demand the government rewrite the legislation
    and laws which allow companies to come in and take over our NHS for the
    first time in 60 years*."

    **Helen Keller once bravely said : "I will not refuse to do the something I
    can do".**
  2. tansy

    tansy New Member

    is the source of many of our current problems. It is through the insurance industry, including UNUM, that the psychobabblers gained their stranglehold over medical policies.

    tc, Tansy