Arun D. Ellis's Blog, page 57
April 7, 2016
PFI scam and the destruction of the NHS
http://www.telegraph.co.uk/news/nhs/1...
The NHS is spending more than £3,700 every minute to pay for privately financed hospitals, The Telegraph can disclose.
The bill for private finance initiative (PFI) hospital schemes will hit £2 billion for the first time this year – or £3,729 every 60 seconds. The cash is paid to private companies as part of an annual repayment fee for building and operating new hospitals as well as redeveloping old ones.
Bills have grown so large they would pay for the wages of all qualified midwives for two and a half years.
The Royal College of Nursing said last night that the new figures showed that PFI deals “were poor value for money” and said that the funds would have been better spent on patient care.
Under the deals, private investors take on the risk of building and operating new hospitals and clinics, and in return they receive repayments spread typically over 25 to 30 years that far exceed the original costs of the project.
All bar one of the hospital PFI deals were signed by Labour governments between 1997 and 2010. They had the effect of shifting the cost of big projects out of government borrowing figures.
The scale of the PFI charges is contained in official figures compiled by the Department of Health and obtained by The Telegraph.
The Telegraph has been investigating the huge expense of running the NHS, which faces a £22 billion black hole over the next five years, highlighting problems of waste of resources.
An analysis of the Department of Health figures shows that:
104 NHS trusts in England will have to pay private companies £1.96 billion by the end of the financial year for PFI deals – enough to pay for treatment of cystic fibrosis patients for 20 years.
The PFI deals financed £11.8 billion in building hospitals in England but will cost £79 billion to pay back over 31 years – equivalent to almost £4,000 per household in Britain.
The 20 most expensive PFI deals will cost the NHS £970 million in debt repayment fees this year.
Four private firms will be paid £39 billion over the course of the PFI deals, and almost £1 billion this year.
Under the PFI deals, the repayments tend to escalate in the early years, peaking in 2030 when the total bill is expected to reach £2.67 billion.
A leading health think-tank condemned the deals signed by the NHS. Nigel Edwards, chief executive of the Nuffield Trust, said: “PFI did enable some outdated and poor quality buildings to be replaced but at a significant additional cost. In many cases, what was provided has proved to be not what is needed.”
Dr Peter Carter, chief executive of the Royal College of Nursing, said: “The RCN repeatedly warned that many PFI deals in the NHS represent extremely poor value for money for the taxpayer. Locking trusts into these deals for decades is deeply concerning.”
Their words echo the findings of Prof Allyson Pollock, an expert on PFI in the NHS, who said in a report in 2013 that the costs of borrowing in PFI deals “are consistently higher than public borrowing costs”.
She said: “The high cost of PFI services and debt repayment has had a serious impact on NHS services by creating an affordability gap. There is a correlation between large PFI building projects and hospital deficits and reductions in services and staff.”
The biggest PFI deal, considered widely to have been a mistake, was to build new hospitals on the sites of two old ones – the Royal London in Whitechapel, east London, and St Bartholomew’s two miles away.
The rebuild cost £1.1 billion but, under the terms of the PFI, the final cost will be more than £7 billion with the Barts Health NHS Trust making payments until 2049. The trust, paying £143.6 million this year in repayments, runs a budget deficit of £90 million.
It was placed in special measures in March after it received one of the worst inspection reports handed out by the Care Quality Commission (CQC), which found understaffing, serious concerns over patient safety and a track record of cancelled operations because there were too few beds.
One and a half floors at the Royal London Hospital have remained vacant because there wasn’t enough money to kit them out.
Barts is among nine trusts labelled “inadequate” by regulators and is seeking a new chief executive and finance director. A temporary finance director is being paid £47,000 a month, equivalent to an annual salary of £561,000.
The Telegraph investigation into PFI shows one investment fund can expect repayments totalling almost £18 billion over the lifetime of 18 PFI deals in which it is involved. Innisfree Group Ltd, which employs just 25 staff, has major stakes in a number of big PFI hospitals including the Barts’ deal, as well as PFI contracts in education and transport, both in the UK and abroad.
According to the latest accounts, Innisfree’s highest paid director, who is unnamed but who is not the chief executive, was paid more than £2 million, for the year ending March 31, 2014 – a rise of £500,000 on the previous year.
NHS nurses by contrast were restricted to a one per cent pay rise last year that followed several years of a pay freeze. Innisfree’s chief executive David Metter, 62, a South African-born financier, is said to be worth at least £80 million. Innisfree declined to comment.
The NHS is spending more than £3,700 every minute to pay for privately financed hospitals, The Telegraph can disclose.
The bill for private finance initiative (PFI) hospital schemes will hit £2 billion for the first time this year – or £3,729 every 60 seconds. The cash is paid to private companies as part of an annual repayment fee for building and operating new hospitals as well as redeveloping old ones.
Bills have grown so large they would pay for the wages of all qualified midwives for two and a half years.
The Royal College of Nursing said last night that the new figures showed that PFI deals “were poor value for money” and said that the funds would have been better spent on patient care.
Under the deals, private investors take on the risk of building and operating new hospitals and clinics, and in return they receive repayments spread typically over 25 to 30 years that far exceed the original costs of the project.
All bar one of the hospital PFI deals were signed by Labour governments between 1997 and 2010. They had the effect of shifting the cost of big projects out of government borrowing figures.
The scale of the PFI charges is contained in official figures compiled by the Department of Health and obtained by The Telegraph.
The Telegraph has been investigating the huge expense of running the NHS, which faces a £22 billion black hole over the next five years, highlighting problems of waste of resources.
An analysis of the Department of Health figures shows that:
104 NHS trusts in England will have to pay private companies £1.96 billion by the end of the financial year for PFI deals – enough to pay for treatment of cystic fibrosis patients for 20 years.
The PFI deals financed £11.8 billion in building hospitals in England but will cost £79 billion to pay back over 31 years – equivalent to almost £4,000 per household in Britain.
The 20 most expensive PFI deals will cost the NHS £970 million in debt repayment fees this year.
Four private firms will be paid £39 billion over the course of the PFI deals, and almost £1 billion this year.
Under the PFI deals, the repayments tend to escalate in the early years, peaking in 2030 when the total bill is expected to reach £2.67 billion.
A leading health think-tank condemned the deals signed by the NHS. Nigel Edwards, chief executive of the Nuffield Trust, said: “PFI did enable some outdated and poor quality buildings to be replaced but at a significant additional cost. In many cases, what was provided has proved to be not what is needed.”
Dr Peter Carter, chief executive of the Royal College of Nursing, said: “The RCN repeatedly warned that many PFI deals in the NHS represent extremely poor value for money for the taxpayer. Locking trusts into these deals for decades is deeply concerning.”
Their words echo the findings of Prof Allyson Pollock, an expert on PFI in the NHS, who said in a report in 2013 that the costs of borrowing in PFI deals “are consistently higher than public borrowing costs”.
She said: “The high cost of PFI services and debt repayment has had a serious impact on NHS services by creating an affordability gap. There is a correlation between large PFI building projects and hospital deficits and reductions in services and staff.”
The biggest PFI deal, considered widely to have been a mistake, was to build new hospitals on the sites of two old ones – the Royal London in Whitechapel, east London, and St Bartholomew’s two miles away.
The rebuild cost £1.1 billion but, under the terms of the PFI, the final cost will be more than £7 billion with the Barts Health NHS Trust making payments until 2049. The trust, paying £143.6 million this year in repayments, runs a budget deficit of £90 million.
It was placed in special measures in March after it received one of the worst inspection reports handed out by the Care Quality Commission (CQC), which found understaffing, serious concerns over patient safety and a track record of cancelled operations because there were too few beds.
One and a half floors at the Royal London Hospital have remained vacant because there wasn’t enough money to kit them out.
Barts is among nine trusts labelled “inadequate” by regulators and is seeking a new chief executive and finance director. A temporary finance director is being paid £47,000 a month, equivalent to an annual salary of £561,000.
The Telegraph investigation into PFI shows one investment fund can expect repayments totalling almost £18 billion over the lifetime of 18 PFI deals in which it is involved. Innisfree Group Ltd, which employs just 25 staff, has major stakes in a number of big PFI hospitals including the Barts’ deal, as well as PFI contracts in education and transport, both in the UK and abroad.
According to the latest accounts, Innisfree’s highest paid director, who is unnamed but who is not the chief executive, was paid more than £2 million, for the year ending March 31, 2014 – a rise of £500,000 on the previous year.
NHS nurses by contrast were restricted to a one per cent pay rise last year that followed several years of a pay freeze. Innisfree’s chief executive David Metter, 62, a South African-born financier, is said to be worth at least £80 million. Innisfree declined to comment.
TTIP will kill British Steel
http://www.waronwant.org/media/ttip-m...
The projected impacts of EU-US trade deal the Transatlantic Trade and Investment Partnership (TTIP) on the UK metals sector means there is no way the government will be able to save the steel industry, warns War on Want.
Under official predictions for the controversial trade deal, steel industry jobs will likely be lost as the UK metals sector is set to contract while US metals exports to Europe are set to increase by 120%.
According to a study commissioned by the UK Business, Innovation and Skills Department, within Europe it is only the UK metals sector which is set to suffer.
War on Want Senior Trade Campaigner Mark Dearn said: “While the government claims it will save the UK steel industry, it is championing a secretly negotiated deal which will drive a final nail into the coffin of the sector.
“It is clear from the government’s own figures that it expects the UK metals industry to suffer while US industry is set to see a doubling of its exports.”
He added: “If the government is really concerned about the industry and its workers, it is imperative it spells out how it will address TTIP’s negative impacts on the sector and why it is a cheerleader for a deal that means job losses across Europe and the death knell for the UK metals industry.”
ENDS
The projected impacts of EU-US trade deal the Transatlantic Trade and Investment Partnership (TTIP) on the UK metals sector means there is no way the government will be able to save the steel industry, warns War on Want.
Under official predictions for the controversial trade deal, steel industry jobs will likely be lost as the UK metals sector is set to contract while US metals exports to Europe are set to increase by 120%.
According to a study commissioned by the UK Business, Innovation and Skills Department, within Europe it is only the UK metals sector which is set to suffer.
War on Want Senior Trade Campaigner Mark Dearn said: “While the government claims it will save the UK steel industry, it is championing a secretly negotiated deal which will drive a final nail into the coffin of the sector.
“It is clear from the government’s own figures that it expects the UK metals industry to suffer while US industry is set to see a doubling of its exports.”
He added: “If the government is really concerned about the industry and its workers, it is imperative it spells out how it will address TTIP’s negative impacts on the sector and why it is a cheerleader for a deal that means job losses across Europe and the death knell for the UK metals industry.”
ENDS
David Owen on Brexit
http://www.dailysquib.co.uk/health/18...
LONDON – England – Former Labour Health Secretary and Independent SDP politician, Lord Owen today in a landmark speech, outlined the serious dangers to the NHS if Britain remains in the EU.
The Transatlantic Trade and Investment Partnership (TTIP) will have negative implications towards Britain’s health service, and will eventually lead to its full privatisation unless there is a Brexit. This is why David Cameron and his cohort George Osborne are so keen for Britain’s people to vote to remain in the EU.
The majority of people who wish to remain in the EU are clueless to TTIP and how it will impact on the NHS, and the Britain Stronger in Europe team are not keen to divulge the true information regarding the TTIP treaty between the EU and US.
Speaking today, former Labour Health Minister, Lord Owen demystified the many variables and faults of TTIP with regards to the NHS, and how it is ultimately in Britain’s interests to vote to leave the EU on June 23.
We have included Lord Owen’s speech in full:
Protecting our NHS from the EU
The EU could have been the champion of the social market and by including the term in its treaty structure I hoped it would be its prime exponent worldwide. Yet in 2016, for many millions of young people, the EU is indelibly linked to unemployment and ‘austerity’, not the social market. The fatal flaws in the design of the Eurozone have created a dysfunctional EU, united only in its incapacity to run a social market or a single currency.
Can anyone justify the appalling figures for unemployment – a direct result of the euro crisis – for the under 25s in Spain, that reached 54% and is expected to be between 18-19% in 2017 despite encouraging economic growth. In Greece, Portugal, Italy there is still savage unemployment, in Ireland many young people left to go abroad. Still the euro crisis persists; a dysfunctional EU cannot, it appears, make the structural reforms.
Can anyone justify the secret trade negotiations the Commission have signed up for in TTIP? Despite protests little has been done to redress its errors. No regard for the social purpose of healthcare and the erosion of health as a Member State responsibility. The EU/Eurozone from 1992, in marked contrast to the old European Community of 1975, creeps into every nook and cranny of our life. It is now becoming entrenched in the NHS and this June we have a once-in-a-lifetime opportunity to get it out.
The Second World War brought the Emergency Medical Service in the UK, the Beveridge report and the 1944 White Paper outlining the provisions of a UK-wide service. A cross-party resolve emerged in wartime within the British people that when peace came there would be a different and better system of healthcare for everyone. The result was the NHS of 1948. It lasted until 2002. In England it is no longer national in the sense of being comprehensive or planned.
Healthcare, in a very real sense, is infinite. The amount of money invested in the NHS is a democratic choice, relative to what we choose to spend on education, housing, welfare, defence. That rationing process within the 1948 design of the NHS was flexible, professional and democratically accountable. In England it is barely answerable to the Westminster Parliament. The Scottish Parliament, the Welsh and Northern Ireland Assemblies still run recognizable national health services. Different designs exist in many parts of the world but no system has been judged internationally as being able to match, for overall cost effectiveness, the 1948 UK design.
In this EU referendum, as in the September 2014 Scottish independence referendum, the design of the marketised English NHS promises to be a source of legitimate political division. Politics cannot be an ideology-free zone. The report released on Friday of the collapse of the Cambridgeshire and Peterborough contract calls for a review of “all current and planned clinical commissioning groups and NHS England contracts of this sort as a matter of urgency, before entering into any new commitments.” That manifest failure is a dire warning about the massive extra costs of market structures and advisers.
We in the cross-party Vote Leave Campaign, however, share a common democratic commitment. We will restore legal powers and democratic control of the NHS to voters in the UK. If we vote Leave – we will be able to protect our NHS from EU interference.
We all need to respect and value, whatever political parties we support, those elements which bind the citizens of the UK together and the NHS is one of those. Now is the time to take back control from the EU and protect our NHS for future generations.
From 1973-2002 the European Commission, by and large, stayed out of interfering in the UK NHS. It was assumed that this was politically too sensitive and in those days the Commission was not obsessed with proposing market solutions to social policy. The EU social market was always open to exceptions, perhaps the most famous being the French railway system, where Paris has historically not accepted any EU intervention. Lately, however, on health it has been accepted in Brussels that for ‘consumer’ the Commission can read ‘patient’.
In 2006 the Labour government commissioned a legal opinion on the effect of EU legislation on the NHS. The Health Department’s then commercial director, Ken Anderson, who had been involved with independent surgical treatment centres (ISTCs), told the Financial Times in January 2007: ‘My personal conviction is that once you open up NHS services to competition, the ability to shut that down or call it back passes out of your hands. At some point European law will take over and prevail … In my opinion, we are at that stage now.’ As if recognising the truth of this interpretation on 13 December 2007, with not much publicity, the Department of Health issued a document titled Principles and Rules for Cooperation and Competition, running through which are EU legal positions which have become the law that operates in the UK.
The advisory Co-operation and Competition Panel was reported in the Financial Times to have been applying its interpretation of the law since 2009 – by advising on NHS mergers and handling complaints about anti-competitive practices by hospitals and primary care trusts. In truth, since 2002 the Labour government, the Coalition government and now the Conservative government have accepted an EU market in health.
Personally I believe a ‘progressive alliance’ government supported by Labour, SNP, Green, Plaid Cymru and Northern Irish politicians from all parts of the UK will emerge within the next decade which will challenge that market consensus. As democrats we agree they must have the democratic right to reinstate the 1948 design.
Barbara Castle predicted in the 1975 referendum, against my view as the then Minister of Health, when she was Secretary of State for Health and Social Security, that the NHS would be challenged by Brussels. She has been proven right.
The NHS Operating Framework from the Department of Health for 2011 encouraged, for the first time, price competition below a maximum tariff. David Bennett, the current chief executive of Monitor, who had been a senior partner at McKinsey and head of the Downing Street policy directorate and strategy unit under Tony Blair, gave an interview to The Times in February 2011 which described the regulator’s new role in promoting competition. ‘We did it in gas, we did it in power, we did it in telecoms,’ he said. ‘We’ve done it in rail, we’ve done it in water. So there is actually twenty years’ experience of taking monopolistic, monolithic markets and providers and exposing them to economic regulation.’ It was, he declared, ‘too easy to say “How can you compare buying electricity with buying healthcare services?” Of course they are different. I would say … there are important similarities and that’s what convinces me that choice and competition will work in the NHS as they did in those other sectors’. This encouraged the Commission to apply competition rules.
Nigel Edwards, the acting chief executive of the NHS Confederation, underlined the degree to which under the 2012 legislation it was intended that the state would ‘be withdrawing from the day-to-day management of health care’, with the service becoming ‘like a regulated industry’ on the lines of telecommunications, water and the energy industries. It could, he warned, ‘trigger a major reshaping of the way care is delivered with services closing and changing’. ‘I do not think most people have grasped the scale of this change,’ he continued. ‘By 2014, the NHS will no longer be a system which still contains the characteristics of an organisation. Instead it will be a regulated industry in which that management chain no longer exists.’ Amid ‘any willing provider’, services would have to become more responsive to patients. But in a system with no real financial growth that would mean that new providers would have to replace existing ones. ‘There will have to be an element of Joseph Schumpeter’s “creative destruction”.’That too encouraged the Commission.
The campaigning group 38 Degrees commissioned an important legal opinion on the EU and the NHS. ‘It is likely that, even as matters stand, and in view in particular of recent non-statutory reforms which increase the involvement of the private and third sector in health services provision, competition law already applies to PCTs and NHS providers.’ They concluded that the 2012 legislation reinforced that view, adding that there was ‘nothing in the Bill which has or can have the effect of preventing the application of competition law’ since prohibitions on anti-competitive conduct ‘gives rise to actionable claims in the High Court by any person affected’.
The Dutch competition authority (the NMa) has had the effect of fragmenting service provision and impeding the provision of high-quality care. A €7.7 million fine levied on the Dutch GP association for a ‘bad case of anti-competitive behaviour’, which was the association’s efforts to ensure that all areas of the country were adequately provided with GP services. The Dutch Patients’ and Consumers’ Federation called for the involvement of competition in healthcare to be urgently reviewed.
The EU has deliberately obfuscated TTIP. The hugely experienced Pascal Lamay has rightly criticised the design of TTIP for it is not just a trade agreement, it is also a regulatory agreement. This always was an indefensible mixing up of what are two quite different legislative matters and all done with no reference whatever to the British Parliament.
In September 2014 in order to head off the growing opposition in the SPD and German trade unions to the ISDS terms, the Economic Affairs Ministry – headed by SPD leader Sigmar Gabriel – issued a joint position paper on the TTIP along with the DGB, Germany’s trade union confederation including the country’s largest trade unions like IG Metall and Ver.di. The paper, while praising elements of the TTIP, pledged on the ISDS: ‘Investment protection provisions are generally not required … In any case, investor–state arbitration and unclear definitions of legal terms such as “fair and just treatment” or “indirect expropriation” must be rejected.’ The German government and the European Commission are at odds over whether national parliaments will need to ratify alongside the European Parliament. The Commission said no, but Berlin argued that a ‘mixed agreement’ with some of the issues, goods and services covered falling outside of the EU’s sole jurisdiction, the Bundestag and Bundesrat should also get to scrutinise the agreement and vote on it. The German government warned that it was willing to go all the way to the ECJ on this issue.
After having carefully considered the joint statements by the Commission and the United States government of 20 March 2015 and the defence of the present TTIP by the British government, the legal advice from Michael Bowsher QC, is very critical about its implications for the UK NHS . He advised that despite the new right to regulate it was vague and subject to inherent uncertainties as to how it would be interpreted by arbitral tribunals and that the valid exercise of a right to regulate could, nonetheless, give rise to compensation even when there was no valid claim in domestic law.
We are agreed in Vote Leave, that whatever our political views on the present marketization of the NHS, decisions on the NHS should for the future be for the UK Parliament and devolved administrations to take. It should not be for the European Commission nor the European Parliament.
Our longstanding democracy has hitherto for a century and more accepted as a principle that the people through their vote in national elections should decide the policy and direction of health care.
If people Vote to Leave on 23 June – as I hope they will – it will automatically follow that no British government can ratify the present TTIP. Thereafter, UK legislation will govern the NHS in future and as a consequence we can take back control and protect the NHS from the EU. The NHS will not have to be part of any new UK-EU free trade agreement. There will no longer be competition and market led interference from the European Commission.
LONDON – England – Former Labour Health Secretary and Independent SDP politician, Lord Owen today in a landmark speech, outlined the serious dangers to the NHS if Britain remains in the EU.
The Transatlantic Trade and Investment Partnership (TTIP) will have negative implications towards Britain’s health service, and will eventually lead to its full privatisation unless there is a Brexit. This is why David Cameron and his cohort George Osborne are so keen for Britain’s people to vote to remain in the EU.
The majority of people who wish to remain in the EU are clueless to TTIP and how it will impact on the NHS, and the Britain Stronger in Europe team are not keen to divulge the true information regarding the TTIP treaty between the EU and US.
Speaking today, former Labour Health Minister, Lord Owen demystified the many variables and faults of TTIP with regards to the NHS, and how it is ultimately in Britain’s interests to vote to leave the EU on June 23.
We have included Lord Owen’s speech in full:
Protecting our NHS from the EU
The EU could have been the champion of the social market and by including the term in its treaty structure I hoped it would be its prime exponent worldwide. Yet in 2016, for many millions of young people, the EU is indelibly linked to unemployment and ‘austerity’, not the social market. The fatal flaws in the design of the Eurozone have created a dysfunctional EU, united only in its incapacity to run a social market or a single currency.
Can anyone justify the appalling figures for unemployment – a direct result of the euro crisis – for the under 25s in Spain, that reached 54% and is expected to be between 18-19% in 2017 despite encouraging economic growth. In Greece, Portugal, Italy there is still savage unemployment, in Ireland many young people left to go abroad. Still the euro crisis persists; a dysfunctional EU cannot, it appears, make the structural reforms.
Can anyone justify the secret trade negotiations the Commission have signed up for in TTIP? Despite protests little has been done to redress its errors. No regard for the social purpose of healthcare and the erosion of health as a Member State responsibility. The EU/Eurozone from 1992, in marked contrast to the old European Community of 1975, creeps into every nook and cranny of our life. It is now becoming entrenched in the NHS and this June we have a once-in-a-lifetime opportunity to get it out.
The Second World War brought the Emergency Medical Service in the UK, the Beveridge report and the 1944 White Paper outlining the provisions of a UK-wide service. A cross-party resolve emerged in wartime within the British people that when peace came there would be a different and better system of healthcare for everyone. The result was the NHS of 1948. It lasted until 2002. In England it is no longer national in the sense of being comprehensive or planned.
Healthcare, in a very real sense, is infinite. The amount of money invested in the NHS is a democratic choice, relative to what we choose to spend on education, housing, welfare, defence. That rationing process within the 1948 design of the NHS was flexible, professional and democratically accountable. In England it is barely answerable to the Westminster Parliament. The Scottish Parliament, the Welsh and Northern Ireland Assemblies still run recognizable national health services. Different designs exist in many parts of the world but no system has been judged internationally as being able to match, for overall cost effectiveness, the 1948 UK design.
In this EU referendum, as in the September 2014 Scottish independence referendum, the design of the marketised English NHS promises to be a source of legitimate political division. Politics cannot be an ideology-free zone. The report released on Friday of the collapse of the Cambridgeshire and Peterborough contract calls for a review of “all current and planned clinical commissioning groups and NHS England contracts of this sort as a matter of urgency, before entering into any new commitments.” That manifest failure is a dire warning about the massive extra costs of market structures and advisers.
We in the cross-party Vote Leave Campaign, however, share a common democratic commitment. We will restore legal powers and democratic control of the NHS to voters in the UK. If we vote Leave – we will be able to protect our NHS from EU interference.
We all need to respect and value, whatever political parties we support, those elements which bind the citizens of the UK together and the NHS is one of those. Now is the time to take back control from the EU and protect our NHS for future generations.
From 1973-2002 the European Commission, by and large, stayed out of interfering in the UK NHS. It was assumed that this was politically too sensitive and in those days the Commission was not obsessed with proposing market solutions to social policy. The EU social market was always open to exceptions, perhaps the most famous being the French railway system, where Paris has historically not accepted any EU intervention. Lately, however, on health it has been accepted in Brussels that for ‘consumer’ the Commission can read ‘patient’.
In 2006 the Labour government commissioned a legal opinion on the effect of EU legislation on the NHS. The Health Department’s then commercial director, Ken Anderson, who had been involved with independent surgical treatment centres (ISTCs), told the Financial Times in January 2007: ‘My personal conviction is that once you open up NHS services to competition, the ability to shut that down or call it back passes out of your hands. At some point European law will take over and prevail … In my opinion, we are at that stage now.’ As if recognising the truth of this interpretation on 13 December 2007, with not much publicity, the Department of Health issued a document titled Principles and Rules for Cooperation and Competition, running through which are EU legal positions which have become the law that operates in the UK.
The advisory Co-operation and Competition Panel was reported in the Financial Times to have been applying its interpretation of the law since 2009 – by advising on NHS mergers and handling complaints about anti-competitive practices by hospitals and primary care trusts. In truth, since 2002 the Labour government, the Coalition government and now the Conservative government have accepted an EU market in health.
Personally I believe a ‘progressive alliance’ government supported by Labour, SNP, Green, Plaid Cymru and Northern Irish politicians from all parts of the UK will emerge within the next decade which will challenge that market consensus. As democrats we agree they must have the democratic right to reinstate the 1948 design.
Barbara Castle predicted in the 1975 referendum, against my view as the then Minister of Health, when she was Secretary of State for Health and Social Security, that the NHS would be challenged by Brussels. She has been proven right.
The NHS Operating Framework from the Department of Health for 2011 encouraged, for the first time, price competition below a maximum tariff. David Bennett, the current chief executive of Monitor, who had been a senior partner at McKinsey and head of the Downing Street policy directorate and strategy unit under Tony Blair, gave an interview to The Times in February 2011 which described the regulator’s new role in promoting competition. ‘We did it in gas, we did it in power, we did it in telecoms,’ he said. ‘We’ve done it in rail, we’ve done it in water. So there is actually twenty years’ experience of taking monopolistic, monolithic markets and providers and exposing them to economic regulation.’ It was, he declared, ‘too easy to say “How can you compare buying electricity with buying healthcare services?” Of course they are different. I would say … there are important similarities and that’s what convinces me that choice and competition will work in the NHS as they did in those other sectors’. This encouraged the Commission to apply competition rules.
Nigel Edwards, the acting chief executive of the NHS Confederation, underlined the degree to which under the 2012 legislation it was intended that the state would ‘be withdrawing from the day-to-day management of health care’, with the service becoming ‘like a regulated industry’ on the lines of telecommunications, water and the energy industries. It could, he warned, ‘trigger a major reshaping of the way care is delivered with services closing and changing’. ‘I do not think most people have grasped the scale of this change,’ he continued. ‘By 2014, the NHS will no longer be a system which still contains the characteristics of an organisation. Instead it will be a regulated industry in which that management chain no longer exists.’ Amid ‘any willing provider’, services would have to become more responsive to patients. But in a system with no real financial growth that would mean that new providers would have to replace existing ones. ‘There will have to be an element of Joseph Schumpeter’s “creative destruction”.’That too encouraged the Commission.
The campaigning group 38 Degrees commissioned an important legal opinion on the EU and the NHS. ‘It is likely that, even as matters stand, and in view in particular of recent non-statutory reforms which increase the involvement of the private and third sector in health services provision, competition law already applies to PCTs and NHS providers.’ They concluded that the 2012 legislation reinforced that view, adding that there was ‘nothing in the Bill which has or can have the effect of preventing the application of competition law’ since prohibitions on anti-competitive conduct ‘gives rise to actionable claims in the High Court by any person affected’.
The Dutch competition authority (the NMa) has had the effect of fragmenting service provision and impeding the provision of high-quality care. A €7.7 million fine levied on the Dutch GP association for a ‘bad case of anti-competitive behaviour’, which was the association’s efforts to ensure that all areas of the country were adequately provided with GP services. The Dutch Patients’ and Consumers’ Federation called for the involvement of competition in healthcare to be urgently reviewed.
The EU has deliberately obfuscated TTIP. The hugely experienced Pascal Lamay has rightly criticised the design of TTIP for it is not just a trade agreement, it is also a regulatory agreement. This always was an indefensible mixing up of what are two quite different legislative matters and all done with no reference whatever to the British Parliament.
In September 2014 in order to head off the growing opposition in the SPD and German trade unions to the ISDS terms, the Economic Affairs Ministry – headed by SPD leader Sigmar Gabriel – issued a joint position paper on the TTIP along with the DGB, Germany’s trade union confederation including the country’s largest trade unions like IG Metall and Ver.di. The paper, while praising elements of the TTIP, pledged on the ISDS: ‘Investment protection provisions are generally not required … In any case, investor–state arbitration and unclear definitions of legal terms such as “fair and just treatment” or “indirect expropriation” must be rejected.’ The German government and the European Commission are at odds over whether national parliaments will need to ratify alongside the European Parliament. The Commission said no, but Berlin argued that a ‘mixed agreement’ with some of the issues, goods and services covered falling outside of the EU’s sole jurisdiction, the Bundestag and Bundesrat should also get to scrutinise the agreement and vote on it. The German government warned that it was willing to go all the way to the ECJ on this issue.
After having carefully considered the joint statements by the Commission and the United States government of 20 March 2015 and the defence of the present TTIP by the British government, the legal advice from Michael Bowsher QC, is very critical about its implications for the UK NHS . He advised that despite the new right to regulate it was vague and subject to inherent uncertainties as to how it would be interpreted by arbitral tribunals and that the valid exercise of a right to regulate could, nonetheless, give rise to compensation even when there was no valid claim in domestic law.
We are agreed in Vote Leave, that whatever our political views on the present marketization of the NHS, decisions on the NHS should for the future be for the UK Parliament and devolved administrations to take. It should not be for the European Commission nor the European Parliament.
Our longstanding democracy has hitherto for a century and more accepted as a principle that the people through their vote in national elections should decide the policy and direction of health care.
If people Vote to Leave on 23 June – as I hope they will – it will automatically follow that no British government can ratify the present TTIP. Thereafter, UK legislation will govern the NHS in future and as a consequence we can take back control and protect the NHS from the EU. The NHS will not have to be part of any new UK-EU free trade agreement. There will no longer be competition and market led interference from the European Commission.
Eu Referendum
http://www.bbc.co.uk/news/uk-politics...
David Owen says Leave vote will help reverse NHS competition
Former Labour Foreign Secretary Lord Owen says leaving the EU is necessary to protect the NHS from interference and stop the spread of market forces.
The peer, who backed Britain's membership in the 1975 referendum, said he had been wrong to think the "common market" would "leave the NHS alone".
He warned a planned trade deal between the EU and US would harm the NHS.
But Labour's Rachel Reeves said EU membership had helped the NHS fund research and recruit skilled workers.
And she suggested the Transatlantic Trade and Investment Partnership (TTIP) he is concerned about was being "manipulated" by Leave backers, many of whom did not support the NHS.
◾EU vote: all you need to know
The NHS has become the latest battleground for arguments over whether the UK is better off inside or outside the EU ahead of the referendum on 23 June.
Earlier this week, four former Labour health secretaries said a vote to leave the EU would seriously undermine the NHS and its founding principle of care free at the point of use.
The Leave campaign retaliated with claims about the cost to the taxpayer of treating EU nationals using the NHS.
Now Lord Owen - a former GP who has campaigned against government health reforms in recent years - has said the NHS needs to be "protected" from EU interference, which he believes its threatening its heritage and independence.
'Take control'
In a speech in London in support of the Vote Leave campaign group, Lord Owen - who served as Labour foreign secretary in the late 1970s before defecting to the SDP and is now a crossbench peer - said the dream of European co-operation once supported by many on the centre-left of politics had turned sour.
In the past 20 years, he said the EU had "crept into every nook and cranny" of British life, including the NHS, and had to stop.
The European Commission, he said, had become "obsessed with proposing market solutions to social policy" and, in respect of health legislation emanating from Brussels, patients were being treated as consumers.
"In truth, since 2002 the Labour government, the coalition government and now the Conservative government have accepted an EU market in health," he said.
He said the application of EU competition law to the NHS would be exacerbated by the passing of TTIP, a set of free trade and regulatory agreements which he said had "no regard for the social purpose of healthcare" and would erode member states control over healthcare policy and spending.
Leaving the EU would prevent any future UK government from ratifying TTIP, he said. "We all need to respect and value, whatever political parties we support, those elements which bind the citizens of the UK together and the NHS is one of those.
"Now is the time to take back control from the EU and protect our NHS for future generations."
'Trojan Horse'
Several trade unions, while backing EU membership, are opposed to TTIP, saying it would allow private firms running NHS services to sue the government if it chose to return the services to the public sector - a claim rejected by the government.
Unison, the main union for NHS workers, say it is a threat to public services and should be rejected unless changes are made.
Ms Reeves, who backs continued EU membership, said she understood concerns on the left that TTIP would be a "Trojan Horse for further privatisation of the health service" but believed they were unfounded.
In an article for Labour List, the former Labour frontbencher said the issue was being exploited by those backing EU exit "many of them right-wingers with no love for the NHS".
"Let me be clear. I would not support TTIP if I believed in any way that it would allow American health providers to sue our government into breaking open the NHS, as some claim it would.
"Thankfully, anyone who studies both the detail and the political intention of this deal can see that it poses no threat at all to our health service.
"What it will do is open up the American market to British companies, creating opportunities for business that will boost jobs and growth here at home."
At a time of acute challenge for the NHS, she said the "last thing" it needed was the "shock" of EU exit.
"The EU has made the NHS stronger, providing it with research funding, skilled workers and the economic stability needed to plan future spending. Exit would put all this in peril."
David Owen says Leave vote will help reverse NHS competition
Former Labour Foreign Secretary Lord Owen says leaving the EU is necessary to protect the NHS from interference and stop the spread of market forces.
The peer, who backed Britain's membership in the 1975 referendum, said he had been wrong to think the "common market" would "leave the NHS alone".
He warned a planned trade deal between the EU and US would harm the NHS.
But Labour's Rachel Reeves said EU membership had helped the NHS fund research and recruit skilled workers.
And she suggested the Transatlantic Trade and Investment Partnership (TTIP) he is concerned about was being "manipulated" by Leave backers, many of whom did not support the NHS.
◾EU vote: all you need to know
The NHS has become the latest battleground for arguments over whether the UK is better off inside or outside the EU ahead of the referendum on 23 June.
Earlier this week, four former Labour health secretaries said a vote to leave the EU would seriously undermine the NHS and its founding principle of care free at the point of use.
The Leave campaign retaliated with claims about the cost to the taxpayer of treating EU nationals using the NHS.
Now Lord Owen - a former GP who has campaigned against government health reforms in recent years - has said the NHS needs to be "protected" from EU interference, which he believes its threatening its heritage and independence.
'Take control'
In a speech in London in support of the Vote Leave campaign group, Lord Owen - who served as Labour foreign secretary in the late 1970s before defecting to the SDP and is now a crossbench peer - said the dream of European co-operation once supported by many on the centre-left of politics had turned sour.
In the past 20 years, he said the EU had "crept into every nook and cranny" of British life, including the NHS, and had to stop.
The European Commission, he said, had become "obsessed with proposing market solutions to social policy" and, in respect of health legislation emanating from Brussels, patients were being treated as consumers.
"In truth, since 2002 the Labour government, the coalition government and now the Conservative government have accepted an EU market in health," he said.
He said the application of EU competition law to the NHS would be exacerbated by the passing of TTIP, a set of free trade and regulatory agreements which he said had "no regard for the social purpose of healthcare" and would erode member states control over healthcare policy and spending.
Leaving the EU would prevent any future UK government from ratifying TTIP, he said. "We all need to respect and value, whatever political parties we support, those elements which bind the citizens of the UK together and the NHS is one of those.
"Now is the time to take back control from the EU and protect our NHS for future generations."
'Trojan Horse'
Several trade unions, while backing EU membership, are opposed to TTIP, saying it would allow private firms running NHS services to sue the government if it chose to return the services to the public sector - a claim rejected by the government.
Unison, the main union for NHS workers, say it is a threat to public services and should be rejected unless changes are made.
Ms Reeves, who backs continued EU membership, said she understood concerns on the left that TTIP would be a "Trojan Horse for further privatisation of the health service" but believed they were unfounded.
In an article for Labour List, the former Labour frontbencher said the issue was being exploited by those backing EU exit "many of them right-wingers with no love for the NHS".
"Let me be clear. I would not support TTIP if I believed in any way that it would allow American health providers to sue our government into breaking open the NHS, as some claim it would.
"Thankfully, anyone who studies both the detail and the political intention of this deal can see that it poses no threat at all to our health service.
"What it will do is open up the American market to British companies, creating opportunities for business that will boost jobs and growth here at home."
At a time of acute challenge for the NHS, she said the "last thing" it needed was the "shock" of EU exit.
"The EU has made the NHS stronger, providing it with research funding, skilled workers and the economic stability needed to plan future spending. Exit would put all this in peril."
April 5, 2016
The real war is against the 1%
WWI & WWII were the cataclysmic events that led to our current dystopian world. After both wars some of the best leaders the world might have had were dead.
Before WWI the world was calm and emotionally mature, admittedly full of empires and subservient peoples but there was no global turmoil and the wealthy were obliged to observe the political mood of the day.
After WWII the world was in chaos, the richest and strongest power (USA) was the one with the most immature history and structure; it was also the one most susceptible to take over by the rich elites.
The rich 1% strengthened financially and politically. They removed troublesome potential leaders from their midst. The most well known examples - JFK, Dr. Martin Luther King, Robert Kennedy, John Lennon, Malcolm X, Princess Diana and dozens of other less prominent potential leaders, and hundreds of social leaders from the entertainments industry, whether by McCarthyism in America, or drugs and murder elsewhere.
They bought the new professional politicians, they set their stooges in place to preach 'trickle down' economics, they set up pressure groups, lobby groups, they changed laws to enable them to take more money out of the pot for themselves, they set about waging phoney wars to destroy countries that didn't bend before them and their corporations, unleashed the IMF dragging poor countries with rich resources ever deeper into debt and all the while, they strengthened and got richer.
They distracted the masses with sports, TV, consumerism, cheap alcohol, cheap zombie food, drugs and sex. They undermined religion to destabilise society, and used the resultant destabilisation as an excuse to militarise their police forces, put in CCTV everywhere and spy on mobile phone and internet activity. The more aggressive the police force the more angry the population, enabling further ramping up of the police with water cannons, riot gear and guns.
Orwell's 1984 - that world is already upon us.
Instead of being ruled by Communists we are ruled by a rich elite hiding behind the big Corporations that are raping the world. We in the West are the stupid ignorant workers who plod off to meaningless jobs. If unemployed we dream of being able to do that plodding. We are attacked by evil 'terrorists' from the far off deserts who we are told are trying to overthrow us but who in reality are trying to throw off the chains the 1% are tying around their necks.
We are already fighting WWIII but unfortunately, because we have been blinded by the lies of the corporate media working for the rich 1% we are fighting the wrong enemy, we are fighting the freedom fighters of the third world when we should be fighting the rich 1%, we should be in the streets hunting down our so called political leaders, the wealthy and the greedy because they are busy working on our eternal enslavement.
For those of you who say 9/11 or 7/7 or draw reference to any other terror attack just take a moment to think.... these people don't have armies, air forces or navies. The rich elites are attacking them commercially and economically, their only recourse is violence but they cannot declare war for they do not have the means and in most cases their own governments or leaders are already in the rich global 1%, they can only attack with the weapons that they have and they can only make limited strikes.
We do not need a massive armed police force to deal with this threat...the nature of these attacks (unexpected, random, brief and bloody) means we are always on the back foot, the police presence brought to bear after the event. The arming of our police is to ensure our compliance when we finally wake up to what's been happening right under our noses.
The unpalatable reality is that the terrorists aren't seeking to destroy us; they are seeking to free themselves from the rule of our psychotic rich, the 1% and indirectly serve as a wake up call to us, to free ourselves.
This is the reality and we need to recognise it before it's too late.
Before WWI the world was calm and emotionally mature, admittedly full of empires and subservient peoples but there was no global turmoil and the wealthy were obliged to observe the political mood of the day.
After WWII the world was in chaos, the richest and strongest power (USA) was the one with the most immature history and structure; it was also the one most susceptible to take over by the rich elites.
The rich 1% strengthened financially and politically. They removed troublesome potential leaders from their midst. The most well known examples - JFK, Dr. Martin Luther King, Robert Kennedy, John Lennon, Malcolm X, Princess Diana and dozens of other less prominent potential leaders, and hundreds of social leaders from the entertainments industry, whether by McCarthyism in America, or drugs and murder elsewhere.
They bought the new professional politicians, they set their stooges in place to preach 'trickle down' economics, they set up pressure groups, lobby groups, they changed laws to enable them to take more money out of the pot for themselves, they set about waging phoney wars to destroy countries that didn't bend before them and their corporations, unleashed the IMF dragging poor countries with rich resources ever deeper into debt and all the while, they strengthened and got richer.
They distracted the masses with sports, TV, consumerism, cheap alcohol, cheap zombie food, drugs and sex. They undermined religion to destabilise society, and used the resultant destabilisation as an excuse to militarise their police forces, put in CCTV everywhere and spy on mobile phone and internet activity. The more aggressive the police force the more angry the population, enabling further ramping up of the police with water cannons, riot gear and guns.
Orwell's 1984 - that world is already upon us.
Instead of being ruled by Communists we are ruled by a rich elite hiding behind the big Corporations that are raping the world. We in the West are the stupid ignorant workers who plod off to meaningless jobs. If unemployed we dream of being able to do that plodding. We are attacked by evil 'terrorists' from the far off deserts who we are told are trying to overthrow us but who in reality are trying to throw off the chains the 1% are tying around their necks.
We are already fighting WWIII but unfortunately, because we have been blinded by the lies of the corporate media working for the rich 1% we are fighting the wrong enemy, we are fighting the freedom fighters of the third world when we should be fighting the rich 1%, we should be in the streets hunting down our so called political leaders, the wealthy and the greedy because they are busy working on our eternal enslavement.
For those of you who say 9/11 or 7/7 or draw reference to any other terror attack just take a moment to think.... these people don't have armies, air forces or navies. The rich elites are attacking them commercially and economically, their only recourse is violence but they cannot declare war for they do not have the means and in most cases their own governments or leaders are already in the rich global 1%, they can only attack with the weapons that they have and they can only make limited strikes.
We do not need a massive armed police force to deal with this threat...the nature of these attacks (unexpected, random, brief and bloody) means we are always on the back foot, the police presence brought to bear after the event. The arming of our police is to ensure our compliance when we finally wake up to what's been happening right under our noses.
The unpalatable reality is that the terrorists aren't seeking to destroy us; they are seeking to free themselves from the rule of our psychotic rich, the 1% and indirectly serve as a wake up call to us, to free ourselves.
This is the reality and we need to recognise it before it's too late.
