Health Select Committee inquiry into the state of NHS Finances

On 11 October the House of Commons Health Select Committee will start an inquiry into the state of NHS finances. At 2.30pm, the committee will take oral evidence from:

Sir Amyas Morse, Comptroller and Auditor General
Chris Hopson, Chief Executive, NHS Providers
Julie Wood, Chief Executive, NHS Clinical Commissioners
Rt Hon Stephen Dorrell, Chair, NHS Confederation

This is in response to the recent request from NHS Providers – the trade association for NHS Foundation Trusts and Trusts  – for an inquiry into how to get NHS Providers out of the impossible situation they are now in, as a result of NHS underfunding. That is ok. What is not ok is that they said the  inquiry should look at a range of chilling proposals – including ending comprehensive NHS care that’s free to all at the point of use, based on people’s clinical need.

The terms of reference for the inquiry are exactly as NHS Providers suggested. This is not good news. Please email the Health Select Committee, FAO Sarah Wollaston, and tell them so. You can download and use this template email if you like.

Written evidence from NHS Providers, the NHS Confederation and NHS Clinical Commissioners basically reads like an attempt to normalise and validate what the NHS Providers, private health companies and Clinical Commissioning Groups are already doing – with years of growing cuts and privatisation that are now wrapped up in a big Sustainability and Transformation Plan bow.

It’s as if they want to bolster themselves against growing public opposition, by getting their unpopular plans endorsed by the Health Select Committee.

We have to make sure that this is not the outcome of this inquiry. Everyone please email the Health Select Committee FAO the Chair Sarah Wollaston, calling for:

  • adequate NHS and social care funding,  pointing out that as the sixth richest country in the world we can perfectly well afford to fund the NHS properly;
  • recognition that rising demands on the NHS are not down to the old, fat, mad and bad –  as the cutters and privatisers like to make out – but because years of growing inequality and poverty are taking their toll on people’s health; there is an abundant evidence base about the links between inequality, insecurity and austerity economics, and ill health
  • an end to the privatisation and marketisation of the NHS and the restoration of a fully publicly owned, run and funded NHS that is comprehensive, that the Sec of State has a duty to provide, and that is free at the point of use and based on clinical need; apart from anything else, this will save at least 10% of the NHS budget, that is currently wasted on the costs of marketisation and privatisation
  • an end to the 5 year Forward View and STPs, which aim to impose a US-style private health care system on the NHS, complete with its payment systems, care models, and workforce models.

There is a template email here

The NHS Confederation, the organisation that represents the interests of private health companies in the NHS, has submitted written evidence from its Chair, Stephen Dorrell, who is also a senior adviser at KPMG.

He joined KPMG as private health adviser in 2014, while still a serving MP, leading to calls for his resignation because of the obvious conflict of interest.

Formerly a Tory Health Secretary who stepped down as an MP at the 2015 General Election,  Stephen Dorrell sped through the revolving door to advise private  health firms how to capitalise on NHS changes. He told them the NHS should no longer be seen as a “national religion” but a “service sector” with huge economic value.

Dorrell’s “evidence”  extols Simon Stevens’ 5 Year Forward View and its fast track implementation by Sustainability and Transformation Plans, while calling on the government to:

  1. Guarantee that additional funding, already earmarked for 2017/18, is ring-fenced for investment in transformation, specifically as investment in STPs;
  2. Enable resources to be available for one-off investments in buildings and equipment from next year, by offering routes to greater public and private capital investment;
  3. Bring forward money already committed to social care to reflect the pressing need for action, by releasing the £1.5 billion Better Care Fund currently set for 2020;
  4. Stop cuts to public health and protect investment in prevention for the next four years, to ensure we work to keep people healthy and sustain the NHS for the future.

This is driven by private health companies’ self interest: the Sustainability and Transformation Plan commits to an increase in NHS privatisation. This was a condition of the extra money made available for the STPs in the Autumn 2015 Comprehensive Spending Review.

Corporate Watch reports on the influence over the NHS Confederation of the NHS Partners Network, a group of private health companies that successfully lobbied Andrew Lansley – Jeremy Hunt’s predecessor – on the Conservative’s “draft bill” that went on to become the 2012 Health and Social Care Act.

The Chief Executive of NHS Clinical Commissioners has also given written evidence to the inquiry, saying that 31 CCGs ended 2015/16 in deficit and more CCGs are entering into and predicting future deficits for the first time. Their proposed solution? They:

“agree with the NHS Providers that there are some stark choices to make…around…having a serious debate about what can be funded and the routes to access within the existing financial envelope, moving ahead confidently with service reconfiguration and controlling the cost of the NHS workforce.”

What do they mean when they say “the routes to access within the existing financial envelope”? Whose routes to access, to what? Do they mean patients’ access to NHS services and treatments? If so, is this code for charging? And/or cherrypicking only some patients who will be able to access treatments? No wonder euphemisms litter the page.

Ok, they say “We strongly believe there must be a national debate about the future of the NHS and the funding pressures on the service” – but they are not calling for the government to relieve the funding pressures by investing properly in the NHS. Their five big asks are:

  1. There must be an open and honest public debate about what the NHS can and must be in the 21st century.
  2. There must be system transformation alongside adequate funding in the system to achieve stability and sustainability in the service.
  3. Prevention, self-care and patient activation are key to fairly rebalancing demand upon the health service.
  4. Investment in public health is a vital component of achieving sustainability in the NHS.
  5. Politicians must support commissioners to make decisions locally about how to allocate finite resources.  This may mean doing things differently in order to improve the quality of care, patient experience and outcomes, and optimise cost-effectiveness.

“Politicians must support commissioners”!!!!!!

I thought politicians must represent the interests of their constituents.

Here is the link to the Health Select Committee inquiry webpage

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3 comments

  1. PLEASE support the needs of the ordinary man and woman in the street . Cut back on wastage but NOT on care ! Look after the elderly and the mentally ill as you one day could be one of this vulnerable group.

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  2. Please remember this is our NHS you are dealing with. Any decision to privatise any or all of it was in no manifesto I have ever seen.
    You are there to safeguard this precious and valued service. We are a rich nation. Much richer than when we set up the NHS in 1948 just after the second world war. I remember the lifeline it provided to my family. It is for today’s Poiticians to cherish and safeguard it now.

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